Strokes represent a significant health concern, especially among the elderly. This guide aims to provide an in-depth understanding of strokes, from recognising symptoms and risk factors to exploring treatment options and preventive measures.
At MACG’s residential homes, we provide tailored palliative care for elderly stroke patients. Our residents are surrounded by trained medical professionals 24/7. They know how to identify strokes and take action immediately, as well as how to provide ongoing stroke recovery care.
What happens when an elderly person has a stroke?
When a stroke occurs, blood flow to a part of the brain is interrupted, depriving brain tissue of oxygen and nutrients. The type and severity of the stroke determine the immediate effects. An acute ischemic stroke, caused by a blockage or blood clot, often results in localised brain damage. On the other hand, a haemorrhagic stroke, caused by bleeding in the brain, often leads to more widespread damage.
What are the signs of a stroke in the elderly?
Recognising the early signs of a stroke can make a critical difference in the outcome for an elderly individual. Common signs include:
- Sudden numbness or weakness in the face, arm, or leg, particularly on one side of the body
- Confusion
- Trouble speaking
- Vision problems in one or both eyes
- Difficulty walking
- Dizziness, loss of balance, or coordination
- Severe headache with no known cause
These symptoms may not always be immediately recognisable, especially since they can inhibit the individual’s ability to ask for help. If you notice one or more of these symptoms, you’ll need to notify medical professionals immediately. The sooner treatment is administered, the better the chances of minimising brain damage and improving recovery outcomes.
What types of strokes are there?
There are two main categories of strokes.
1. Hemorrhagic stroke
Hemorrhagic strokes occur when a blood vessel in the brain ruptures. The bleeding starves the brain of blood, which can cause cells to die. With nowhere to go, the blood may also begin to put pressure on the brain, causing further damage.
Approximately 15% of all strokes are hemorrhagic.
2. Transient Ischemic Attack (TIA)
An ischemic stroke (sometimes referred to as a mini-stroke or an acute stroke) occurs when a blood vessel in the brain becomes blocked but doesn’t rupture. The blockage stops blood from feeding the brain, which will cause cell death.
As the name implies, TIA’s are transient — they typically only last for a few minutes before the block clears itself. These mini-strokes can be a sign that a larger, more severe stroke is about to occur, so they should be treated as a medical emergency.
The role of blood clots in strokes
Blood clots play a crucial role in many strokes, particularly ischemic strokes. These clots can form in arteries, blocking blood flow to the brain and causing brain cells to die.
Different types of blood clots can lead to a stroke, including thrombotic clots, which form in arteries supplying blood to the brain, and embolic clots, which form elsewhere in the body (often the heart) and travel to the brain, causing a blockage.
Risk factors for strokes in the elderly
Several risk factors increase the likelihood of strokes in the elderly. Understanding these factors can aid in prevention and early intervention.
Age significantly increases the risk of stroke, as does gender, with men being at higher risk than women, although women are more likely to die from strokes. A family history of strokes can also elevate the risk.
Additionally, health conditions such as hypertension, diabetes, high cholesterol, and heart disease play significant roles in increasing stroke risk.
Lifestyle factors including smoking, excessive alcohol consumption, a sedentary lifestyle, and an unhealthy diet are also critical contributors.
High blood pressure and strokes
High blood pressure, or hypertension, is a leading cause of strokes. It damages arteries, making them more likely to clog or burst, which can lead to ischemic or haemorrhagic strokes.
Managing blood pressure is essential for stroke prevention. Strategies to control high blood pressure include regular monitoring of blood pressure readings, taking antihypertensive drugs, and adopting lifestyle changes such as a healthy diet, regular exercise, reducing salt intake, and avoiding tobacco.
What to do when an elderly person has a stroke
If an elderly person shows signs of a stroke, immediate action is essential. Here’s what you need to do:
- First, call emergency services as time is crucial.
- Keep the person calm and comfortable by laying them down with the head slightly elevated.
- Note the time when symptoms first appeared, as this information helps medical professionals determine treatment.
- Avoid giving food or drink to prevent choking.
- Wait for emergency services to arrive.
Post-stroke recovery in the elderly
Recovery after a stroke varies significantly among individuals. Here’s an overview of the recovery process.
Stabilisation
The journey to recovery begins with medical stabilisation, which involves immediate medical intervention to prevent further strokes and stabilise the patient's condition. This critical phase includes addressing the acute symptoms and mitigating any immediate life-threatening complications.
Rehabilitation
Following stabilisation, the focus shifts to rehabilitation, a vital part of the recovery process. Rehabilitation aims to help patients regain as much functionality as possible. This often involves a multidisciplinary approach, including physical therapy to improve mobility and strength, occupational therapy to assist with daily activities, and speech therapy to address any communication or swallowing difficulties that may have resulted from the stroke.
