Cerebralvascular Accident - Cva (Stroke)

Definition
A cerebralvascular accident [CVA] or stroke, occurs when the blood flow to the cerebral tissues is interrupted, either by a clot or by hemorrhage.

Cause
Some of the conditions that can lead to a CVA are hypertension, carotid artery disease, diabetes mellitus, and smoking.

Caregiver Hot Tips

1. Be aware that the individual has changes in cognition due to the CVA.
   
   
2. Some of these changes can be a change in mental status, restlessness, drowsiness, lethargy, not able to follow a command, or do an activity they did prior to the CVA, or unresponsiveness.



3. You should contact the doctor if there is any increase weakness, paralysis, choking, or difficulty breathing.
   
   
4. As the caregiver you can do range of motion, on the unaffected side, after instructions from physical therapy to the neck, shoulders, elbows, wrists, forearms, fingers, toes, hips, knees, and ankles.



5. When positioning the individual in bed or the chair remember to keep them in a normal position. When placing the individual on their side support the back with a pillow or a rolled blanket and a pillow between their legs. Also put a pillow under the affected arm for support. Repositioning should be done every two hours for a bed bound individual.
   
   
6. When giving care to the bed ridden individual give close attention to all the boney areas such as shoulders, back, hips, knees, and ankles. Rubbing these areas with lotion is important and making sure the heels are elevated off the sheets.
   
   
7. If any open areas occur the doctor should be called for treatment.



8. Swelling of the legs and feet can happen and this can be reduced by the use of a pillow under the legs and feet.



9. When dressing the individual start with the affected side then the unaffected side.
   
   
10. If the individual can assist in their care then they should maintain as much independence as possible. They can assist with toileting, grooming and meals.
    
    
11. Because the individual has impaired verbal communication does not mean they do not hear or cannot think.
    
    
12. Waiting when talking to the individual helps as well as facing them and speaking slowly.



13. You will find the individual can become frustrated and angry because they cannot express themselves. BE PATIENT.
    
    
14. Pictures can be used such as a toilet, food, fluids, or a clothing helps stops some of their frustrations.
    
    
15. To reduce the possibility of injury the home should be neat and clutter free.
    
    
16. Placing care items within the individual’s vision and on the unaffected side helps the individual with maintaining independence.
    
    
17. When feeding the individual they should be sitting up with the neck slightly forward. Do not rush and make sure they swallow one bite at a time. They may pocket the food in their cheeks so check to be sure there is no food in their mouth.
    
    
18. Be sure you include the individual in family conversations so they do not become frustrated because of their inability to speak.
    
    
19. If the individual is able to participate in any activity this should be encouraged as this also helps maintaining their independence and improving their self worth.
    
    
20. Have a list of all the individual’s medications and dosage. Be sure to read all the information the pharmacy sends with the medication for adverse effects and interaction. This list should be taken with you in the event it is necessary to go to the hospital as well as visits to the doctor. This list must be updated frequently for dosage change and any new medications ordered.
    
    
21. If the individual requires constant care a plan should made for relief when you as the caregiver has to go shopping or take a vacation.
    
    
22. Backup plans as a caregiver, if the individual requires constant care, should be made for relief when you have to go shopping or take a vacation.