One-Sided Neglect

Have you seen your stroke survivor leave food on half of their plate? Forget to put their recovering arm into a shirt sleeve? Not turn their head in your direction when you speak? This is one-side neglect, and it can be very frustrating.

Neglect is more than not being able to use the recovering side. Think of it as a lack of awareness of that side. This common stroke effect can reduce the possibility of independent living and increase the potential for painful injury.

Family members and caregivers can help survivors incrementally overcome weak-side neglect.

Here are some tips to get started:

Approach the neglected side.

Place a comfortable chair next to the bed on the neglected side. This encourages the stroke survivor to look in your direction as you speak. Hold the survivor’s hand and make contact to help increase awareness of that side. If he or she has difficulty turning their head in your direction, gently place your hand on their chin and slowly help them turn their head toward you (far enough for their eyes to meet yours). At first, you may need to do this several times a day until they can do it on their own.

Place the nightstand on the neglected side.

Placing the phone, TV remote, glass of water or other necessities on the neglected side encourages movement. One note of caution: Don’t place the control for calling the nurse on the neglected side. It should always be on the strong side where it can be found quickly.

Include the neglected hand during daily tasks.

As your stroke survivor improves, you may notice that they are still unaware of objects on one side. Saying things like “What did you forget?” or “Look to your left” aren’t very helpful. Instead, use gentle reminders such as “Here is your fork” and guide their hand. An interesting phenomenon occurs when you take someone’s hand — their head automatically turns in that direction and their eyes follow. By first saying “Let's get your fork” and then taking their hand in yours to “search” for the fork, you’ve combined the sense of hearing with the sense of touch.

Improve awareness.

Whatever the reason for lack of awareness of one side, everyone from family members to caregivers to nurses to visiting friends and relatives can be helpful. Take every opportunity, large or small, to help survivors tune in to that side.

Every day provides simple opportunities for helping the survivor get stronger at home or in the hospital.