SAM Stroke Community Presentation Guide

Explaining Stroke __________________

May is National Stroke Awareness MonthNational Stroke Association encourages everyone to spread awareness about stroke in May about how to:

- STOP primary and secondary stroke through risk factor management. - Act F.A.S.T. to increase recognition of and response to stroke symptoms.- Spread HOPE about recovery from stroke.

Visit www.stroke.org/SAM for free educational resources.

Recognize: stroke symptomsReduce: stroke riskRespond: at the first sign of stroke, Call 911 immediately!

Stroke FactsA leading cause of death in the United States

795,000 Americans suffer strokes each year

134,000 deaths each year- From 1996 to 2006, the stroke death rate fell 33.5% and number of deaths fell by 18.4%

6,400,000 stroke survivors

Stroke FactsA leading cause of adult disability

Up to 80% of all strokes are preventable through risk factor management

On average, someone suffers a stroke every 40 seconds in America

Women & StrokeStroke kills more than twice as many American women every year as breast cancerMore women than men die from stroke and risk is higher for women due to higher life expectancyWomen suffer greater disability after stroke then menWomen ages 45 to 54 are experiencing a stroke surge, mainly due to increased risk factors and lack of prevention knowledge

African Americans & StrokeIncidence is nearly double that of Caucasians

African Americans suffer more extensive physical impairments Twice as likely to die from stroke than Caucasians

High incidence of risk factors for strokeHypertensionDiabetesObesitySmokingSickle cell anemia

Hispanics & StrokeHigher incidence among Mexican Americans than Caucasians

Mexican Americans are at increased risk for all types of stroke and TIA at younger ages than Caucasians

Spanish-speaking Hispanics are less likely to know stroke symptoms than English-speaking Hispanics, African Americans and Caucasians

Well-known Stroke SurvivorsMary Kay Ash

Charles Schultz

Harry Caray

Charles Dickens

Ed Koch

Ted WilliamsPresident Gerald Ford

Teddy Bruschi

Sharon Stone

Della Reese

Kirk Douglas

Roy Horn of Siegfried & Roy

Definition of StrokeSudden brain damageLack of blood flow to the brain caused by a clot or rupture of a blood vessel

Ischemic = Clot (makes up approximately 87% of all strokes) Hemorrhagic = Bleed- Bleeding around brain- Bleeding into brainEmbolicThrombotic

Brain Attack!Stroke is a Brain Attack.

Stroke happens in the brain not the heart

Stroke is an emergency. Call 911 for emergency treatment.

Sudden and severeheadacheTrouble seeingin one or both eyesSudden dizzinessTrouble walkingSudden numbnessor weakness of face, arm or legSudden confusionTrouble speakingIf you observe any of these symptoms,call 911 immediately.

Every minute matters!

F = Face: ask the person to smile A = Arm: ask the person to raise both arms S = Speech: ask the person to speak a simple sentence T = Time: to call 911

Every minute matters!

TIATransient ischemic attack (TIA) is a warning sign of a future stroke up to 40% of TIA patients will have a future strokeSymptoms of TIAs are the same as strokeTIA symptoms can resolve within minutes or hoursIt is important to seek immediate medical attention if you suspect that you are having or have had a TIA

The Perceptions of StrokeMythStroke is not preventableStroke cannot be treatedStroke only strikes the elderlyStroke happens in the heartStroke recovery ends after 6 monthsRealityUp to 80% percent of strokes are preventableStroke requires emergency treatmentAnyone can have a strokeStroke is a Brain Attack

Stroke recovery can last a lifetime

The Cost of StrokeThe estimated direct and indirect cost of stroke is 73.7 billion in 2010The mean lifetime cost of ischemic stroke is about $140,048 in America

National Stroke Association Recommends that you follow these guidelines to help people reduce their risk for stroke

Stroke Prevention GuidelinesKnow your blood pressure. Have it checked at least annually. If it is elevated, work with your doctor to control it.

