Socio-psychological technologies for the rehabilitation of stroke survivors. Therapy of post-stroke disorders in specialized centers. What is post-stroke depression

06.05.2019

Stroke — acute disorder cerebral circulation, characterized by a sudden (within a few minutes, hours) appearance of focal and / or cerebral neurological symptoms that persist for more than 24 hours or lead to the death of the patient in a shorter period of time due to cerebrovascular pathology.

Vascular diseases of the brain take the second place in the structure of mortality from diseases of the circulatory system after coronary disease hearts.

Stroke Symptoms

Strokes include cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage, which have etiopathogenetic and clinical differences.

Taking into account the time of neurological deficit regression, transient cerebrovascular accidents (neurological deficit regresses within 24 hours, unlike stroke itself) and small stroke (neurological deficit regresses within three weeks after the onset of the disease). Stroke can be either ischemic or hemorrhagic.

Causes of a stroke

The most common cause of a stroke is cerebral thrombosis, a blockage of a blood clot (thrombus) in an artery that supplies the brain. Such a clot (plaque) occurs most often with atherosclerosis.

Another cause of stroke is cerebral hemorrhage, internal bleeding in the brain. A diseased brain artery can rupture (burst) and flood nearby brain tissue with blood. The cells fed by this artery are unable to receive blood and oxygen.

Hemorrhage in the brain is most likely to occur when the patient has atherosclerosis and high blood pressure at the same time.

In other words, the cause of a stroke is damage nerve cells located in the brain and controlling all functions human body. And such damage, or rather, the death of nerve cells, occurs as a result of an acute circulatory disorder in one or another part of the brain, when its highly active cells suddenly stop receiving the necessary and sufficient amount of blood for them. As a result, blood does not flow through the vessels, brain cells die, commands are not sent to the corresponding muscles, which ultimately leads to paralysis, visual and speech disorders, and other neurological disorders.

Recovery after a stroke

Stroke - serious illness, after which most people lose some of the functions of the musculoskeletal, speech apparatus, memory. To prevent a recurrence or complications, it is necessary to follow some medical advice. Even after severe stroke in elderly patients with various pathologies, a significant recovery of lost abilities is possible. Thanks to the joint efforts of the patient himself, his relatives, as well as health workers, many patients manage to return to a full life.

Recovering from a stroke requires huge effort, patience of the patient and his relatives, who must be ready for a long, difficult process of restoring the lost functions of the patient. The duration of recovery depends on the type of stroke and the severity of the patient's condition.

The more nerve cells located around the lesion can be preserved during post-stroke treatment, the more effective rehabilitation will be. The recovery program for each patient is selected and carried out on the basis of individual factors. It depends on various aspects, for example, the severity stroke, the nature of the violations caused by it, etc.

However, there are basic general directions of rehabilitation that apply to all patients:

– medical physical exercises, massage for recovery motor functions;

– social and psychological rehabilitation of the patient;

- recovery after a stroke of memory, speech;

- relapse prevention preventive measures against complications.

plays an important role in the recovery process after a stroke. social and psychological rehabilitation. The emotional state of the patient in the first weeks or even months after the stroke is extremely unstable: he can be capricious, whiny, quick-tempered. In addition, some stroke survivors tend to be indifferent to their condition. In such patients, even mild impairments of motor functions are poorly restored. They are often helpless in everything. And this is not due to laziness, as their relatives sometimes believe, but to the defeat of certain areas of the brain.

In addition to physical ailments and other immediate manifestations of a stroke, the patient also experiences moral suffering. He is having a hard time breaking up with in the usual way life, feels shame for his helpless state, fear of becoming a burden for relatives, anxiety that he will remain disabled forever, longing for immobility and isolation.

Many patients are painfully experiencing their dependency on others. This is especially true for people who, before the impact, were distinguished by independence and love of freedom, a strong character, a heightened sense of dignity. A person who is used to always making decisions himself and being responsible for his life finds it extremely difficult to adapt to the fact that he is now in the care of his relatives.

All listed reasons may lead to depression in a patient after a stroke. This can be expressed in the fact that a person does not believe in his recovery, loses interest in life, and, in particular, in recovery exercises, upsets his loved ones with irritability and sometimes rude, grumpy behavior. Now the depression caused by the disease itself is an obstacle to recovery - after all, the patient does not make efforts to restore impaired functions, repels the help of doctors and relatives.

