Taking action

Goal setting plan

1. What is my goal?
I want to feel happier
2. Where am I at just now?
Date: 23 March
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3. My action list
By when?
  • Spend time with my grandchildren
  • Meet my friend regularly for coffee
  • Go for a swim
  • Weekly
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Action
Meet Susan Tuesday, 10am café

Next Rosie decided which action from her list she was going to concentrate on first – “Meet my friend regularly for a coffee.”

Rosie planned the first small step:

How and when am I going to do it?

Rosie

Key point

Breaking down the actions into ‘chunks’ will make them more achievable.

Medication – FAQs

How long do I need to keep taking my medicines?

Many of the medicines that you have been prescribed after your stroke will be treatments you take for the rest of your life. If you have any problems or concerns about your medication, you should talk with your GP or pharmacist.

What should I do if I experience side effects?

Medicines work in a delicate balance with your body and with each other. Sometimes the balance tips, and this can cause side effects or medicine interactions.

All medicines have side effects. But many people don’t feel the side effects, or they don’t interfere with daily life.

Side effects may go away after you take the medicine for a while.

If side effects continue to bother you, call your GP. He or she may be able to lower your dose, or change your medicine. Do not stop taking your medicine suddenly, unless your doctor tells you to.

What if I have an urgent problem with my medicines?

If you, or somebody else, notice one of the things on this list, don’t delay -talk to a doctor or pharmacist
straight away.

  • If you have taken too much of any medicine
  • If you have an allergic reaction to a new medicine
    (such as wheezing, rash, swelling or fainting)
  • If you notice a serious side effect or any unusual
    symptoms
  • If you notice your health getting worse.

In any of these cases, talk to a doctor or pharmacist straight away.

What if I have difficulty swallowing my tablets?

There are alternatives to some medicines; you might be able to take a liquid instead of a tablet.

Ask your GP or pharmacist about what is available.

It is not easy to use my medicines since my stroke, what are the options?

Most pharmacists can supply easy-to-open containers for tablets and liquids. There are easy-to-use eye drop dispensers and inhalers. Ask your pharmacist what is available.

More information


References from:

I want to make healthy eating choices

Meet Malcolm
malcolm_01

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After I had my stroke, my wife was really worried about me. We were both a bit overweight so we decided to do something about it. I couldn’t be bothered with those ‘fad’ diets which don’t work anyway, we wanted to make changes that we would stick to. We had a look online and realised we didn’t eat enough fruit and vegetables and had too many takeaways.
Our meal time What we used to eat What we eat now
Breakfast Sugary cereal
Fry up		 Porridge, with fruit toppings
Grilled sausages, scrambled eggs with grilled tomato and mushrooms
Lunch Chips Baked potato
Dinner Steak pie & Chips Grilled steak with steamed vegetables (or salad)
Make meals that can be frozen and then used for another day (e.g. Chilli)
Snacks Chocolate bar
3 chocolate biscuits (with tea)		 1 fun size equivalent
1 biscuit (sometimes don’t have biscuits)

Something to try

Swap one snack for a piece of fresh fruit.

Limit takeaways to once a month.

Something to think about

Think about how you react to things you find stressful. Do you do something to calm yourself down or make yourself feel better such as eating rich fatty food? It might help to explore the Stress relief topic.

It’s all about taking my medicine and stopping smoking

THE DAILY NEWS

  • www.dailynews.com
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  • Since 1879

“It’s all about taking my medicine and stopping smoking”

  • Picture of ChrisI think self management is just telling me to not smoke any more, not to drink and try to diet and take my pills properly… ”, says Chris, 43 years.
  • PIcture of SarahSarah, 58, views self management in relation to her ability to cope with things since her stroke. She says “it’s about my confidence and being able to take care of myself, wash and get dressed and cook…being able to cope here in the house.”

Key point

Self management is not about telling me what to do, but it is about helping me take control and make good choices for myself.

Adjusting to change

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It is normal to have an emotional reaction to any trauma or loss. Many people describe feeling as though they are on an emotional roller coaster following a stroke – they may feel out of control and emotions and responses fluctuate.
It takes time to take in what having had a stroke means and everyone copes with this differently.
It’s good to recognise why you may react or feel a certain way and this may be part of the normal process of reacting to this.
Try to ensure the more positive things you have identified are your first choices in future situations.
Reflect on your journey, how things have changed but also where you want to see yourself in the future.
Let go of what you used to be and embrace who you are now. Talking and sharing about how you are feeling can be good.