Find out if you have atrial fibrillation (AF) a type of irregular heartbeat. If you have it, work with your doctor to manage it.

If you smoke, stop.

4. If you drink alcohol, do so in moderation.

5. Know your cholesterol number. If it is high, work with your doctor to control it.

6. If you are diabetic, follow your doctors recommendations carefully to control your diabetes.

Stroke Prevention Guidelines

7. Include exercise in your daily routine8. Enjoy a lower sodium (salt) and lower fat dietIf you have circulation problems, work with your doctor to improve your circulation.If you experience any stroke symptoms, call 911 immediately. Every minute matters!

Stroke Prevention Guidelines

National Stroke Association recommends that you learn stroke symptoms and how to respond to symptoms by calling 9-1-1

Why People Dont Recognize and Respond to SymptomsDont recognize symptoms

Denial

Think nothing can be done

Worry about cost

Think symptoms will go away

Fear or dont trust hospitals

Acute Stroke TreatmentsIschemic stroke (Brain Clot)Clot busting medication: t-PA (Tissue Plasminogen Activator)

Clot-removing devices: Merci Retriever, PenumbraHemorrhagic Stroke (Brain Bleed)ClippingCoiling

Stroke Recovery10% of stroke survivors recover almost completely25% recover with minor impairments40% experience moderate to severe impairments requiring special care10% require care within either a skilled-care or other long-term care facility15% die shortly after the stroke

Types of Stroke RehabilitationPhysical Therapy (PT)Walking, range of movementOccupational Therapy (OT)Taking care of ones selfSpeech Language TherapyCommunication skills, swallowing, cognitionRecreational TherapyCooking, gardening

BehaviorDepression & AngerEmotional LiabilityOne-sided NeglectMemory LossCommunication ProblemsDaily living skillsDressing and groomingDiet, nutrition and eating difficultiesSkin care problemsPainSexuality/IntimacyLifestyle Changes for Survivors and Caregivers

Types of Recovery ServicesRehabilitation unit in the hospitalIn-patient rehabilitation gacilityHome-bound therapyHome with outpatient therapyLong-term care facilityCommunity-based programs

National Stroke AssociationWhat we doReduce the incidence and impact of strokeAdvocate for prevention and public educationProvide professional education and trainingProvide recovery resources for stroke survivors and caregivers

1-800-STROKES (787-6537)

www.stroke.org

*This presentation will help you understand more about stroke its prevention, treatment and recovery. It will cover stroke risk factors, prevention measures, how to recognize the symptoms of stroke and how to respond.

National Stroke Awareness Month takes place in May every year. In honor of this special time, National Stroke Association strives to provide everyone with the tools and inspiration to raise public awareness about stroke.Stroke is the third leading cause of death and a leading cause of disability, but many people do not realize how educating themselves and others will help reduce the incidence of stroke. National Stroke Association encourages everyone to take time during May to spread awareness about how to:STOP primary and secondary stroke through risk factor management. Act F.A.S.T. to increase recognition of and response to stroke symptoms.Spread HOPE about recovery from stroke.

**We hope your participation in todays presentation will support you in becoming more Stroke Smart.We want you to know and understand the 3 Rs of Stroke:Reduce RiskRecognize Stroke SymptomsRespond by Calling 911

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Stroke is a leading cause of death in the United States behind heart disease and all forms of cancer combined.

Approximately 795,000 Americans have a new or recurrent stroke each year.

Stroke kills approximately 134,000 Americans each year. From 1996 to 2006, the stroke death rate fell 33.5% and actual number of stroke deaths fell by 18.4%.

There are more than 6 million stroke survivors living in the United States. Men make up about 2,500,000 of survivors and women make up 3,900,000. About one-third have mild impairments, another third are moderately impaired and the remainder are severely impaired.

