A cerebrovascular accident (CVA) is also known as a “stroke”. It may occur suddenly or over a period of time as a result of diminished blood supply to the brain (repeated TIAs). The person can suffer from impaired communication and sensory, perceptual, and motor function. Factors that predispose the elderly to strokes are arteriosclerosis and heart disease.
The signs and symptoms can be subtle; they include the following :
- Little memory lapses
- Sudden numbness in an extremity
- Difficulty in swallowing or speaking
- Some loss of vision in one eye
- Finding oneself on the floor, unable to get up, and not remembering the fall
Severe signs and symptoms follow occlusion of a large vessel; these are hemiplegia, quadriplegia, incontinence, sensory losses, and the major visual problem of being able to see only half of everything in the visual field.The treatment depends on the symptoms and begins with assessing the damage. The patient can be in various stages of paralysis and helplessness. Long-term treatment can involve total care, speech therapy, and physical therapy. Visual retraining is often required. The rehabilitation period following a major stroke is long and intense. Family education and support are essential to the success of the program. The American Heart Association and the Sister Kenny Institute have a wealth of information on strokes, self-help, and rehabilitation.
Reference :
Farrell J : Nursing Care of the Older Person, J.B. Lippincott Company, Philadelphia, 1990.
