Stable marriage boosts stroke survival

Posted by Amy Norton, HealthDay Reporter 

 Stroke patients may have better odds of surviving if they’re in a long-term stable marriage, a new study suggests.

Researchers found that among more than 2,300 stroke sufferers, those who’d been “continuously” married had a better chance of surviving—versus both lifelong singles and people who’d been divorced or widowed.

The long-term marrieds’ outlook was better even compared to people who’d gotten remarried after divorcing or losing a spouse.

The reasons for the findings aren’t completely clear, and the study doesn’t prove a cause-and-effect relationship. But researchers said the study highlights the potential importance of “social support” in stroke recovery.

“This implies that the support of a lifelong partner has benefits,” said Dr. Ralph Sacco, a professor of neurology at the University of Miami and a past president of the American Heart Association.
A spouse can give emotional support, he said, as well as help with day-to-day basics—such as eating a healthy diet and remembering to take medications.

“People sometimes consider it ‘nagging,’ but it can help,” said Sacco, who wasn’t involved in the study.

“What we don’t know,” he added, “is whether other forms of social support might have similar benefits.”

In a previous study, Sacco and his colleagues did find that older stroke patients who had friends generally fared better than those who were socially isolated.

But it’s not clear whether friendships directly aided people’s stroke recovery. And no one knows whether unmarried stroke patients would live longer if they joined a support group, for example.
Those are important questions, according to Matthew Dupre, one of the researchers on the new study.
It’s known that “social support” can help people stick with their medication regimens or change unhealthy habits, said Dupre, an associate professor of community and family medicine at Duke University in Durham, N.C.

So it’s possible that unmarried stroke patients could benefit from resources that connect them with other people, according to Dupre.

“More research is needed, though, to know the full implications of our findings, and to identify possible avenues of intervention,” he said.

The findings, reported Dec. 14 in the Journal of the American Heart Association, are based on 2,351 U.S. adults who’d suffered a stroke. Their health was followed for about five years after the stroke, on average.

During that time, 1,362 people died — leaving just under 1,000 survivors. Among those who survived, 42 percent were in a stable marriage with their first spouse. That compared with 31 percent among patients who died.

Overall, Dupre’s team found, lifelong singles were 71 percent more likely to die than stroke patients in a stable marriage.

Much of that disparity seemed to be explained by “psychosocial factors,” the researchers said — including depression symptoms and a lack of children or other close relationships.

It wouldn’t be surprising, Sacco said, if depression were a key reason that unmarried people tend to fare more poorly after a stroke.

“Depression is common after stroke, and it’s been shown to be a predictor of stroke outcomes,” he said. “Depression needs to be recognized and treated.”

Dr. Paul Wright, chief of neurology at North Shore University Hospital in Manhasset, N.Y., agreed.
He said stroke patients at his center are routinely screened for depression. But the new findings, he said, suggest that unmarried patients may need closer attention in general — including extra help with lifestyle changes that can improve their outlook.

“We may need to bring them in for follow-up earlier, and start monitoring them more closely,” Wright said.

Lifelong singles were not the only ones at higher risk in this study. People who’d been divorced or widowed were more likely to die after their stroke — particularly if they’d lost more than one marriage.
Patients who’d been divorced or widowed more than once were about 40 percent more likely to die than those in stable marriages. And those who were currently remarried fared no better.
Certain practical factors, such as income and access to health insurance, seemed to explain part of the risk — but not all of it.

“It may be that patients with a history of marital instability experienced more severe and debilitating strokes — and in turn have fewer economic resources and social support to use toward their recovery,” Dupre said.

For now, Sacco suggested that stroke survivors “reach out and interact with other people” if they feel isolated. Many hospitals have support groups, he said.

People could also try community or church organizations, or even online groups, Sacco said — though, he added, “we don’t know whether computer connections can replace face-to-face human connection.”
Wright agreed that unmarried stroke survivors should reach out for help. But in reality, he added, many do not — so their family members should be proactive.

“Be the ‘nudge’ who makes sure they’re taking care of themselves, even if they say they’re OK,” Wright said.

Copyright © 2016 HealthDay. All rights reserved.

HELP!!!

shutterstock_390496966

Ask Leigh: It Helps to Learn from Others

Posted by Leigh Kost

Dear Leigh: My husband is a stroke survivor.  He had a stroke at age 52 on Oct. 30, 2015.  He has right side paralysis and expressive aphasia. It is very hard to see your soul mate this way. I have been trying to fix him, but just realized I can’t.  I’ve had to stop working to care for him.  He has progressed fairly well, according to the therapist, and is trying to gain back his independence.  I don’t know what to expect. I haven’t been able to find any support groups in my area. – Tammy

Leigh Kost: I do believe exposure to successful stroke survivors and their caregivers would help you immensely. To find a support group you might try looking on the support group registry on Stroke.org, or contacting the stroke coordinator at your local hospital. As an alternative, I personally have found support on social media groups such as Facebook, but I can’t endorse any specific internet group. These groups are unregulated, not run by professionals, and are subject to the various personalities involved, but it might be worth looking into.

There are also groups for caregivers. Interaction with other survivors helped me tremendously. I have spent countless hours online having conversations with other survivors. Be careful; not everyone online can be trusted. Additionally, whenever you encounter anyone in the stroke community, ask as many questions as you can. I have found it’s best to learn from other’s experiences. Unfortunately, there does not seem to be a guidebook regarding how to address the myriad of issues faced by stroke survivors and caregivers.

