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Stroke: Perception Changes

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.

Credits

Current as of: December 19, 2022

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Martin J. Gabica MD - Family Medicine
Adam Husney MD - Family Medicine
Richard D. Zorowitz MD - Physical Medicine and Rehabilitation