Questions and answers on how caregivers can help a loved one’s recovery process go smoother.
Recovery from a heart attack or stroke takes time and patience on your part as a caregiver. Some people are able to recover more fully than others, so it’s important to talk to your medical team to get a better understanding of what to expect for the future. Be prepared that your loved one may not be able to do all that he or she could before the heart attack or stroke. At the same time, remember that the rehabilitation process enables many people to do much more than they ever expected.
Here are some answers to some caregivers’ questions when helping a loved one after a stroke or heart attack:
My loved one is so angry about this heart attack. Is this normal?
It’s not at all unusual for heart attack and stroke survivors to be angry and agitated. After all, they — and perhaps, you — have to change the way things are done in daily life. Change like that is hard. It also takes time and skill. It’s especially important for everyone involved to recognize the signs of depression. It’s a common after-effect of a stroke or heart attack.
How can I tell if my loved one is depressed or just discouraged?
It’s natural for someone who’s had a major medical problem to feel blue or become depressed. Often, it’s because of physiological changes that are a result of the medical problem. Other times a person is scared about what the future holds. As a caregiver, you need to be on the alert for symptoms of depression. If you suspect your loved one is depressed, tell the doctor.
My loved one had open-heart surgery, and I’m afraid he or she is overdoing rehabilitation. How can I know how much is too much?
It’s great that your loved one is so motivated, however, the rehabilitation process should be done in a sensible manner. Each survivor has a different capacity. Find out from the healthcare professionals what is considered “too much.” You may find that his or her pace is OK, but if they’re overdoing it, gently share your concerns without nagging or being overprotective. Your loved one’s surgery has affected you too, and they need to know what you’re feeling.
My loved one weighs 200 pounds. How can I bathe him? If your loved one is disabled from a heart attack or stroke or weak from heart surgery, you may not be able to take care of all his needs by yourself. Contact your healthcare provider for home-health resources in your community. They can help you in this and many other ways. At the very least, they can show you how to give a sponge bath by yourself. Or, they can provide staff to bathe him regularly. Putting a stool in a shower or bathtub with a rubber mat underneath it helps patients who are weak or dizzy.
How can I give my loved one the care needed when he or she won’t/can’t speak to me?
Your loved one may not be able to speak clearly, especially if he or she is a stroke survivor. Aphasia is common after strokes. Be sure your loved one has been fully evaluated to see if a there is a medical or physiological reason for not speaking. Depression from a major medical trauma may also cause this. Finally, be patient. Your lives have changed. That takes some getting used to. Don’t let your loved one’s silence keep you from communicating with him or her.
My loved one has nothing to say to family and friends when they come to visit. How can I encourage participation?
It’s possible that the stroke caused some injury to your loved one’s brain. They might not fully comprehend what’s going on around them or what people are saying. Talk to the healthcare professionals to determine if the injury was in an area that could affect hearing, comprehension or speaking ability. If so, find out what course of rehabilitation is needed to recover as much of those functions as possible. Depression also might be a cause, make sure to review the signs to see if professional help is needed.
My loved one acts as if nothing has happened. I’m afraid he or she is going to have another heart attack. What can I do?
There’s a fine line between being supportive and being overprotective. Your loved one is the best judge of how he or she is feeling at any given time. Have you both taken steps to reduce the risk of a future event, such as staying physically active, not smoking, eating low-saturated-fat and low-cholesterol meals, taking medications as prescribed, and checking in with the doctors as recommended? If so, your loved one is probably heading in the right direction. Talk the situation over with the doctor with your loved one present.
Since his heart surgery, my loved one has lost so much weight, I’m afraid for him. How do I balance the need to gain weight with the cholesterol-lowering requirements?
First, check with his doctor to determine if there’s a medical reason for your loved one’s weight loss and ask what the target weight should be. If there’s no medical explanation and he or she is truly underweight, then eating more calories will help. Try to make the calories come from low-fat foods. Also, try getting your loved one to eat more often — instead of having three meals a day, try four or five.
After the stroke, my loved one went back to smoking. I can’t say anything without a fight. What can I do to help?
For starters, if you smoke, please set a good example and quit. If you don’t smoke, you can’t really do anything but be there to offer support when your loved one gets ready to quit. Nagging won’t help. Learn all you can about the difficulties in quitting and the most successful ways a person can quit. Review with your loved one the damage that cigarette smoking can cause and the high risk it is for having another event and future health problems. Remember, a smoker often has to quit several times before achieving success. Be patient and stay supportive.
I take my loved one’s blood pressure often. How high can it go before I should worry?
The goal in preventing another heart attack, stroke or heart surgery is to keep blood pressure at the goal level set by the doctors. Find out the danger zone. Then keep a chart of the different readings each day for several weeks. Be sure to take the chart to the next doctor’s visit so the doctor knows how well treatment is working. The preferred blood pressure level is less than 120 mm Hg systolic and 80 mm Hg diastolic. A blood pressure of 120 mm Hg systolic and/or 80 mm Hg diastolic to 139 mm Hg systolic and/or 89 mm Hg diastolic is considered “prehypertension” and lifestyle changes are recommended to lower it. A reading of 140 mm Hg systolic and/or 90 mm Hg diastolic or higher is high blood pressure and is dangerous. Losing weight, becoming more physically active, eating low-fat and low-salt foods, and taking medications your loved one’s doctor prescribes can help lower blood pressure.
My loved one talks about dying, feels less than a person and refuses to go see a doctor. What can I do?
This is very serious and needs quick attention. Contact the doctor and explain your concerns. The doctor will tell you the best way to get your loved one in for an appointment.
Before the heart attack and heart surgery, my loved one was the original couch potato. I don’t want to push too hard, but he or she just doesn’t want to get moving. Any suggestions?
First, the doctors should clearly outline how much and what type of physical activity your loved one needs. If your loved one says that’s too much, take it up with the doctor. You can help by coming up with ideas that will make being physically active easier for your loved one. Offer to take a walk together. Get a stationary bike they can ride while watching television. Start being more active yourself and then draw your loved one in. Be patient and don’t nag. Your loved one might be afraid that exercising will cause something else to happen. Get the doctor to help calm those fears and explain the health benefits of physical activity and the health risks of staying inactive.
Money worries are weighing us down. What can we do?
Unexpected bills can pile up quickly, whether or not you have health insurance or Medicare. So stay organized. Open all correspondence from your insurance company or healthcare provider immediately and take the appropriate action. Put all of your medical bills in one place. If you’re too busy taking care of your loved one to deal with the bills, get a trusted friend or relative to help. Or, contact your hospital’s or healthcare provider’s patient services representative for help. Talk to others to find out how they managed their medical bills. Often, simple patience and persistence succeeds in the end.
Article courtesy of the American Heart Association. For more information, visit heart.org/Cleveland.
