Heart-to-heart Advice to Stroke Patients

Dr. LEE Wing Ho, Peter, Ph.D.

Director, Clinical Health Psychology Centre

Clinical Psychologist

Health Psychologist

Honorary Consultant in Clinical Psychology

Life is an organic process. Throughout our lives we go through predictable evolution and changes. The Chinese is correct in summarising life as going through stages of being born, growing old, enduring sickness and eventual death.

Imagine someone who is not accepting of life’s inevitable challenges. He/she will suffer much on top of the pains generated by his/her failing conditions. There would be more bitterness, sense of unfairness, ruminating about “why me”, inability to part with what one has prior to the illness, e.g. mobility, appetite, independence, joy, and choice. Obsessed with the losses, we lose our ability to adjust to and learn how to enjoy the current life condition which while initially unacceptable, actually promises much fulfillment, meaning and joy. Not accepting renders the previously joyful person to become bitter, irritable and negative. To reduce the much unnecessary suffering, we need to nurture acceptance, learn new strategies and adopt new perspectives to see the good in the bad.

Any illness and infirmity can pose major threats to our pride and even generate shame, particularly when we desperately try to hold on to the image of how good, strong, smart, capable, and lovable we previously are. Instead of reacting, try to think proactively to digest, discuss, open up and make the best of life as it is. It is never too late to learn.

As we all hurt, the trick is to hold on, hang on, learn new coping and create joy regardless. In sickness and being cared for, it is important that we pause before we speak and think before we act. Out of kindness and genuine care, the carer is willing to devote time, energy and work to making the cared’s life comfortable and less burdensome. The best reward for the carer is when the person being cared for attains a better quality of life. A true form of gratitude is thus to totally endorse the care and help with open arms and deeply feel the care and the blessedness. With gratitude, rather than feeling guilty for imposing on loved ones, or shame to have to be dependent, the carer is helped to fulfill his/her goals of care, and the cared should find life much more livable and joyful. 

It is also vital to adopt novel strategies to ensure continuation of joy in life. Think well and trust yourself to rise to the challenge. Stay focused on creating happiness and fulfillment rather than being bogged down by complaints, negativity and bitterness.

Here some words of advice to stroke patients in the face of uncertainty:

• Avoid unnecessary pains, particularly the self-imposed exaggeration of pains and non-acceptance of the inevitable.
• Approach rewards that really count, and strive to be happy regardless.
• Enhance connectivity: build rewarding social connections and shared wisdom from your long life of experience.
• Do not be greedy. Be simple. Don’t make life more difficult than it is.
• Be aware of negativity bias. Have realistic appraisal of the reality and accept it. Stay in the moment “be here now”, and strive to enjoy every day with gratitude and love.
• Learn from every experience, enhance resilience and wisdom
• Enjoy life with more positivity and an enhancing attitude.
• Take in the positive around you, nature, cooling winds, flowers and plants. Take a zoom perspective along a wide angle perspective to look at life and your surroundings.
• See how blessed you are for being cared Receive care with gratitude and open mind. Pray that your carer would receive the same love and quality care when his/her time comes.
• Do not stop trying everyday even with small goals. Little triumphs add up.
• Talk to someone who cares about your worries and fears.
• Open up, acknowledge, be aware of strengths and impairments, develop strategies, accepting, and let go and get used to a different kind of life where you still find meaning, values, kindness and reciprocity.
• If you are happy, your carers are happy
• It is important to move and act slowly and consistently according to our abilities.

What is the best that could happen? Trust that you can also make someone’s life meaningful, get closer to friends and relatives, overcome your fear of the future and become the better person you want to be.

Of course it takes time even to be kind to ourselves: try to stop and think about what we need most at this moment, and perhaps to slow down, take a walk, relax. Think of kindness as an accessory you always wear; soak in the kindness bestowed on us and also let it become the trademark by which people recognise you.

It is not uncommon for carers to experience compassion fatigue. It is a type of stress caused by too much caring for others. In the face of others’ good intentions, most patients might strike them out in the first place, feeling embarrassed that as patients their needs are perceived as being weak or incompetent. As the extender of kindness, carers might feel embarrassed by the possible response, be it rejection, gratitude, confusion, or stony silence. Instead of avoiding embarrassment by shunning human contact and living half-heartedly, the best response is for carers to embrace any kindness. And as patients, let us stop thinking about ourselves and think instead about the givers and how we can respond to please and thank them most. Despite our sickness, do not underestimate our capacity to improve the world around us. Think about the kindness we can extend to our carers by our affectionate smile, biding good morning and good night, sharing our interests and accepting their gifts with grace.

Patients are also advised to practise thinking and saying things to themselves that are encouraging and compassionate. Ignore any voice that tells you are not worthy. What are your satisfaction triggers? Your small indulgence? How do you express kindness toward yourself? Are you carrying around regrets that serve no purpose other than weighing you down? Acknowledge the regrets and thank them for the lessons they taught you and let them go. Ponder what might be the kindest thing you can do for yourself right now, and what might be stopping you doing it. Life is supposed to be lived forward instead of backward, and to be cherished in its every single moment. Do not belittle yourself, strive for and see the positive in each day with a grateful and peaceful mind.