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Healthy stroke (Sobreviver um AVC)

Como sobreviver a um AVC

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E V E R Y D A Y 
survival Co n n e c t i n g Y o u t o He l p f u l I d e a s 
For many stroke survivors, loss of 
appetite is a common problem. Even 
when appetite isn’t affected, other 
challenges can make getting the 
proper nutrition seem like a chore. But 
a healthy diet is an important part of 
recovery, and it helps reduce the risk 
of another stroke. 
Challenges to the Survivor 
Many factors can make eating 
profoundly difficult for a stroke 
survivor. Some survivors experience 
a reduced sense of taste or smell 
— or both. For others, short-term 
memory loss can cause the survivor 
to forget to chew or swallow. For 
others, paralysis or other physical 
effects of stroke can reduce their 
ability to handle eating utensils. 
Survivors who live alone may find 
getting to the store, buying food and 
preparing it to be more effort than 
they can manage. Such conditions 
as right or left hemiplegia can take 
away the ability to prepare food and 
eat with both hands, creating more 
obstacles to good dietary 
habits. Survivors in 
Eating Smart After a Stroke 
30 January/February 2005 
these cases must learn 
one-handed techniques 
for food preparation 
and eating. 
One common 
condition affecting 
survivors is dysphagia, 
difficulty swallowing. 
(See “Clarifying 
Dysphagia” on 
page 14.) In stroke 
survivors, dysphagia 
typically results from 
an inability to start the 
swallowing reflex, from weakened 
or damaged muscles. The condition 
can create challenges for survivors 
as they try to maintain a healthy diet 
and weight range. 
Food Frustrations 
Along with physical difficulties, 
emotional problems can diminish 
a survivor’s appetite. Depression 
can cause a survivor to lose interest 
in many daily activities, including 
eating (see sidebar on page 31). 
For others, the frustrations of trying 
to get and prepare food while 
dealing with stroke-related physical 
limitations can contribute to a sense 
of helplessness. Survivors may also 
be frustrated or saddened when 
someone has to help them eat. 
With both physical and emotional 
issues to contend with, survivors 
sometimes need help in recovering 
their appetite and maintaining good 
eating habits. Indeed, malnutrition and 
dehydration are potential problems 
for survivors who don’t make the 
necessary adjustments. A 1996 
Canadian study found that 49 percent 
of stroke survivors entering inpatient 
Nourishing Good 
Eating Habits 
A low-fat, low-salt, low-cholesterol 
diet can play a key role in 
preventing a recurrent stroke, 
and controlling weight is also an important 
factor in restoring and maintaining health. 
Here are a few other steps in the right direction 
toward a healthy diet for stroke survivors: 
• Count carbs. Carbohydrates provide a tremendous 
source of glucose, which your brain needs. With this in 
mind, avoid low-carb diets as a way to lose weight. A 
nutritionist can recommend an appropriate eating plan 
especially if you have other diseases, such as diabetes. 
• Make friends with fruits, vegetables and grains. Meat and 
dairy products can be high in saturated fats, which can 
increase stroke risk. Choose lean meat, chicken, fish, and 
nonfat dairy products. 
• Consider what you can eat and enjoy it. Rather than 
focusing on what you’ve had to give up, focus on the 
good things you can eat — and all you’re gaining in terms 
of your health by eating them.
Is Depression Affecting 
Your Appetite? 
January/February 2005 31 
rehabilitation clinics were 
malnourished upon admission. 
Malnutrition symptoms are 
often specific to the particular 
disorder, but the symptoms 
generally include dizziness, 
fatigue, weight loss and a 
decreased response from the 
body’s immune system. If you 
notice any of these symptoms, 
contact your healthcare 
provider. Malnutrition can be 
treated effectively. 
Planning for an Appetite 
The good news is that with 
some planning and possibly 
a few adjustments, keeping a 
healthy appetite and eating a 
healthy diet can be compatible 
goals for stroke survivors. 
Here are some easy measures 
you can take to make eating a 
pleasure again: 
• Choose healthy foods with 
stronger flavors, such as 
broiled fish and citrus fruits. 
Also, spices add flavor to food 
and serve as a good substitute 
for salt. 
• Choose softer, easier-to-chew 
foods, such as whole-grain 
hot cereals, bananas, soups 
and yogurt. 
• Choose colorful, visually 
appealing foods, such as 
salmon, carrots and spinach. 
