Home care for cerebrovascular accidents and Alzheimer's disease

Middle-aged and elderly people with long-term hypertension and cerebral arteriosclerosis are at risk of cerebrovascular accidents at any time, such as cerebral hemorrhage or cerebral infarction, both of which are called stroke.

If a patient suddenly experiences headache, dizziness, limb weakness, facial drooping, or speech difficulties, and may also experience confusion or coma, sensory disturbances, or nausea and vomiting, it indicates the occurrence of a stroke.

Whether it is a cerebral hemorrhage or a cerebral infarction, movement should be minimized as much as possible to avoid aggravating the bleeding or worsening the infarction.

Of course, the best course of action is to provide on-site emergency care, including oxygen therapy, maintaining an open airway, controlling blood pressure, and reducing intracranial pressure, with the focus on maintaining basic life functions.

If on-site rescue is not possible, care must be taken to prevent bumps and handle the vehicle gently during transport, and every effort should be made to rescue the patient as quickly as possible.

If a patient survives the acute phase, they will enter the recovery phase, during which most patients can go home for treatment. Home care is especially important during this period.

Early passive movement of the limbs should be initiated, such as massage or acupuncture, to promote the recovery of brain function and prevent deformities and contractures of the paralyzed limbs.

For paralyzed and bedridden patients, it is necessary to turn them over frequently and give them warm water baths to prevent bedsores and skin infections.

Patients with difficulty swallowing should take precautions to prevent water and liquid food from entering the trachea and causing spasmodic coughing.

It is important to maintain regular bowel movements to prevent constipation and difficulty in defecation, which can lead to a recurrence of the condition.

Family members must be patient and attentive, and help the patient build confidence and determination to recover as soon as possible.

Once the paralyzed limbs regain voluntary movement, the patient should be immediately encouraged to engage in vigorous exercise to enhance the muscle strength and flexibility of the affected limb.

Depending on the patient's physical condition, patients should be trained as early and gradually as possible to sit up, stand, raise their arms and legs, and walk with support.

If the patient is able to walk with assistance, family members should accompany them in their exercise routine, gradually increasing the intensity, but taking precautions to prevent falls, excessive fatigue, and high blood pressure.

For patients with language impairments, language training should also be provided.

Cerebral arteriosclerosis can easily lead to multiple cerebral infarctions, cerebral softening, and cerebral atrophy, which can manifest as Alzheimer's disease.

The patient experiences memory and cognitive impairments, personality changes, and significant impairment in social functioning.

In mild cases, individuals can manage their daily lives with the help of others; in severe cases, they require specialized care.

Because patients are prone to getting lost due to memory and orientation impairments, they should be restricted from going out alone and should ideally be accompanied by a caregiver.

To prevent accidents caused by getting lost, the patient's name, contact person's name, address, and phone number can be sewn onto their clothing.

Because the patient is slow-moving, has difficulty moving, and has intellectual disabilities, he sometimes cannot find a toilet and urinates or defecates in his pants.

Sometimes, due to difficulty in dressing or undressing, or misjudgment, children may urinate or defecate indiscriminately. In such cases, individual care should be provided according to the severity of the situation. Family members should not simply blame or scold the patient, but should consider the patient's self-esteem and feelings of shame, understand the patient's difficulty in judgment and motor skills, help and guide the elderly to clean themselves, and remind the elderly of their established hygiene habits.

Forgetfulness and misplacing items are the most common behaviors of Alzheimer's disease. Patients should be patiently and repeatedly helped to neatly place commonly used items in fixed locations, and unnecessary and dangerous items around and in the environment should be removed at any time.

In particular, one must be especially careful when using fire (gas, electrical appliances), water, and tools that may cause harm, as well as medicines and poisons.

Some elderly people with dementia may claim other people's belongings as their own, or shout and yell randomly if they are not properly supervised. In such cases, it is important to patiently dissuade them and not to force or provoke them, in order to avoid accidents.

It is important to regulate the patient's appetite and eating habits.

Most elderly people with dementia have weakened digestive function. This can be due to insufficient nutrition from eating too little or overeating due to memory impairment, leading to indigestion. Therefore, it is important to balance nutrition, the patient's appetite, and their sense of satisfaction.

It is necessary to ensure that patients not only meet their physical nutritional needs, but also provide them with a sense of satisfaction and fulfillment.

Food should be easily digestible, the dining environment should be comfortable and quiet, and if the appetite is poor, it should be improved through emotional communication. If the person eats too much, they should be discouraged in time, and if there is difficulty swallowing, they should be fed patiently.

We should do our best to help patients learn to eat on their own in order to maintain their ability to eat.

Special attention should be paid to fluid intake, and water should be drunk 3 to 4 times a day at regular intervals to ensure that the body has enough water.

Sleep problems in elderly people with dementia should also be taken seriously.

Patients often experience insomnia due to changes in environment, physical discomfort, or unhappiness.

Some patients experience sleep disorders due to hallucinations or delusions, while others have their sleep schedules reversed.

Some patients wake up in the middle of the night and cannot sleep. They can be given a small amount of snacks or warm drinks.

Some patients experience drowsiness due to insufficient blood supply to the brain and reduced excitability of the cortex.

To address the underlying cause of the sleep disorder, appropriate sleep aids should be taken under the guidance of a doctor.

More importantly, it is important to plan daytime activities to maintain a certain level of tension in the patient's mind, muscles, and blood vessels, thus preventing excessive daytime sleep and insomnia at night.

In addition to the behavioral, dietary, and sleep care mentioned above, psychological care is even more important.

Family members should understand the nature of Alzheimer's disease and have sufficient understanding of the various changes in mental state, emotions, personality, and behavior.

Patients should be cared for with affection and consideration, and they should have more emotional communication and physical contact with them. While patiently guiding and helping them, they should also offer more encouragement and explanation. It is important to maintain the patient's self-esteem, and to talk about the patient's past good deeds and happy events to evoke the elderly person's self-esteem and cheerful mood.