What is a Stroke?
A stroke in the elderly occurs when there is a sudden interruption of blood supply to the brain, and the brain does not get enough oxygen. While there are many things that can lead to a stroke, it is often due to a quick blockage of the arteries that lead to the brain.
Depending on the location of the broken or blocked blood artery, you might be left with a temporary or permanent disability. A stroke can affect your mobility, speech, and coordination. It can also lead to brain damage.
What are the Causes of a Stroke?
Any time that the brain does not receive enough blood flow and oxygen, it can lead to a stroke. This happens either from a blocked or broken blood vessel. Also, there are multiple types of strokes, each of which is indicated by its cause:
- Blocked arteries: With a thrombotic/embolic stroke, the arteries are damaged through a buildup of cholesterol and fats, or atherosclerosis. With a lot of buildup in the artery, blood cannot get to the brain.
- Irregular heartbeat: Embolic strokes often occur from an irregular heartbeat. The heart is responsible for pumping blood through the artery to the brain.
- High blood pressure (hypertension): High blood pressure, or hypertension, can lead to a blockage in the carotid artery or an ischemic stroke.
- Weak and broken blood vessels: Weak or broken blood vessels that lead to an aneurysm often lead to a subarachnoid hemorrhagic stroke. A weakened carotid artery can also put patients at risk of a stroke.
The elderly population is an increased risk of a stroke. In fact, the American Stroke Association estimates that the chances of having a stroke doubles every ten years after a person reaches age 55.
What are the Symptoms of a Stroke?
Understanding the symptoms of a stroke is important, as it can help you take action quicker. Immediate action can ensure that you or your loved one gets the medical care that you need to prevent life-long damage.
A few of the most common symptoms of a stroke include:
- Sudden onset of numbness or weakness
- Loss of coordination or dizziness
- Fatigue or unresponsiveness
- Difficulty speaking or understanding
- Cognitive decline
- Blurry or loss of vision
- Severe headache
- Inability to identify items
- Inability to read or write
- Inability to swallow
- Nausea or vomiting
Some patients might also experience a mild stroke, known as an ischemic stroke, before suffering a more severe one. Ischemic strokes should be taken seriously.
The National Stroke Association designed an acronym, F.A.S.T., to remind individuals of the symptoms of a stroke. They include:
- FACE: Check if the face is dropping.
- ARMS: Check if one of the arms is weak or numb.
- SPEECH: Check if the speech is slurred.
- TIME: If you have any of these symptoms, it’s time to call 911.
If you notice any of these symptoms, either in yourself or a loved one, it is crucial that you call 911 immediately. It is important to note that the symptoms that you experience will also depend on the type of stroke you have, and not everyone will experience the same symptoms.
How is a Stroke Treated?
It is crucial to receive medical treatment for a stroke immediately. A stroke can be life-threatening. If the emergency medical doctors determine that an ischemic stroke or other types of stroke, is the cause of your symptoms, they will begin treatment immediately.
They will likely insert an IV to begin fluids while also attaching you to an oxygen machine. If another medical condition is a concern, like hypertension or high sugar, they might begin medications. If the stroke was due to a blood clot in an artery, they would also inject blood thinner medication.
Then, surgery will be considered to remove the blood clot from its location. Carotid endarterectomy surgery removes a buildup of cholesterol from the arteries. Brain surgery might also be needed if the blood clot is in the brain, and stents may also be used to keep the arteries open for efficient blood flow.
Once the stroke is treated, the patient will undergo extensive rehabilitation and therapy. You might be required to keep up with medications for many months, or even life-long. Physical therapy is also commonly used to re-train the body how to move in certain ways. Patients whose speech was affected might need speech therapy. Admittance to a comprehensive stroke center might be beneficial for the first couple of weeks for treatment. Additionally, some patients might choose to become a part of a clinical trial.
When to See a Doctor for a Stroke
A stroke is a serious medical condition. It can lead to disability or even death. If you think that you or someone you know is having a stroke, it is important to seek medical care immediately. Call 911 or get to the hospital immediately.
Many elderly individuals learn that they have had a stroke in the emergency department. Once you present to the emergency room with symptoms, the doctor will run additional tests to determine the likeliness of a stroke.
The first thing that they will do is to complete a physical exam. They will look for any signs of confusion or disability, as well as testing your mental functioning.
They might complete tests like a C.T. scan, angiogram, echocardiogram, Doppler ultrasound, electrocardiogram (EKG or E.C.G.), or a heart rhythm monitoring test. They might complete just one of these tests or multiple in order to come to a diagnosis.
It is also likely that your medical doctor will run blood tests to check levels. These tests can identify your blood pressure, cholesterol levels, diabetes, and blood clotting time. During this exam, it is also important to evaluate the risk factors of having another stroke. Many patients present after having an ischemic stroke, which can then lead to a more severe stroke.
Medications for Stroke
It is likely that medications will be a part of your stroke treatment and rehabilitation. Common medications will include:
- tPA (tissue plasminogen activator): tPA medications are often referred to as clot busters. They are used to immediately treat the symptoms of a stroke by breaking up the clot. Your doctor will evaluate whether you are eligible for tPA medications upon visiting the emergency room with the signs of a stroke.