• Cut tougher foods into small 
pieces to make them easier 
to chew. 
• If you wear dentures, it’s 
important to make sure the 
dentures fit comfortably and 
firmly. Denture discomfort can 
discourage good eating habits. 
• If physical impairment of 
your arms or hands is a 
problem, consider specially 
adapted eating utensils, such 
as flatware with thicker, 
easier-to-grasp handles and 
rocker knives that permit 
cutting with one hand. Check 
a Web directory such as www. 
homemods.org, www.atnet. 
org/atsd/ or www.uchsc.edu/ 
atp/adapted_home/kitchen. 
htm, for information on 
adaptive products. 
• If you’re noticing difficulty in 
swallowing, talk to your doctor. 
Dysphagia can be treated. 
Of course, it’s always a good 
idea to talk to your healthcare 
team to make sure you’re getting 
the nutrition you need. 
Caregivers should observe 
survivors who have dysphagia 
while they eat in case choking or 
other problems occur. Observing 
survivors as they eat will also 
help the caregiver become aware 
of specific issues a survivor 
may be having with eating 
and swallowing. Some ways 
caregivers can promote good 
eating habits include: 
• Sharing meals with the survivor 
at regular times each day 
• Setting a leisurely pace for 
the meal 
• Serving meals that the 
survivor wants 
• Encouraging healthy snacks or 
even multiple small “meals” 
through the day 
• Reducing distractions around 
the dinner table 
Depression is very common among stroke 
survivors, and it’s a serious matter that can 
affect every aspect of recovery — including 
the willingness to maintain healthy 
eating habits. The challenges that some 
stroke survivors face in adapting to new 
techniques and utensils for preparing and 
eating food may make depression worse. In 
that sense, the challenges could become a 
double-edged sword. 
Part of the challenge 
with depression 
is diagnosis. 
Depressive 
symptoms are 
sometimes 
misinterpreted as an 
emotional reaction 
to the effects of a 
stroke, rather than a 
separate condition 
that needs to be 
treated. This means 
the condition should 
be diagnosed as 
soon as possible 
if a survivor is 
demonstrating 
any symptoms of 
depression, such as: 
• A persistent sad, anxious or empty mood 
• Feelings of hopelessness, guilt, 
worthlessness or helplessness 
• Loss of interest in hobbies and activities 
that the survivor used to enjoy 
• Fatigue or a loss of energy 
• Problems with concentration, memory and 
decision-making 
• Insomnia, awakening early in the morning 
or oversleeping 
• Changes in appetite or weight 
• Restlessness or irritability 
• Thoughts of death or suicide, or suicide 
attempts 
Depression can be treated effectively through 
anti-depressant medication, psychological 
counseling and group therapy. If you suspect 
depression in yourself or the survivor you’re 
caring for, contact your doctor.

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Healthy stroke (Sobreviver um AVC)

  • 1. E V E R Y D A Y survival Co n n e c t i n g Y o u t o He l p f u l I d e a s For many stroke survivors, loss of appetite is a common problem. Even when appetite isn’t affected, other challenges can make getting the proper nutrition seem like a chore. But a healthy diet is an important part of recovery, and it helps reduce the risk of another stroke. Challenges to the Survivor Many factors can make eating profoundly difficult for a stroke survivor. Some survivors experience a reduced sense of taste or smell — or both. For others, short-term memory loss can cause the survivor to forget to chew or swallow. For others, paralysis or other physical effects of stroke can reduce their ability to handle eating utensils. Survivors who live alone may find getting to the store, buying food and preparing it to be more effort than they can manage. Such conditions as right or left hemiplegia can take away the ability to prepare food and eat with both hands, creating more obstacles to good dietary habits. Survivors in Eating Smart After a Stroke 30 January/February 2005 these cases must learn one-handed techniques for food preparation and eating. One common condition affecting survivors is dysphagia, difficulty swallowing. (See “Clarifying Dysphagia” on page 14.) In stroke survivors, dysphagia typically results from an inability to start the swallowing reflex, from weakened or damaged muscles. The condition can create challenges for survivors as they try to maintain a healthy diet and weight range. Food Frustrations Along with physical difficulties, emotional problems can diminish a survivor’s appetite. Depression can cause a survivor to lose interest in many daily activities, including eating (see sidebar on page 31). For others, the frustrations of trying to get and prepare food while dealing with stroke-related physical limitations can contribute to a sense of helplessness. Survivors may also be frustrated or saddened when someone has to help them eat. With both physical and emotional issues to contend with, survivors sometimes need help in recovering their appetite and maintaining good eating habits. Indeed, malnutrition and dehydration are potential problems for survivors who don’t make the necessary adjustments. A 1996 Canadian study found that 49 percent of stroke survivors entering inpatient Nourishing Good Eating Habits A low-fat, low-salt, low-cholesterol diet can play a key role in preventing a recurrent stroke, and controlling weight is also an important factor in restoring and maintaining health. Here are a few other steps in the right direction toward a healthy diet for stroke survivors: • Count carbs. Carbohydrates provide a tremendous source of glucose, which your brain needs. With this in mind, avoid low-carb diets as a way to lose weight. A nutritionist can recommend an appropriate eating plan especially if you have other diseases, such as diabetes. • Make friends with fruits, vegetables and grains. Meat and dairy products can be high in saturated fats, which can increase stroke risk. Choose lean meat, chicken, fish, and nonfat dairy products. • Consider what you can eat and enjoy it. Rather than focusing on what you’ve had to give up, focus on the good things you can eat — and all you’re gaining in terms of your health by eating them.