References:

American Heart Association. Heart Disease and Stroke Statistics 2010 Update At-a-Glance. At: http://www.americanheart.org/presenter.jhtml?identifier=1200026.

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Stroke is a leading cause of serious, long-term adult disability. Over the course of a lifetime, four out of every five American families will be touched by stroke.

Up to 80% of all strokes are preventable.

Every 40 seconds someone suffers a stroke, every four minutes someone dies from a stroke.

References:

American Heart Association. Heart Disease and Stroke Statistics 2010 Update At-a-Glance. At: http://www.americanheart.org/presenter.jhtml?identifier=1200026.

Gorelick PB. Stroke Prevention. Arch Neurol. 1995;52: 347-355. At: http://archneur.ama-assn.org/cgi/content/abstract/52/4/347.

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Stroke kills more than twice as many American women every year as breast cancer.

Each year, about 55,000 more women than men experience a stroke.More women than men die from stroke - accounting for more than 67% of all stroke deaths.Overall lifetime risk of stroke is higher in women then men because life expectancy is higher. Also, women who have already suffered a stroke are significantly more at risk for a second stroke than men after two years.Women suffer greater disability and functional outcomes because they are more likely to require institutionalized care than men, which adds to the economic burden of stroke. Women ages 45 to 54 are experiencing a stroke surge, mainly due to increased risk factors and lack of prevention knowledge.

References: American Heart Association. Heart Disease and Stroke Statistics 2010 Update At-a-Glance. At: http://www.americanheart.org/presenter.jhtml?identifier=1200026.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. Centers for Disease Control and Prevention National Center for Health Statistics National Vital Statistics System. National Vital Statistics Report. Volume 57, Number 14. Deaths: Final Data for 2006. April 17, 2009.

Dearborn JL, McCullough LD. Perception of Risk and Knowledge of Risk Factors in Women at High Risk for Stroke. Stroke. 2009;40:1181-1186.

*Incidence rate of stroke in African Americans is almost double that of Caucasians.

African Americans suffer more extensive physical impairments.

African Americans are twice as likely to die from stroke than Caucasians.

Unfortunately, African Americans have disproportionately high incidence of risk factors for stroke, including:> Hypertension> Diabetes> Obesity> Smoking> Sickle cell anemia

References: American Heart Association. Heart Disease and Stroke Statistics 2010 Update At-a-Glance. At: http://www.americanheart.org/presenter.jhtml?identifier=1200026.

Perry HM, Roccella EJ. Conference report on stroke mortality in the southeastern United States. Hypertension. 1998;6:1206-15.*Higher incidence among Mexican Americans than Caucasians.

Mexican Americans are at increased risk for all types of stroke and TIA at younger ages than Caucasians.

Spanish-speaking Hispanics are less likely to know stroke symptoms than English-speaking Hispanics, African Americans and Caucasians.

References: American Heart Association. Heart Disease and Stroke Statistics 2010 Update At-a-Glance. At: http://www.americanheart.org/presenter.jhtml?identifier=1200026.*Seeing a disease in the news always brings greater attention to it. Prominent people who have experienced strokes include:

U.S. Presidents Gerald Ford, Thomas Jefferson, Woodrow Wilson, Warren G. Harding, Franklin Delano Roosevelt, Dwight Eisenhower, Richard NixonSuper Bowl player Teddy BruschiActors Sharon Stone, Della Reese, Kirk Douglas and Robert GuillaumeEntertainers Luther Vandross and Roy Horn of Siegfried & RoyCosmetics entrepreneur Mary Kay AshComics artist Charles SchultzSports commentator Harry CarayNovelist Charles DickensFormer New York City Mayor Ed KochMajor league baseball player Ted Williams

References:National Stroke Association. The Complete Guide to Stroke. 2003. At: http://www.stroke.org/site/DocServer/NSA_complete_guide.pdf?docID=341.