Relatives of the patient also need psychological help. A stroke dramatically changes the life of not only the patient, but also his household. They experience what happened no less, and often more than the patient himself. A huge additional burden suddenly falls on the shoulders of relatives: in the first month they are torn between home, work and hospital visits, then, after discharge, the development of the difficult work of caring for a bedridden patient begins.

If the restoration of impaired functions in a patient is delayed, freedom of movement, memory, speech, self-service skills do not return for a long time, then the patient's relatives accumulate chronic fatigue and emotional, and physical, and the so-called "responsibility fatigue". Like the patient himself, the family member caring for him experiences an oppressive sense of anxiety, and sometimes he too leaves the hope of returning to former life, which now, from afar, seems prosperous and carefree.

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The content of the article:

Post-stroke depression is a condition due to which a person can completely lose his taste for life, stop fighting for himself. The voiced problem occurs due to the fact that the patient is injured not only in the physical, but also in emotionally. Based on the relevance of the voiced factor, it is worth understanding some aspects of its development.

What is post-stroke depression

Post-stroke depression (PID) is a common complication after such damage to the body and circulatory disorders in the brain. More than a third of people who have had a stroke experience this mental pathology in the future. Development this disease depends on many reasons, among which social and cognitive factors are in the lead.

emotional disorder in the form of PID occurs after the impact of the focus of stroke on neurotransmitters that are located in the brain. Further, due to the lack of mediators of emotions in the form of norepinephrine and serotonin, the onset of post-stroke depression begins.

In some people, it is expressed exclusively in minor emotional instability, which is easily corrected. However, after the tragedy that happened to them, most of the victims are very acutely aware of all the manifestations of PID.

Causes of post-stroke depression

As life practice shows, not a single problem arises out of the blue. Specialists after long studies and observations as follows identified factors provocateurs of post-stroke depression:

Unstable emotional condition in the past. There is a specific type of people who are already initially predisposed to being constantly under stress. Therefore, such a serious situation as a stroke only exacerbates emotional instability sick.
Acute reaction to the incident. After a partial or complete loss of professional and everyday skills, the likelihood of post-stroke depression increases. The patient develops a sense of his own helplessness, which has an extremely negative effect on his psychological condition.
Severe consequences of a stroke. If the focus of the disease covered left side human body, then the likelihood of PID increases. In addition, it should be noted the localization of the center of the lesion in the thalamus and basal ganglia, which also leads to the likelihood of developing a stressful state in the patient.
Oxygen starvation of the brain. As already mentioned, the focus of a stroke has an extremely negative effect on the blood supply to this human organ. Consequently, the access of oxygen to the brain becomes problematic, which leads to a depressed emotional state.
Lack of support from loved ones. It is easier to endure adversity only when there are devotees and considerate people. In some cases, relatives perceive a family member after a stroke as a burden, which has an extremely negative effect on his psyche.

The listed causes of PID have both physical sources of education and emotional factors provocateurs of the problem. In most cases, the occurrence of post-stroke depression is complex, so you should not ignore the first alarming bells, harbingers of impending disaster.

The main signs of the presence of post-stroke depression in humans

AT this case it is very difficult to give a clear definition of the current problem, because it sometimes has a rather hidden picture of pathological dynamics. However, according to some indications, it is possible without special efforts identify a person who has post-stroke depression:

Emotional instability. A similar violation is expressed in a person with a voiced problem in the form constant feeling depression and unwillingness to perceive any life pleasures. To this state is added a systematic premonition of impending disaster and general discomfort in the perception of reality.
Changes in behavior. With post-stroke depression, the deviation from the norm begins with the lack of initiative in the affected person with a pronounced unwillingness to further rehabilitation. As a result, the patient becomes irritable at times to the point of aggression towards the close environment. It is expressed in motor anxiety, depending on the degree of damage to the body.
Somatic deformities. Patients diagnosed with "post-stroke depression" quite often feel the so-called "wandering" symptoms throughout the body, which cause pain. All this may be accompanied by asthenic syndrome and a feeling of discomfort in chest due to lack of oxygen.
The cognitive dissonance. Slow and difficult thinking is often the result of a voiced factor. At the same time, after a stroke, a person's concentration of attention decreases and negative attitude to society.

