In Nigeria, Caregivers of Severe Stroke Survivors Suffer More from Mental Health Disorders and Tips on Coping

 

By Oluwasola Samuel, Freelance Writer. With medical review and editorial support by the DLHA Team.

Family craegiver hugging stroke survivor in wheel chair

 

 

Introduction

 

Stroke takes a great toll on its victims and their families. Its aftermath is intense. It leaves most people with lasting effects like disability and difficulty in talking or swallowing. Stroke survivors encounter many physical, mental, social, family and financial challenges during and after stroke treatment.

 

Whereas, a lot of studies have been carried out regarding burden, quality of life and stress-related issues of caregivers of stroke survivors in diverse income countries [1-3], less attention has been paid to the well-being of caregivers of stroke survivors in the African context. [4.5]

 

Caregivers build a support system for stroke survivors. [6] They define what stroke survivors need. They help with a lot of things like grocery shopping, meal preparation and feeding, walking, and exercising. 

 

Most times, caregivers' emotions and mental well-being change. This is a result of the overwhelming demand for care needed by stroke survivors, the limited available resources and how long it takes to care for a stroke survivor. 

 

According to a 2019 study from Nigeria, caregivers are more susceptible to anxiety and depression when compared to stroke survivors. [7] Other findings of the study are summarised below:

• Women make up a larger percentage of caregivers (87%)

• Caregivers, mostly women, had an average age of 42 years. They were younger than most stroke survivors, whose average age was 61 years old. 

• Caregivers reported feeling the stress or burden of taking care of stroke survivors. Over 80% had moderate-to-severe burden scores. 

• 17% of caregivers had depression and anxiety disorders. 

• Caregivers with a higher burden experienced a low quality of life (physically, financially, and mentally). 

• Caregivers struggle more with stroke survivors who have no control over bodily discharge (mucus, faeces, or urine). They also found it difficult to address psychological symptoms in stroke survivors. 

• Factors like age and health affect how stressed they feel.
   

The study proposed adopting a dyadic approach to helping caregivers and the stroke survivor. It suggested therapy sessions and support groups for both the stroke survivor and their caregivers arguing that both parties get the help they need to cope and learn together.

 

In developing nations, like in most African nations, resources for stroke rehabilitation are scarce and expensive. Caregivers remain one of the most reliable and cost effective sources of caregiving for stroke survivors.

 

Taking care of a severe stroke survivor who is disabled can be stressful. In this condition, they solely rely on their caregivers to eat, feed, bathe, and perform other tasks.

 

So, the burden of care can affect caregivers' mental and physical well-being. Hence, the need for psychological counseling and social support. This, in turn, will have a positive impact on the quality of care that caregivers give stroke survivors.

 

Seeing a loved one experience the physical and emotional impact of a stroke can be challenging for a caregiver. It can result in mood swings, feelings of helplessness, anger, and hatred towards loved ones. To prevent this, family members and friends need to support caregivers physically and emotionally to stay focused.

 

Tips for caregivers to attain positive physical and mental health while caring for stroke survivors.

 

Seeing your once active and vibrant family member now at your mercy to eat, sleep, walk, or do other things due to the lasting effects of stroke can be heart-wrenching for anyone, not to talk of caregivers. Below are some tips to help caregivers give the best care and stay active. [8, 9]

 

1. Learn to take breaks and adopt relaxation techniques

 

Taking care of yourself doesn't mean you are selfish; it only means you are conscious and you value your well-being. As a caregiver, it's important to incorporate breaks into your caring routine. Most especially when caring for a stroke survivor.

 

Caregivers should see taking breaks as a game of soccer. In a game of soccer, there are two halves and two cooling breaks each. This helps the players get a breather and approach the game fresher and stronger. Taking time off allows you time to refuel and come back to your duty stronger and with a clear mind.

 

Below are effective and practical ways to help you take breaks during your caring routine:

• Practice relaxation techniques.

• Engage in activities you enjoy doing.

• Delegate tasks to friends or family members if the need arises.

• Plan your break and schedule it for 15–30 minutes every day.

 

2. Engage in physical activities 

 

Physical activities impact your physical and mental health positively. The body releases endorphins when you engage in physical activities. This combats stress and anxiety commonly experienced by caregivers.

 

Also, engaging in physical activities or exercises helps to improve the quality of your sleep. It also helps the function of your muscles and it helps divert your attention away from your worries. This provides a temporary escape from the stress of caregivers. [9]

 

Before engaging in any physical activity, ensure to do the following:

• Sometimes, involve the stroke survivor to enjoy the moment and stay motivated together.

• Start gradually and find activities you enjoy doing.

• Make sure you listen to your body; know when to stop.

 

Incorporating physical activities or exercise into your routine will help you a great deal in improving your physical and mental well-being. 
 

3. Eat balanced diet

 

You need to take your diet seriously at all times because you are what you eat. Eating a nutritious and balanced diet is a no-brainer. A balanced diet doesn't only provide you with energy or strengthen your immunity. It also enhances your mood and cognitive function. An improved cognitive function is crucial for decision-making when caring for a stroke survivor.