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A stroke occurs when a blood clot blocks a blood vessel or artery, or when a blood vessel breaks, interrupting blood flow to an area of the brain. When a stroke occurs, it kills brain cells in the area surrounding where the clot or breakage occurrs.

There are 2 types of stroke:1. Ischemic Strokes can occur two ways and are the most common, accounting for approximately 87% of strokes. Embolic: Clot travels to the brain from another part of the body Thrombotic: Clot develops in an artery

2. Hemorrhagic Stroke is a second type of stroke which occurs when a blood vessel in the brain breaks or ruptures. While hemorrhagic stroke is less common, its more deadly.

References:American Heart Association. Heart Disease and Stroke Statistics 2010 Update At-a-Glance. At: http://www.americanheart.org/presenter.jhtml?identifier=1200026.

National Stroke Association. The Complete Guide to Stroke. 2003. At: http://www.stroke.org/site/DocServer/NSA_complete_guide.pdf?docID=341.

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The term Brain Attack is the most descriptive and realistic description of a stroke. It also provides a powerful call to action.A brain attack should warrant the same degree of emergency care as a heart attack. After all, your brain is your mind and your bodys most vital and delicate organ.Immediate response is crucial because every minute matters from the time symptoms first become noticeable to the time treatment is received, more brain cells die. In other words TIME IS BRAIN. The best thing to do is to call 911 for immediate assistance. Treatment is available and some options are most effective if administered within the first three hours after experiencing symptoms.Your chances of walking out of the hospital with little to no disability are greatly improved if you receive appropriate treatments early.Unfortunately, it takes the average American 12 to 24 hours to get to the hospital after experiencing the first stroke symptom. This is why its important that everyone learns how to RECOGNIZE stroke symptoms and how to RESPOND.


Lichtman JH, Watanbe E, et al. Hospital Arrival Time and Intravenous t-PA Use in USAcademic Medical Centers, 20012004. Stroke. 2009;40:00-00.

*So how do you know if someone is having a stroke?The most common stroke symptoms are: Sudden numbness or weakness of face, arm or leg, especially on one side of the body Sudden confusion, trouble speaking or understanding Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden severe headache with no known cause

If you see someone having these symptoms or experience any of these symptoms yourself, Call 911 immediately.

Appropriate treatment can be more effective if given quickly. Every minute matters!

References: National Stroke Association. The Complete Guide to Stroke. 2003. At: http://www.stroke.org/site/DocServer/NSA_complete_guide.pdf?docID=341.

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One way to help remember the symptoms of stroke and what to do, is to learn the Face, Arms, Speech Test, otherwise knows as F.A.S.T.:

F = Face: ask the person to smile do both sides of the face move equally? (Normal) Or does one side of the face not move at all? (Abnormal)

A = Arm: ask the person to raise both arms do both arms move equally? (Normal) Or does one arm drift downward compared to the other? (Abnormal)

S = Speech: ask the person to speak a simple sentence Does the person use correct words with no slurring? (Normal) Or do they slur their speech, use inappropriate words or is unable to speak at all? (Abnormal)

T = Time: to call 911 if you observe any of these symptoms, call 911 immediately. Every minute matters!

References: National Stroke Association. The Complete Guide to Stroke. 2003. At: http://www.stroke.org/site/DocServer/NSA_complete_guide.pdf?docID=341.

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TIAs transient ischemic attacks are a serious warning of an impending stroke.TIA symptoms are the same as for stroke.TIAs are brief episodes of stroke symptoms that resolve within minutes or hours, unlike stroke symptoms which can last longer. Up to 40% of all persons who experience a TIA will go on to have a full stroke. - Within two days of a TIA, 5% of patients will have a stroke - Within 90 days of a TIA, 10% to 15% will have a stroke Management of TIAs focuses on preventing a future stroke.


Easton JD, Saver JL, et al. Definition and Evaluation of Transient Ischemic Attack: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. Stroke. 2009;40:2276-2293.

*There are many misconceptions about stroke.