Features of the treatment of depression after a stroke

From given state must be unambiguously disposed of, because it has quite severe consequences. It is strictly forbidden to prescribe treatment based on Internet data and the advice of friends, because we are talking about a serious psychological disorder.

Treatment of post-stroke depression with medications

At the first sign of a voiced problem, you should immediately contact a specialist. Treatment of post-stroke emotional disorders is not an easy task, which may involve taking the following drugs:

Antidepressants. As already mentioned, the lesion negatively affects the accumulation of norepinephrine and serotonin in the body of the victim. Therefore, it is necessary at all costs to make up for the lack of sounded substances. This will help drugs such as Cipramil, Sertraline and Paroxetine. These funds belong to the group of balanced antidepressants. Moclobemide, Fluoxetine and Nortriptyline will also be a salvation for the voiced problem. These drugs are classified as activating antidepressants. Mirtazapine, Fevarin and Agomelatine significantly reduce intellectual (cognitive) impairment after a stroke. They belong to the group of sedative antidepressants, and they should be taken only as directed by a specialist.
Atypical antipsychotics. Emotional disorder after a stroke is eradicated with the help of voiced drugs. A typical subset of these drugs can cause parkinsonian complications. As a result of this, the possibilities locomotive system human are severely limited. Quetiapine, Clozapine, Ziprasidone, Periciazine and Olanzapine will help to solve the problem of post-stroke depression without any complications. The usual term for taking these drugs is 6 months.
Psychostimulants. They can be prescribed by a doctor in combination with antidepressants. Social alertness, apathy and loss of interest in life are perfectly treated in this case with Deoxinate, Ritalin, Focalin and Provigil. They must be used with great care and only as prescribed by a doctor, because they can cause mental dependence and even provoke stimulant psychosis.

Treatment of depression after a stroke without medication

In the treatment of post-stroke depression, you can completely do without the use of medical preparations. To do this, you can use the methods of psychotherapy, folk remedies, therapeutic gymnastics and massage.

Consider the popular ways to help get rid of depression:

Psychotherapy. It can be carried out both in groups and in personal contact with a specialist. drug therapy this way struggle with mental illness is definitely not a substitute. However, as an accompaniment to the desire to have a stress-free life, it will do just fine. Relatives and friends of the victim need to approach the choice of a specialist with great responsibility. He should have experience working with such patients who then found positive dynamics after sessions with a psychotherapist.
Folk remedies. In addition to antidepressants, you can try to relieve stress after a stroke using recipes that have been tested for centuries. An infusion of angelica has proved to be excellent, in which the roots are the most healing. Two tablespoons of crushed raw materials per 0.5 liters of boiling water must be infused for an hour. Then you need to drink the resulting vigor elixir every 6 hours (4 doses per day). Useful in the treatment of post-stroke depression at home are also mint, lemon balm, borage, hops, chamomile and valerian root.
Massage of the patient. in a natural way toning the whole organism has always been a voiced remedy. Many rehab centers offer this plan. You can resort to the help of a massage therapist who will come to the patient's house. However, in this case, you must first ask about the experience of a specialist and his recommendations.
Transcranial stimulation technique. Science does not stand still, so this progressive method of dealing with post-stroke depression has become widely popular. The sounded procedure consists in the fact that a weak current is directed to the brain of the victim. Such manipulation causes irritation of the motor cortex of the brain, triggering the patient's emotions in the future.
Physiotherapy. The path of recovery after a stroke is never an easy and painless process. However, even at home, it is realistic to perform special exercises daily, which the specialist advised. As a result, the patient will have an incentive that will not allow the mechanism of the described mental illness to start.

Note! These methods of dealing with the disease after a stroke are quite simple and do not require significant material costs. However, in most cases, the use of antidepressants and antipsychotics is still indispensable.

