Recovery after a stroke. Psychological online tests
A stroke suffered by a person in a mild or severe form radically changes the quality of life of the patient and his loved ones for the worse.
The first feeling of relief from the fact that the disease did not kill the patient passes, it is replaced by fear and anxiety for the state of health and the recovery process of the stroke survivor. Unfortunately, the mortality of patients in the post-stroke recovery period remains high, the risk of death remains high in the next three months, and increases by the end of the six-month period.
Medical studies prove that in half of the cases of deterioration in a person’s condition, post-stroke depression is to blame, which significantly worsens mental and physical state sick.
Causes and symptoms of a decrease in emotional background
On the question of what is the root cause of a sharp deterioration in the mental state of a stroke survivor, the opinions of experts differ. Most people think that acute disorder blood supply to the brain leads to a disruption in the transport of oxygen to the brain. oxygen starvation, in turn, leads to a pathologically depressed state of the psyche.
According to the supporters of the second version, the oppression of the general emotional state a person who has had a stroke lies in the awareness of his own helplessness and dependence on loved ones.
A person who understands his own helplessness and realizes that he greatly complicates the life of his relatives subconsciously wants to save them from this fate. As a result - depression, psychosis, unwillingness to live an inferior life.
The presence of depressive psychosis in more than 50% of post-stroke patients is a scientifically recognized fact. Experts identify a number of main reasons that cause it:
- psychological reaction to the disease;
- psychological response to subsequent disability;
- damage to brain areas associated with the formation of emotions;
- exacerbation of a history of mental and degenerative mental disorders.
Symptoms of a depressive disorder
Against the backdrop of a general disease state it can be difficult to understand what worries a person more: severe pain or psychological problems. In addition, the symptoms of depressive disorder in post-stroke patients are complex and complex, including a group of symptoms of a psychological orientation.
| Group of symptoms | Manifestations |
|---|---|
| emotional | Depressed state, feeling of sadness, melancholy, loss of a sense of pleasure from life, anxiety, expectation of "trouble" and troubles, a feeling of internal tension and discomfort. |
| Behavioral | Lack of initiative, decreased motivation to recover, state of apathy, increased background of irritability, occasional restlessness. |
| Somatic | Feeling "wandering" pain symptoms all over the body, confusion of thoughts, feeling of fullness in chest, lack of oxygen, temporary increased heart rate, numbness of moving limbs, asthenic syndrome. Possible sleep disturbances and appetite suppression |
| cognitive | Difficult and slow thinking, difficulty concentrating, decreased concentration, inertia, sharp impulsivity, negativity towards oneself and others. |
Often the patient is concerned about the symptoms individually, but sometimes all at once. That is why it is difficult to diagnose mental pathological condition, since the combined symptoms indicate a normal exacerbation of stroke.
If you are faced with a problem such as STROKE and are looking for a reliable rehabilitation center where doctors know and understand what to do? - we recommend to pay attention to the rehabilitation center "Evexia". Doctors set themselves the goal of recovering patients after a stroke so that they can at least serve themselves. Official website >>>
The correct determination of the cause of the deterioration of the patient's condition is available only to a specialist, since the diagnosis of post-stroke depression requires professional approach and studying the overall clinical picture of the patient's condition.
Clinical picture of post-stroke depression of the psyche
When making a diagnosis of post-stroke depressive disorder, specialists take into account the presence or absence of certain criteria for the clinical picture.
| Criteria | Symptoms | Duration of manifestation |
|---|---|---|
| Main |
|
Daily for two weeks |
| Additional |
|
Constantly |
Important! With the combination of most of the criteria, we can talk about the occurrence of signs of a post-stroke depressive state. This should serve as a reason to turn to specialists for qualified help.
Medical therapy for psychopathology
Treatment of post-stroke patients from pathological depressive disorders should be carried out in compliance with certain principles:
First of all, specialists prescribe antidepressants to patients. Choice optimal drug depends on individual characteristics patient and the degree of manifestation of psychopathology. For the treatment of depressive disorders after stroke doctors prescribe long-term antidepressants to their patients. The intake of antidepressants is calculated by the doctor for at least six months, provided that the medication is started immediately after the stroke.
| A drug | Performance Rating | Patient tolerance rating |
|---|---|---|
| 2 | 1 | |
| Sertraline | 4 | 2 |
| Bupropion | 7 | 3 |
| Citalopram | 5 | 4 |
| Milnacipran | 6 | 5 |
| Mirtazapine | 1 | 6 |
| fluoxetine | 11 | 7 |
| 3 | 8 | |
| 8 | 9 | |
| Fluvoxamine | 9 | 10 |
No less important for the mental recovery of patients is the timely start complex rehabilitation including treatment in specialized centers.
