Is it normal for a stroke survivor to not follow directions?

Patiernan asked...

My 81 yr. old mother had a hemorrhagic stroke on the left side of her brain a year ago. She has since moved in to my home and has Parkinson-like symptoms. My husband and I are getting frustrated to say the least with some of the things that she is doing. For example, when she goes to the bathroom she repeatedly gets urine on the floor because she tends to pull her pants down way before she is at the toilet and then tries to back in with her butt in the air. Everyday I demonstrate to her what she should do but it never seems to sink in. Also, every night at the dinner table when she is done eating she insists on taking her napkin to "wipe up" her plate but instead gets it all over her hands, the table, etc. We repeatedly tell her not to do this, but the next night it is the same routine. As a result of the stroke and several seizures later, I am sure that she has some brain damage. What I do not understand is that she can remember some things and not others. She will ask a question and then repeat the same question within minutes of you answering her. Is this normal behavior for a stroke victim or is it that she just doesn't listen?

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

Sorry to hear about this.

Much of what you are describing sounds to me like a post-stroke dementia. Many patients who have a large stroke have memory problems and personality changes. Two things that come to mind as possible treatments: First, consider having her started on a cognitive enhancing medication such as donepezil. This may improve her memory and behavior and I have had quite a bit of success with this. Second, consider placing her in an assisted living facility that has full time nursing care to help with such issues. Assisted living facilities and nursing homes were created specifically for these types of issues - when someone needs full time care to help take care of them. If the idea of sending your mother to a facility is unbearable to you and your husband, consider hiring a 24 hour nursing service to help with these issues.

Good luck!