Family rehabilitation guidance for stroke patients

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After surviving hospital treatment, patients with stroke often leave some obstacles such as exercise, feeling and language. Due to various factors, they can not receive rehabilitation treatment in hospital for a long time. It is an effective and effective method to carry out family rehabilitation after discharge. . Pay attention to the following points in family rehabilitation:

   First, attach importance to psychological counseling

Due to hemiplegia or aphasia, stroke patients can't take care of themselves in daily life. They often show depression, sorrow, inferiority and other psychological states, and their personality becomes violent. Family members should give more love and understanding, meet their psychological needs, and try their best to eliminate the pessimism of patients. When the family talks, they try to smile, softly whisper, and be cautious. Give the patient enough confidence and strength. Department of Rehabilitation, First Affiliated Hospital of Xiamen University

   Second, pay attention to early rehabilitation exercise

After the onset of many stroke patients, they think they should be in bed, all life is taken care of by others, and they are even more reluctant to exercise. A considerable number of patients have less severe hemiplegia, but they are highly dependent. They do not pay attention to rehabilitation in the early stage and cause severe physical function impairment in the late stage. Clinical trials have shown that when the human body rests in bed for two weeks, the muscle strength is reduced by 40% , and bone atrophy, joint contracture, orthostatic hypotension, and decreased heart reserve capacity may occur, and mental disorders may also be caused, especially in elderly patients. This disuse syndrome occurs. Early rehabilitation exercises can reduce the occurrence of sequelae. Therefore, brain stroke rehabilitation should be done sooner or later. Generally, after the vital signs such as breathing, heartbeat, and blood pressure are stabilized, the family can turn over, massage, and passively move the patient until the active exercise resumes. The patient can then perform bed movement training, bed movement training, sit-up training, sitting balance training, and the like. Once the patient has the ability to balance the position, he can begin to move from bed to wheelchair and from wheelchair to bed. Gradually carry out walking, upper limb functional exercise and daily living ability training to lay a good foundation for standing in the future.

   Third, pay attention to daily life ability training

It includes diet, washing, dressing, self-care, bathing, housework and walking, and must be taken care of during training. For example, housework ( cooking, cleaning, child care and family affairs management ) , use of home appliances and devices ( key unlocking, switch lights, doors and windows, household appliances, etc. ) , communication skills ( hand writing, reading, using the phone and Recorders, etc. ) , transportation, and various entertainment activities can also achieve good rehabilitation results. It is worth reminding that the training focus should be placed on the affected limb. Some patients and their families are inclined to exercise on the healthy side during training, ignoring the affected side. The correct way is to start from the affected side, which is beneficial to the blood circulation of the affected limb and prevent the muscle ligament from contracting.

   Fourth, strengthen diet conditioning

Patients with stroke should follow the principle of “ three lows, two highs and two highs ” , namely low calorie, low fat, low cholesterol, moderate amount of carbohydrates, moderate amount of protein, high dietary fiber, and high vitamin diet. Do not eat too much, do not drink a lot, eat more foods rich in vitamins, such as fresh fish, fresh eggs, vegetables, etc., to enhance the body's resistance, and help the body to recover. At the same time, because the patient stays in bed for a long time, the skin is prone to acne due to moisture, friction and the like. At this time, patients should be given a high-protein diet, especially vitamin C and cod liver oil, zinc gluconate, etc., to promote wound healing. To ensure adequate drinking water. Insufficient drinking water will increase blood viscosity in the body. Drinking one or two cups of boiled water on an empty stomach in the morning can reduce the viscosity of the blood and dilate the blood vessels, so as to improve the body's metabolism and reduce thrombosis.

   Five, pay attention to sleep

In the patient's room, the air should be circulated, keep the indoor air fresh, and when the weather changes, the patient should pay attention to add and remove clothes to prevent colds. The patient's sleeping position should be in the lateral position, which is conducive to the discharge of respiratory and oral secretions to prevent aspiration pneumonia. When lying on the side, pay attention to the affected limb. In order to avoid hemorrhoids, it is best for the patient to sleep in an inflatable bed, a water-filled bed, etc., pay attention to turning over every 2 hours, which is the most effective and convenient measure to prevent hemorrhoids. Each time you turn over, pat the patient's back to help drain the sputum, but be careful not to rub the patient's skin against the bed surface when turning over.

   6. Pay attention to language rehabilitation training

For those who are aphasia, oral training and written language training are required to train the patient to use the throat to pronounce, or to induce a pronunciation by coughing or blowing with a mouth. With the pronunciation and speaking of the family, it should be easy to difficult, from short to long, step by step, the content should be suitable for the patient's interest, as far as possible in connection with daily life. The patient should also be allowed to watch TV, listen to the radio, etc., giving auditory and visual stimulation.

   Seven, pay attention to protect the joints

If cerebrovascular disease causes more severe hemiplegia, the patient often needs to stay in bed for a long time, which will lead to joint damage of the limbs, mainly due to the atrophy of the limb muscle weakness, which relaxes the muscles and ligaments around the joint. The protection and fixation of the joints are weakened, resulting in dislocation of the joints, arthritis, and the like. There are also some patients, because of cerebrovascular disease, how many limb dysfunctions remain, even if they can return to walking, but due to poor limb strength, walking or abnormal walking posture, resulting in excessive wear of the hemiplegic knee and ankle joint, resulting in Joint damage or bone hyperplasia, rigidity and joint pain. Therefore, patients with cerebrovascular disease should pay attention to protecting the joints in the early stage: on the one hand, pay attention to moderate activities, on the other hand, the joints can be fixed in the normal posture to avoid dislocation. For the rehabilitation of patients with hemiplegia, the rehabilitation exercise should also be moderate. Excessive increase in the amount of exercise of the paralyzed limbs can also cause pain in the affected limbs. In this case, the patient needs to rest or take physical therapy, or take an analgesic to relieve pain.

 

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