  • 2. Is Depression Affecting Your Appetite? January/February 2005 31 rehabilitation clinics were malnourished upon admission. Malnutrition symptoms are often specific to the particular disorder, but the symptoms generally include dizziness, fatigue, weight loss and a decreased response from the body’s immune system. If you notice any of these symptoms, contact your healthcare provider. Malnutrition can be treated effectively. Planning for an Appetite The good news is that with some planning and possibly a few adjustments, keeping a healthy appetite and eating a healthy diet can be compatible goals for stroke survivors. Here are some easy measures you can take to make eating a pleasure again: • Choose healthy foods with stronger flavors, such as broiled fish and citrus fruits. Also, spices add flavor to food and serve as a good substitute for salt. • Choose softer, easier-to-chew foods, such as whole-grain hot cereals, bananas, soups and yogurt. • Choose colorful, visually appealing foods, such as salmon, carrots and spinach. • Cut tougher foods into small pieces to make them easier to chew. • If you wear dentures, it’s important to make sure the dentures fit comfortably and firmly. Denture discomfort can discourage good eating habits. • If physical impairment of your arms or hands is a problem, consider specially adapted eating utensils, such as flatware with thicker, easier-to-grasp handles and rocker knives that permit cutting with one hand. Check a Web directory such as www. homemods.org, www.atnet. org/atsd/ or www.uchsc.edu/ atp/adapted_home/kitchen. htm, for information on adaptive products. • If you’re noticing difficulty in swallowing, talk to your doctor. Dysphagia can be treated. Of course, it’s always a good idea to talk to your healthcare team to make sure you’re getting the nutrition you need. Caregivers should observe survivors who have dysphagia while they eat in case choking or other problems occur. Observing survivors as they eat will also help the caregiver become aware of specific issues a survivor may be having with eating and swallowing. Some ways caregivers can promote good eating habits include: • Sharing meals with the survivor at regular times each day • Setting a leisurely pace for the meal • Serving meals that the survivor wants • Encouraging healthy snacks or even multiple small “meals” through the day • Reducing distractions around the dinner table Depression is very common among stroke survivors, and it’s a serious matter that can affect every aspect of recovery — including the willingness to maintain healthy eating habits. The challenges that some stroke survivors face in adapting to new techniques and utensils for preparing and eating food may make depression worse. In that sense, the challenges could become a double-edged sword. Part of the challenge with depression is diagnosis. Depressive symptoms are sometimes misinterpreted as an emotional reaction to the effects of a stroke, rather than a separate condition that needs to be treated. This means the condition should be diagnosed as soon as possible if a survivor is demonstrating any symptoms of depression, such as: • A persistent sad, anxious or empty mood • Feelings of hopelessness, guilt, worthlessness or helplessness • Loss of interest in hobbies and activities that the survivor used to enjoy • Fatigue or a loss of energy • Problems with concentration, memory and decision-making • Insomnia, awakening early in the morning or oversleeping • Changes in appetite or weight • Restlessness or irritability • Thoughts of death or suicide, or suicide attempts Depression can be treated effectively through anti-depressant medication, psychological counseling and group therapy. If you suspect depression in yourself or the survivor you’re caring for, contact your doctor.