Severe personality changes after strokes?

A fellow caregiver asked...

Almost a year ago my husband of 14 years had a serious stroke that affected both sides of his brain, he was 58 at the time and not his first stroke, but the worst one by far. He was in rehab for a month and then he went home and had in-home physical therapy for another month, until we ran out of insurance care. He has much difficulty walking and trouble using his hands. At first he did his exercises but that dwindled until now he does nothing but watch TV and take a shower (at least he does that since he is incontinent.) He used to do the dishes and suddenly stopped and said that he didn't like doing them. I tried and tried to get him to at least do that! If I suggest that he do something he yells at me. His personality has greatly changed, he used to be sweet. I think he hates me now. I have been told that he has had many strokes and will keep stroking which will affect his personality. I try to be patient, but it is difficult. None of his friends have stood by him and none of my friends and family want to hear about any problems, except for my daughter. His daughter (my step-daughter) has not visited since his stroke, although she keeps saying that she will. He keeps telling me to shut up and just leave him alone, I am essentially a maid and chauffeur. Fortunately I have many hobbies, but I wish that he would take an interest in doing something besides watching TV, the doctors don't take me seriously when I say that he won't do anything, I think that they don't want to hear it either. (I feel like a ghost about this issue). Incidentally, he was somewhat like that before the stroke and always seemed to enjoy being sick. He used to look at people in wheelchairs and say somewhat longingly that that would be him someday.

Since he can't do much I have to do everything for us, which I don't mind, but would like just a little appreciation. Sometimes I feel angry at the situation. He is not bad enough to go to a home and no one else would take him. How can I handle him, or get him to be interested in something? He is on Celexa for depression and he says that he is not depressed, in fact he acts pretty normal at doctors and around others. What to do? I can't leave him long enough to have a job or go to school, since he doesn't think things through sometimes, so could be potentially dangerous to himself, also he falls occasionally and I have to help him up.

Expert Answer

Mikol Davis, PhD has worked in community hospitals with geriatric patients suffering from dementia, depression, and other psychiatric problems. He has a doctorate in Psychology from the University of San Francisco and has been in private practice in Marin County, California. Davis co-founded with his wife, Carolyn Rosenblatt.

Dear Caring Member, Unfortunately severe personality changes after a stroke is very common. First off your intense sense of lack of appreciation is so important. Let's first address the need to better take care of yourself. You need all the support you can get whether from community or online. Please look into National Family Caregiver Alliance.

Next your husband sounds quite depressed based on his anger not sadness. Perhaps he hates being so dependent NOT You. A consultation with a GeroPsychiatrist to re-think his medications is in order. New medication combinations can be more effective for depression. I would urge you to consider adult day health services at least weekly to give you a break. This could help him slot more than watching TV. Overall get some support for yourself.