Signs of Sadness

[dfebner]

My father is really starting to stabilize and we are seeing light to move him into rehab soon; however, today though he seemed to have one of the most alert and best days from a overall health perspective, he seemed more annoyed and unhappy. I know that there are risks of depression and tomorrow will be 3 weeks in the hospital since this began, but I was wondering if there are some things we should/should not do to help the situation.

 

I would hate for him to lose motivation to rehabilitate just as we start to see some signs that this could be imminent. This was quite a massive stroke and he will really need a lot of will and focus to regain any ability to use right side, walk and speak.

 

The one thing I'm wondering is that they finally inserted a feeding tube in stomach and were feeding him that way and had to stop yesterday due to signs of infection around the tube. I don't know if this can be just knowing more what is going on and being frustrated about things continuing to set him back. I know that he still gets a lot of friends and family in the hospital and we all tend to talk about things often as if he is not there and I'm thinking that may be very frustrating to him as well. Any thoughts you have that I can pass on to others to ensure we are doing the right things for him would be appreciated.

 

Thanks.

[bstockman]

Hi, Your dad may be coming more aware now. It would be best if you could include him in the conversations or be aware he is there and even though he may not be able to respond he can probably hear you.

 

The infection may be making him feel bad, tired also.

 

When you talk does he respond. can you get him to blink once for yes two for no, or squeaae your hand..move a toe.. something?

 

Try to positive and supportive, once the infection is undercontrol, and he starts physical therapy, make sure you let him know.. how prod, or positive reinforcement.

 

Best wishes Bonnie

[Keepongoing]

Hi,

Glad to hear about the improvement with your father. One thing I did ask my husband was could he understand what was going on and what people were saying in the beginning. I always included him in on decisions even when he could only nod yes or no. I was not really sure he understood what was going on. but, He said he always knew what was going on. Once when Rod got a kidney infection I thought he was getting depressed too. It could be both causing the problem. Hang in there, it will get better day by day.

Lynn

[jriva]

 

 

I know that he still gets a lot of friends and family in the hospital and we all tend to talk about things often as if he is not there and I'm thinking that may be very frustrating to him as well.

 

dfebner,

 

If this were my dad, I'd pass the word to family and friends that your dad may not be able to talk but he still has ears. If they have questions about his prognosis take them out into the hallway. Or if people ask you things that wouldn't necessarily be good for your dad to hear, invite the person asking to go get a Coke or coffee down the hall with you before you answer.

 

By all means, explain things to you dad about procedures, rehab, etc. but don't talk over him as if he's not there!

 

Jean

[dfebner]

I shoud probably be clearer - we are constantly talking to him and asking him questions and telling him things...he often responds with some nods, squeezing hands, etc.

 

There are times that we talk about things - how he is doing, what the doctors say about the infection, etc. while he is there so maybe that bothers him but it's not completely things that we wouldn't expect that he should or would know...

 

Today he just seemed less interested in talking with any of us...when we told him things he wasn't really happy...didn't smile at all - often he does. That is what I am more concerned about and want to know if we shouldn't try so hard to engage him or get too down if he is not feeling up to talking with us.

[bstockman]

It could be the infection making him tired and not feel so well, he may have some discomft from it too that he is not able to say. Some antibiotics make you feel tired or queasy, not up to par.

 

I think the main concern now is the infection and getting it cleared up, he is now healing from the brain injury and also has an infection. How are they feeding him now? so I would say a combination of both, he is not feeling to great.

Bonnie

[marlen]

INITIALLY AFTER A SROKE, SADDNESS, DEPRESSION, AND FATIGUE ARE ALL PART OF THE SCENERIO. ADD AN INFECTION, AND YOU MAGNIFY THE THREE. HAVING YOUR LIFE CHANE IN A SPLIT-SECOND LIKE THIS MAKES EVERYONE SAD. BEING TIRED LASTS QUITE A WHILE, BUT THINGS DO GET BETTER.

