It’s common knowledge that strokes are frequently unpredictable, and physically devastating. Lesser known, but even more devastating, is the transformation of a loved one’s personality following a stroke or the onset of dementia.
According to the National Stroke Association, “Approximately 20 percent of stroke survivors have cognitive impairments after a stroke,” with the risk of impairments growing along with an increase in age. Stroke survivors aged 65 and over face higher risks, and complications can include “memory loss, confusion, decreased attention span and problems performing everyday activities.” The Centers for Disease Control and Prevention also notes that at least 25% of caregivers for adults over age 50 are looking after someone with cognitive impairment or dementia.
Depending on the area the stroke affects, caregivers may notice drastic changes in their loved one’s personality and emotions. For example, right brain strokes can cause damage in the part of the brain responsible for empathy, where left brain strokes can result in the loss of ability to learn new information, or depression. Aggression, apathy, passivity and memory loss can occur with damage to either side of the brain. Caregivers may also notice their loved one reacting to the effects of their own stroke as well. Lauren Shapiro, Psy.D., Clinical Psychologist, comments:
“Though many emotional changes following a stroke are due to chemical or physical changes in the brain, they can also stem from one’s reaction to the effects of the stroke. For example, stroke survivors may feel sad or depressed if they can no longer live independently, angry if their speech has become impaired, or fearful that they may have another stroke.”
When a Loved One Becomes a Stranger
One of the remarks I hear most often while talking with family members is that they feel that they are now dealing with a stranger; a stroke or dementia has changed their loved one so much that they don’t know them anymore. After decades of marriage, spouses can become strangers, or children can find that their parent is no longer the comforting presence they have always been.
The gentle, kind wife you married could become aggressive and belligerent following a stroke or after dementia has progressed to a later stage; Or- your once energetic, on-the-go mother could become apathetic, sitting and staring out the window all day. Although this can be a difficult situation to deal with, it helps to remember that this is not something you are causing in your loved one, rather, that the behavior is the direct result of the health condition. Dr. Shapiro notes,
“It is very common for caregivers and their loved one to experience feelings of loss and grief after a stroke. It’s important to know that it is okay to mourn the losses associated with changes in your loved one’s mood, personality and abilities.”
Caring for Your Loved One
While caregiving can be stressful, caring for someone who has changed so much is exponentially more difficult. It can be very hard not to compare the person who once was to the person who is now. A common sentiment is “I just want my loved one back.”
Although coping strategies depend on your loved one’s specific behavior, it is generally important for the caregiver to get support from other family members and caregiver groups during recovery. Dr. Shapiro recommends this kind of coping strategy saying,
“Caregivers often find it helpful to meet others who are experiencing similar challenges. You learn that, although challenges and coping styles may differ from person to person, you are not alone.”
It’s important to note that although each survivor is different, behaviors can be managed in several ways. For instance, you can prompt and encourage a now apathetic loved one to take part in activities with you. Someone who has lost emotional control will benefit from a calm and structured environment. For the person now lacking empathy, telling them how you feel about their responses and thanking them when they do respond appropriately can help. Aggression is often more difficult to handle, but above all, the caregiver and the survivor need to be kept physically safe. If any behavior is putting you or your loved in danger, it is imperative that you get help right away.
Although it can be difficult to care for a loved one whose personality has changed, conditions can improve with time, and many family members and friends often see glimpses of the person they love reemerging.
Has your loved one changed after suffering from a stroke or are you caregiving for someone who suffers from dementia?
About Lauren Shapiro, Psy.D:
Dr. Lauren Shapiro is a Staff Clinical Psychologist at Primary Care Psychology Associates (PCPA). She received her doctorate in Clinical Psychology from The Chicago School of Professional Psychology, and works as a behavioral health consultant within primary care settings at Northwestern Memorial Physicians Group (NMPG). Dr. Shapiro works with patients who have recently been discharged from Northwestern Memorial Hospital, and her areas of interest include trauma, anxiety, depression, adolescent struggles, anger management, parenting skills, and adjustment difficulties.