Hidden effects after a stroke

You were admitted to the neurological department due to a stroke (blood clot or brain haemorrhage).

International studies show that hidden effects after a stroke can have a great influence on the extent that one can resume daily activities including work.

During hospitalization you were appraised by an occupational therapist, who, amongst other things, assessed whether you had one or more hidden effects, and you both have determined whether there is any need for further rehabilitation.

Experience shows however that individuals can experience signs of hidden effects of a stroke when everyday activities (work, housework, leisure activities and social activities) are resumed.

Have you experienced difficulties resuming your usual activities?

In the unlikely event that you or any of your relatives experience any problems with resuming everyday activities on the same level as before you were admitted, you can contact the occupational therapist at the hospital within one month after being discharged, latest by: date___________________________

On the basis of telephone conversations and consultation with you, she will reassess your needs and set up appropriate measures for your rehabilitation.

Who you can contact

Occupational therapist: __________________________

Tel: 6541 2461 between 12.00 noon and 1.00 pm

Examples of hidden effects

Mental and physical fatigue

This can manifest itself in terms of you becoming tired more quickly whilst carrying out activities, having less stamina and taking longer to complete tasks that you used to perform faster.

It can affect you in a social context, for example you may need to go home earlier or take a few days to recover. It can be difficult for others to understand your fatigue and they may interpret it as laziness.

Impaired memory

Memory problems have many aspects. You may feel that it is difficult learning new things and remembering appointments. It may also be difficult to remember details of conversations that you have just had. You could also experience memory loss for a limited period of time.

Impaired attention span and concentration

You may find it difficult to pay proper attention to things you are dealing with, to shift attention an to deal with more than one thing at a time.

Impaired overview and planning ability

You may have difficulties managing your daily routine, keeping track of engagements and/or finishing tasks. Perhaps you start to do too many things at once and therefore lose sight of the whole picture. Even small changes in your daily routine can lead to stress and frustration if you do not have a proper overview of things.

Impaired initiative

This can manifest itself in terms of you finding it difficult to get started on things. You might become passive and feel the need for others to initiate things for you.

Perception of sensory input

All forms of sensory input sound, sight, smell, touch etc can seem different than before. For example, you may find that loud noise irritates you more than it used to, perhaps you find touch uncomfortable or painful.

Emotional life

Emotional changes can be due to a psychological reaction to your new life situation, whilst other changes may be due to changes in the brain. Perhaps you experience increased irritability, loss of control of your feelings (laughing/crying), or you feel carefree/indifferent and/or a greater fear of having another stroke.

Depression

Research indicates that up to 50% of stroke victims are affected by depression. This can both be due to a psychological reaction to your new life situation, as well as other changes in the brain.

Language

Perhaps you will experience that you are unable to formulate complex sentences orally, for example regarding work, whereas you can communicate normally when it involves everyday speech. You may also find it difficult to express yourself in writing.

Cognitive flexibility

You might find it difficult to manage change and might become fixed in certain routines and solutions even when the requirements of your surroundings have changed.

Problems with wakefulness/arousal

You might find that you have very Little energy or even the opposite too much energy. Too little arousal can be confused with fatigue, but it is a more basic underlying problem, which cannot be solved by more sleep. Too much arousal manifests itself in, for example, restlessness and difficulty in concentrating.

Visual disturbances

You may experience increased dizziness, headaches or difficulty with reading (not difficulty understanding what you read but physical difficulties), as well as experiencing that your do not function properly together or get tired very quickly. If you experience any of these symptoms it would be advisable to see an ophthalmologist.