United States Department of Veterans Affairs
Resources & Education for Stroke Caregivers' Understanding & Empowerment

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View previous issues of RESCUE newsletters in our Newsletter Archive.

Image of a previous issue of the RESCUE newsletter

Masthead with red and white life preserver and RESCUE, which stands for Resources and Education for Stroke Caregivers' Understanding and Empowerment
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   May/June 2011
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This newsletter is a product of a VA research project titled “Web-based Informational Materials for Caregivers of Veterans Post-Stroke” (Project #SDP 06-327), funded by the VA Health Services Research & Development Quality Enhancement Research Initiative (QUERI). The objective of the project was to develop stroke and caregiver related information and materials for VA website. The information for the website was based on identified gaps in currently available information and formative evaluation findings. Visit the RESCUE website TODAY @ www.cidrr8.research.va.gov/rescue. Enter your email in the box to the left if you would like to be added to the RESCUE Newsletter distribution list.

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~~~ SPECIAL EDITION ~~~

National Stroke Awareness Month - May 2011

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RAISING STROKE AWARENESS, AN OUNCE OF PREVENTION
by Kristen Wing, RESCUE Project Team

Photo image of my Dad, a U.S. Army Veteran who suffered a stroke
My Dad,
A U.S. Army Veteran who suffered a stroke

As a member of the “Resources and Education for Stroke Caregivers’ Understanding and Empowerment (or RESCUE) Project Team, May is always marked on my calendar as National Stroke Awareness Month. It is also a memorable month because my Dad, a U.S. Army Veteran, suffered a stroke in May of 1998. On that day, my family became one of the four out of five families in the United States that are affected by stroke, and my Mom became a stroke caregiver.

My Dad had suffered a mild heart attack in March of 1998. Several years earlier he had been diagnosed with high blood pressure and high cholesterol. He loved steak, baked potatoes covered in butter and sour cream, and cookies with a big glass of whole milk. He disliked exercise. He had been a heavy smoker, and at times, a heavy drinker. We all knew that he was at risk for a heart attack and had encouraged him to make healthy changes, but he was set in his ways and wanted to “enjoy life.”

The evening before he was scheduled for surgery to clear a blocked blood vessel in his heart, he and my Mom were strolling the hospital hallways. They were trying to take their minds off of the next morning’s procedure and the heart attack that had led to it. That’s when it hit—like most strokes do—out of nowhere. “Time lost is brain lost,” when it comes to a stroke. Even though my Dad was in a hospital and the doctors acted fast, his stroke was severe and had serious effects. My Dad survived the stroke, but he was partially paralyzed on one side of his body and could not speak. After he was released from the hospital, he spent countless hours in physical therapy and speech therapy. Over time, he was able to walk again, and speak again, and even drive again—but he was never 100% of where he had been before. He could only walk short distances and tired very quickly. Common phrases like “Hi, how are you doing?” eventually came out easily, but he had difficulty with full conversations. He suffered from aphasia, which doesn’t affect a person's intelligence, but does make speaking hard. His brain knew exactly what he wanted to say but couldn’t put the right words together to complete his thoughts. His memory was affected and he did not remember my wedding, which had only been months before. Because of his physical issues and his problems communicating, my Dad would become frustrated, angry, and depressed. He knew that his life would never be the same.

As his caregiver, my Mom shared my Dad’s frustration and faced her own challenges. Her life was also forever changed by the stroke. She worked very hard to help my Dad with his stroke recovery and to deal with the many changes in his life. She tried to lift his spirits, managed his medications, and made sure that he got to his many appointments. She served as his advocate and his “voice” when he could not say what he wanted to doctors, therapists, family members, and friends. Like many caregivers, she had to balance this new role with her full-time job and other responsibilities.

After my Dad’s stroke he learned to adapt to his new life. He never gave up and he kept trying to get better. He improved his diet and ate more healthy foods. He exercised more, including swimming and riding a three-wheeled bike. He stopped smoking and drinking alcohol. His blood pressure came down and so did his cholesterol levels. The changes he made helped prevent a second stroke, which can often occur within the months or years after a first stroke.

Logo for the VA Brain Rehabilitation Research Center (BRRC)

In May of 2003, my Dad volunteered to be part of a research study at the VA’s Brain Rehabilitation Research Center (BRRC). The BRRC, located in Gainesville, Florida, was in the building next to where I worked, so my Dad lived with me and we drove to “work” together that summer. My Dad felt like his participation in the study could somehow help other Veteran stroke survivors. I really enjoyed the time I spent with him, and I gained a new perspective and a deep appreciation for my Mom as a caregiver.