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  • Trauma or loss – for instance having a stroke, It is normal to have an emotional reaction to trauma, it is important to acknowledge these reactions do occur and can make emotions fluctuate
  • Anger – often an angry reaction when acknowledging there is a problem. Can be as obvious as saying ‘why me?’ but it may be expressed in many ways such as frustration with family members. You may also have feelings of denial and disbelief
  • Low mood “what is the point?” – thinking about what has happened, realising loss of who you used to be, this can cause irrational or distorted thinking and feelings of worthlessness. Feeling what is the point if you cannot do things you were doing before. Sadness is a normal reaction to a traumatic event.
  • Fear / Anxiety – often the anxiety a person feels is literally about the stroke happening again but more often it is just feeling less sure of oneself in situations, particularly social situations and meeting people
  • Letting go – what your life was like before and starting to adjust, life may be calmer and realising there can be pleasure in doing things in a different way
  • Experimenting – thinking about realistic solutions to problems, being a new you, thinking on how things have changed but also how they can be in the future
  • Adjusting – learning to deal with reality and feeling ok with where your life is now
  • Flourishing – embracing a new you and a new life by moving on to new things.

    • Key point:

    Recovery is gradual, by setting small goals or challenges and going through these stages you can achieve it – this can help to keep you positive, think of something you have achieved in the past, reflect on the path you took to get there and remember “you can do it” .

    What do you do to help you sleep?

    We all try different things to get a good nights sleep, but some of the things we think help can disturb your sleep.

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    Select the sheep that you think will help you sleep.

    Yes No
    Relaxation techniques

    • Reading a book, relaxation exercise/ tape, listening to music or having a bath can help you unwind before you go to bed but it is best to do this outwith the bedroom.
    • It is common to over think and worry at night. This can stop us sleeping. Writing a to do list earlier in the day may prevent you worrying. (query – add link to stress).
    • We cannot make ourselves go to sleep. If you can’t sleep it is best to leave the bedroom and try an activity that helps you relax, then when you are feeling tired go to bed again.
    		 Smoking

    • Nicotine is a stimulant and will keep you awake.
    • It is also important not to smoke if you wake during the night and cannot get back to sleep. This can cause your body to wake up during the night for a cigarette.
    Regular bedtime

    • A routine of going to bed at the same time each day and getting up at the same time each day will help regulate your `body clock`.
    • Napping during the day can disrupt this routine.
    		 Alcohol

    • Drinking a lot of alcohol before you go to bed may help you fall asleep but it will later cause restlessness and cause you to wake.
    • It will also cause you to wake to go to the toilet.
    Comfortable bedroom

    • Keep the temperature in your bedroom comfortable. Not too hot or too cold.
    • Try and keep the bedroom quiet.
    • Keep your bedroom dark.
    • Comfortable bed.
    		 Caffeine
    Caffeine is a stimulant which can be found in tea, coffee, soft drinks, chocolate and cocoa. It can make us feel more awake so if taken too close to bedtime can increase the time it takes us to get to sleep and make sleep more disturbed. It is best to avoid caffeine 4-6 hours before going to bed.
    Exercise
    Regular exercise, especially in daylight, can improve sleep but avoid exercise 4 hours before going to bed.    		 Heavy meal before bedtime

    • Taking a heavy meal before you go to bed will keep you awake as it causes your tummy to work overtime.
    • A light snack/ milky drink however can help some people sleep.
    Gadgets
    Don’t use gadgets such as mobile phones, tablets or laptops before going to bed as the blue light from them may over stimulate your brain and keep you awake.

    Something to think about

    Have you identified any habits that might be affecting your sleep? Habits can be hard to break, but it is worth giving it a go, as a good night’s sleep will help you keep well.

    Key point

    Remember, habits take time to develop so they may take time to break. Don’t give up if it doesn’t work the first time.

    In the house

    Meet Isobel. Isobel has had to overcome some difficulties following her stroke in order to become more active. Lets see how she has got on. Tap on the picture to find out what Isobel’s advice is.

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    My arm doesn’t work properly. I find that making sure that my arm rests in a natural position when I’m not using it helps to keep it relaxed and more comfortable. This also helps to keep swelling down in my hand. Using the arm of a chair or cushion under my elbow supports my shoulder, which can get sore if the arm hangs down.

    My legs are stiff. I find that if I bend my legs up and down when I am sitting before I get up and walk it is easier. I also pace myself so that I am not getting too tired as this can make my legs stiffer. Drinking plenty of fluids like water can also help.

    My ankles get really puffy as the day goes on. My nurse told me that puffy feet and ankles are really common if you have to sit for a long time. I often put my feet up on a stool or on the sofa and move my feet in circles. It really helps. I try not to sit too long and make myself get up for walks around the house. That gets the blood pumping and improves my circulation.

