Overview

When a stroke occurs on the right side of the brain, a person's ability to judge distance, size, position, rate of movement, form, and the way parts relate to the whole is affected (spatial-perceptual problems). People with these problems may have more trouble learning to care for themselves.

Signs of perception problems are often noticed by the caregiver of a person who has had a stroke. These signs may include:

• Not noticing people or things on the affected side and turning their head or eyes to the unaffected side. The person may not be able to steer a wheelchair through a large doorway without bumping the door frame.
• Not being aware of body parts on the affected side.
• Having trouble recalling how to form numbers and letters, or confusing similar numbers. The person may not be able to add numbers.
• Having trouble recalling the written spelling of words. The person may not be able to read.
• Confusing the inside and outside of clothing or the right and left sides of clothing.
• Having a hard time knowing when they're sitting or standing.

Helping someone who has perception changes

If a person has perception problems after a stroke, the stroke rehab team can teach you how to help. Here are some examples.

• Help prevent a fall.
  • Cut down on clutter.
  • Make sure that rooms are well lit.
  • Install night lights in the bedroom and bathroom.
• Avoid rapid movements around the person. Other people moving around in the room also may be distracting.
• Mark lines on door frames or full-length mirrors. This can help the person see what is vertical.
• Do not overestimate the person's abilities. Watch to see what can be done safely rather than taking the person's word for it.
• Help the person do a task.
  • Tell the person how to do things if they have trouble remembering how to do a task.
  • Put your hands in your pockets to keep yourself from gesturing as you talk the person through the steps.
  • It may also be good to have the person talk through the task.
  • Give lots of praise.
• Break tasks into small steps.
  • Encourage the person to slow down and check each step carefully.
  • Don't nag. Nagging may cause the person to become angry and upset.
• Arrange transportation. People with perception problems-—even minor ones—should not drive a car.