 

A balanced diet isn't difficult to achieve. Aim for a variety of fruits, vegetables, whole grains, lean protein sources, healthy fats, nuts, and seeds.

 

For a personalised recommendation or advice, kindly visit a nutritionist or a dietitian. 
 

4. Welcome support

 

Caregivers often end up feeling fatigued and out of shape. This often puts them at risk of falling ill. 

 

Caregivers should seek support from family members or friends. You can assign little tasks for them to execute. This gives you ample time to rest and recuperate from the stress of caregiving. 
 

5. Socialize

 

Amidst caring for stroke survivors, socialising is a great way of improving one’s mood. Sharing your experience with others in an online closed group of caregivers can provide you with valuable insight. It can help you learn how to cope with the stress of caregiving.

 

Also, there is lots of comical social media content online. You can watch them while it makes you smile, laugh, and relieve your stress.

 

It's important to note that how everyone chooses to socialise differs. So choosing how you socialise will help you feel less isolated. It will also improve your stress levels.
 

6. Access to mental health services

 

Support groups where other caregivers narrate their ordeal or experience can help you a great deal. They can help you overcome your emotional and mental stress. Listening to how other caregivers overcome their struggles will help a lot. Also, booking therapy and counseling sessions with a mental health professional will help you process your thoughts and emotions. It also will help you develop coping mechanisms against stress, anxiety, and depression.

 

Having access to mental health services is an important resource for caregivers of stroke survivors. This can help you cope with the emotional challenges that come with caring for a stroke survivor.

 

 

Conclusion

 

Caring for stroke survivors can cause physical and mental strain for a caregiver. This reduces the quality of care they give stroke survivors. However, there is hope on the horizon. Acknowledging your struggles and adopting solutions like taking breaks, engaging in physical activities, and using mental health services will help a great deal.

 

Having access to mental health services can empower caregivers. It will help caregivers prioritise their mental health and improve their general well-being. Remember, a healthy caregiver is a better caregiver.

 

 

References

1. Kumar A, Yadav AK, Singh VK, Pathak A, Chaurasia RN, Mishra VN, Joshi D. Caregiver Burden in Caregivers of Stroke Survivors: A Hospital-Based Study. Ann Indian Acad Neurol. 2022 Nov-Dec;25(6):1092-1098. doi: 10.4103/aian.aian_318_22.

2. Sidek NN, Kamalakannan S, Tengku Ismail TA, Musa KI, Ibrahim KA, Abdul Aziz Z and Papachristou Nadal I. Experiences and needs of the caregivers of stroke survivors in Malaysia—A phenomenological exploration. Front. Neurol. 2022. 13:996620. doi: 10.3389/fneur.2022.996620

3. Muthucumaran MW,  Samarasinghe K,  Elgán C. (2018) Caring for stroke survivors: experiences of family caregivers in Sri Lanka – a qualitative study, Topics in Stroke Rehabilitation, 2018. 25:6, 397-402, DOI: 10.1080/10749357.2018.1481353

4. Okonkwo UP, Agbo CF, Ibeneme SC, et al. The Burden and Quality of life of Caregivers of Stroke Survivors with Cognitive Impairment in Selected Healthcare Facilities in Anambra State, Nigeria. Gerontology and Geriatric Medicine. 2022;8. doi:10.1177/23337214221126329

5. Bekele G, Yitayal MM, Belete Y, Yisak G, Tesfa K,  Awoke AY, Gedlu NS, Azeze EG. Caregiver burden and its associated factors among primary caregivers of stroke survivors at Amhara regional state tertiary hospitals: a multicenter study. Frontiers in Stroke, 2023. Vol. 2. DOI=10.3389/fstro.2023.1226140

6. American Stroke Association. Let’s talk about being a caregiver for a stroke survivor [Internet, n.d.]. [cited 2024 Jan 27]. Available from: https://www.stroke.org/en/help-and-support/resource-library/lets-talk-about-stroke/being-a-stroke-family-caregiver

7. Oni OD, Olagunju AT, Okpataku CI, Erinfolami AR, Adeyemi JD. Predictors of caregiver burden after stroke in Nigeria: Effect on psychosocial well-being. Indian J Psychiatry. 2019 Sep-Oct;61(5):457-464. doi: 10.4103/psychiatry.IndianJPsychiatry_395_18.

8. American Heart Association. Top 10 caregiver tips for maintaining health and well-being [Internet.Last reviewed Oct. 25, 2021 ]. [cited 2024 Jan 27]. Available from: https://www.heart.org/en/health-topics/caregiver-support/top-10-caregiver-tips-for-staying-healthy-and-active

9. Mayo Clinic. Practical solutions for caregiver stress [Internet. Aug. 9, 2023]. [cited 2024 Jan 27]. Available from: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/caregiver-stress/art-20044784

 

 

Related:

• Stroke in Africa: What you need to know
• Stroke treatment in Africa
• Solutions to the challenges of stroke care in Africa

 

 

Published: January 29, 2024

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