Danger zone after brain bleed

[MsLaura]

Hey yal, 

I have two questions.
I am a caregiver for the elderly . One patient is 7 months out from a major brain bleed back. She is paralyzed on her left side, speech has been unaffected, but her emotions and mental health are all over the place despite antidepressant. She's refusing to exit bed, toilet or shower. Argumentative, yelling and combative. 

Is there some secret to getting her back on track to exit bed, to want to get in the shower and to be more cooperative? 
Also Is there such a thing as a 7 month danger zone for another major stroke after the first one?

TIA 

MsLaura

[DavidFR, BSN, MSN, RN]

Your patient sounds frustrated and depressed - with good reason.

Has she received evaluation and support from a psychiatrist and/or phychologist?

[RNMoxie]

Try to keep her on a schedule. It MIGHT improve. Once there is one stroke, there is ALWAYS a risk of another. To be more cooperative it includes one or combination of risperidone, diazepam, Ativan, haldol, depakote, lithium, doxepin, or buspar. Bupropion, fluoxetine, melatonin, trazodone, and Effexor won't usually touch delirium in my experience despite what is published. Good luck 

[Tenebrae, BSN, RN]

You can start with acknowledging her feelings. Literally in the space of a day her life has been turned upside down and she is reliant on someone else for the most basic of personal cares. It can be simple as acknowledging that this must be really hard for them and is there anything staff can do to make things less stressful for them

Some pyschology input would also be good, 

[MsLaura]

Thanks yal,

 I will try to be more empathetic with my patient when she comes back home.  As for the meds, those suggestions have fallen on deaf ears. 
thanks again