Therapy of post-stroke disorders in specialized centers
The fact that the treatment and recovery of a patient after a stroke is best entrusted qualified specialists– obviously, since a stroke is quite serious illness threatening with irreversible consequences and complications.
Assistance in this process is provided specialized centers in which experienced specialists develop a program for the restoration and correction of the psychophysical state, taking into account the individual characteristics of the patient.
Rehabilitation neurological center "Evexia"
It provides an expanded range of services in the field of recovery and rehabilitation of patients after a stroke. Qualified helps to correct and conduct a recovery course for a sick person without side effects and risk.
The directions and priorities of the specialists' activities are:
One of the most important reasons depressive psychosis in post-stroke patients is the loss of upright posture. The patient is forced to observe the surrounding reality from a prone position, which distorts the system of perception of the world. The specialists of the clinic are engaged in the restoration of walking skills and rehabilitation of the musculoskeletal rehabilitation treatment Evexia.
conditions successful treatment patients of the clinic are the following factors:
An important factor in the efficiency of the clinic is the use of innovative modern methods rehabilitation:
Complete recovery of the patient is also achieved through physiotherapy procedures performed in the clinic, as well as:
- correction of speech defects;
- special rehabilitation procedures in the pool
- professional psychological counseling;
- treatment of psychiatric disorders in post-stroke patients.
Rehabilitation Center for Post-Stroke Patients "Three Sisters"
The treatment of post-stroke patients by the specialists of the center is adjusted taking into account the specifics of the symptoms of the disease and the severity of the course.
The course of rehabilitation measures includes:
- massages and special procedures for the body affected by a stroke;
- development of methods of special physical education and therapeutic gymnastics;
- correction of psychological, personal and social disorders.
Adaptation of a post-stroke patient in society
In addition to the correct drug therapy and literate hygiene care for the sick, not less important aspect successful recovery is considered proper organization social adaptation sick in society healthy people. The timing of recovery and the full recovery of a stroke survivor depend on it.
Close people and family members can help the patient adapt to new living conditions if they follow the following recommendations:
The main thing that the patient needs in the post-stroke period is the feeling that he is not alone, he is needed and fully supported.
History of rehabilitation after a stroke
My name is Natalya Efratova. In the summer of 2017, my husband had a left-sided stroke. Paralyzed almost completely. He spent a month in the city hospital. Then, with great difficulty, we transferred him to a rehabilitation center, where he just lay for a month, and there was no talk of any full-fledged rehabilitation. A month later, we were discharged in the same condition in which we were admitted. Sergei did not even learn how to sit properly.
After such treatment, we decided to throw all our strength into recovery and decided to contact private center. I reviewed a lot of information on the Internet and the Evexia center caught my eye. From the very first contact, I felt a desire to help us cope with our problem.
We originally came here for two weeks but stayed for a month and a half. My husband started walking. So far not very confident and we have not yet achieved desired result in hand, but we were told it would take time. But Sergey is already walking and this is already a big victory for us.
A stroke is a tragic event that dramatically changes worst life the patient and his family. Therefore, depression is, unfortunately, a common companion of stroke patients.
Some changes in the patient's behavior are due to brain lesions themselves - these are syndromes of emotional lability and decreased mental activity.
The emotional state of the patient in the first weeks or even months after the stroke is extremely unstable: he can be capricious, whiny, quick-tempered. Do not be offended by him - this syndrome of emotional lability is typical for most patients.
Some survivors tend to indifferent attitude to your condition. Therapeutic gymnastics they exercise only under duress, they may lie in bed for hours or mindlessly watch one TV show after another. In such patients, even mild impairments of motor functions are poorly restored. They are often helpless in everything. And this is due not to laziness, as their relatives sometimes believe, but to defeat. certain areas brain. With extensive lesions of the right hemisphere, along with a violation of movements in the left arm and leg, a decrease in mental activity occurs. Such a patient should be patiently encouraged to act, by all means try to develop the need for movement, walking, self-service. He should be given as much attention as possible, but if the patient feels unwell, not in the mood, do not force him to do it at all costs. Be patient, be kind and gentle to him.
