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.


Stephanie Trelogan

Stephanie Trelogan writes about heart disease, stroke, and depression issues that concern people caring for their aging parents. See full bio


about 13 hours, said...

My dad had a stroke August of 2017 and lost mobility on his right side but gain 95% of is back. His hand eye coordination needs improvement. But anyways he stuggles with aphasia , so it’s difficlt for him to articulate and write . And the icing on the cake he only really tries to say things in engala or French when he know English also ? He has become very violent with my siblings and I but he won’t hit others . Its very testing because my first reflex is to hit back it you hit in a hateful manner. But I understand that he cannot Express the way he is use to expressing himself. But it get heavy someday because you want to strike back and I’m not sure how to reframe him from conducting in such violent behavior when instructed to do an activity in a mannerly fashionn? Also it’s difficult because he thinks he knows everything and do everything himself when in all actuality he can’t. He refuses anyone’s assistant when he needs it the most . And when you give him the space to do it himself he gets frustrated because your not helping him . Only God keeps me together and going really because honestly I would of given him to a facility to treat him but they would kill him in there . And my Father is young he’s 51 . My siblings and I try our best with his condition and juggle being homeless and jumping from family members houses. It’s tuff but God won’t give me more than what I can’t handle.


about 2 months, said...

Hey everyone, I'm 18 and my mother had a stroke my sophomore year of high school, along with already having complications of stage 4 breast cancer. This has been extremely hard for me from the start, exhasperated by the fact that I received the call from the emergency room that she had a stroke, which is pretty traumatizing for a 15 year old. Anyway, these days I feel like my mom is a different person. I know she still loves me and deep down she's the same, but our only mode of communication is her yelling at me to clean things in the house, or screaming at me over a dish left in the sink, and quite frankly I am human and I will leave a plate in the sink once in a while. I can't help but get frustrated having losing a lot of the connection me and my mom had, and when I try to point out to her times when she is being mean or overly not picky, she just cries, and it makes me feel like a horrible person. If there are any suggestions for how to help my situation I'd be happy to hear, writing this out has already made me feel a lot better about t honestly.


3 months, said...

Hello


4 months, said...

My husband had a stroke about a year and a half ago, it was a right brain stroke. The symptoms that remain are limited use of his left arm and behavioral/cognitive functioning. He often sits and stares at the floor. when asked a question he doesn't know how to respond. He gets irritated and verbally abusive frequently replying in an immature, snotty bully manner. As his caregiver, my feelings get hurt., it's so difficult to not personalize his attacks. He'll say something out of frustration just to hurt me, make me go away. Constantly, I offer other ways he can handle his frustration but nothing seems to sink in. He can't or hasn't learned how to assess a situation and employ an appropriate response. i have been reduced to tears, even yelling. I dont know what to do except for continuing to address the issue and hope one day it gets through.


9 months, said...

I almost had it with my mom today, she had a pretty severe stroke back in January 2010 and ever since has demanded everything be done for her. Today, my dad (her primary caretaker) and I took her out to the museum and had a great da, afterwards we decided to grab dinner and she wanted to go to a specific thai restaurant that was out of the way so we offered to take her to somewhere closer, also thai, well she refused to go in and enjoy the meal with us. If she doesn't get what she wants when she wants it she throws a tantrum like a 2 year old and it's beyond frustrating to deal with. She'll make a scene or call us derogatory names, I feel bad for my dad because he caters to her just to avoid fighting but I'm a believer in tough love and thinks that if everyone constantly caters to her than she'll just continuing acting that way. Also, she constantly makes comments about peoples weight even to relatives that we don't see often. How is that ok?! It's uncomfortable to be around and I tell her all the time that it's not nice but she doesn't care. Any tips are appreciated! Best, Diana


over 1 year, said...

about 3 months ago on October 5 2016 I had 2-min stokes and dealing with it with my wife's help I love her and my kids very much but yesterday 12-24 2016 my behavior wasn't very nice, today I found this web side and I find this very helpful so I can show it to my wife kids, and let them know that I love them and that I would never do anything to heard them just work with me


over 1 year, said...

My father had a series of strokes in May of 2015, and has suffered some mini strokes since. He is always so negative, angers easily and can be really hateful to my mom at times. He has lost partial eyesight in his left eye and a lot of use of his left hand. He is still able to go to the shop which he owned and retired from, but is still able to go and work occasionally - but then he comes home and complains about everyone. I see my mom so down and depressed most of the time and I just feel helpless.


over 1 year, said...

My husband is 6 mos post massive left sided stroke that doctors did not think he could survive. He is currently able to walk using a cane but requires minimal assist at all times. His right arm has very little movement and he has global aphasia and apraxia (oh god is the only thing he can say). He requires my assistance for all personal hygiene bathroom, shower etc. His cognition is in and out. After several months he was able to remember the passcode for his lap top and visits all his familiar sites daily but I don't think he can read things in their entirety it's more like he recognizes familiar alerts on the various sites. The alphabet is a challenge he still cannot remember any alpha passwords and though he recognizes some familiar words he cannot read. His temperament is changed he will stomp his cane and clinch his fist out of frustration. He is also very anal over things like flipping his pillow every time he gets out of bed and consumed if a small scrap of paper is on the ground. I am his sole care giver 24/7, no one (including our 5 adult children) routinely relieves me of this responsibility. Since the stroke my life has been totally consumed by his care and I've cried to many tears. Oh yes I forgot that my husband oversaw all our finances including taxes and though I asked he never clearly shared our financial status I was even partially locked out of our main bank account. The financial situation has been less than pretty as he was apparently suffering from procrastination and while he filled out our complex tax forms he hadn't filed some years so it's been a nightmare too. My husband survived but the man here now is not the same and he's pulling me down the rabbit hole right behind him.


almost 2 years, said...

my mother has brain injury due to a tumor that was removed a few years ago and just recently had a stroke. I am taking FMLA to give my father a break before he strokes out. I need advice on how to get her in her nightgown, wear adult pull ups at night at least, shower, take a little walk. very stubborn, and does not understand the severity of this. has short term memory loss that does not help me at all when trying to get her to remember instructions.


almost 2 years, said...

my aunt is the most horrible person I ever knew in my life next to my husband and my uncle. The strokes my aunt has had made her impossible to deal with. I have a stressful job marriage and I am all she has but she is so difficult to deal with t hat I need to stay away from her. any suggestions? I almost hate her and wish her ill will because she is so abusive to me that I am hoping I do not have to deal with her in any fashion. and help?


about 2 years, 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 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?


over 2 years, 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,