Neglecting the affected side after a stroke

Some people who have had a stroke have problems seeing in some or all of the normal areas of vision. For example, people with left-sided paralysis may have difficulty seeing to the left. If the problem is due to a vision loss, most people learn to make up for this loss by turning their heads. If the person does not turn his or her head to the affected side, that side of the body may be ignored or neglected.

Caregivers may notice signs that the person is ignoring the affected side, such as:

• Mentioning or responding to stimulation only on the unaffected side of the body.
• Using only the unaffected arm or leg.
• Looking only to the environment on the unaffected side.
• Noticing only someone who speaks or approaches from the unaffected side of his or her body.
• Responding to only half of the objects he or she would normally see, such as eating from just one side of the plate.
• Not recognizing the affected arm and leg as belonging to his or her body and thinking that they belong to someone else.

The following tips may be useful when caring for someone who neglects his or her affected side:

• When you are working with the person's affected side, reduce distractions on the unaffected side.
• Place objects that are needed most often on the person's unaffected side. Encourage use of the affected side by placing some objects on that side, prompting the person to use the affected side.
• Remind the person to pay attention to the affected side. Sometimes, attaching a small bell or bright ribbon to the affected arm or leg may act as a reminder.
• Point out landmarks on the person's right and left sides when going places. Remember that the person may look at only one side of the environment, so talk about what's on the person's affected side.
• Give frequent cues to help orient the person to the environment.