Behavior After Stroke

How to Handle Difficult Behaviors After a Stroke

How to deal with difficult stroke behaviors

Some stroke survivors behave in ways that can make life unpleasant for the people around them. A stroke survivor may be depressed, anxious, and angry, and he may not know how to express his feelings in a positive way. He may lash out at you verbally or even physically.

Difficult behaviors can also arise from personality changes. Almost half of people who care for stroke survivors describe them as being negative, impatient, and easily upset. A stroke survivor may exhibit child-like behaviors, lashing out verbally or even physically.

Here's what you can do to deal with these behaviors:

  • Recognize that it's not about you. The person in your care is angry about his situation, and he may have lost some of the ability to control his emotions that he used to have. As impossible as it may sound, try to keep your own emotions under control. If necessary, give yourself a time-out for a while so that you both can cool down.
  • Be positive and supportive -- but firm. You can say things like, "I can see that you're very angry right now, but it's not okay for you to yell at me like that. What do you think would help us both feel better?"
  • Use distraction and soothing techniques. Sometimes the best way to deal with difficult behavior is to distract him with a calming activity, like watching a favorite TV show or listening to relaxing music. You can talk about his behavior when you've both calmed down.
  • Try positive reinforcement. A point system may help him relearn how to behave appropriately. For example, if he tells you he's upset instead of crying or screaming at you, you can give him points that can be added up for a later reward. You can use a sticker chart so he can see his progress. (Even though this may sound like the way you'd treat a child, many stroke survivors respond well to this type of reward system.) The best rewards are those you can enjoy together, like going to the movies or some other enjoyable activity.
  • Decrease distraction and stimulation. If the television is on while the stroke survivor is trying to get dressed, he may have a hard time focusing -- and he may become frustrated and lash out at you. So try to eliminate such "background noise."
  • Find a support group where he can share his feelings. Talking to other people in a similar situation can be tremendously helpful, and he'll benefit from the social interaction. It's also a great way for you to connect with other caregivers.
  • Protect yourself. If he's physically abusive, you should take measures to prevent him from hurting himself or you. Talk to his doctor and rehabilitation team. You may need to consider a nursing facility.

Coming to terms with changes in a stroke survivor's emotions, personality, and behavior may be even more difficult than managing his physical disability. He may seem like a completely different person from the one you knew before the stroke, and this can be very upsetting at times. You may want to get counseling or join a support group. Having someone to talk to and knowing that you're not alone can ease a world of anxiety and fear.

3 months ago, said...

My brother had a stroke on June 5, 2015. His right side was paralyzed and he lost his speech. He did have speech, occupational, and physical therapy. He can walk with a tri pod cane very slowly, he has fallen a few times. He can not use his right arm and still can not speak. His wife recently hurt her back so I have been helping them go to Dr appts and cook for them once in a while. Recently, he has had aggressive anger. This weekend our family is going out of town because of a family... Show more My brother had a stroke on June 5, 2015. His right side was paralyzed and he lost his speech. He did have speech, occupational, and physical therapy. He can walk with a tri pod cane very slowly, he has fallen a few times. He can not use his right arm and still can not speak. His wife recently hurt her back so I have been helping them go to Dr appts and cook for them once in a while. Recently, he has had aggressive anger. This weekend our family is going out of town because of a family ceremony. He is upset because he can not go, due to his wife's back injury. He has gotten very angry with her. The other night he was beating his chest till it was red. His wife feels he doesn't care about her feelings and she just wants to leave. She said she can no longer take the abuse. He was suppose to go to the VA this morning for a group therapy session but he changed his mind. What kind of help can we get for him? Is there medication the neurologist can give him. to calm him down? Hide

6 months ago, said...

