Update On Brother 3

[abbybuggie]

Hey guys. So, my brother saw his doctor and she prescribed him medicine to help with his swallowing and eating and he is doing significantly better. He is now consuming up to 1500 calories a day, which is the bare minimum, but it's good. Though, he is severely depressed. He cries about every 2 hours, either over thinking too much, or a sad song even. He also had a life on the internet, along with a romantic relationship he had via online which he cannot contain in the moment. He can walk fine, and the rest of his body moves fine too besides his hands. The doctor told us that he should be doing therapies with them and they should be fine because it wasn't too damaging, but he has no motivation to do them and I do not know why. Any tips on how to motivate him? This is one of his main obstacles along with his talking. He can speak, but when he does it's very 'breathy'. And although he can speak, he wont. If you have any ideas, please tell me! Thank you.

[Buenchico]

I'm out of my depth here but I hope that these links might help:

https://www.stroke.org.uk/sites/default/files/user_profile/helping_someone_with_communication_problems.pdf

https://www.stroke.org.uk/sites/default/files/user_profile/depression_and_other_emotional_changes.pdf

[rowanwitch]

Woofgang will probably be on later and will help, don't worry too much about the crying it's normal for a lot of stroke patients as is depression while they adjust counselling will help and they might consider pills for a while.

Computers normally have a voice activated mode these days and once it learns his breathy voice he might be able to re engage.
Sounds like he is doing brilliantly though.

[murraymints]

heading in the right direction..he will get stronger day by day if he continues to eat.. his mood will be all over the place understandably,has he been seen by the psychs yet ? physio daily will help get him motivated... woofy is the expert hopefully she will call by soon.. I wish you both the very best xx

[Sqad]

Thanks for the update and i reiterate the comments on my post:

https://www.theanswerbank.co.uk/Body-and-Soul/Question1609139.html

He is doing fine and you are developing unrealistic rapid expectations which will take longer than you think. There are no quick shortcuts here and rehabilitation will be slow but luckily he is in the USA which concentrates more on these issues rather the UK.
I agree with rowan, woofgang will be along shortly.

He must walk before he can run and this will take time....no shortcuts.

[woofgang]

Well Woofgang is here but with nothing much useful to add this time I am afraid. Sqad has nailed it in his post. There is no short cut or quick way, all of us wish there was. Post stroke depression is very common and has three main causes. A person can be affected by one, two or all three and its often hard to tell what is happening. The first is bereavement, grieving for the person he was and will never be again and for the abilities he has lost. This is part of the reality hitting thing. Like any kind of bereavement grief, its a process that is individual to the person and will take as long as it takes to resolve. Close people can help by being there, calm, patient and not expecting too much.
The second cause seems to be purely neurological and a part of the stroke. Not everyone gets this but it is seen in some people....also of course its very hard to unpick what is causing anyone's depression and to what extent so this very hard to be sure about.
The third cause (and I mean this kindly but it has to be said) is caused by the behaviour of those close to the patient.....by their kindly meant expectations and "attempts to motivate" This can make the person who has had the stroke feel like a failure and a loser. Relatives and close friends mean well but there has to be patience in bucketloads and realism in how they behave. Love accept and appreciate the person who you have. Make it clear to them that they are not failures because their recovery is slow or does not come. Time and again I have seen and heard loving and well meaning relatives say that they have postponed things "until Dad is better" "until bro can walk again" and so on. Can you imagine the pressure this puts on someone who is struggling to make sense of new disabilities or the exacerbation of existing ones?

Of course with your brother, his pre existing problems might be a factor too. I am not aware of research on how someone on the autistic spectrum is affected by stroke but it would seem possible/likely that there will be changes not seen in someone who is not on the spectrum. Both Autistic Spectrum difficulties and stroke can have a marked effect on how people see and interpret the world and I would imagine a mix of both would add to the problems of recovery.
It sounds like he is getting good medical and rehab care and you are a loving sister. I would urge you to also be a patient one....support your brother of course but maybe back off a little on the attempts to motivate?

[woofgang]

Sorry I had to let the dogs out. Crying and loss of emotional control after a stroke is very common indeed and is usually caused by the location of the brain damage ...it can also manifest itself in fits of anger......of course having a stroke and dealing with its aftermath also gives the person a lot to feel both sad and angry about which doesn't help. The same damage location can also lead to a more general disinhibition (loss of control) I did meet one lady who had been very shy and withdrawn all her life who was changed completely by her stroke into a chatty outgoing person. Of course we who met her post stroke weren't aware of this till her neighbours and people from her church asked what had happened to her.
The best way to help your brother when he cries is to be as calm and unworried as possible. If you become distressed by his distress it will make things worse. Keep tissues handy, let him have his cry, keep the reaction loving but low key. It can help to think of the tears as the same sort of reaction as people have when they cry at sad movies or at weddings. The feelings are real and valid but perhaps more fleeting than is usual in adults. Again this is something that may or may not resolve....and again may be affected by your brother's other issues.