Rules of behavior with a person with depression after a stroke

We present to your attention recommendations for dealing with a person with post-stroke depression:

Healthy microclimate in the family. Clarifying relationships in the circle of loved ones during this period is simply inappropriate, because it can only aggravate the patient's post-stroke depression. It is necessary to bury the "axe of war" once and for all when there is an injured person in the family. If there is an urgent need to enter into conflict with relatives, this should be done outside the native walls and not in the presence of a patient after a stroke.
Behavior according to the scheme "you are not a burden". Of course, both a stroke and a microstroke make significant adjustments to the life of the victim's family. He begins to painfully feel his limitations in many matters, considering himself an inferior person. It is necessary to coordinate the life of the victim so that he can do things that are feasible and not burdensome for him.
Organization of full communication. You can’t lock yourself in four walls when loved one had a stroke. There is no need to be afraid of visitors who want to communicate with the victim. Communication with familiar people will help to avoid the development of post-stroke depression.
Maximum Care. Organizing the life of the patient, it should be remembered that he was seriously injured both physically and morally. A stroke is not the flu, for which it is enough to take antibiotics and observe bed rest. Therefore, without going to extremes in the form overprotection, it is necessary to surround the victim with maximum attention.

How to get rid of post-stroke depression - look at the video:

Post-stroke depression is a factor that should alarm all family members of the victim. A close environment is able to get rid of the voiced problem, if you make every effort to do so. It is necessary to take care of your relatives, because their psychological state after a blow inflicted by fate can significantly complicate rehabilitation after a stroke.

anonymous , Woman, 62

Hello, my grandmother had a stroke 5 days ago, she just fell, she was called an ambulance and provided timely assistance. MRI showed that the stroke hit the speech zone. On the first day after the stroke, the right side was paralyzed, now she is already moving and even getting up, but her mouth is twisted and she has no speech at all. She understands everything and carries out the commands that the doctor asks. But sometimes when relatives they talk to her, it seems that she does not understand, and is in her own world, of course, very little time has passed, but I would like to know if it will be possible to restore speech and understanding, and approximately at what time will this begin to recover? We We are very sorry for her. I would like to add that after the hospital she is sent to a rehabilitation center for recovery. Thank you in advance for your response

Hello. A disorder in which speech comprehension is mostly preserved, but independent speech is absent, is called motor aphasia. In the early days, it is impossible to predict how quickly speech will be restored, and how completely it will be restored. The first 21 days are called acute period stroke. The main task current treatment is to stabilize the condition. The main process of restoring impaired functions (in your case, speech) occurs during recovery period. It starts from the fourth week after the onset of a stroke and lasts from 1 to 2 years. But usually, early rehabilitation measures begin already in the hospital. The main method of restoring speech is classes with a speech therapist - an aphasiologist. I hope that such classes will soon begin for you. Ask your doctor about this. But keep in mind that only classes with a doctor are not enough. If you are interested in recovery, you will have to deal with it yourself daily for a long time. And how to build classes, what specific exercises you need to do - ask a specialist aphasiologist. Moreover, it is impossible to get recommendations immediately for the entire recovery period, you need the supervision of a specialist. And now try not to focus the patient's attention on his defect, as often people are very painfully experiencing the inability to speak. Nevertheless, engage her in a conversation, ask her to nod, repeat simple words, ask her to sing along to you some simple song (... little Christmas tree ...), try to have her finish the phrase using well-known sayings (you can’t even pull a fish out of ... ??? without difficulty). Be sure to discuss everything that you are doing next to her, do not be silent. (“Now we will drink tea, will you put sugar in?” - wait for an answer, ask to repeat after you “yes”). If it doesn’t work out, don’t dwell on it, carry on the conversation, “as if nothing had happened.” I hope that your recovery will go quickly. If suddenly you do not know what exactly to do - contact me through the site. Please note that this is not advice, but my opinion on your letter. Sincerely, Nikolai Nikolaevich

anonymously

Thank you very much for your advice!

Consultation of a neurologist on the topic "Post-stroke condition" is given for reference purposes only. Based on the results of the consultation, please consult a doctor, including to identify possible contraindications.

About consultant

Details

Neurologist, anesthesiologist-resuscitator, rehabilitation specialist.

The main activity is stroke: treatment, restoration of motor and speech disorders, consultations on the care of seriously ill patients, psychological assistance to patients and their loved ones.

C 1997, the first in the Nizhny Novgorod region, began to work as a neuro-reanimatologist of the ward intensive care, and then, the intensive care unit for patients with stroke. Repeatedly attended advanced training courses, including on the topic "New technologies for the diagnosis, treatment and prevention of stroke."

At the same time, he worked on the rehabilitation of motor and speech disorders after a stroke, organized and directed the "Doctor Zhulov's Rehabilitation Service", within which he carried out both administrative and medical work, as well as training staff in the methods and technologies of rehabilitation treatment.

