Catingub, Cherrielyn C.

BSN III C NEL 301 DATE: FEB 06, 2014 I interviewed the clients grandson, and this is the data I acquired. Accordingly his grandfather (In his 70's) got a very small stroke in his brain (blood clot). Its located in HIS BACK RIGHT of his head. He got the symptoms of; Dizziness, headaches and confusion. He is an Angry person and he is also a VERY heavy smoker. Anyway, he has been into hospital and got treatment. He got discharged about 3-4 weeks ago. (Still got medication). BUT he has a bit of a memory loss. The doctors said this is normal and will eventually get better over time. The problem is that, he was already an angry person and recently he is showing ALOT more anger. He is swearing alot more. We have asked him to stop because its not good for him anymore but he won't listen. Well he listens for about half an hour then he forgets - and swears and shouts again. We are also telling him to cut down on ciggerettes because we read (and heard from doctors) its not good for the blood. One minute he says he will quit slowly and the next he says "I don't care, let me have my ciggerettes. Let me die.". And this is just unbearable. Also, BEFORE he got the stroke, he was incharge of all bills and things in his house. With this memory loss of his, he seems to want to count his money all the time - more than he ever did. Once he even counted all of his money he earnt in his whole life :(. Nearly lost it all. As he is likely to have some form of brain damage, which can include brain cells, as well as blood supply - veins/ateries, that deliver oxygen to his brain, as well as clear away waste products, then he needs managing with utmost care. Obsessive behaviour is common with people, where they are anxious having suffered specific deficits in their functional abilities, especially if they are repeatedly confronted with an awareness that things aren't what they were. Again, specialist support can help him so much with this. Sometimes it's important to understand more clerarly how something like this has affected us, as well as knowing that there is support there for us to help erase the need for

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Much of the functioning in our brains, although localised, can be met by other parts of our brain - this is known as brain plasticity. There is generally a period where spontaneous improvements occur, often referred to as being more significant within the first couple of years following brain damage. But, improvements continue to occur for the rest of our lives. Good rehabilitation can help to maximise our improvements, and never forces anything. There are some people who will talk about brain plasticity not being present in the elderly, but research strongly contradicts this. There's a lot of evidence that indicates that remaining active, including getting regular exercise, is good for our brains, so do what you can to help him keep his activity levels at a good level. Do what you can to stop people criticising him, as this is likely to lead to him getting more anxious, and potentially feeling worse about himself and his future. Often there is a feeling of loss after someone has such a major event in their lives as he has, to an extent, lost some of the person that he was before his stroke. The easier his life is made, with less things that stress his abilities, the better his chances for managing things as well as he is able to. Emotional outbursts are also common in people who have some damage to their brains. Our frontal lobes functioning includes abilities such as organising, planning, decision making and also inhibition. Whilst he may, under the surface, want to swear, shout and get angry less, his abilities for self-inhibition may be somewhat diminished - so please encourage no-one to blame him as a person for any of his outbursts, nor pressure him to stop. The areas of his brain, more responsible for emotional responses, may also have suffered some damage too. I'd avoid telling him off, criticising him etc, as he is better perceived as no longer on an equal footing as the rest of you to manage himself in these areas. Better to be understanding, reassuring and offer a listening ear, whilst you're waiting to secure support from him from the professional services out there.