 

MY WIFE HATES MEDICATION, BUT I WAS PUT ON AN ANTI-DEPRESSANT RIGHT AFTER MY STROKE. I STAYED ON THE PILL FOR SIX MONTHS, THEN QUIT, MY WIFE NOTICED A CHANGE IN MY DISPOSITION, AND I FOUND DEPRESSION MORE FREQUENT. SO I STARTED BACK ON THE MEDICATION AND NOTICED THE DIFFERENCE RIGHT AWAY. I'M SO DARNED NICE AND HAPPY, I CAN'T STAND MYSELF.

 

ASKED THE DOCTOR FOR A RECOMMENDATION. I'TS SO EASY FOR EVERYONE, NOT ONLY THE PATIENT, TO BE DEPRESED. KEEP THE NEGATIVE CONVERSATIONS AWAY FROM HIM, BUT AS EVERYONE HAS SAID, HE REMAINS A PART OF ALL VISITS.

 

GOOD LUCK. THERE IS LIGHT AT THE END OF THE TUNNEL.

 

MARTY

[clstrange]

It could be depression and they will put him on something. I don't know how many people visit at a time or how often, My father in law was real social and liked people around pre stroke but also enjoyed his quiet time we found that he wanted the fuss to stop and have time to rest. I am not saying not to visit by any means but maybe make sure he has some quiet time during the day for himself and to rest. We also found that my father in law hated to be talked about even if it was just what the doctor said that morning since he couldn't answer for himself and sometimes just did not want the visits to be about that. That was just my situation now that he can voice some concerns (1 yr past stroke) I think back and say ok maybe thats what was upsetting him but like most caregivers we can only learn from our situations. In our case I say thank god for the happy pill it allows him to have his old personality back evan if thats all he gets back we are fine with it as long as he is happy. Don't expect to much, take each acomplishment like thats all your gonna get and let him know your very happy with what he has done.

 

Best wishes

 

Cindy

[4mom]

Your father also may just be coming to undertand what happened to him. I think that it takes a while for it to set in. My mother was locked in (only able to move her eyes up and down, couldn't even breathe on her own) for about a week. She is 1.5 years post stroke and doesn't remember the first 2 weeks after her stroke. The doctor started my mom on zoloft for deppression right away as she has always had problems with depression and anxiety.

 

He may need reassurance that he has a chance of getting better. He may think this is it. 3 weeks must feel like forever to the patient but in stroke rehabilitaion it is like a second. This past year and a half has been the longest for me and my mom, but tell him he can't give up. Every gain is worth the work. My mom has went through spurts where she doesn't want to work anymore, and I think that everyone prob. does. Her stroke was in her brain stem and she literally lost it all. Today to a outsider they prob. don't think she has come very far, but if you think about someone that could only move her eyes to now it is a long long way.

I also told her that if she gives up then I am which means I will put her in a nursing home cause I am not busting my but for her if she isn't doing the same for me. I never would and she knows that but I don't want her to give up. There is so much hope still.

 

Don't be suprised to see your father have major mood swings such as uncontolable laughter or crying. It is a common side effect of strokes. I remember when it started with my mom it was so hard. One day we went to a educational movie about strokes where the whole rehab group was there and just out of the blue she started wailing, I say wailing cause it was so loud. Everyone turned and started staring at us. It was the only time I ever felt embarassed by her. I was so ashamed of myself for feeling that way, it was just my gut reaction. I knew it wasn't her fault and she would never want to call attention to her self like that. That day it took over a hour to calm her down. Therapists ended up coming in. To this day she has lost the inappropriate laughter, but still has issues with crying. We all thought in the begininning after her stroke she is laughing and smiling more than we have ever seen her before, then someone explained it to us. I thought in the begining I was so happy she could cry when they capped her trech. I thought finally a way for her to express herself. It prob. felt good to just make noise. Now when she starts I want to run for the hills. It can go on and on and on. I have learned to ingnore it or at least most days I try to. If I play into it, it goes on and on. So distracting her or by changing her settings sometimes it works.

 

Also like they said changes in medication can affect them. One day we came up to see my mom the only time I left her alone and they had put her on baclofen for spasticity. I called the doctor in cause she had changed so much. She was almost lathargic. Once she adjusted to the medication she came back to herself, but I didn't like it. My mom also gets so weak when she has a infection. It zaps her and she always has a set back. Just recently she was hospitalized her central line had gotten infected and she ended up spending 4 days in ICU then 6 more on the reg. floor. This was in Jan. Just nw she is getting her strength back. She really lost alot. Now we have to work hard just to get her back up to where she was.