As time went by, my Dad learned to focus on the things that he COULD do, and not the things that he couldn’t. He had always been great with computers so he drew on those skills to scan hundreds of photographs and created a video history of our family. He even got a part-time job restocking shelves during the holiday season. He visited with other stroke survivors, reaching out to them to offer encouragement and hope.

My Dad and my Mom have been a great inspiration and motivation for my work on the RESCUE Project. If my Dad was here today, I believe that he would be pleased by the RESCUE website. He would see what a valuable resource it is for stroke survivors and their caregivers. He would have recognized how helpful the RESCUE website would have been for my Mom when she became a stroke caregiver. My Dad would also wish that there wasn’t a need for a RESCUE website. He would want other Veterans to learn from his experience, to be aware of the risk factors for stroke, and to take the steps to prevent a stroke.

If you or someone you know may be at risk for stroke, please take the time to learn about reducing stroke risk and the life changes that can be made to help prevent a stroke. For more information, visit the Prevention page on the RESCUE website at www.cidrr8.research.va.gov/rescue/prevention.

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Graphic image of a stopwatch
Time lost is brain lost!
Recognizing a stroke can be as easy as S-T-R.

  1. S - Ask the person to SMILE.
  2. T - Ask the person to TALK or SPEAK A SIMPLE SENTENCE (coherently). Example: “It is sunny out today.
  3. R - Ask the person to RAISE BOTH ARMS together.
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Colorful cartoon image of a rocket blasting off


THE RESCUE WEBSITE HAS LAUNCHED!

The full Resources and Education for Stroke Caregivers’ Understanding and Empowerment(RESCUE) website is LIVE! The site contains 44 fact sheets created especially for caregivers of Veteran stroke survivors and lots of helpful resources. The fact sheets cover nine specific topic areas and are available in a printer-friendly version. Spanish versions of the Fact Sheets will be available on the website at the end of May 2011.

Visit http://www.ciddr8.research.va.gov/rescue TODAY!

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STROKE PREVENTION - REDUCING RISK FACTORS

Stroke risk factors are behavioral or environmental (and include pre-existing conditions) which can increase the likelihood of a person experiencing stroke. The same risk factors that increase the chance of having a stroke for the first time also apply to having a second stroke. Though the significance of risk factors will vary from person to person, there are two general categories of stroke risk factors: controllable and uncontrollable risk factors (see below).

Illustration from the comic "Beetle Bailey"  of a retired sargeant and his dog walking, with the words "Reduce Your Risk, Prevent a Stroke" around them
CONTROLLABLE

ArrowHigh blood pressure
ArrowDiabetes mellitus
ArrowCarotid/other artery disease
ArrowAtrial fibrillation
ArrowOther heart disease
ArrowSickle cell disease
ArrowHigh blood cholesterol
ArrowPoor diet
ArrowPhysical inactivity/obesity
ArrowDrinking alcohol
ArrowCigarette smoking
UNCONTROLLABLE

ArrowAge
ArrowHeredity
ArrowRace
ArrowGender
ArrowPrior cases/ conditions

OTHER FACTORS

ArrowGeographic location
ArrowSocioeconomic

Uncontrollable stroke risk factors, such as age or gender, cannot be changed. On the other hand, controllable risk factors can be changed, managed or treated to reduce the likelihood of having a stroke. Two major modifiable stroke risk factors, high-blood pressure and diabetes, are also risk factors for coronary heart disease and kidney disease. Below are some common things you can do to take control of your health and reduce your stroke risk.

Making healthy choices, such as eating more fruits and vegetables and reducing sodium intake, is a great start to preventing a stroke. Eating a nutritious, balanced diet plays an important role in managing blood pressure, blood sugar and weight. Daily exercise is also important for overall health and stroke prevention. Regular exercise can help reduce stress, which in turn can help keep blood pressure regulated. Even if exercising is limited or difficult, modified exercises or other activities, such as gardening, can be done. Two lifestyle changes that can reduce the risk for stroke and many other health conditions are 1) quitting smoking, and 2) reducing alcohol consumption. Smoking reduces oxygen level and thickens blood, which increases the risk of stroke, and alcohol can raise blood pressure.