Myths vs. Realities:

Stroke is not preventable up to 80% of strokes are preventable. Well discuss steps you can take to reduce stroke risk in a minute.

Stroke cannot be treated - Stroke can be treated, but requires emergency treatment. Call 911 immediately if you experience or see someone with stroke symptoms.

Stroke only strikes the elderly - Anyone of any age can have a stroke.

Stroke is like a heart attack - Stroke is a Brain Attack.

Stroke recovery ends after 6 months - Stroke recovery can continue throughout a survivors life.

References:National Stroke Association. The Complete Guide to Stroke. 2003. At: http://www.stroke.org/site/DocServer/NSA_complete_guide.pdf?docID=341. *

The cost of stroke: Direct and Indirect costs are estimated at more than $73 billion a year. The estimated direct and indirect cost of stroke is 73.3 billion in 2010

Direct costs make up over 60% of this total and include things like Hospital, Nursing Home, Physicians/Other Professionals, Drugs/Medical, Home Health Care

Indirect costs make up nearly 40% of the total and include things like Lost Productivity and Mortality

References:American Heart Association. Heart Disease and Stroke Statistics 2010 Update At-a-Glance. At: http://www.americanheart.org/presenter.jhtml?identifier=1200026.

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Many strokes are preventable if you pay attention to pre-existing medical conditions and control lifestyle factors such as diet and exercise.

National Stroke Association recommends the following public stroke prevention guidelines.

References:Gorelick PB. Stroke Prevention. Arch Neurol. 1995;52: 347-355. At: http://archneur.ama-assn.org/cgi/content/abstract/52/4/347.

Gorelick PB, Sacco RL, et al. Prevention of a first stroke: a review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. JAMA. 1999;281:1112-20. At: http://www.stroke.org/site/PageServer?pagename=PREVENT.

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1. Know your blood pressure. Have it checked at least annually. If its elevated, work with your doctor to keep it under control. Having high blood pressure, or hypertension, increases stroke risk four to six times.

2. Find out if you have atrial fibrillation a type of irregular heartbeat. If left untreated, AF can increase stroke risk four to six times. Should we talk about coumadin being the best treatment if there are no risk factors?

3. If you smoke, stop. Smoking doubles stroke risk.

References: Gorelick PB, Sacco RL, et al. Prevention of a first stroke: a review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. JAMA. 1999;281:1112-20. At: http://www.stroke.org/site/PageServer?pagename=PREVENT.

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4. If you drink alcohol, do so in moderation. Recent studies have suggested that modest alcohol consumption (up to two glasses of wine or the alcohol equivalent) may reduce stroke risk. If you dont drink, dont start.

5. Find out if you have high cholesterol. High cholesterol can indirectly increase stroke risk by putting people at greater risk of heart disease. Talk to your doctor if your total cholesterol is higher than 200 mg/dL or if you LDL cholesterol is higher than 100 mg/dL.

6. If you are diabetic, follow you doctors recommendation carefully to control your diabetes. People with diabetes have a significantly higher stroke risk. This may be related to circulation problems that diabetes can cause.


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7. Incorporate physical activity that you enjoy into your daily routine. Active people tend to have lower cholesterol levels. Regular exercise also seems to slow down or stop clogging of blood vessels.

8. Enjoy a low-sodium (salt) and low-fat diet. Too much salt may contribute to high blood pressure and make it more difficult to control. A diet that is low in fat will likely include vegetables, lean meats such as chicken and fish, low-fat dairy products and a limited number of eggs.

9. Ask your doctor if you have circulation problems which increase your risk for stroke. If you do, work with your doctor to control this condition.