Hello everyone, I am hoping for some help or information on handling my 58 year old husband who has had 3 strokes and his short term memory is terrible, since his last stroke in July, he talks non stop about having sex, every time I walk In the room it starts, and it does become very vulgar at times, it starts as soon as he wakes up, all day long. I have tried to turn the conversation to something else but it doesn't help, Hello everyone, I am hoping for some help or information on handling my 58 year old husband who has had 3 strokes and his short term memory is terrible, since his last stroke in July, he talks non stop about having sex, every time I walk In the room it starts, and it does become very vulgar at times, it starts as soon as he wakes up, all day long. I have tried to turn the conversation to something else but it doesn't help, Hide

about 1 year ago, said...

I am the person who had two strokes and I hate what I have become. Not only for myself but for my Husband and children. I am so angry and anxious all I do is yell and scream all the time. I may have a good day from time to time but most days are bad. I'm not the same person anymore and I can't seem to do anything about it. Sometimes I feel like why go on! I am the person who had two strokes and I hate what I have become. Not only for myself but for my Husband and children. I am so angry and anxious all I do is yell and scream all the time. I may have a good day from time to time but most days are bad. I'm not the same person anymore and I can't seem to do anything about it. Sometimes I feel like why go on! Hide

over 1 year ago, said...

Hi, my husband had a mini stroke about 5 months ago and his anger at me at times blows me away! I know it's not really his fault but I can't believe how nasty he can be. It's good to read from other people that are going through this. I won't give up on us. Hi, my husband had a mini stroke about 5 months ago and his anger at me at times blows me away! I know it's not really his fault but I can't believe how nasty he can be. It's good to read from other people that are going through this. I won't give up on us. Hide

over 1 year ago, said...

Comforting to read others share similar concerns as I. I could add: impulsiveness; gregarious rambling; lying without reason; paranoia; childish; manipulative. I will not go down with this ship. Just can't. Our marriage had deteriorated before the stroke. You can only betray and disrespect someone so many times without chipping away the relationship until there is very little left. Comforting to read others share similar concerns as I. I could add: impulsiveness; gregarious rambling; lying without reason; paranoia; childish; manipulative. I will not go down with this ship. Just can't. Our marriage had deteriorated before the stroke. You can only betray and disrespect someone so many times without chipping away the relationship until there is very little left. Hide

about 2 years ago, said...

we have an individual after his 3rd stroke has made sexual request from staff at nursing home and now to staff at adult foster care facility..looking for any information on handing clients with this issue or training or help anyone can send my way would be appreciated we have an individual after his 3rd stroke has made sexual request from staff at nursing home and now to staff at adult foster care facility..looking for any information on handing clients with this issue or training or help anyone can send my way would be appreciated Hide

about 2 years ago, said...

My husband had a stroke in 2001 and then smaller ones later on but now he has become billigerant and nasty to me. we have been married 43 years and dn't know if there is medication to help him. I need help also can't take it much longer. My husband had a stroke in 2001 and then smaller ones later on but now he has become billigerant and nasty to me. we have been married 43 years and dn't know if there is medication to help him. I need help also can't take it much longer. Hide

about 2 years ago, said...

since having his stroke my dad is adament that there are three people up in his attic ,we have reassured him there is nobody else in the house except for him and my older brother who is his main carer ,he thinks my brother is letting these people into the house at night and is angry when any one of the family tells him there are no strangers in the house ,we are at our wits end and do not know how to cope with the situation since having his stroke my dad is adament that there are three people up in his attic ,we have reassured him there is nobody else in the house except for him and my older brother who is his main carer ,he thinks my brother is letting these people into the house at night and is angry when any one of the family tells him there are no strangers in the house ,we are at our wits end and do not know how to cope with the situation Hide

over 2 years ago, said...

