A stroke, also known as a cerebrovascular accident (CVA), occurs when there is a disruption of blood flow to the brain, leading to damage or death of brain cells. Strokes are medical emergencies that require immediate intervention to minimize brain damage and prevent long-term disability or death.
There are two main types of strokes:
- Ischemic Stroke: This type of stroke occurs when a blood clot or plaque buildup blocks or narrows an artery supplying blood to the brain. Ischemic strokes account for the majority of stroke cases, and they can be further classified into thrombotic strokes (caused by a clot forming in an artery supplying blood to the brain) or embolic strokes (caused by a clot that travels from another part of the body and lodges in a brain artery).
- Hemorrhagic Stroke: Hemorrhagic strokes occur when a weakened blood vessel in the brain ruptures and causes bleeding into the surrounding brain tissue. This type of stroke can result from conditions such as high blood pressure (hypertension), aneurysms, arteriovenous malformations (AVMs), or trauma.
Impaired Swallowing and Impaired Verbal Communication
Impaired Swallowing
Impaired Swallowing is one of the health problems caused by stroke. Usually the patient shows symptoms of choking when eating and drinking, rice out of the nose, is not able to control the discharge of saliva from the mouth (drool), take a long time to eat, and the food left in the mouth after eating.
Where possible as well as eat in a sitting position, but if can not sit, can be arranged in a sitting position leaning 60-90 degrees. When the patient swallows, instruct the patient to bend neck and head in order to facilitate the closing of the airway when swallowing. At the time of swallowing instruct the patient turning heads / look to the weak side. Use a small spoon and place the food on the healthy side. Make sure the food has been swallowed all before the next feeding. Keep the patient still sitting upright half an hour after eating. Make sure the patient's mouth was empty, there was no leftover food that has not been ingested after the meal is finished. Clean the patient's teeth and mouth after eating.
The food was given in stages, starting with the semi-solid food or soft consistency, then gradually down to liquid form. Avoid the use of glasses, and drinking straws at the beginning of the exercise, because it can cause the patient to choke. The symptoms of choking due to the muscles of the tongue and mouth coordination is not good, or because of the malfunctioning of swallowing center in the brain. So it is better to use a small spoon and place the food on the healthy side.
Impaired verbal communication
In general aphasia is divided into three types, namely motor aphasia, sensory aphasia, and global aphasia.
Patients with motor aphasia is characterized by the inability of the patient to disclose or express words, but the patient understand what the other person is saying.
In contrast, sensory aphasia not understand the speech of others but can get the words out. As a result of sensory aphasia patients seen not connect when spoken to, because the brain is not able to interpret the speech of others despite good hearing.
Meanwhile, when extensive brain damage and attack the center of the expression and understanding speech center in the left brain, the patient will experience a global aphasia. Patients are not able to understand the speech of others, and are not able to express in words.
That must be understood by nurses is that aphasia patients still need the opportunity to hear other people talk normally. If we ignore the stroke patients who suffered from aphasia, for example, silence or considered as if the patient does not understand our conversation, then the patient will feel frustrated and hurt.
While talking with aphasia patient, keep our face, facing straight into the face of the patient. This will help the patient to see the lips and our facial expressions. Try to use short sentences and give emphasis to the important word. If possible, use facial expressions, body movement, and rhythm sound so that the patient can understand our words.
If the patient does not understand our words, try to pronounce the sentence which means the same. Encourage and give the patient the opportunity to communicate in total, ie by using facial expressions and body movements. Do not worry if the patient gives the answer is less clear.
In order to understand the speech of patients, should we listen carefully and pay attention to key words, then figure out what you want to convey patients. Do not be angry if we guess wrong, apologize and instruct the patient to repeat the words.
To help patients understand the speech of others, try to speak slowly, calm, normal tone of voice, do not shout. Use adult language, short sentences and provide a visual stimulus if possible.
Motor aphasia patients often feel frustrated, because, not being able to express what he wants, so that patients angry or tantrums. One attempt to overcome that by using a communication board that contains a picture or symbol of the daily activities of patients. To keep in mind that this communication board is not used to train but as a communication medium in anticipation of a difficult patient wishes us to understand, so that the patient is not frustrated. To speed recovery, aphasia patients should practice with a speech therapist on a regular basis at least 2 times a week.
CONCLUSION:
Aphasia patients is frustrating not being able to express his desire to others, needed the support of people around him to train communication.
Difficulty swallowing in stroke patients can be trained by feeding stages of semi-solid to liquid and eating properly to avoid aspiration of food into the airway.
ADVICE:
Nurse and the patient's family synergize to provide training support to patients aphasia and swallowing disorders in stroke patients, in order to smooth communication and nutrients are met.