In addition to physical ailments and other immediate manifestations of a stroke, the patient also experiences moral suffering: it is hard for him to break with his usual way of life; feels ashamed of his helpless state; fear of being a burden for relatives; anxiety that he will remain disabled forever; longing for immobility and isolation...
Many patients painfully experience their dependence on others. This is especially true for people who, before the impact, were distinguished by independence and love of freedom, a strong character, and a heightened sense of their own dignity. A person who is used to always making decisions himself and being responsible for his life finds it extremely difficult to adapt to the fact that he is now in the care of his relatives.
All listed reasons can lead to depression in the patient. This can be expressed in the fact that a person does not believe in his recovery, loses interest in life, and, in particular, in recovery exercises, upsets his loved ones with irritability and sometimes rude, grumpy behavior. Now the depression caused by the disease itself is an obstacle to recovery - after all, the patient does not make efforts to restore impaired functions, repels the help of doctors and relatives. It turns out a vicious circle from which it is necessary to escape. How?
It is necessary to communicate with the patient. An immobilized person needs moral support, contact with the outside world. Even if the patient does not speak and the center of motor speech is affected, he is usually still able to perceive oral speech - after all, the center of perception oral speech lies in another area of the brain
Academician A.I. Berg wrote: “A person can think normally long time only under the condition of continuous information communication with the outside world. Complete informational isolation from the outside world is the beginning of madness. An informational, thought-stimulating connection with the outside world is as necessary as food and warmth.”
Believe me, communication and conversation with the patient is no less important than medicine. Tell him about your work and friends, discuss children, weather and politics. Do not forget to talk with the patient about his condition, to note the slightest progress. Express your love, your confidence that the situation will change and he will definitely return to an active life.
How to communicate with a patient who cannot answer? In the famous novel by A. Dumas “The Count of Monte Cristo”, the paraplegic Noirtier expressed his consent by closing his eyes, refusal by blinking, and when he needed to express any desire, he raised his eyes to the sky. Make an effort to ensure that the patient regularly experiences positive emotions: from tasty food, a flower on the bedside table, pleasant music. At the same time, do not forget that different people react differently to the same events. For someone, for example, it will be a joy to visit grandchildren, meeting with old friends. And perhaps this will only disturb or embarrass the patient in vain.
If the patient is almost constantly sullen and irritable, it is especially important to try to guess and fulfill his little desires.
If your efforts remain in vain for a long time, then you should contact a psychologist or psychotherapist, who may consider it necessary to use antidepressants to correct the patient's mood. Take the advice you receive seriously. psychological condition no less important for recovery than drugs and procedures.
A little effort, a little imagination, a lot of patience and love - and depression will have to recede.
Relatives of the patient also need psychological help.
We have already mentioned that stroke dramatically changes the life of not only the patient, but also his household. They experience what happened no less, and often more than the patient himself. A huge additional burden suddenly falls on the shoulders of relatives: in the first month they are torn between home, work and hospital visits, then, after discharge, the development of the difficult work of caring for a bedridden patient begins.
If the restoration of impaired functions in a patient is delayed, freedom of movement, memory, speech, self-service skills do not return for a long time, then the patient's relatives accumulate chronic fatigue and emotional, and physical, and the so-called "responsibility fatigue". Like the patient himself, the family member caring for him experiences an oppressive feeling of anxiety, and sometimes he also leaves the hope of returning to his former life, which now, from afar, seems prosperous and carefree ...
There are many rules and techniques that will help you deal with stress and fatigue. Here are some of them:
"The driven horses are shot." If you are almost at the limit, stop and rest. This simple rule many, oddly enough, neglect, not giving themselves a break until fatigue literally knocks them off their feet. Meanwhile, breaks, smoke breaks, breaks and weekends significantly increase the efficiency of any activity.
Ask other people for help
There is nothing shameful about asking for help in a difficult situation. Help can be very different - a neighbor or girlfriend can sit with the patient while you are resting, go to a store or pharmacy. Someone you know or Charitable organization may help with medications or nursing aids. Finally, you may need one too. Moreover, now it can even be obtained virtually, for example, on the website psychology.ru. Try to find or organize a "support group" for people with similar problems. Sometimes it's good to just talk. However, in this you need to know the measure and not get used to constantly complaining about life to everyone around.
