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Post Stroke Depression

W.Hazzard "Principles of Geriatric Medicine and Gerontology".. 2. DEPRESSION. Depression is not a normal consequence of aging any more than it is a natural part of any life stage. depression is caused in part, by certain life goals which become unfeasible, but which a person cannot abandon, result

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Post Stroke Depression

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    1. 1 Post Stroke Depression Lana Richardson BSW, RSW Social work consultant Maureen McDermid Jill Rita- Patey An overview of depression especially following a stroke, the causes, symptoms and PREVENTIVE STRATEGIES Some slides have been borrowed from presentations given by Maureen McDermid and Jill Rita-Patey. My own research will be noted in the references. An overview of depression especially following a stroke, the causes, symptoms and PREVENTIVE STRATEGIES

    2. W.Hazzard "Principles of Geriatric Medicine and Gerontology". 2 DEPRESSION Depression is not a normal consequence of aging any more than it is a natural part of any life stage. “depression is caused in part, by certain life goals which become unfeasible, but which a person cannot abandon, resulting in reflection on lost goals. To gradually abandon these goals and work towards other goals is to overcome depression”. Later in the presentation we will see how we can be instrumental in helping individuals realize new goals.Later in the presentation we will see how we can be instrumental in helping individuals realize new goals.

    3. 3 STROKE AND DEPRESSION Depression can affect anyone, but people who have a serious illness such as stroke may be at greater risk Now recognized as a frequent consequence to stroke Estimated that between 40 – 50% of stroke patients have Post Stroke Depression (PSD)

    4. 4 Depression and Stroke Survivors Stroke survivors are most likely to suffer from depression within the first three months post-stroke, after multiple TIA’s and within the first four months after placement in a residential care setting. Sometimes this is delayed in onset up to 2 years post stroke

    5. 5 CONTRIBUTING FACTORS Location of lesion - left frontal lobe significantly at risk Previous or family history of depression - 20% of PSD have prior history Bereavement - those over age 70 who recently lost a spouse were 9x more at risk High pre-stroke alcohol intake

    6. 6 Major functional impairment - especially in stroke survivors who have lost the capacity to care for their own needs Helplessness and hopelessness - due to losses of social roles and control Pain - frequently not recognized and under treated A useful tool is the Edmonton Symptom assessment Scale. A useful tool is the Edmonton Symptom assessment Scale.

    7. 7 Physiological Side Effects Depression is often accompanied by: - a change in sleep pattern - weight gain or loss - a change in appetite Other effects are: - flat affect - increased sensitivity to pain and discomfort - lack of self care Some changes to look for are… Depressive symptoms and anxiety are both associated with the presence of serious pain. Pain is frequently not recognized especially in those who lack communication skills. It is also observed that pharmalogical treatment is suboptimal. New tools such as the ISAS and ______ will greatly help us to measure pain. ISAS- ------Some changes to look for are…

    8. 8 Emotional Side Effects Frustration Feeling inadequate Feeling unworthy Discouraged Grumpy Helpless

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