Stroke hits the minds of spouses, too

Depression common in caregivers after sudden illness

MONDAY, July 23, 2001 (HealthDayNews) -- Swedish researchers have found spouses of stroke victims suffer high levels of stress and depression after their husbands or wives become sick.

While accidents and some illnesses also hit suddenly, stroke has a unique way of harming how married couples function, says study co-author Dr. Christian Blomstrand, a professor at Sahlgrenska University Hospital.

"A changed personality can be particularly wounding to the spouse," he says.

Researchers also found the mental stress can spell trouble because it can affect a person's ability to care for an afflicted spouse.

Using a questionnaire and interviews, researchers studied 83 spouses of stroke patients during the 10 days after a stroke. The stroke patients ranged in age from 23 to 75, with an average age of 58.

The findings appear in the July issue of Stroke: Journal of the American Heart Association.

Most spouses suffered from a significant decline in psychological "well-being," regardless of whether they were men or women. The subjects suffered even if their partners' strokes were mild.

Blomstrand says doctors and nurses may fail to realize the problems caregivers face, raising the risk of "misunderstandings and conflicts." Even when medical personnel view a stroke as minor, it may have a huge impact on the sufferer's spouse, he says.

"The crucial thing for the spouse is how he or she perceives the disease, and not how we as experts in the health-care field measure (the stroke)," Blomstrand says.

Doctors and nurses can help spouses by paying attention to how they cope with stroke, Blomstrand says. The spouses also should be active participants in the rehabilitation of their partners, he says.

While the study took place in Sweden, Blomstrand says the findings should reflect how couples act in other Western countries.

But Dr. James Grisolia, a neurologist at Scripps Mercy Hospital in San Diego, says the findings may not translate to the United States, especially since research has shown Swedes tend to be more depressed than people of other countries and cultures.

"But it's fair to say that stroke is the leading cause of disability in the United States, causing more than head trauma, AIDS or cancer," he says. "It's a sudden thing that has a marked effect on peoples' sense of who they are. Their cognition, speech and freedom of movement can all be compromised. That's something that really is devastating, not only to the patient, but their family as well."

In some cases, a stroke can reverse roles in a relationship, turning a nurturer into someone who needs to be nurtured, he says.

"The suddenness of it is devastating. Since it's an abrupt onset, they don't have the same chance to adapt to it, compared to the slow onset of arthritis, for example," he says.

In some ways, a stroke also can a bring a couple together, he says.

"I had one lady who came in with a stroke that was really frightening to her and her husband. The way they adapted was to focus on preventative health measures," such as blood-pressure tests and exercise.

"That gives them more of a sense of control over their lives," he says.

Most spouses don't need individual counseling and do better in support groups where they can learn from the experiences of others, he says.

"It's very psychologically wearing for the spouse who gets trapped at home as the sole caregiver," he says.

What To Do

Learn more about stroke and its effects on patients in this fact sheet from the Family Caregiver Alliance.

Learn about stroke support groups from the American Heart Association.

SOURCES: Interviews with Christian Blomstrand, M.D., Ph.D., cerebrovascular research group, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Goteborg, Sweden; James Grisolia, M.D., Scripps Mercy Hospital, San Diego; July 2001 Stroke: Journal of the American Heart Association
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