Find ways to distract yourself from painful thoughts and improve your mood
When a traumatic situation continues for months, the ability to enjoy the little things in life is especially important. Learn to “turn off” the flow of negative thoughts. Be aware of the good things that are always around you - the taste of food, the view from the window, the sounds of your favorite music and the joy that another hard day is finally over ... Give yourself small gifts, get out to visit - this will help you survive.
Use traditional ways stress relief
Among them are hiking, various water procedures, sports, yoga and meditation, acupressure, aromatherapy, sedatives herbal preparations and listening to relaxation tapes. Many are calmed by knitting or sorting out the rosary. It is also useful to describe on paper or draw your fear, resentment or fatigue, and it does not matter whether you do it professionally or not. Use self-suggestion and self-training techniques
Now there are many publications devoted to such techniques. For example, for many years the book famous psychologist Vladimir Levy, dedicated to auto-training: “The Art of Being Yourself”. Classes can take only a few minutes a day (before going to bed and immediately after waking up), but you will definitely feel the effect.
Choose for yourself a complex of vitamins, adaptogens, tonic and immunostimulating drugs
To your organism and, in particular, to nervous system life is presenting increased requirements. Therefore, you need additional support. In any pharmacy you will find a sufficient range of vitamin and restorative products. Choose from them the most suitable for you.
Don't Lose Your Optimism
All the methods listed above will only help you if you consciously set yourself up to win. Of course, from time to time feelings of hopelessness, irritation and even hostility to the patient can cover even the most patient person, and you should not condemn yourself for them. It is only important not to remain in these states for a long time, but to stubbornly return oneself to benevolence, patience, endurance and optimism.
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How to help a person who has had a stroke? Olga Frolova, a medical psychologist at the Vladimir City Hospital No. 4, tells our readers about this as an expert.
- Olga Sergeevna, what role does relatives play in the rehabilitation of a patient after a stroke?
After medical care the help of relatives and close people is urgently needed. It must be regular. It is important to help actively - to engage in, restore lost skills. If a person cannot move his hand, then it is necessary to teach it again. The period after a stroke is especially acute for those who, before the illness, were engaged in vigorous activity or was in high office. And after a stroke, sometimes even elementary actions and skills become difficult. Sometimes patients are unable to respond to simple questions due to speech impairment. Sometimes, with a severe form of stroke, the character changes. Negative traits are more pronounced. No need to get angry, offended, shout at the patient. Especially if for some reason he does not want to respond to requests and perform simple exercises. You need to understand and accept his difficult psychological state. In order for a patient after a stroke to be able to feel love from his close people, you need to pay more attention to him, give small instructions, show that he is needed. During this period, support and approval are very important: you could not do this a week ago, but now you are doing it. This strengthens the patient's belief that he is going in the right direction.
- Can patients fully recover?
It does not depend on the person, but on the severity and volume of the disease. Some make a full recovery. It is necessary to help such patients first relieve acute stress, and then successfully rehabilitate. It is important to restore and train cognitive functions. Speed of thinking, memory, attention. A person must necessarily engage in mental work, solve problems, learn poetry. Very often he has a fear of a second stroke. Some are thinking: should I continue to work, or should I quit? Work! If you feel normal and if there is such an opportunity. As soon as a person ceases to engage in mental work, all cognitive sphere. Be sure to follow all the recommendations of doctors.
Is stroke related to depression?
80% of stroke patients are depressed. They consider themselves a burden. Especially if the disease is severe, with paralysis, speech impairment. Although the stroke itself also causes sadness. The disease can affect those areas of the brain that are responsible for emotions, and this may be the cause of low mood, unwillingness to do anything. Psychological help most often needed by both the patient and his relatives. The impetus for getting out of depression can be either psychotherapy or medication.
-How to improve mood, relieve stress?
- Observe the regime of work and rest. 8-9 hours of sleep is a must. Support correct mode nutrition. Refuse bad habits. Use music therapy and art therapy, auto-training, emotional and muscle relaxation. Daily walks help fresh air. Good breathing exercises, it is worth taking up a hobby - something that a person likes. In general, experience more positive emotions- someone will be happy with a bouquet of flowers, someone with a photo of their beloved granddaughter or cat.
Cardiologist
Higher education:
Cardiologist
Saratov State Medical University. IN AND. Razumovsky (SSMU, media)
Level of education - Specialist
Additional education:
"Emergency Cardiology"
1990 - Ryazan Medical Institute named after Academician I.P. Pavlova
The process of rehabilitation after a stroke, along with somatic complications, is hampered by a disorder of cognitive functions, pathological emotional reactions of the patient to the consequences of the disease. For this reason, there is a need psychological adaptation patients with acute cerebrovascular accident. Full-fledged psychological rehabilitation of patients after a stroke consists of several areas.
