PTHER524 Lecture Notes - Lecture 12: Diagnostic And Statistical Manual Of Mental Disorders, Executive Functions, Frontal Lobe

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Psychological Reactions to Changes in Function
PTHER 524
Lecture 4-2
September 21, 2010
Stroke
• Leading cause of disability in Western cultures
• 50 000 new strokes each year in Canada;
Incidence expected to double by 2020
What is lost?
• Brain tissue
Communication (aphasia)
• Cognition
• Swallowing (dysphagia)
• Sexual function
• Motor function
Hemiplegia
Hemiparesis
Spasticity
Rigidity
What does this mean?
• Stroke patients and families rarely define their loss in terms of body structure/function, but in everyday
activities they are no longer able to do
Walking, driving, toileting, etc
Think, Pair, Share Identity
• Many people define themselves by what they do
Athlete, breadwinner, traveler
“I’m more dependent on than being depended on.”
50 yr old stroke survivor
• “A stroke is a small death. It comes on suddenly,
often hitting someone who is quite well for his
age, and leads to obvious physical loss. The
victim is rendered helpless „at a stroke‟, and is
robbed of his dignity and independence.”
» Wade et al. 1985
Loss and Grief
• Loss: when you no longer have something or have less of something
• Loss….
Of function
Of health status
Of role capacity
Of life
• Grief: very great sadness, especially at the death of someone
• Cambridge Dictionaries on-line
Adjustment to Loss
Shock and disbelief
Numb, confused, anxious
Treatment stage
High expectations of recovery; deny permanent disability; grief
Developing awareness
“starting to sink in”; anger, frustration, depression
Restitution
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Document Summary

Stroke: leading cause of disability in western cultures, 50 000 new strokes each year in canada; What is lost: brain tissue, communication (aphasia, cognition, swallowing (dysphagia, sexual function, motor function. What does this mean: stroke patients and families rarely define their loss in terms of body structure/function, but in everyday activities they are no longer able to do. Think, pair, share identity: many people define themselves by what they do. Athlete, breadwinner, traveler: i"m more dependent on than being depended on. 50 yr old stroke survivor: a stroke is a small death. It comes on suddenly, often hitting someone who is quite well for his age, and leads to obvious physical loss. The victim is rendered helpless at a stroke , and is robbed of his dignity and independence. Loss and grief: loss: when you no longer have something or have less of something, loss .

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