Nourishing Good Eating Habits by jennyyingdi


									 E V E R Y D A Y

survival                                       Con n e c t i n g Y o u t o H e l p f u l I d e a s

     Nourishing Good
        Eating Habits
 For many stroke survivors, loss of           these cases must learn
 appetite is a common problem. Even           one-handed techniques
 when appetite isn’t affected, other          for food preparation
 challenges can make getting the              and eating.
 proper nutrition seem like a chore. But         One common
 a healthy diet is an important part of       condition affecting
 recovery, and it helps reduce the risk       survivors is dysphagia,
 of another stroke.                           difficulty swallowing.
                                              (See “Clarifying
 Challenges to the Survivor                   Dysphagia” on
    Many factors can make eating              page 14.) In stroke
 profoundly difficult for a stroke             survivors, dysphagia
 survivor. Some survivors experience          typically results from
 a reduced sense of taste or smell            an inability to start the
 — or both. For others, short-term            swallowing reflex, from weakened          dealing with stroke-related physical
 memory loss can cause the survivor           or damaged muscles. The condition        limitations can contribute to a sense
 to forget to chew or swallow. For            can create challenges for survivors      of helplessness. Survivors may also
 others, paralysis or other physical          as they try to maintain a healthy diet   be frustrated or saddened when
 effects of stroke can reduce their           and weight range.                        someone has to help them eat.
 ability to handle eating utensils.                                                       With both physical and emotional
    Survivors who live alone may find          Food Frustrations                        issues to contend with, survivors
 getting to the store, buying food and           Along with physical difficulties,      sometimes need help in recovering
 preparing it to be more effort than          emotional problems can diminish          their appetite and maintaining good
 they can manage. Such conditions             a survivor’s appetite. Depression        eating habits. Indeed, malnutrition and
 as right or left hemiplegia can take         can cause a survivor to lose interest    dehydration are potential problems
 away the ability to prepare food and         in many daily activities, including      for survivors who don’t make the
 eat with both hands, creating more           eating (see sidebar on page 31).         necessary adjustments. A 1996
               obstacles to good dietary      For others, the frustrations of trying   Canadian study found that 49 percent
                    habits. Survivors in      to get and prepare food while            of stroke survivors entering inpatient

                       Eating Smart After a Stroke

                              low-fat, low-salt, low-cholesterol   nutritionist can recommend an appropriate eating plan
                              diet can play a key role in          especially if you have other diseases, such as diabetes.
                              preventing a recurrent stroke,     • Make friends with fruits, vegetables and grains. Meat and
                   and controlling weight is also an important     dairy products can be high in saturated fats, which can
                 factor in restoring and maintaining health.       increase stroke risk. Choose lean meat, chicken, fish, and
             Here are a few other steps in the right direction     nonfat dairy products.
         toward a healthy diet for stroke survivors:
                                                                 • Consider what you can eat and enjoy it. Rather than
 • Count carbs. Carbohydrates provide a tremendous                 focusing on what you’ve had to give up, focus on the
   source of glucose, which your brain needs. With this in         good things you can eat — and all you’re gaining in terms
   mind, avoid low-carb diets as a way to lose weight. A           of your health by eating them.

30                    January/February 2005
                                                                        Is Depression Affecting
                                                                        Your Appetite?
rehabilitation clinics were        • If physical impairment of          Depression is very common among stroke
malnourished upon admission.         your arms or hands is a            survivors, and it’s a serious matter that can
   Malnutrition symptoms are         problem, consider specially        affect every aspect of recovery — including
often specific to the particular      adapted eating utensils, such      the willingness to maintain healthy
disorder, but the symptoms           as flatware with thicker,           eating habits. The challenges that some
                                                                        stroke survivors face in adapting to new
generally include dizziness,         easier-to-grasp handles and        techniques and utensils for preparing and
fatigue, weight loss and a           rocker knives that permit          eating food may make depression worse. In
decreased response from the          cutting with one hand. Check       that sense, the challenges could become a
body’s immune system. If you         a Web directory such as www.       double-edged sword.
notice any of these symptoms,, www.atnet.           Part of the challenge
contact your healthcare              org/atsd/ or        with depression
provider. Malnutrition can be        atp/adapted_home/kitchen.          is diagnosis.
treated effectively.                 htm, for information on            Depressive
                                     adaptive products.                 symptoms are
Planning for an Appetite                                                sometimes
                                   • If you’re noticing difficulty in    misinterpreted as an
   The good news is that with        swallowing, talk to your doctor.   emotional reaction
some planning and possibly           Dysphagia can be treated.          to the effects of a
a few adjustments, keeping a                                            stroke, rather than a
healthy appetite and eating a         Of course, it’s always a good
                                                                        separate condition
healthy diet can be compatible     idea to talk to your healthcare      that needs to be
goals for stroke survivors.        team to make sure you’re getting     treated. This means
   Here are some easy measures     the nutrition you need.              the condition should
you can take to make eating a         Caregivers should observe         be diagnosed as
                                   survivors who have dysphagia         soon as possible
pleasure again:                                                         if a survivor is
                                   while they eat in case choking or
• Choose healthy foods with        other problems occur. Observing      demonstrating
  stronger flavors, such as                                              any symptoms of
                                   survivors as they eat will also      depression, such as:
  broiled fish and citrus fruits.   help the caregiver become aware
  Also, spices add flavor to food   of specific issues a survivor         • A persistent sad, anxious or empty mood
  and serve as a good substitute   may be having with eating            • Feelings of hopelessness, guilt,
  for salt.                        and swallowing. Some ways              worthlessness or helplessness
• Choose softer, easier-to-chew    caregivers can promote good          • Loss of interest in hobbies and activities
  foods, such as whole-grain       eating habits include:                 that the survivor used to enjoy
  hot cereals, bananas, soups      • Sharing meals with the survivor    • Fatigue or a loss of energy
  and yogurt.                        at regular times each day          • Problems with concentration, memory and
• Choose colorful, visually                                               decision-making
                                   • Setting a leisurely pace for
  appealing foods, such as           the meal                           • Insomnia, awakening early in the morning
  salmon, carrots and spinach.                                            or oversleeping
                                   • Serving meals that the
• Cut tougher foods into small                                          • Changes in appetite or weight
                                     survivor wants
  pieces to make them easier                                            • Restlessness or irritability
  to chew.                         • Encouraging healthy snacks or
                                     even multiple small “meals”        • Thoughts of death or suicide, or suicide
• If you wear dentures, it’s                                              attempts
                                     through the day
  important to make sure the                                            Depression can be treated effectively through
  dentures fit comfortably and      • Reducing distractions around       anti-depressant medication, psychological
  firmly. Denture discomfort can      the dinner table                   counseling and group therapy. If you suspect
  discourage good eating habits.                                        depression in yourself or the survivor you’re
                                                                        caring for, contact your doctor.

                                                                             January/February 2005               31

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