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NATIONAL STROKE ASSOCIATION CELEBRATES NATIONAL STROKE AWARENESS MONTH

Image depicting figures saying "Stop Stroke," "Act F.A.S.T." and "Spread HOPE" for National Stroke Awareness Month

Join the National Stroke Association (www.stroke.org) in celebrating National Stroke Awareness Month, May 2011.

This is an important time to educate the public about important stroke information, such as the warning signs of stroke and stroke risk factors. Did you know that research indicates that up to 80 percent of strokes might be prevented with prevention measures like better risk factor management? Learn more about risk factors for stroke, and if you are at risk, by visiting www.stroke.org/RISK.

Manageable risk factors for stroke include:

  • High Blood Pressure
  • High Cholesterol
  • Atrial Fibrillation
  • Diabetes
  • Alcohol Use
  • Tobacco Use and Smoking
  • Physical Inactivity
  • Obesity
To learn more about stroke or find ideas for how to spread awareness this May, and all year long,
visit
www.stroke.org/SAM.
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THE IMPORTANCE OF GETTING HELP RIGHT AWAY
 a skull, showing a pink brain

Stroke, or “brain attack,” is among the leading causes of death and disability in the United States. According to the American Heart Association, approximately 780,000 individuals experience a stroke each year. It is estimated that a quarter of stroke survivors will suffer another stroke within five years of the first one.

Stroke affects people of all ages, race, gender and socio-economic status. Stroke happens very fast with little to no warning. Seeking medical attention immediately can make the difference between life and death. Every minute counts.

The RESCUE project has a fact sheet titled “About Stroke,” which provides general stroke information in easy-to-understand language. This fact sheet discusses the risk factors for stroke, ways to lower your risk and the importance of seeking medical attention immediately. The section below, from “About Stroke” lists the warning signs of a stroke.

Photo image of an ambulance


If someone experiences one or more of the stroke warning signs listed below, CALL 911 IMMEDIATELY! These changes may last or may start, briefly subside, and then return.


• Sudden numbness or weakness of face, arm, or leg (mainly on one side)
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, or loss of balance
• Sudden confusion or trouble talking or understanding speech
• Sudden bad headache with no known cause

Take the Warning: Stroke Ahead quiz to see if you can recognize the warning signs of stroke: http://www.strokeassociation.org/presenter.jhtml?identifier=3070550

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Rotating banner images for the VA National Caregiver Support Line, 1-855-260-3274 

The Department of Veterans Affairs has launched a toll-free
National Caregiver Support Line 1-855-260-3274.

The Caregiver Support Line was created to recognize the significant contributions made by caregivers allowing Veterans to remain at home surrounded by family and friends. Open Monday through Friday 8:00 a.m. to 11:00 p.m. and Saturday 10:30 a.m. to 6:00 p.m. Eastern Time; licensed clinical social workers will be available to answer your questions, listen to your concerns and directly link you to the Caregiver Support Coordinator who can locate assistance tailored to your unique situation. For more information, visit http://www.caregiver.va.gov.

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MY HEALTHeVET SPOTLIGHT: CAREGIVER ASSISTANCE
eVet

My HealtheVet, the VA Health Care Portal, has created a special area in the Healthy Living Center called Caregiver Assistance. In this area, visitors will find links to many helpful Web sites that cover topics such as:

  • Caregiver resources for specific diseases and conditions and when to get additional help
  • How family and friends can provide support
  • Benefits of change, how to start healthy living, and special situations
  • Understanding and tracking health behavior change progress

To access the Caregiver Assistance section of My HealtheVet visit http://www.myhealth.va.gov,
then click on:

Image of the RESEARCH HEALTH tab on the MyHealtheVet Web Site
TAB AT THE TOP OF THE PAGE
Arrow pointing to right
then
Image of the HEALTHY LIVING CENTERS tab on the MyHealtheVet Web Site
TAB AT THE TOP
OF THE PAGE
Arrow pointing to right
then
Image of the CAREGIVER ASSISTANCE button on the MyHealtheVet Web Site
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DID YOU KNOW?
National Stroke Awareness Month Edition
Image of a purple brain on a blue background being hit by a lightning bolt, to signify a stroke or brain attack

• A stroke is also known as a “brain attack.”
• On average, every 40 seconds someone in the United States has a stroke.
• Stroke is a leading cause of serious, long-term disability in the United States.
• Each year, about 55,000 more women than men have a stroke.
• When considered separately from other cardiovascular diseases, stroke ranks No. 3 among all causes of death, behind diseases of the heart and cancer.
• The estimated direct and indirect cost of stroke for 2010 is $73.7 billion.
• Of all strokes, 87% are ischemic (clots blocking an artery, keeping oxygen and vital nutrients from the brain), and 13% are hemorrhagic (known as a “bleeding stroke” where ruptured blood vessels bleed into the brain).