    I am afraid I will trip. I find that if I take some precautions I feel less like I’m going to trip. I always make sure that I am wearing shoes or slippers that fit me. I had swollen feet in hospital, but this has gone down now and I had to replace my slippers as they had stretched! A good Christmas present from my daughter! Making sure rugs and furniture that could get in my way were moved, helped too.

    My arm does not move as well as it used to. Because my arm is weaker after my stroke it does not move as well as it used to and it makes doing things harder especially as it is my right hand and I am right handed! What I try to do is still use it as much as possible when doing things. When I am watering my plants I put my weaker hand on the watering can and use my strong hand to help move it.

    My muscles are weak. Because of my stroke I find it hard to move around, but if I sit in my chair all day I get stiff! I have found that even small amounts of movement and stretches help. I started by standing up during the adverts on TV. I noticed a difference quite quickly. I also set an alarm clock every 20 minutes to remind me to get up and move


     

    Something to think about

    Do any of Isobel’s challenges sound familiar to you? Why not try some of her suggestions.

    Key point

    Small and frequent movements in and around your house can help improve your fitness.

    How are you going to get there?

    Sometimes the best way to move on is to identify what is stopping you.

    Sometimes the best way to move on is to identify what is stopping you. Select the arrow keys to see what may stop you.

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    The bag fills up as the phrases progress and the bag gets bigger.

    • Scene 1: How am I going to get there and back? (transport picture)
    • Scene 2: What if I can’t answer questions and lose track of conversation? (talking heads)
    • Scene 3: Will I manage my lunch? (picture of a plate of food)
    • Scene 4: Where is the nearest toilet? (toilet signs)
    • Scene 5: what if I forget the names of my grandchildren? (children)
    • Scene 6: What if I get emotional? (Tissue box)
    • Scene 7: Will I get too tired? (Tired zzz)
    • Scene 8: No wonder I put things off – the bag is really heavy!

    Something to try

    What might be in your bag? Have a look at your priority list and jot down some of the reasons for putting them off.

    Let’s look at how we can make your bag lighter.

    Neil playing golf

    3 Replies

    Neil explains how he managed to get back to playing golf again.

    Hints and tips:

    • Talk to people who have had a similar experience but are now doing well
    • Ask someone to accompany you the first time you go out
    • Break your goal down into small sections, don’t try it all at once!
    • Look for organisations related to your particular activity and the support that is available
    • Prepare for your first visit by letting members know that you are coming
    • Using the club restaurant or cafe can be a way to become used to the environment

    Something to try

    Would any of these hints and tips help you? Make a note of these and think how you could put them into action.

    Relationships with the people in my world

    Q. Lets now look at your relationships with the people in your world. Fill out a name below, select 6 words that best describe them and then select ‘Finish’.

    Add

    2. Select 6 words that best describe this person, your relationship with them and how they make you feel.

    • Close
    • Sad
    • Critical
    • Supportive
    • Distant
    • Overbearing
    • Encouraging
    • Helpful
    • Solid
    • Listens
    • Difficult
    • Get me down
    • Get on my nerves
    • Helps me
    • Hard work
    • Happy
    • Trust
    • Gives me a hard time
    • Frustrating
    • Understanding
    Start again
    Finish

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    Think of a person in your world. Choose the words that best describe this person, your relationship with them and how they make you feel.

    Positive words Negative words
    CLOSE
    SUPPORTIVE
    HELPS ME
    HAPPY
    HELPFUL
    SOLID
    ENCOURAGING
    UNDERSTANDING
    TRUST
    LISTENS    		 SAD
    GET ME DOWN
    CRITICAL
    DISTANT
    HARD WORK
    OVERBEARING
    GET ON MY NERVES
    DIFFICULT
    GIVES ME A HARD TIME
    FRUSTRATING

    Feedback: if you chose mostly positive words
    It looks as though you have good relationships with this person. That’s great it’s important to have supportive people around us.
    Has your relationship with these people always been so good? Understandably, we often concentrate on the negative impact of stroke but in some circumstances it can strengthen relationships and bring people closer together.
    Feedback 2: if you chose some positive and negative words
    It looks as though your relationship with this person has some good and bad points. Think about the words you used to describe these relationships; could these relationships be improved?
    Has your stroke had an impact on this relationship? Before your stroke would you have picked different words to describe this relationship, how have things changed?
    Feedback 3 : if you chose mostly negative words
    Your relationship with this person doesn’t look too great; is this surprising to you?
    Is this since your stroke or was it a difficult relationship before? Do they know how you feel – have you tried talking to them? Communication is really important in all relationships. See the section on Talking and Sharing for some tips and advice.