How can I encourage my father to use his left side that has no feeling after stroke?

1 answer | Last updated: Sep 23, 2009
A fellow caregiver asked...

My dad has no feeling after stroke, in his left arm and leg. In fact, he insists that they're actually made of plastic and don't belong to him. What can I do to encourage him to use his left side?

Expert Answers

Leslie Kane is a clinical instructor in occupational therapy at Columbia University and is the manager of occupational therapy for New York Presbyterian Hospital/Columbia University Medical Center.

The term for what you're describing is anosognosia, which means "without knowing." It's a profound lack of awareness of the side of the body affected by the stroke.

Anosognosia is not to be confused with denial. Your father isn't denying that he has a problem; he's literally disconnected from his left arm and leg. For him, they're not a part of his body.

Your father's problem is also probably coupled with neglect, meaning that he ignores the left side of his body and his left visual field, the area he can see with his peripheral vision when focusing in front of him.

This is a tough syndrome to treat, but you can try several different approaches. First, work to increase your father's intellectual attention to what is going on. Keep reminding him that he had a stroke, that the stroke affected his left arm and leg, and that his arm and leg do in fact belong to him. Have him stand in front of a mirror and try to reorient him to where those body parts are: "Where is your left arm? Where is your left leg?"

You should also try to draw your father's sensory awareness to his left side: Touch his left arm and leg, move them for him, encourage him to use them while dressing and eating. If he can, have him put weight on his left leg. When you're talking to him, address him from his left side so that he has to look in that direction.

To help your father use his full range of peripheral vision, it may help to place brightly colored objects in his environment. (Red is very prominent, but anything bright will do.) When you're encouraging your father to scan to his left side, tell him to search for these specific objects so he knows he's looking in the appropriate spot.

Part of the battle of this this phenomenon is understanding that there's no magic formula to solve it. It might be helpful to consult an occupational therapist -- if only for a few sessions -- to help you come up with strategies to use at home.