Intrapersonal correction
Complications after a stroke lead to deformity mental processes And pathological changes the patient's personality.
Post-stroke depression
Depressive states cannot be unequivocally explained by only one vascular lesion of the brain. On early stage restoration, a person’s rejection of his new physical and mental appearance arises. The patient develops an acute sense of shame due to the resulting helplessness and forced dependence on others, there is a fear of possible disability, self-esteem falls. escalate character traits personality: apathy, tearfulness is possible, in others - outbursts of irritability, anger.
Realizing the duration and complexity of treatment, patients often overestimate the severity of their condition and lose faith in their ability to recover. As a result, the motivation for inclusion in the rehabilitation process decreases. As a result of depression, patients not only stop making personal efforts for the sake of recovery, but also reject the help of doctors and relatives.
Psychological help
Shown after stroke psychological correction using the methods of humanistic psychotherapy. It is necessary to get the patient to accept his position, take responsibility for restoring his health, and form adherence to treatment. Acceptance of oneself occurs due to the acceptance of the patient in a new state by his micro-society: a psychologist, relatives, friends, medical staff, members of the rehabilitation group.
Group classes (art therapy, video therapy) contribute not only to the restoration of tactile sensitivity and motor skills, but also contribute to emotional uplift and satisfaction of the need for communication.
Application of methods of body-oriented psychotherapy, special breathing exercises for relaxation, they help relieve muscle tension, restore coordination of movements and establish contact with your body.
Medical therapy
Unfortunately, depression after a stroke also develops as a result of certain drugs (corticosteroids, tranquilizers, barbiturates, cardiac glycosides) prescribed for bodily recovery. In the case of a permanent depressed mental state of the patient, a correction of the course of drug therapy, the selection of antidepressants is required. Elderly patients are prescribed Escitalopram. With moderate oppression psycho-emotional state and for the prevention of depressive disorder recommends taking Tazodone, Paroxetine, Fluoxetine, Malnacipran.
Vascular dementia
It has been established that a stroke of the left hemisphere or several micro-strokes significantly increase the risk of dementia. Clinical manifestations vascular dementia are very diverse and are determined by the localization of the lesion. Most often, the disease is diagnosed in elderly patients and is characterized by a decrease in memory and an increase in dementia. Psychological assistance to people with dementia includes classes in art therapy, music therapy, aimed at improving memory, maintaining intellectual activity. Classes in a group for the development of communicative potential are shown.
Post-stroke psychosis
Regression often occurs after a stroke mental activity the victim. Many functions of the psyche are temporarily lost, there is inappropriate behavior. Excessive emotional arousal, spontaneity, spontaneity, or, conversely, deceit, suspicion, aggressiveness, obsessions. Most often, aggression is observed in older patients. The closest circle of relatives and friends of the patient is not ready for such changes. The danger of this condition is that the patient can harm himself and others.
Psychosis, predominantly in the form of hallucinations and delusions (delusions of jealousy, damage, poisoning, and exposure are more often noted), remains a rare complication of stroke. It develops as a result of damage to certain areas of the brain. It can manifest itself immediately after an ischemic attack with the formation of a pathological focus in the left hemisphere, or even after a year or more if the focus is on the right. In people with pre-existing mental disorders in history or predisposition to them, the likelihood of developing psychosis after a stroke increases several times.
On early stage vascular psychosis, the condition can be controlled with medication (atypical antipsychotics, anticonvulsants). The main thing is to detect a change in personality in a timely manner loved one and seek help from a doctor (neurologist, psychiatrist). He will be able to assess the severity of the patient's condition and the amount of medical care required.
Interpersonal correction
As a result of the disease, the patient experiences the loss of the former social roles and changing the nature of relationships with others. Therefore, a special target audience for the work of a psychologist is also the relatives of the patient, who need help to build the right relationship with him, help him understand his condition, deal with his own experiences.