Since 2012, he has been the executive director of the Nizhny Novgorod branch of the Interregional Public Fund for Assistance to Relatives of Patients with Stroke "ORBI". As part of the work of the foundation, he conducts lectures for junior and middle-level staff of departments for patients with stroke and for relatives of patients on topics related to care, rehabilitation treatment, and stroke prevention.

Currently, he continues to work both as a neuro-resuscitator and as a specialist in the rehabilitation of patients with stroke.

More than half of the inhabitants of Russia (53%) die due to diseases of cardio-vascular system: this is more than from all other causes combined. It is generally accepted that we are talking mainly about myocardial infarctions, but this is not true: in 2 out of 5 cases, the “vascular catastrophe” of the brain becomes the culprit of death. According to statistics, every 1.5 minutes in Russia someone has a stroke.

The insidiousness of a stroke is not only in its lethality. Up to 80% of acute blockage survivors cerebral artery or brain hemorrhages become disabled, and a third of them need permanent care. A serious problem in Russia is the rehabilitation of patients who have survived a stroke: only one in five undergoes rehabilitation treatment aimed at returning to a full life.

Meanwhile, timely psychological rehabilitation according to the program, developed in accordance with the recommendations of experts in the field of rehabilitation therapy, can achieve a significant improvement in the patient's well-being, as well as protect him from death due to stroke complications.

Data scientific research show that every second patient who survives an attack dies within a year after it, but treatment outside the home, in a specialized center, reduces the likelihood of a tragic outcome by half.

What is a stroke

The brain is without a doubt the most important organ human body, and he needs active nutrition and blood supply. Even such a phenomenon as fainting is "invented" by nature in order to ensure the flow of oxygen to the head - in a horizontal position.

The vessels of the brain, like the vessels of the whole organism, wear out with age: this may be due to atherosclerosis - the appearance of cholesterol plaques narrowing the lumen of the arteries, - or hypertension. If a pathological process develops slowly, it leads to a gradual deterioration of the nervous system: therefore, many older people develop vascular dementia, in which there is a deterioration in memory, attention, intelligence, changes in character, and so on.

If, under certain circumstances, a vessel in the brain is clogged, squeezed or torn, then an acute violation of cerebral circulation occurs. This condition requires urgent medical care, which is aimed at eliminating the consequences of an attack and can save a patient's life or reduce the degree of damage to the nervous system.

Unfortunately, it is impossible to help a person who has had a stroke at home. Therefore, it is so important to recognize the signs of this condition and deliver the patient to a specialized hospital as soon as possible.

Types of Strokes

Depending on the mechanism of circulatory disorders, two main types of stroke are distinguished:

Ischemic stroke . It develops when the lumen of the vessel is clogged with an atherosclerotic plaque, a thrombus (blood clot), an air bubble, and so on. One more possible cause ischemic stroke is a sharp drop blood pressure in which blood is not supplied to a specific part of the brain. Strokes of this type are diagnosed in 80% of patients.
Hemorrhagic stroke. Usually develops due to jump blood pressure, which leads to rupture of the cerebral vessel with subsequent hemorrhage in soft tissues brain or the space between its outer shells. According to statistics hemorrhagic stroke often ends in the death of the patient: it requires emergency surgical care aimed at removing a hematoma that compresses the brain.

What is a microstroke?

In some cases, circulatory disorders in the brain are short-term and disappear on their own within a day after the first symptoms of a stroke. Doctors call this condition transient. ischemic attack(TIA), but among the inhabitants the term "microstroke" is popular.

Despite the fact that it does not threaten the life of the patient and in most cases does not entail serious health consequences, a microstroke requires a mandatory examination by a neurologist, treatment and rehabilitation: 10% of patients develop a "full" stroke within the next 90 days after a TIA.