Information from AHA Heart Disease Stroke Statistics: 2010 Update At-A-Glance
To download, visit: http://www.americanheart.org/downloadable/heart/1265665152970DS-3241%20HeartStrokeUpdate_2010.pdf

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American Stroke Association

Map of the United States covered by the words Stroke Care Near You, to represent the American Stroke Association's Stroke Map of stroke-certified hospitals

According to the American Stroke Association (ASA), six out of ten Americans don’t know where the stroke-certified hospitals are in their communities.

To help remedy this, the ASA has created a new stroke web-mapping site that can locate stroke-certified hospitals throughout the United States.

To find stroke care near you, visit the
ASA’s stroke mapping Web site:

http://maps.heart.org/quality


My HealtheVet

Logo for My HealtheVet, the VA Healthcare Portal

My HealtheVet (MHV), the VA healthcare portal,
provides an educational and health promotion
library of materials on certain health conditions to
enable veterans to take control of their own health. The Health Education Library contains great information about Stroke.

Visit www.myhealth.va.gov, then click on the
RESEARCH HEALTH tab, then click on
Disease + Condition Centers. You will find the Stroke section under Common Conditions.

Register with My HealtheVet to receive access
to even more helpful health-related information and tools.

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THE FOLLOWING EDUCATIONAL MATERIALS CAN BE DOWNLOADED AT THIS WEB SITE:
www.ciddr8.research.va.gov/rescue/prevention

Image of the Beetle Bailey character, Sarge, jogging with his dog Otto. He is surrounded by the words "Reduce Your Risk, Prevent a Stroke"
Image of a downloadable pamphlet which tells you the warning signs of a stroke
Image of a downloadable pamphlet which describes how to lower your blood pressure
Image of a downloadable pamphlet which describes how to lower your cholesterol
Image of a downloadable pamphlet which describes what your cholesterol numbers mean
Image of a downloadable pamphlet which describes what high blood pressure is
Image of a downloadable stroke risk scorecard
Educational materials available to download include:
  • Information about cholesterol and how to control it
  • Information about high blood pressure (hypertension) and how to control it
  • Quick reference of the warning signs of a stroke
  • A stroke risk scorecard
  • A stroke risk checklist
  • Informational fact sheets about stroke and how to prevent it
  • Information on how to act F.A.S.T.
Image of the downloadable "Act F.A.S.T." pamphlet which depicts people who are experiencing a stroke
Image of a downloadable fact sheet which is titled "What is your risk for stroke?"

Image of five different downloadable fact sheets from the

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Photo of a computer screen with http://www, to signifiy Web Links
Web Links from This Issue
DISCLAIMER OF HYPERLINKS: The appearance of external hyperlinks does not constitute endorsement by the Department of Veterans Affairs or the RESCUE Project of the linked web site, or the information, products or services offered by this site. In addition, this site may have privacy and security policies that are inconsistent with those of the Department of Veterans Affairs. For other than authorized VA activities, the Department does not exercise any editorial control over the information you may find at these locations. All links are provided with the intent of meeting the mission of the Department of Veterans Affairs and the RESCUE Newsletter and forthcoming Web site. Please let us know about existing external links which you believe are inappropriate.
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RESCUE, which stands for Resources and Education for Stroke Caregivers' Understanding and Empowerment, above a red and white life preserver

www.cidrr8.research.va.gov/rescue

Web-Based Informational Materials for Caregivers of Veterans Post-Stroke

Project Number SDP 06-327 funded by VA HSR&D
Quality Enhancement Research Initiative (QUERI)

Connie Uphold,
Principal Investigator
Connie.Uphold@va.gov

For more information, contact Kimberly Findley.
Kimberly.Findley@va.gov
Phone: 352-376-1611, x. 4951

Logo for the Center of Innovation on Disability & Rehabilitation Research
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RESCUE Newsletter Editorial Team: Kimberly Findley, Kristen Wing, and Jini Hanjian. Graphic Design by Lindsay Knauff and Kristen Wing.