These comments are so helpful for me, my mom suffered a stroke over a year ago; she is in a nursing facility right now, health wise she is doing well. I have been going everyday for an hour or two, each day is different, today she told me to get the hxxx out! My sisters and brothers feel I should not go everyday because it is so painful to be berated by mom. I have taken much of what she has said personal and now that I read the comments I see I am not alone. These comments are so helpful for me, my mom suffered a stroke over a year ago; she is in a nursing facility right now, health wise she is doing well. I have been going everyday for an hour or two, each day is different, today she told me to get the hxxx out! My sisters and brothers feel I should not go everyday because it is so painful to be berated by mom. I have taken much of what she has said personal and now that I read the comments I see I am not alone. Hide

over 2 years ago, said...

It's been almost 5 years since my husbands stroke and I can handle almost anything expect his anger!!!!! It does not take much to set him off but when it happens all hell breaks lose. The other day there was ice in the milk and he let me know that I was the worst person in the world!!! We have been married for 28 years and it is so hard to see him this way. I try to make his life so easy and make sure that everything is in its place but sometimes it's not enough. I'm not given up on him but... Show more It's been almost 5 years since my husbands stroke and I can handle almost anything expect his anger!!!!! It does not take much to set him off but when it happens all hell breaks lose. The other day there was ice in the milk and he let me know that I was the worst person in the world!!! We have been married for 28 years and it is so hard to see him this way. I try to make his life so easy and make sure that everything is in its place but sometimes it's not enough. I'm not given up on him but it's so hard to not cry when he gets this way. Most days are really good but it's those few days that are so hard. What can I do??? Please someone help me!!!!!!! Hide

over 2 years ago, said...

Can a TIA cause angry outbursts and yelling? Swearing? Focusing on one topic to the point of obsession?Political topics retold again and again? Can a TIA cause angry outbursts and yelling? Swearing? Focusing on one topic to the point of obsession?Political topics retold again and again? Hide

about 3 years ago, said...

I can relate. I take care of my mom and it is emotionally hard. Regardless of what I say or do it gets turned around on me and makes me feel like i'm the bad person. I can't have a regular conversation without being yelled at. I have even caught her trash talking me and my husband to her sister. As much as I would hate for her to not stay here, I have found myself thinking of how to approach her to move into assisted living. Every time I picture myself approaching her, I see her yelling at... Show more I can relate. I take care of my mom and it is emotionally hard. Regardless of what I say or do it gets turned around on me and makes me feel like i'm the bad person. I can't have a regular conversation without being yelled at. I have even caught her trash talking me and my husband to her sister. As much as I would hate for her to not stay here, I have found myself thinking of how to approach her to move into assisted living. Every time I picture myself approaching her, I see her yelling at me. I can handle it better when she has her meds and when it is time to refill, it is so hard getting her to do so. She always claims that she doesn't do any of the things I say she does. It is very stressful because i also have a 3 yr old and 1 yr old i take care of on my own while my husband is overseas. Everything i say or do with my kids seem to be wrong in her eyes. she approaches me with, "They are your kids but......" and proceeds to tell me what i should and shouldn't do. i sometimes feel like i might go crazy. Hide

about 3 years ago, said...

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about 3 years ago, said...

My dad had a stroke in 2009, and since then his personality is completely different, it's like he's two different people. He gets angry so easily now and a lot of it is directed towards me and what he thinks i should or shouldn't do. He has his good days and his bad days and when its bad he is verbally abusive towards me and my mom. It gets to where my mother considers divorce, but she knows that it isn't him anymore. Is there anyone who can give me some advice as to how we can cope with it... Show more My dad had a stroke in 2009, and since then his personality is completely different, it's like he's two different people. He gets angry so easily now and a lot of it is directed towards me and what he thinks i should or shouldn't do. He has his good days and his bad days and when its bad he is verbally abusive towards me and my mom. It gets to where my mother considers divorce, but she knows that it isn't him anymore. Is there anyone who can give me some advice as to how we can cope with it or is it possible to prescribe him a mood stabilizer or something? He doesn't believe in counseling and we're desperate to get him help for all our sakes. Any advice would be great. Hide

over 3 years ago, said...

it was good to read about the changes in people you love and need to help, it was good to read about the changes in people you love and need to help, Hide