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Excerpt from “Behavior Changes After Stroke,” appearing in the Stroke Connection Magazine January/February 2005

Of all the areas of life that stroke affects, its impact on the survivor’s personality may be the most difficult for family and friends to understand and become accustomed to. “Emotional changes are typical after any type of stroke,” says Dr. Janet Spradlin, a rehabilitation psychologist at St. Anthony Rehabilitation Center in Oklahoma City. “Depression is very common after any life-changing health challenge, especially if it means a loss of independence.”

While depression is the most common emotional change after stroke, other psychological changes can be equally debilitating or frustrating.

Cognitive Challenges

Cognitive deficits are changes in thinking, like difficulty solving problems. This category also includes dementia and memory problems, as well as many kinds of communication challenges. Read more about cognitive challenges.

Personality Changes

Some survivors experience apathy and don’t seem to care about anything. “People often mistake this for depression because survivors are content to sit and stare at the wall all day,” says Dr. Spradlin. “The best response is to get them active and moving. Give them a choice of what to do or where to go, but make it clear they have to choose to do something, they can’t just lie in bed.” Read more about personality changes.

Behavior Intervention Tips

Contributed by Dr. Janet Spradlin, St. Anthony Rehabilitation Center, Oklahoma City

Guidelines to help the stroke survivor who may be demonstrating inappropriate or unsafe behaviors:

Always treat the person with respect and listen to his or her side of the story

Offer praise when the person is exhibiting appropriate and safe behaviors (e.g., “You really handled that situation well, I’m so glad you decided to take the bus rather than drive…..”).

Allow the person to choose among appropriate and safe choices (e.g., “Do you want me to drive you, or would you rather take a cab?”).

Be assertive and set necessary limits. Explain your concerns and feelings in a supportive way (e.g., “I know you want to use your power tools, but I care too much about you to let you use them at this time.”).