- Antiplatelet medications: Antiplatelet medications bind the blood together, which can reduce bleeding.
- Anticoagulants: Anticoagulants can prevent a new blood clot from forming or an existing one from getting larger.
- Blood pressure medications: Blood pressure medications are used to reduce blood pressure. They might include A.C.E. inhibitors, A.R.B.’s, beta-blockers, or calcium blockers.
- Cholesterol medications: Cholesterol medications might be used to reduce cholesterol levels to prevent a buildup.
- Over-the-counter medications: Some over-the-counter medications, like Aspirin, might be recommended to reduce the risk of stroke.
Your doctor will help you choose a medication plan that works for you and your individual needs. It is important to follow medication dosage directions carefully and always to know what you are taking. It is also a good idea to avoid mixing medications with over-the-counter medications without first consulting with your doctor.
Depending on the type of medication, your doctor might want to monitor your blood levels routinely. Some medications can affect other parts of your body, so it is important to monitor blood levels.
Stroke Risk Factors
While a stroke can affect anyone, there are a few factors that can put you at an increased stroke risk. These factors include:
- Age group: The elderly population is at an increased risk of having a stroke. In fact, the chances of a stroke double after the age of 55 and continue to increase with age.
- Genetics: Genetics can also increase your chances of a stroke. Individuals with family members who have suffered a stroke have a higher stroke risk. Arteriovenous malformation is also a genetic condition that can limit blood flow to the brain, leading to a hemorrhagic stroke.
- Hypertension: High blood pressure, especially untreated, can also mean a higher risk of stroke.
- Diabetes mellitus: Individuals with untreated diabetes mellitus are also at a higher risk of stroke.
- Gender: Your gender can also impact your likeliness of having a stroke and how severe the stroke is. Research shows that men are more likely to have a stroke, but women tend to experience higher mortality rates.
- Lifestyle: An unhealthy lifestyle can also increase your chances of developing different diseases that lead to a blocked artery or stroke. Lifestyle habits like smoking, drinking heavily, eating unhealthy, and obesity have all been related to stroke occurrence.
- Previous stroke or a T.I.A.: Having a history of strokes or having a transient ischemic stroke can increase your chances of having a stroke.
- Atrial fibrillation: History of atrial fibrillation, also referred to as arrhythmia, can lead to artery blockages and other heart diseases.
- Untreated blood circulation disorders: Untreated blood circulation disorders, like sickle or anemia, can also lead to hemorrhagic strokes. Coronary artery disease is also a disease that blocks the artery.
Having untreated cerebrovascular diseases can also lead to an increased risk of a stroke. If you are at an increased chance of a stroke, it is important to discuss and develop a health plan to reduce your risk with your medical doctor.
Many strokes are preventable. These are a few of the best ways to reduce your risk of stroke:
- Eat a healthy diet: Diets that are high in sodium or fats can increase cholesterol in the body.
- Exercise regularly: Exercise is an important tool in preventing many of the disorders that older adults experience. Exercise can also help to control blood pressure.
- Monitor and control blood pressure: Monitoring and controlling blood pressure is an important step in preventing a stroke.
- Control other medical conditions: Controlling other medical conditions, like diabetes mellitus, can help reduce the risk of the blockage of the carotid artery and reduce your chances of a stroke.
Keeping up with routine medical visits is also important in preventing a stroke. During your annual exam, your doctor will complete physical evaluation. If they have any concerns, they might order additional tests like imaging or blood work. Stroke survivors will also require ongoing monitoring.
Special Concerns for Elderly Patient
Many seniors are at risk of having a stroke. In addition to the higher risk, seniors are more likely to have complications following the stroke. Seniors tend to have multiple health conditions, which can make it more difficult to monitor for the symptoms of a stroke or to recover from one. Mobility issues can make it difficult to regain movement. Also, Alzheimer’s disease has been correlated with the occurrence of stroke, making it difficult to determine whether the patient is experiencing cognitive difficulty from the stroke or the disease.
Additionally, seniors tend to have other medical conditions that increase the chances of a stroke. Related disorders might include cardiovascular disease, hypertension, high cholesterol, and diabetes mellitus. Living a healthy lifestyle is one of the most important ways to prevent a stroke. However, medical conditions might stop seniors from exercising. Financial concerns or difficulty getting out of the house can prevent them from being able to plan for healthier meals. Seniors with dementia might not fully understand their treatment or rehabilitative directions, also affecting their stroke recovery.
Questions to Ask Your Doctor
The time following a stroke can be overwhelming and confusing. Here are just a few questions that you might want to talk about with your doctor:
- What type of stroke did I have?
- What does my recovery look like?
- What lifestyle changes do I need to make?
- Should I change my diet?
- What do you think caused the stroke?
- How often should I follow up with you?
- What additional symptoms should I be aware of?
- How can I reduce my chances of having another stroke?