As a rule, an attack of cerebrovascular accident begins with a person's complaints of acute pain in the head. It is important to know the main symptoms of a stroke, which doctors have combined for convenience into the abbreviation BLOW:

U (smile): Ask the person you suspect is having a stroke to smile. If at the same time the corner of the lip on one side remains lowered (or the whole face seems to be warped), then this is a sign of a stroke.
D: movement the patient becomes asymmetrical - he cannot raise both arms or simultaneously bend his legs, one limb lags behind or does not obey at all. Also, a person with a stroke often loses his balance and falls to the ground.
A: articulation(the ability to pronounce words) the patient is difficult, the tongue is slurred like a drunk, sometimes he is not able to pronounce the simplest phrase, he confuses syllables, stutters or mumbles.
R: solution should be taken immediately - if at least one of the above symptoms occurs, you must call ambulance and call the resuscitation team. Minutes count.

Consequences of strokes

One in three people who have a stroke die due to severe brain damage or delayed medical care. Effects suffered an attack for those who survived depend on several factors. The most significant of them are the amount of damage to the nervous system, the part of the brain in which the stroke occurred, the timeliness and quality of treatment.

For example, if the brain stem center responsible for vital functions - breathing, heartbeat, thermoregulation and others - is left without oxygen, then the life of the patient will hang in the balance.

In some other situations, the functions of the affected areas are taken over by other nerve centers, which makes it possible to compensate for all violations over time and return to a full life.

Is full recovery possible after a stroke?

Despite the scientific progress of the last decades, there are still many blind spots in medicine. And first of all it extends to neurophysiology. Experienced Doctors Those involved in the treatment of patients after strokes avoid accurate predictions: in world practice there are many cases when patients with signs of severe brain damage fully restored their health. At the same time, alas, opposite stories are also not uncommon - when a seemingly insignificant violation of nervous functions turned into a disability, and even expensive medicines and procedures did not pronounced effect on the patient's condition.

Nevertheless, doctors note that the discipline of patients and their relatives, as well as an optimistic attitude, can achieve tangible results in recovery after a stroke, regardless of the diagnosis and statistics. The desire to gain independence and restore lost functions, whether it be the ability to speak, strength and sensitivity in the legs and arms, vision, a firm gait without crutches and canes sometimes works wonders. But it is also highly desirable to provide the patient with the necessary organizational and medical support aimed at preventing recurrent attacks and preventing possible complications and injuries. Thus, it is important that rehabilitation takes place in a comfortable and friendly environment, and relatives or medical workers monitored the observance of medical prescriptions, visits to procedures, controlled the performance of physical exercises.

Doctors play a significant role in recovery after a stroke psychological support sick: often people who have experienced an attack feel depressed due to the loss of their usual abilities.

This is noted in both elderly and young patients, and relatives are not always able to the right way support a person by restoring his interest in life and motivation to overcome the disease. Experienced Psychologist not only be able to pick the right words, but also prompt effective practical ways to overcome depression.

How long does it take to recover from a stroke

Experts agree that the optimal early start rehabilitation measures, the duration of which should be from several weeks to a year. Most of the reversibly lost functions, as a rule, return to the patient during the first months after the attack, after the first six months, the recovery progress slows down significantly, but does not stop. There are cases when certain skills - for example, speech, hearing or sensitivity of paralyzed limbs - returned to the patient several years after a stroke. To increase the chances of a similar outcome, it is necessary to continue wellness procedures even after the end of rehabilitation, as well as from time to time to take courses of maintenance therapy.

Rehabilitation methods

Post-stroke rehabilitation is divided into four main areas:

Recovery motor system . Includes a variety of techniques aimed at combating paralysis. These include massage, kinesiotherapy, physiotherapy, restoration of walking skills, physiotherapy and occupational therapy - restoration of skills necessary in everyday life.
Recovery of speech and memory. Within the framework of this direction, a speech therapist (with a specialization in aphasiology) works with the patient, who, with the help of special exercises restores the patient's ability to speak clearly.
Recovery of pelvic functions. Since some patients experience urinary incontinence and problems with stools after a stroke, a rehabilitation doctor prescribes medications and physiotherapy procedures that allow you to partially or completely restore work genitourinary system and intestines.
Psychological recovery involves consultations with a psychologist, as well as activities aimed at the socialization of the patient. It is important for people who have had a stroke - especially in old age - not to be alone, to communicate with others, to have a hobby. Therefore, often courses of treatment in rehabilitation centers include a cultural and leisure program.

Benefits of taking a course of psychological rehabilitation in the "Three Sisters"

Recovery after a stroke in modern rehabilitation centers is the most advanced method of care, which is much more effective than "home" treatment. After all, the patient's relatives, even sincerely wanting to help him, most often are not specialists in rehabilitation therapy and often themselves need to be trained in the skills of caring for a person with disabilities.