Medication
Medications play a crucial role in the post-stroke recovery phase. They are used to manage and control factors that could lead to another stroke. For instance, antihypertensive drugs help control high blood pressure, which is a major risk factor for both ischemic and haemorrhagic strokes. Blood thinners and antiplatelet medications are prescribed to prevent the formation of new blood clots. Statins may be used to manage high cholesterol levels, further reducing stroke risk.
Lifestyle changes
Lifestyle adjustments are equally important in supporting recovery and preventing future strokes. Adopting a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins can help manage weight, cholesterol levels, and blood pressure. Regular physical activity tailored to the patient's abilities not only aids in physical recovery but also improves overall cardiovascular health. Smoking cessation and limiting alcohol intake are critical changes that can significantly reduce the risk of another stroke.
Ongoing checkups
Moreover, continuous monitoring and follow-up with healthcare providers are essential to manage any ongoing health issues and to adjust treatment plans as necessary. Support from family members and caregivers is also crucial, as emotional and psychological support can significantly impact the recovery process. In some cases, joining support groups or engaging in counselling can help stroke survivors and their families cope with the challenges of recovery.
The severity of the stroke plays a critical role in the recovery process; minor strokes may allow for a full recovery, whereas severe strokes can result in long-term disabilities. Additionally, the overall health of the individual significantly impacts recovery outcomes, with healthier individuals often recovering more quickly. Access to comprehensive care and rehabilitation services is also crucial, as high-quality care and targeted rehabilitation programs can greatly enhance recovery prospects.
What to expect in the hospital
Upon arrival at the emergency room, healthcare professionals will thoroughly assess the patient’s condition. This assessment typically involves the use of the NIH Stroke Scale to evaluate the severity of the stroke by examining various neurological functions. The goal is to determine the extent of the reduced blood flow to the brain and to identify the specific areas of brain tissue affected.
For ischemic strokes, which are caused by a blocked artery, medical professionals may administer thrombolytic therapy to dissolve the clot and restore blood flow to the brain. In some cases, a procedure called a carotid endarterectomy may be performed to remove plaque buildup in the carotid artery, thereby preventing future strokes. If the stroke is haemorrhagic, caused by bleeding in the brain, immediate surgical intervention may be necessary to relieve pressure and address any bleeding complications.
The patient will be closely monitored in the hospital to manage factors for stroke and to prevent further complications. This monitoring includes controlling high blood pressure, managing diabetes, and addressing high cholesterol levels. Continuous observation is essential, as the risk increases for subsequent strokes and other health issues, such as a heart attack.
Occupational therapists focus on helping the patient regain independence in daily activities, while physical therapists work to restore mobility and strength. Speech therapists are involved if the stroke has affected the patient's ability to communicate or swallow.
Family members play a vital role during this time, providing emotional support and assisting in the decision-making process regarding the patient’s care. Healthcare professionals will also educate the patient and their family on how to prevent future strokes through lifestyle changes and medication management.
By understanding what to expect in the hospital, patients and their families can be better prepared for the road to recovery. This section should be added after the "Immediate Steps When an Elderly Person Has a Stroke" section to provide a logical progression from the initial emergency response to the detailed hospital care process.
In summary…
Understanding strokes in the elderly, from symptoms to treatment and prevention, is crucial in managing this serious health condition. By staying informed and proactive, you can help ensure the well-being of elderly individuals at risk of or recovering from a stroke.
If you’re ready to book yourself or a loved one into our stroke palliative care, please don’t hesitate to call us.
FAQs about strokes
Life Expectancy After a Stroke
The prognosis for elderly stroke survivors varies. Key factors include the type and severity of the stroke, the age and overall health of the individual, and the quality of post-stroke care and rehabilitation. On average, about 50% of elderly stroke survivors live beyond five years post-stroke.
What Causes Strokes in the Elderly?
Understanding the causes helps in prevention. Common causes of strokes in the elderly include high blood pressure, which damages blood vessels; atherosclerosis, which leads to the narrowing of the arteries due to plaque buildup; and heart diseases, such as atrial fibrillation, which can lead to blood clots. Diabetes also increases the risk of both ischemic and haemorrhagic strokes. Lifestyle factors such as smoking, poor diet, and physical inactivity are also significant contributors.
Causes of Mini Strokes (TIAs) in the Elderly
Mini strokes or TIAs are caused by temporary blockages in blood vessels supplying the brain. They serve as warning signs for more severe strokes. Common causes of mini-strokes in the elderly include blood clots, which are temporary clots that dissolve on their own and narrowed blood vessels due to atherosclerosis.
Are Mini Strokes Common in the Elderly?
Yes, mini-strokes are relatively common in the elderly. They should be taken seriously as they indicate an increased risk of a full stroke. Recognising the symptoms of TIAs can help prevent a major stroke. Symptoms to watch for include temporary weakness or numbness, often on one side of the body, brief periods of confusion or speech difficulties, and temporary vision problems.