Formation of new life values and meaning of life
In many patients, complications after a stroke provoke a decrease or complete loss of working capacity. There is a need premature termination labor activity or its continuation under modified conditions. Inability to implement professional skills, loss of the former social status, a crisis of self-identity often leads to frustration. Therefore, patients need help in adjusting to fatal
A stroke always becomes a tragic event in the life of not only the patient himself, but also his family. This merciless disease can dramatically change the worst condition not only physical, but also moral. The syndrome of emotional lability of such patients, which is present in them already in the first weeks after the stroke, manifests itself in tearfulness, indifference to everything that happens, capriciousness and irascibility over trifles. Some stroke patients are indifferent to the need for even physical rehabilitation and perform necessary procedures only after lengthy persuasion or even under duress. There is a category of patients who are brought a lot of mental suffering by their shame for their weakness and confusion of speech. They may spend hours staring at the wall or watching uninteresting TV shows, negatively perceive outdoor walks, and respond inadequately to care from relatives, friends, or medical staff.
Psychological recovery program
The state after a stroke requires mandatory psychological rehabilitation and understanding from others, which are impossible without constant communication and contact with the outside world. Psychological recovery after a stroke is aimed at developing an adequate attitude towards health and illness, focus and strong motivation for a speedy recovery, returning to the public and working life. For each patient, a individual program on psychological rehabilitation, which would take into account:
- a state of psychological status, which can be unburdened or burdened (neurosis, depression, psychopathic character traits, psychoses, etc.);
- the presence of mental complications caused by cerebral hemorrhage or a particular response of the patient's personality to the disease.
The importance of communicating with the patient belongs to explanatory, persuasive and informational conversations. It is extremely important to teach a weak person to overestimate values and try to switch his attention to other aspects of life: the interests of friends, relatives, the team, hobbies and social life. In such situations, the rehabilitation doctor works not only with his patient, but also with his environment.
More quick recovery conducive to the home environment. Patience and gentleness of relatives and friends contribute to the adaptation of the patient to his condition and avoid severe depression. The ability to learn to enjoy life again, to enjoy communication, to make plans for future life help to tune in to the need to patiently and regularly follow all the recommendations of doctors and understand that the disease worsens the quality of life, but is not a threat to it, but requires a fight against the consequences of the disease.
Relatives of a patient after a stroke need to learn to anticipate those tasks that are difficult for a still not fully rehabilitated patient.
- As a rule, it is difficult for such people, especially in the morning, to get up or get out of bed, take large pieces bread and bring them to your mouth, drink from a cup. In such cases, you can offer them finely chopped pieces of bread and a drinking straw.
- It is important to be able to help the patient maintain self-esteem in any situation and always refrain from criticizing his condition.
- The daily regimen must necessarily include the usual activities that instill in the patient a sense of security and self-confidence. For example, if he is used to working in the garden, then his involvement according to the measures of his strength will contribute to the normalization of his emotional state and bring pleasure from his favorite pastime.
- Conflicts with the patient should be avoided in every possible way, since this can lead to a deterioration in his well-being and cause him resentment and isolation. Be sure to keep calm, try to joke more often in a kind way, do not argue or criticize in a negative way.
- You should not refuse the help of friends, relatives, employees and neighbors. Such communication will benefit both the patient and his relatives.
- You need to leave time for yourself. Such minutes and hours of rest will help to overcome severe psycho-emotional and physical activity and continue caring for the sick in good spirits.
- To prevent overwork caused by overestimating your capabilities, you need to think in advance about who can help and replace you. Many relatives who care for such patients overestimate their capabilities and patience - this can lead to neurosis, nervous breakdowns and depression.
Activities for psychological recovery
- individual and group psychotherapy;
- autogenic training;
- psychotherapy with the use of acupuncture;
- book therapy;
- psycho-gymnastics with the use of pantomime, rhythm, dancing, singing, etc.;
- cultural therapeutic activities;
- work in the clubs of "former patients".
How to set up the patient to fight the disease?
- Try to be specific about each step.
- Distract from moral self-torture by comparisons with those who are even worse off.
- Learn to recognize the need for humility with what happened.
- Get involved in helping others.
- Encourage hope and improvement in the future.
- Teach the patient to live for today.
- Learn to adapt to the created conditions of life.
- To give the opportunity to feel needed and needed member of the family and society.
- Avoid slovenliness and detachment from society.
- Learn to behave with dignity in any situation.
All methods and methods of psychological rehabilitation after a stroke will help only if the patient and his environment are determined to win. Of course, feelings of irritation from one’s own weakness, hostility to the current situation will overshadow this faith, but the ability not to remain in such states for a long time and a stubborn return to goodwill and positive attitude will help overcome all adversity.
