About the Author
Helen Underwood was born in Berkeley, California in 1914, and has had a long and rewarding career serving others. Her interest in pursuing nursing as a career started with the terminal illness of her father who died of multiple sclerosis after several years of incapacity. Later she cared for her mother who suffered a severe stroke with aphasia.
After one year at the University of California, Berkeley, she began nurses' training at the UC Hospital in San Francisco, graduating as a Registered Nurse. After several years of private duty and office nursing, she enlisted in the Army Nurse Corps (1943) at the San Francisco Presidio as a Hospital Train Duty Nurse. From there she traveled all over the country delivering patients from the Pacific War area nearer their homes after initial care at the Presidio.
In 1944, she married Donald E. Underwood, an attorney. After losing twins in 1948, they adopted a male infant in 1949, and a seven-year-old boy nine years later.
Helen has taken many courses in teaching and has certified scores of nursing assistants in long-term care. She emphasizes understanding the problems and frustrations faced by elderly and terminal patients. "Only by knowing the symptoms and problems can one fully relate, sympathize, and properly care for the disabled." She hopes that nurses and family caregivers will benefit from her experience and suggestions.
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Definition of Stroke
Stroke, or cerebrovascular accident (CVA) is described as destruction of brain substance resulting from intracranial hemorrhage, thrombosis, or embolism which causes vascular insufficiency. In other words, an area of the brain does not receive the necessary blood because of a ruptured or blocked blood vessel. When oxygen and blood are cut off from a part of the brain, the cells in that part of the brain are damaged. How the patient is affected depends upon where the damage occurs. The stroke patient may have one-sided, both lower extremities and possibly trunk, or all four extremities, weakness or paralysis (inability to move), loss or diminished sensations of touch, memory, emotions, and/or aphasia (communication defect or loss of the power of expression by speech, writing, or signs, or understanding spoke or written language in varying degrees). Stroke has also been described as a sudden loss of feeling and movement of the body except for respiration. There are also "minor strokes" (fleeting and temporary with no structural damage).
The clinical picture of a stroke varies widely. It may be a violent attack in which the patient falls suddenly, deprived of motion and sense; however, the most frequent type is that in which there is variable defect in speech, motion, thought, vision, or sensation without loss of consciousness. In the latter case, some degree of recovery is almost always certain. The violent attack is usually caused by massive cerebral hemorrhage and the more mild attack is usually due to thrombosis. It is always important to keep in mind that almost all patients can be helped to some degree, even though the process can be extremely slow and requires much patience.