 

It will be a long battle and it won't always be uphill, but look at the alternative. I would rather fight the battle.

 

How old is your father? Does he have any movement yet? The first thing my mom regained was her middle finger on her right hand. Yep so she flipped everyone off all the time. The rehab doctor said he would know she was recovered when she could flip him off with both hands.

 

Good luck and lots of prayers

Ruth

[dfebner]

My father is 60 - he has been in the rehab facility for a few days now and his mood seems to have improved quite a bit. He has made so much progress just with a few days of therapy. He is trying so hard to talk - he actually said something today to me that I understood - very softly but it was a great accomplishment given he lost all speech and movement on right side. I also see a little movement in fingers on right side - not sure how much of that is voluntary at this point but he is sitting in a wheelchair and trying to move things around...he is really motivated and I think he now sees his goal.

 

I hope that he can stay motivated to work hard at rehab and see progress as I know that frustration can quickly turn into depression, but it has been such an amazing change in just a few days...we are all so hopeful and supportive - it's been great.

 

 

[Helenrc]

Hi

 

My Mum was relatively happy and alert when she came out of a 2week coma after her very major stroke. This lasted for a couple of months along with mood swings and agitation etc, but then she became very sad and depressed She was unable to speak - so it was hard for us to find out and assess how she was. In hindsight (it is now over 10 years since her stroke) I think she was on a bit of a high initially just because she was alive, but though she was having rehab and doing okay, the next several months I think she maybe started to understand the extent of her disabilities (including right side paralysed and hardly any speech), and was quite understandably depressed mourning her old life. It probably took her 2-3 years to come to some sort of acceptance of what had happened to her.

 

As others have said, being sad and depressed is I think part of the process - and understandable given the enormity of the change in her life. We maybe didn't fully understand this at the time, and saw it as a setback. We were so desperately happy that she had survived, and were so desperately hoping that she would make a substantial recovery, that I think we tried to jolly her along when maybe we should have just let her be sad. But - you can only do what you can at the time, and take each day as it comes.

Unfortunately the anti-depressants she tried for a while had bad side effects for Mum- lethargic, hallucinations and extreme agitation - so we weaned her off them and she was more herself and more stable. Time was the real healer for Mum in terms of her depression.

 

All the best to you and your Dad - My Dad passed away last year and I am now Mum's fulltime carer. She hasn't made major improvements with her physical disabilities, but emotionally is far more stable, and relatively content I think. We still have our ups and downs, and the lack of verbal communication is a challenge, but when Mum smiles, or when I manage to exactly understand what she's trying to tell me, or when she laughs at one of my attempts at a joke - these are just moments of pure joy for both of us.

 

One other thing - Mum still has trouble focusing on conversation when there are more than one or two people talking. When there are three or four people chatting around her she withdraws - I think she has to work very hard to follow the thread of a conversation.So we now try to make sure we keep her included and involved by not having lots of people talking around her, and not interrupting each other and jumping topics too quickly. This may be helpful also with your Dad - just a thought.

 

Love to you and your family

Helen

[calendulady]

Hello, d -

 

Initially after my stroke, I spent 5 days in the hospital. During that time I was on a low dose of antidepressant (the same medication I had been taking pre-stroke) and my moods were very steady - I don't think the truth had sunk in.

 

On the 6th day I was wheeled out of the hospital, on my way to in-patient therapy at a rehab hospital about 30 miles from home. That was the first time I cried about the stroke. It hit me like a brick. The depression was overwhelming and I needed some counseling from the clergy in the hospital. My medications changed, increasing the dosage plus adding something for anxiety. I even asked my husband to stay home one weekend, because I just wasn't able to face visitors.

 

But I soon learned that each day was a new start --- some days are good days, other days are not. I was very lucky in the speech department - my only problem is that I have trouble finding the right words so I make some funny substitutions when speaking.

 

Most times, the mood changes may not have anything to do with a specific person or thing or conversation --I think most depression is related to the condition, namely STROKE itself.

 

I pray that as your father's health improves, he will see more light than darkness in his life.

 

Debbie :wub2: