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Heart Health, Cardiology: Difficult Behaviors After A Stroke  Previous Next

Difficult Behaviors After A Stroke

by: Stephanie Trelogan

Some stroke survivors behave in ways that can make life unpleasant for the people around them. A stroke survivor may be depressed, anxious, and angry, and he may not know how to express his feelings in a positive way. He may lash out at you verbally or even physically.

Difficult behaviors can also arise from personality changes. Almost half of people who care for stroke survivors describe them as being negative, impatient, and easily upset. A stroke survivor may exhibit child-like behaviors, lashing out verbally or even physically.

Here's what you can do to deal with these behaviors:

  • Recognize that it's not about you. The person in your care is angry about his situation, and he may have lost some of the ability to control his emotions that he used to have. As impossible as it may sound, try to keep your own emotions under control. If necessary, give yourself a time-out for a while so that you both can cool down.

  • Be positive and supportive -- but firm. You can say things like, "I can see that you're very angry right now, but it's not okay for you to yell at me like that. What do you think would help us both feel better?"

  • Use distraction and soothing techniques. Sometimes the best way to deal with difficult behavior is to distract him with a calming activity, like watching a favorite TV show or listening to relaxing music. You can talk about his behavior when you've both calmed down.

  • Try positive reinforcement. A point system may help him relearn how to behave appropriately. For example, if he tells you he's upset instead of crying or screaming at you, you can give him points that can be added up for a later reward. You can use a sticker chart so he can see his progress. (Even though this may sound like the way you'd treat a child, many stroke survivors respond well to this type of reward system.) The best rewards are those you can enjoy together, like going to the movies or some other enjoyable activity.

  • Decrease distraction and stimulation. If the television is on while the stroke survivor is trying to get dressed, he may have a hard time focusing -- and he may become frustrated and lash out at you. So try to eliminate such "background noise."

  • Find a support group where he can share his feelings. Talking to other people in a similar situation can be tremendously helpful, and he'll benefit from the social interaction. It's also a great way for you to connect with other caregivers.

  • Protect yourself. If he's physically abusive, you should take measures to prevent him from hurting himself or you. Talk to his doctor and rehabilitation team. You may need to consider a nursing facility.

Coming to terms with changes in a stroke survivor's emotions, personality, and behavior may be even more difficult than managing his physical disability. He may seem like a completely different person from the one you knew before the stroke, and this can be very upsetting at times. You may want to get counseling or join a support group. Having someone to talk to and knowing that you're not alone can ease a world of anxiety and fear.


About the Author

Stephanie Trelogan is Senior Editor of the Heart, Stroke, and Depression channels. Older people in Stephanie's family have coped with a variety of stroke- and heart-related conditions, and several family membersincluding Stephaniehave struggled with depression.

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