Managing a Stroke
Once you have had a stroke, it is important to evaluate and change your lifestyle in a way that effectively manages and prevents another one. Lifestyle changes might include:
- Quit smoking
- Avoid heavy alcohol consumption
- Maintain routine medical visits
- Monitor cholesterol and blood pressure levels
- Manage diabetes and other blood disorders
- Develop an exercise routine
- Eat healthily
Stroke survivors can live a fulfilling life. However, making necessary lifestyle changes can help to avoid not only another stroke but other medical conditions.
How Do You Live With a Stroke?
It is possible to recover from a stroke, as long as you receive medical treatment in a timely manner. Also, individuals who keep up with rehabilitation tend to return to a normal lifestyle much faster.
Monitoring your symptoms and rehabilitation plan is crucial following the occurrence of a stroke. This is especially true if your doctor has put you on medications, like blood thinners. Stroke survivors should learn the warning signs of an ischemic stroke while following their doctor’s orders.
How to Help Your Loved One Post Stroke
One of the most difficult parts of a stroke is the long recovery process that follows. Family and loved ones can help with the recovery process by:
- Encourage lifestyle changes to prevent another stroke
- Help with rehabilitation as they re-build their strength
- Offer emotional assistance as a stroke affects a person not only physically, but also emotionally. Some seniors might deal with post-traumatic stress disorder or high levels of anxiety as they worry about another stroke
- Offer patience
- Assistance with household tasks and errands
- Monitor progress
It can be helpful to be involved in your loved one’s treatment plan, while also learning the F.A.S.T. acronym to help you identify any additional concerns.
If your loved one is finding it difficult to cope, it might be helpful to recommend that they join a support group. The support of other patients who have gone through the difficulties of a stroke can be useful during recovery.
What to Do If You Think Someone is Having a Stroke
When you think that someone might be having a stroke, it is important to take action immediately. Call 911 and tell them what symptoms the patient is having. While you wait for the ambulance, it can be helpful to gather a record of the patient’s medical and health history.
If you or your loved one lives alone, ensure that they have access to a phone to call for help in the event of an emergency. Timely treatment is important.
Fortunately, many seniors will find that the majority of health insurance policies cover the prevention and treatment of a stroke. However, it is important to ask questions to determine what will and will not be included, including a nutritionist or rehabilitation therapist.
It is also important to ensure that you are covered. Seniors are at risk of many medical conditions, and proper coverage is important for treatment. If your insurance does not cover your rehabilitation medications, there might be resources available to help you
For More Information Contact
For more information about the prevention and treatment of strokes, you can visit these websites:
- American Stroke Association
- Centers for Disease Control and Prevention
- U.S. Department of Health & Human Services: Office on Women’s Health
- The Internet Stroke Center
Different Types of Strokes
It can be useful to know the different types of strokes and what causes them. The different types of strokes include:
- Transient ischemic attack stroke (T.I.A.): The symptoms of a T.I.A. often mimic a full stroke, but only last for a few minutes and tend to be milder. A TIA is caused by a partial blockage and can be a warning indicator of a larger stroke.
- Thrombotic stroke: A thrombotic stroke is a type of ischemic stroke, except that it is marked by a blood clot of the artery.
- Embolic stroke/cerebral embolism: An embolic stroke occurs when a blood clot forms and is then moved to another part of the body. Over time, the blood clot gets stuck in an artery and leads to a stroke.
- Hemorrhagic stroke: A hemorrhagic stroke occurs when a blood vessel bursts and then sends the blood to the brain, affecting the brain tissue and brain cells.
- Intracerebral hemorrhagic stroke: An intracerebral hemorrhagic stroke occurs when there is bleeding within the brain that blocks oxygen from entering.
- Subarachnoid hemorrhagic stroke: A subarachnoid hemorrhagic stroke occurs when a blood vessel located outside of the brain breaks and brings blood into the area surrounding the brain.
While each of the different types of strokes has similar risk factors, the treatment and recovery of each one might differ.
Effects of Strokes
The location of your stroke can also determine the symptoms you experience. Potential effects of stroke include:
- Right-hemisphere stroke: With a right-hemisphere stroke, blood flow is unable to reach the right half of the brain. Individual symptoms might include impulsive behavior, quick speech, difficulty paying attention, or poor memory.
- Left-hemisphere stroke: With a left-hemisphere stroke, blood flow is unable to reach the left half of the brain. Individual symptoms might include right-side weakness and difficulty moving.
- Cerebellar stroke: A cerebellar stroke occurs when a blood vessel breaks and bleeds into the cerebellum. Symptoms might include uncoordinated movements or difficulty walking.
- Brain stem stroke: A brain stem stroke occurs when enough oxygen is not supplied to the brain stem. This can affect eye movements, swallowing, and even breathing.
The location and type of stroke can indicate the part of the brain that is damaged and what symptoms the individual experiences.
Many seniors are at risk of having a stroke. It is important to develop a lifestyle that prevents a stroke while also knowing the warning signs of one. The outcome of a stroke depends on the type, location, and how long it took the patient to seek medical treatment. Timely treatment is crucial when dealing with strokes.