"Three Sisters" - one of the best centers rehabilitation in Russia, where a friendly team of qualified doctors day after day helps tens and hundreds of patients recover from injuries, surgeries, strokes and chronic diseases. The clinic is located in an ecologically clean place in a pine forest near Moscow and is equipped for round-the-clock stay of patients of any severity. Doctors working in the "Three Sisters" are the authors of exclusive rehabilitation methods based on many years of experience working with patients, and also practice the most effective approaches to rehabilitation treatment- such as Bobath therapy, Exart method, PNF method and others.

Patients of the "Three Sisters" can take courses psychological rehabilitation without parting with relatives - for this, the center provides conditions for cohabitation. At the service of patients: a restaurant, a gym, Internet access and a landscaped area for walking.

"Three Sisters" is a rehabilitation not only with benefit, but also with comfort.

In my opinion, these tips are useful for relatives during any long and serious illness close person.

I saw the article here:

Relatives of a stroke patient also need psychological help.

A stroke dramatically changes the life of not only the patient, but also his household.

They experience what happened no less, and often even more than the patient himself. A huge additional burden suddenly falls on the shoulders of relatives: in the first month they are torn between home, work and hospital visits.

Then, after discharge, the mastering of the difficult work of caring for a bedridden patient begins.

If the restoration of impaired functions in a patient is delayed, freedom of movement, memory, speech, self-service skills do not return for a long time, then chronic fatigue accumulates in the patient’s relatives – both emotional and physical, and the so-called “responsibility fatigue”.

Like the patient himself, the family member caring for him experiences an oppressive sense of anxiety.

And sometimes he also leaves the hope of returning to his former life, which now, from afar, seems prosperous and carefree ...

Basic rules and techniques that will help you deal with stress and fatigue

1. If you are almost at the limit, stop and rest.

This simple rule many, oddly enough, neglect, not giving themselves a break until fatigue literally knocks them off their feet. Meanwhile, breaks, smoke breaks, breaks and weekends significantly increase the efficiency of any activity.

2. Ask other people for help.

To ask for help in difficult situation, there is nothing shameful. Help can be very different - a neighbor or girlfriend can sit with the patient while you are resting, go to a store or pharmacy. Someone you know or Charity organization may help with medications or nursing aids.

3. Finally, you may also need psychological counseling.

Try to find or organize a "support group" for people with similar problems. Sometimes it's good to just talk. However, in this you need to know the measure and not get used to constantly complaining about life to everyone around.

4. Find ways to distract yourself from painful thoughts and improve your mood.

When a traumatic situation continues for months, the ability to enjoy the little things in life is especially important. Learn to “turn off” the flow of negative thoughts. Be aware of the good that is always around you - the taste of food, the view from the window, the sounds of your favorite music and the joy that another hard day is finally over ... Give yourself small gifts, get out to visit - this will help you hold out.

5. Use traditional ways stress relief.

Among them - hiking, various water procedures, sports, yoga and meditation, acupressure, aromatherapy, sedatives herbal preparations and listening to music. Many are calmed by knitting or sorting out the rosary. It is also useful to describe on paper or draw your fear, resentment or fatigue (it doesn’t matter if you do it professionally or not).

6. Use self-hypnosis and auto-training techniques.

Now there are many publications devoted to such techniques. For example, for many years, the book of the famous psychologist Vladimir Levy, dedicated to auto-training “The Art of Being Oneself”, has been invariably popular. Classes can take only a few minutes a day (before going to bed and immediately after waking up), but you will definitely feel the effect.

7. Choose for yourself a complex of vitamins, adaptogens, general strengthening and immunostimulating nutritional supplements.

To your organism and, in particular, to nervous system life is now demanding. Therefore you need additional support. In any pharmacy you will find a sufficient range of vitamin and restorative products. Choose from them the most suitable for you.

8. Stay optimistic.

All the methods listed above will only help you if you consciously set yourself up to win.

Of course, from time to time feelings of hopelessness, irritation, and even hostility towards the patient can cover even the most patient person, and you should not condemn yourself for them.

It is only important not to remain in these states for a long time, but to stubbornly return oneself to benevolence, patience, endurance and optimism.