We don't really know anything about strokes; are these things normal?

Deathana asked...

Me and my family have no experience dealing with stroke patients. My grandpa had stroke only a couple of weeks ago. He's now still in the hospital to be treated for his pneumonia. I'm now sleeping with him at the hospital because I love him so much. He's sleeping most of the time, and can't even begin any form of therapy because he sleeps even when standing up. Is that normal? The therapist is very young, and she said there's another elderly just like my grandpa before, but added, "At least he doesn't fall asleep when standing up like this.". I felt sad. Does that mean my grandpa's condition is worse? :(

And one more question : Last night and tonight, I realized he was trying to speak, trying to say something but no words came out. He tried again and again but to no avail. Then he looked really sad. I've read about depression after stroke. Is there anything we can do to not make him depressed? Should we explain to him that he had stroke and can't talk ,but will be able to soon? Or is it better to leave it for himself to figure out that he can't talk?

Any advice would be very much appreciated. It breaks my heart to see him like this :(

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 your situation. It sounds like your grandfather is having "aphasia", "encephalopathy", and possibly depression.

Aphasia is a condition where language production or understanding is impaired. He may not be able to understand you, and you may not be able to understand him. Depending on how severe the stroke was, comprehension and speech are effected differently. Therefore, you can try talking to him and seeing if he understands you. Ask him to "point at the ceiling" for instance, to see how much comprehension he has intact. Like all stroke symptoms, as a general rule, these deficits get slowly better over time, but the degree of improvement will be unknown. I have seen people get virtually no better, some get substantially better. Having a speech therapist work with him will be very good.

The sleepiness is likely related to "encephalopathy" - also called "delerium" - a combination of the stroke and the pneumonia. It should get better over time, particularly as the pneumonia clears up.

As for the depression, this is very common after stroke. If the stroke occurred several weeks ago and he is still depressed, I would ask your doctor about starting an anti-depressant. Those medicines have been shown in some trials to improve mood and outcome for stroke victims, and it sounds like he would be a good candidate.

Overall, patience is of much importance after a stroke. Strokes often do not improve as fast as we would like. Working with him on his speech and being there for him in a supportive fashion are critically important for his recovery.

Good luck!!