This month’s CE article, “Early Intervention in Patients with Poststroke Depression,” hit home for me. It brought back memories of my Aunt Rita’s decline from a once-vibrant and independent career woman. As authors Gwendolyn Hamid and Meredith MacKenzie note, poststroke depression “often goes unrecognized and untreated because the physical and cognitive repercussions of stroke make it difficult to identify.”
Aunt Rita lived alone in an old Victorian house in Massachusetts. She was fun-loving and lively and enjoyed going to the theater and dinner in Manhattan, shopping, and sipping a beer and rooting for the Red Sox and Boston Bruins—especially when she was with her New York nieces and nephews. When she had cardiac bypass surgery in her 70s, however, things changed drastically. She didn’t bounce back from surgery. Aunt Rita was slow and tentative in moving about and became quiet and withdrawn. A niece came to live with her as a caregiver, but Aunt Rita didn’t seem to want to eat, drink, or even bathe. Her physician diagnosed organic brain disease secondary to the effects of a stroke.
About three months later, I drove up from New York to visit her along with my mother (Rita’s younger sister) and my youngest son, who was then three years old. A natural ham and used to attention as the baby of the family, he would do somersaults and run in circles to get Aunt Rita to react. He was hard to ignore, and after a day, she seemed to take an interest in his antics and constant chatter. We went on a picnic with some other relatives and Aunt Rita seemed to perk up a bit. By the time we left after the three-day visit, she was still slow but was eating and talking and even took an interest in a Red Sox baseball game.
This turnabout didn’t last very long though, and Aunt Rita’s condition progressively deteriorated. She died about six months after our visit. When I think back on my aunt’s final days, it seems to me that she showed all the signs of being depressed. I wonder if antidepressants, more social interaction, and physical therapy might have extended her life. The authors of our June CE on poststroke depression, citing research, note how common the condition can be among stroke survivors:
“Depression is one of the most common neuropsychological consequences of stroke. Pooled data from 61 studies that included more than 25,000 participants with a clinical diagnosis of stroke suggest that roughly 31% of stroke survivors experience depression within the five years following stroke.”
Read this important article, and learn how nurses can “recognize poststroke depression, educate patient caregivers, and aid patients who have poststroke depression in their efforts to achieve physical, cognitive, and emotional recovery.”