Right- and Left-brain strokes: Tips for the CaregiverAfter stroke, behavioral changes can vary and are based on the stroke’s severity and the part of the brain in which the stroke occurs. Left-brain injury and right-brain injury are discussed. Show
The largest portion of the brain — the cerebral cortex — has two halves (hemispheres). The right hemisphere of the brain controls cognition (thinking), emotions, and spatial orientation (sense of body position). The left hemisphere of the brain controls a person’s expressive language skills (ability to talk) and receptive language skills (ability to understand what others are saying). Right-brain stroke and communication difficultiesRight-brain communication difficulties may be hard to notice at first. These difficulties can include poor attention and decreased perception. A right-brain stroke survivor may have a hard time with processing information (visual and verbal) and decreased cognitive (thinking) skills such as poor judgment, short attention span, and short-term memory loss. Caregivers can take steps to help stroke survivors deal with limitations of right-brain injury, once their limitations are recognized. The following are some tips:
Stroke survivors with right-brain injuries frequently have speech and communication problems. Many of these individuals have a hard time pronouncing speech sounds properly because of the weakness or lack of control in the muscles on the left side of the mouth and face. This is called “dysarthria.” Left-brain stroke and communication difficultiesLeft-brain stroke survivors may experience communication problems and paralysis (loss of use) on the right side. Communication problems can affect the survivor’s receptive abilities (understanding) or expressive abilities (getting the words out). This is referred to as “aphasia.” They may also have slurred speech from the right sided face and/or mouth weakness which is referred to as “dysarthria.” When communicating with a stroke survivor who has communication problems (aphasia), it is helpful to:
Stroke survivors may have difficulty with their communication skills following a stroke. Communication problems can be classified into two basic categories: aphasia and motor speech disorders. AphasiaSimply defined, aphasia is the loss of ability to communicate normally resulting from damage, typically to the left side of the brain, which houses the communication center. The condition can affect a person's ability to understand what is being said to them or asked of them (auditory comprehension). Aphasia may also affect the ability to read, write, and deal with numbers. Your speech pathologist can provide you with additional information on aphasia and motor speech disorders. Motor speech disordersSome stroke survivors may have slurred or garbled speech as a result of muscle weakness (dysarthria) or difficulty with motor programming and coordination of the speech muscles (apraxia). A speech-language pathologist may be asked to assess the patient’s communication skills and discuss with the family ways to help improve communication with the stroke survivor. The speech-language pathologist will also recommend any further follow-up after discharge from the hospital. Additional information regarding aphasia can also be obtained from the following websites:
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enews More health news + infoWhich nursing action would be most helpful in promoting communication in a patient experiencing aphasia?Give them time to speak. Resist the urge to finish sentences or offer words. Communicate with drawings, gestures, writing and facial expressions in addition to speech. Confirm that you are communicating successfully with “yes” and “no” questions.
Which of the following terms related to aphasia refers to the inability to perform previously learned purposeful motor acts on a voluntary basis?Apraxia is inability to execute purposeful, previously learned motor tasks, despite physical ability and willingness, as a result of brain damage. Diagnosis is clinical, often including neuropsychologic testing, with brain imaging (eg, CT, MRI) to identify cause.
Which term refers to the failure to recognize familiar objects perceived by the senses?Agnosia is a rare disorder whereby a patient is unable to recognize and identify objects, persons, or sounds using one or more of their senses despite otherwise normally functioning senses. The deficit cannot be explained by memory, attention, language problems, or unfamiliarity with the stimuli.
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