1. Watch for Safety at All Times
A right-hemisphere stroke will usually result in left-sided paralysis. Compounding the problem is the frequent disturbance in sensory perception experienced by those who have suffered damage to the right side of the brain. Caregivers will note an unawareness of the debilitation on the part of the stroke victim. As you might imagine, compounding the basic disability with a denial of it can lead to real safety issues. Once you return home from the treatment facility, the first step is to keep your environment free of clutter and any obstacles to mobility.
2. Plan for the Long Road to Recovery
Right-hemisphere strokes come with a list of possible deficits, but it's important to know you or your loved one's exact limitations and expectations for recovery. This becomes evident to the medical and rehabilitative personnel as rehab progresses in the initial weeks and months after the stroke. Once your rehab team has helped you to understand what the road to recovery looks like, you'll be better able to tackle the goals. These range from getting the person to recognize her debilitated side to gaining strength and sensory perception of that side and gaining most of the left-side ability back.
3. Remember that Object Memory May Be Gone
Agnosia is the inability to recognize or understand sensory information. For instance, a stroke survivor might pick up a comb he's had for 10 years and have no idea what to do with it. It becomes a matter of re-teaching the brain to recognize objects and connect them to meanings again. The caregiver and family should help at every opportunity by reminding the stroke victim what particular objects are and what they're used for. It's important to remember, however, that the extent of changes to the brain makes frequent reminders necessary. Be patient and don't convey your frustration to your loved one. Take heart that the information can usually be relearned.
4. Help Those With Hemianopia
As a caregiver, you may note a loss of vision in your loved one's left eye, which unfortunately adds to the deficits in perception already in place. Always approach the stroke victim from the side that is still intact, and hand her things in her "good" visual field. A frequent result of this condition is a complete non-acknowledgment of food on the left side of a plate, for instance. Help the person by reminding her to turn her head to "scan" frequently, whether it's during mealtime or simply while moving around her immediate environment.
5. Teach to the Person to Avoid One-Sided Neglect
Since the right-hemisphere stroke patient usually has left-sided paralysis and an unawareness of that paralysis, there is a danger for so-called "disuse syndrome." The physical therapist will help design a program to boost the patient's recognition and use of his left side, but it's important to help the stroke survivor complete the exercises at home, as well. Reminding the person how to move his hand, leg or foot to accomplish a task is helpful. Given the impulsiveness and lack of judgment that are inherent in right-hemisphere strokes, the sufferer won't be afraid to try anything, but the fine motor skills are often deficient. As a caregiver, you'll find that frequent "redirection" and reminders are necessary.