10. If you experience any stroke symptoms, seek immediate medical attention by calling 911. Every minute matters!


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Many people dont recognize stroke symptoms. A 2001 National Stroke Association survey reported that many older Americans could not identify stroke symptoms. A 2009 study revealed that despite numerous national stroke public awareness campaigns, public knowledge of stroke symptoms and risk factors has not improved over the last 5 years.People dont want their fear of stroke to be confirmed. Stroke is one of the most terrifying medical emergencies because many people would rather die than be disabled. Yet quick confirmation of stroke is the best way to receive the treatments that are proven to greatly reduce disability after stroke.Of those surveyed, only 40 percent would call 911 immediately if they were having a stroke.Many people worried about the cost of stroke treatment, especially if they do not have health insurance. Studies show that acute treatment is significantly less expensive than the costs of extensive rehabilitation and long-term care.The survey also showed that two-thirds of respondents were unaware of the short time frame in which a person must seek treatment. Waiting to see if symptoms disappear can mean the difference between complete recovery and disability.Fear of hospitals may keep some individuals from calling 911 to get help when they experience stroke symptoms. Those who call 911 immediately when experiencing stroke symptoms are likely to have a much shorter stay in the hospital than those who wait.

References:National Stroke Association. Survivor Survey. 2001. Kleindorfer D, Khoury J, et al. Temporal Trends in Public Awareness of Stroke Warning Signs, Risk Factors, and Treatment. Stroke. 2009;40:2502-2506.*

There are two types of treatment for ischemic stroke (caused by clots):

The Clot Buster or t-PA works by dissolving blood clots that are blocking arteries. t-PA, is an enzyme found naturally in the body. The drug was approved by the Food and Drug Administration in June 1996 for treatment of stroke and can improve outcomes but can only be given within the first three hours of symptom onset.In 2004 the Merci Retriever was FDA approved. This corkscrew-like device is an option for patients ineligible for t-PA treatment. The device is threaded through a catheter up through the body to the clot in the brain. The clot is then removed, restoring the blood flow to the affected area of the brain.The Penumbra System is a new embolectomy device specifically designed to remove the thrombus in acute ischemic stroke secondary to large vessel thromboembolism. The device removes the thrombus through 2 mechanisms: aspiration and extraction.

There are also FDA-approved treatments available for hemorrhagic stroke: surgical clipping and coiling.Clipping, currently the most common treatment, involves making an opening in the skull bone and placing a metal clip across the neck of the aneurysm to stop blood from flowing into the brain.Coiling, performed since the early 1990s, involves inserting a catheter through an artery in the leg, running it through the body into the brain, and filling in the aneurysm with tiny platinum coils.

References:Kothari R, Sauerbeck L, JauchE, et al. Patients awareness of stroke signs, symptomsand risk factors. Stroke. 1997;28:1871-1875.Levitt MA, Dawkins R, Williams V, Bullock S. Abbreviated educational sessionimproves cranial computed tomography scan interpretations by emergency phsycians.Ann Emerg Med. 1997;30:616-621.Alberts MJ, Bertels C, Dawson DV. An analysis of time of presentation after stroke.JAMA. 1990; 1:65-68.NINDS rt-PA Study Group. Tissue plasminogen activator for acute ischemic stroke.New Eng J Med. 1995;333(24):1581-1587.*

Theres still so much we dont know about how the brain can seemingly repair itself from the functional damage caused by stroke. Some brain cells may be only temporarily damaged and may resume functioning. In some cases, the brain can relearn what was lost. Sometimes, a region of the brain takes over for a region damaged by the stroke. People who have had a stroke sometimes experience remarkable and unanticipated recoveries that cant be explained. General recovery guidelines show:10 percent of stroke survivors recover almost completely.25 percent recover with minor disabilities.40 percent experience moderate to severe disabilities requiring special care.10 percent require care within either a skilled-care or other long-term care facility.15 percent die shortly after the stroke.

Stroke survivors and their families can find workable solutions to most difficult situations by approaching every problem with patience, creativity and tenacity.*There are different types of Stroke Rehabilitation

Physical Therapy helps restore skills like walking and range of movement. Physical therapy works on improving partial or one-sided paralysis, faulty balance and foot drop.

