#strokeassembly

www.stroke.org.uk/uksa

Wedi’i drefnu gan | Hosted by

Hidden effects of stroke

Dr Samantha Fisher-Hicks - Abertawe Bro

Morgannwg University Health Board

Workshop: Session 2a

#strokeassembly

www.stroke.org.uk/uksa

Wedi’i drefnu gan | Hosted by

The hidden effects of stroke

Dr Sam Fisher-Hicks, Ken Nazareth & Christine Maddocks

• ‘People expect you to have visible disabilities, but I looked well. That’s what I found hard. People thought that I was making it up and I wasn’t. I thought I was going crazy. I went to my local supermarket and then suddenly it was too much for me – there were too many people. I couldn’t work out what I wanted and it was a panic attack. You feel better when you know it’s not just you’…….stroke survivor.

A brief introduction…..

• 5 min video

Outline of Session

• Introduction to psychological effects of stroke (20 mins)

• Ken & Chris (10 mins)

• Moving forwards (10 mins)

• ‘What I found helpful’ – Ken & Chris (10 mins)

• Questions (5 mins)

Invisible symptoms

Stroke Needs Survey

Difficult Feelings

Psychological problems are the most frequently reported issues after stroke in survivors and carers.

Common reactions after Stroke

• Sleep problems • Agitation • Irritability • Frustration • Loss / grief • Worrying about

the future/ another stroke

Anxiety and depression

This is important because…

Depression and anxiety:- • Cause significant distress • Are associated with poorer recovery after stroke • Cause people to become more socially isolated • Lead to lower levels of activity • Create greater dependency • Make it harder to manage physical health problems

• Depression is not an inevitable consequence of stroke and much can be done to help those who have a depressive episode

(Kneebone and Dunmore, 2000)

• Uncontrolled crying or laughing out of proportion to an event

• Caused by stroke (frontal lobes, brain stem and thalamus)

• Mood disorder or loss/grief can contribute

• Can be distressing, embarrassing and lead to social avoidance, anxiety and depression

Emotionalism

Irritability and Anger

• Very common after stroke • There may be a number of causes e.g. Frustration, difficulties with

speech and communication, emotional difficulties and/or because the brain ins no longer as good at managing emotions

• Can be very difficult for loved ones to cope with

Impact of stroke on self & others

• Physical

• Sensory

• Communication

• Cognitive

• Behavioural

• Emotional

They affect many levels -:

• Personal

Sense of self

Identity

Family

Role change

Work

Responsibilities

Finance

Society

Stigma

Social networks

Health services

• Refers to mental abilities - speed of thought, memory, understanding, concentration, solving problems, language….

Cognitive Problems

•Around a 75% of people who survive a stroke present with persistent cognitive impairment

(ROWE, 2009)

• Ken & Chris (10 mins)

• Experience of emotional and cognitive problems

The essentials of Happiness are:

• Something to do

• Something to love

• Something to look forward to

Simple happiness recipe

A formula for happiness

https://www.authentichappiness.sas.upenn.edu/testcenter 1 Once you follow the link it will take you to a page with a whole list of questionaires. 2 Scroll down to the one that says "VIA Survey of Character Strengths" and select "Take Test"

3 You will have to register to take the test. So select "register" and follow the instructions to creat your account.

4 At this point the link may take you back to the whole list of questionaires, if so simply scroll down again until you see "VIA Survey of Character Strengths" and select "Take Test"

Character Strengths

Positive Emotion

w

Neil Frude, 2016

w

The Wellbeing Daisy

Resilience

Positive Emotion

w

The Wellbeing Daisy

w

Resilience

Positive Emotion

Optimism

Integrated model of identity change. Y- shaped model (Gracey, Evan, Malley, 2009) and Seligman (2011)

‘PERMA’ Model of Well-Being (Seligman, 2011)

• Positive emotion– joy, awe, compassion, delight, happiness, elation

• Engagement/flow– truly engaged in activity/ time seems to stop

• Relationships– positive relationships e.g. family, friends, neighbours

• Meaning– feeling connected to a bigger cause than ourselves e.g. religion, group

• Accomplishment – meeting our personal goals e.g. mastering a skill

Stroke can affect all aspects of PERMA

• Ken & Chris (10 mins)

• Things that helped in moving forwards

Questions

What next?

Refreshments

3.05pm - Plenary 3:

Can the brain rewire itself?

Castell Suite