Some general advice; your husband is still the man you married. He is having the fight of his life and needs you to be the spouse that you promised him that you would be when times got bad. There is nothing in the world that can prepare you for what you are experiencing. While every stroke is different, I am here to testify that many stroke survivors go on to have a very good quality of life. My stroke would have been classified as severe, but I enjoy my life. My life is different, but its’s still good. A term heard often in the stroke community is that stroke recovery is a marathon, not a sprint.

 

Leigh Kost is a stroke survivor who wants to help people within the stroke community cope with the emotional and lifestyle changes that can occur following a stroke. She gives advice based on her own personal experience. She is not a healthcare professional and cannot give medical advice. You can submit questions for Leigh at AskASurvivor@strokesmart.org.

The material provided in this column is designed for entertainment purposes only. The views expressed reflect those of the author and do not reflect the opinion of National Stroke Association. You should not rely on any information on this page to replace consultations with qualified health care professionals to meet your individual medical needs.

A Caregiver’s Perspective on Life Changes Post-stroke


by StrokeSmart

Becoming a caregiver at age 28 forced Brian Baez to reevaluate his time, priorities and make changes to his life. He says he’s grateful for the lessons he’s learned along the way.

A Loss for Words

Baez sensed something was wrong with his husband, Jason Campbell, when he missed two of his lines as the two performed in a matinee theater production in March 2014. Unsure what was happening, the cast covered for Campbell until he slumped over in a chair. Baez carried him off stage and called 9-1-1.

The ischemic stroke did little physical damage but left Campbell—a 34-year-old actor, director, and teacher at the time—struggling for words. While he is able to speak in short sentences and sign language, Baez says they mostly communicate through “20 Questions.”

No Time to Reflect

Although Baez had some experience with stroke survivors through his full-time job as an educational marketer at a skilled nursing facility, he wasn’t entirely prepared for what it meant to care for Campbell on a daily basis. He learned quickly how important a support system, like the one they had in the local theater community, was.

Even with their friends’ help, though, Baez didn’t have much time to process what had happened initially. He says, to an extent, he is still working through the emotions and coming to terms with the fact that he might never have a full conversation with his husband again.

In some ways, though, the stroke has been a blessing. Baez says it forced him to reevaluate his life, “whittle away the extra” and unimportant things, and focus on what really matters.

While others his age are chasing dream jobs and dream homes, he realizes that his life can have meaning without those things.

“In some weird, twisted way, I’m grateful to have learned these lessons at my age,” Baez says.

Helping Other Caregivers

As executive coordinator and caregiver liaison now at The Aphasia Center, Baez shares these tips with other caregivers:

  1. Don’t neglect your own health. Take care of yourself.
  2. Find a support system. Even just one or two people can make a difference.
  3. Take advantage of others’ offer to help. A friend taught Campbell to sign.
  4. Look for online caregiver forums for additional support.
  5. Accept that you will both get frustrated, especially when dealing with aphasia. Step back, take a moment, and then reconnect.

Giving TUESDAY…

Screen Shot 2015-12-01 at 10.41.12 AM

On this Giving Tuesday, support what matters most to you at OHSU.Lifesaving scientific breakthroughs. Healing children and helping families. Care and compassion.

We have created the OHSU 2015 Giving Guide for this giving season to help you find the cause at OHSU that sparks your passion. The need is great, and the possibilities are even greater.

What will you give this season? Make a Gift to OHSU today.

Women Caregivers Are More At Risk

 

Posted by Teresa Bitler

According to a study released at the International Stroke Conference, gender plays a role in a caregiver’s health. The study revealed that women, especially those caring for their spouses, were much more likely to develop serious health conditions, including high blood pressure, heart disease, and diabetes.

Women Are More At Risk

Stressed woman illustration.In general, female caregivers are more at risk for serious health conditions than their male counterparts. They report higher incidences of depression and anxiety and lower levels of well-being and life satisfaction. Female caregivers are also more likely to experience chronic disease, an increased risk of cancer, diminished immune system, and physical ailments such as acid reflux and headaches.

Studies indicate that the increased health risks may be associated with how women are wired. Female caregivers tend to have more of an emotional attachment to caregiving than their male counterparts.

Marriage Impacts Stress And Health

Providing care for your spouse can also put you at a higher risk for developing serious and chronic health conditions. The study released at the International Stroke Conference found that spousal caregivers and caregivers of the opposite sex of those they were providing for tended to experience a greater decline in health.

Spouses are particularly prone to burnout and health risks because caregiving can cause significant changes in the dynamics of the marital relationship. Plus, since you live together, you don’t get breaks from caregiving.

The study also indicated that the women who cared for their spouses tended to be at greater risk than men who cared for theirs.

Other Factors Compound The Risk

Some female caregivers are more susceptible to developing health issues than others. The study found other factors influenced the risk, including:
• Length of caregiving
• Difficulty of caregiving tasks
• Perceived impact on caregiver’s life

What You Can Do

Although female caregivers are at greater risk for developing health issues, providing care for a stroke survivor can have an impact on men, too. The National Alliance for Caregiving states that nearly half of the caregivers they surveyed indicate that their health has gotten worse as a result of caregiving.
Take these steps to alleviate stress and protect your health:

• Ask for help from family and friends
• Join a support group
• Take time for yourself to visit with friends or enjoy a hobby
• Arrange for respite care
• If married, focus on the positive aspects of caregiving on relationship
• Schedule regular physical check-ups for yourself
• Exercise and meditate