Occupational Therapy involves relearning skills needed for everyday living such as eating, using the bathroom, dressing and taking care of oneself.

Speech Language Therapy helps stroke survivors that have problems with aphasia which is when stroke survivors are able to think clearly but cannot put those thoughts into words. Speech language pathologists can teach the aphasic stroke survivor and caregiver methods for coping with this frustrating condition. Speech therapy also helps stroke survivors cope with memory loss and other thought problems caused by stroke. Additionally, speech therapy treats stroke survivors with dysphasia, or swallowing problems, that could result in pneumonia if not appropriately managed.

Recreational Therapy involves regaining enjoyable skills and pastimes such as cooking, gardening, sewing and playing cards. These activities also may help stroke survivors regain some lost thinking abilities and physical capabilities.


National Stroke Association. National Stroke Association Web site. At: www.stroke.org.

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After stroke, both the stroke survivor and his/her family are often concerned about being on their own at home. Among the common issues are:Behavior: Stroke survivors needs vary depending on what area of the brain has been affected. Care-partners need to be aware of the reasons for the stroke survivors behavior, without overlooking the possibility that he or she may also be depressed.

Depression: Many survivors experience a form of depression after stroke. It can be overwhelming, affecting the spirit and confidence of everyone involved. Family can help by trying to stimulate interest in other people, encouraging leisure activities and providing opportunities to participate in spiritual activities. Chronic depression can be treated with individual counseling, group therapy or antidepressant drugs.

Emotional Liability: Sudden laughing or crying for no apparent reason and difficulty controlling emotional responses, known as emotional liability, or Pseudo Bulbar Syndrome, affects many stroke survivors. The inappropriate emotional behavior will occur randomly and end as quickly as it started.

Neglect: Some stroke survivors neglect the side of their world opposite the side of their stroke brain injury. This may impact their ability to complete some activities. Examples: eating only on one side of a dinner plate or recognizing only one side of a clock.

Memory Loss: Memory loss also called vascular dementia can be so subtle the family may not notice it at first. A stroke survivor may be anxious and cautious, needing a reminder to finish a sentence or follow-through with a behavior.

Communication Problems: If a stroke causes damage to the language center in the brain, there will be language difficulties or aphasia. Communication problems are among the most frightening after-effects of stroke for both the survivor and the family, often requiring professional help.



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Rehabilitation Unit in Hospital: Many general hospitals now offer a variety of rehabilitation services. These may include acute rehabilitation (comparable to free-standing rehabilitation facilities) and sub-acute or transitional care units (usually a skilled nursing facility is a long-term care facility.)

In-Patient Rehabilitation Facility: Patients admitted to a rehabilitation hospital must be able to tolerate a minimum of three hours of intensive therapy per day. These hospitals may also offer less intensive programs known as sub-acute rehabilitation units similar to those in long-term skilled nursing facilities.

Home-Bound Therapy: This form of rehabilitation is for patients who cannot leave their homes after discharge from an inpatient setting. A variety of therapies, along with follow-up nursing and social services, may be available. Clinicians can focus on personalized needs and unanticipated concerns for patients in this setting.



*National Stroke Association is the only national nonprofit organization dedicating 100% of its resources to reducing the incidence and impact of stroke.

National Stroke Association has established itself as a leading resource on the topics of stroke prevention, treatment, rehabilitation research and support for stroke survivors and their families through its work in:Advocating for stroke prevention and public educationProviding professional education and trainingProviding and promoting resources for stroke survivors and caregivers

References:National Stroke Association. At: www.stroke.org. *

For more information about stroke or the National Stroke Association, call toll-free at 1-800-STROKES or go to the web at www.stroke.org.

SAM Stroke Community Presentation Guide

Documents

sign of stroke

secondary stroke

types of stroke

stroke riskrespond

stroke symptomsreduce

stroke surge

stroke death rate

caucasiansmexican americans