A stroke is defined as an event in which the blood supply to the brain is either reduced, or eliminated. There are multiple types of stroke including ischemic (a blocked blood vessel) and hemorrhagic (a brain bleed). Ischemic strokes are more common than hemorrhagic strokes. According to the CDC, somebody in the United States has a stroke every 40 seconds and somebody dies of a stroke every 4 minutes. After a stroke, patients may have weakness, pain, numbness, urinary and bowel incontinence, swallowing issues, and memory issues, in addition to many other symptoms.
Hospice care can be very beneficial in patients after a stroke as one of the specialties of hospice in the management of pain and other symptoms. One interesting aspect of post stroke symptoms is called central post stroke pain (CPSP). This is a neurologic, or nerve induced, pain that typically affects the body in the areas in which the stroke had its effect. If the strokes lead to left sided weakness, the CPSP would most likely occur on the left side of the body. Most commonly, we can attempt to treat the pain with antidepressant and anticonvulsant medications that are known to be effective for nerve pain. Opioids, while usually effective for pain, are not the most effective for CPSP. Additionally, the same antidepressants can also help to curb other symptoms, such as post stroke vomiting.
Focusing on Comfort
Stroke prevention, while common in patients who have had a stroke, is not typically seen in hospice care. The most common class of medications for stroke prevention is the “statin” medications. Continuing a statin has been shown to decrease the incidence of additional strokes and decreased symptoms associated with strokes. In the case of a very recent stroke, leaving the medication on can be helpful, however, they are not without issue. Statin medications can have multiple drug interactions that can lead to increased side effects. For example, muscle pain is the most common side effect of statins. Further, stopping statin is the only treatment. Like most medications, side effects become more prominent as patients near the end-of-life.
At Hospice of Southern Illinois, it is our job to keep patients comfortable at the end of their journey. Sometimes this includes stopping medications, like statins, that have benefit due to side effects and risk outweighing the benefit.
Call Hospice of Southern Illinois to learn more about end-of-life care and hospice services, 800-233-1708. Request a chat,
Hospice Month & Our Podcast
Together, hospices around the country are finding ways to make sure families stay safe and supported! We are launching a podcast: Bringing Life to Hospice. It is an exciting extension of Hospice of Southern Illinois’ services. We hope to evoke conversations without fear. It will highlight the importance of planning for a peaceful end-of-life journey. With comfort, education, and safety top of mind, Hospice of Southern Illinois is always looking for ways to support you. More information about hospice, palliative care, and advance care planning is available now. Visit our website, www.hospice.org, or from the National Hospice and Palliative Care Organization’s website, CaringInfo.org.