United States Department of Veterans Affairs
 Resources & Education for Stroke Caregivers' Understanding & Empowerment

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CARING FOR SOMEONE WITH EMOTIONAL & BEHAVIORAL NEEDS

Personality Changes

(Emotional Liability & Self-Centered Attitude)

After a stroke your loved one may act like a different person. This is because injury to the brain can affect personality.



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What Are Personality Changes?

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What Is Depression?

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What Do You Need to Know?

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What Are Behavior Changes?

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Why Is It Important to Get Help?

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Helpful Tips

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What Is Emotional Liability?

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Remember

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What Is a Self-Centered Attitude?

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More Resources

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What Is Apathy?

 


What Are Personality Changes?

A personality change is a difference in someone’s normal character. The person’s thinking and behavior change. If a change is minor, it may go unnoticed. Major changes can affect relationships with others.



What Do You Need to Know?

Changes in personality are common after stroke. They are also among the hardest to deal with. Not all changes are permanent. Some may disappear over time. Personality changes to watch for include self-centered attitude, emotional liability, apathy and depression. You may also notice behavior problems. For instance, your loved one may get angry or easily frustrated. They may have impulsive behaviors. Your loved one may even get physically aggressive.



Why Is It Important to Get Help?

Personality changes are hard for caregivers to handle. Talk with your healthcare team. They can suggest treatments or ways to deal with personality changes. Think about joining a support group. Talking with other caregivers is often helpful. Learn more about stroke support groups.



What Is Emotional Liability?

A woman has her hand over her face as though she has been crying

Emotional liability is used to describe someone with strong emotions. These emotions are close to the surface and difficult to control. The person becomes upset or cries more easily. Stroke survivors often have intense mood swings. They may be happy and sad in only a few minutes. They may react to everyday events in unexpected ways.

  • Be patient. Your loved one cannot help behaving this way. Explain to your loved one that his or her emotions are part of the disease.
  • Talk with other family members. Help them understand that stroke survivors have problems controlling their feelings.  
  • Treat the behavior as a minor problem. Continue what you were doing.
  • Change the subject or lead your loved one in a new direction.


What Is a Self-Centered Attitude?

Many survivors become mainly concerned with their own interests. They may lack empathy, or the ability to understand another’s feelings.

  • Kindly help your loved one know when they are not being thoughtful.
  • Gently remind your loved one to practice polite behavior.
  • Praise your loved one for doing thoughtful things for others.


What Is Apathy?

Apathy is a lack of motivation. Apathy is different than being tired or depressed. A person with apathy shows little emotion or feeling. There is often a loss of interest in the activities. Learn more about apathy.



What Is Depression?

After a stroke, a person may have negative feelings. They may think that things will never get better. Depression is a common response to the losses that occur from a stroke. Learn more about depression after stroke.



What Are Behavior Changes?

Stroke survivors often have problems with impulsive behaviors, frustration, anger and aggression. Changes in your loved one’s behavior are hard to deal with. Learn more about dealing with difficult behaviors.



Helpful Tips

  • Personality changes are hard to deal with. Remember, this is part of the stroke injury. Try not to take it personally.
  • Avoid comparing your loved one to the way they used to be.
  • Seek counseling or join a support group. Talking about your anxieties can help.
  • Keep up your own schedule to avoid caregiver burn-out.


Remember

  • Discuss personality changes with your healthcare provider. Ask for an assessment when needed.
  • Try to accept the changes you see in your loved one. Avoid comparing your loved one to the way they used to be. Some of the changes may be permanent. Others will disappear over time.
  • Be patient and understanding. Your loved one is facing many changes. Your support is important.


More Resources

The following resources are related to this fact sheet only. View a full list of the resources from all RESCUE fact sheets.

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American Stroke Association
Web: www.strokeassociation.org*
Phone: 1-888-478-7653

The American Stroke Association has fact sheets to help with caring for someone with emotional and behavioral needs. They have information on Emotional and Behavioral Conditions After Stroke*.


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Family Caregiver Alliance
Web: www.caregiver.org*
Phone: 1-800-445-8106

The Family Caregiver Alliance provides fact sheets on caregiving issues and strategies*. This includes a fact sheet on “Coping with Behavioral Problems After Head Injury.*” Some information also available in Spanish.

The Family Caregiver Alliance has a fact sheet for caregivers on how to deal with trouble behavior*. Although it addresses dementia, the helpful tips can be applied to caring for stroke survivors as well.


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My HealtheVet
Web: www.myhealth.va.gov

My HealtheVet (MHV) provides trusted information on stroke and other health conditions. It also provides resources for stroke caregivers and tools to track your loved one's health.

Take a screening test for symptoms of depression.

Visit the My HealtheVet Caregiver Assistance Center for more information on caregiving.


Stroke Association (United Kingdom)
Web: www.stroke.org.uk*

The United Kingdom Stroke Association has an A-Z list of fact sheets*. This includes information on the psychological effects of stroke, cognitive problems and communication problems after stroke.

Note: This Web site offers helpful information for caregivers, but some references may not apply to caregivers in the United States.


*Link Disclaimer: Links to information and Web sites outside of the Department of Veterans Affairs do not indicate an endorsement of products or services offered by the sites. In addition, these sites may have privacy and security policies that are inconsistent with those of VA.

Download a free version of Adobe Reader* to view PDF files.



References: Family Caregiver Alliance (December 2008). Coping with Behavioral Problems after Head Injury. Retrieved April 25, 2009, from: http://www.caregiver.org/caregiver/jsp/*; The Stroke Association (October 2006). Psychological Effects of Stroke. Retrieved April 25, 2009, from: http://www.stroke.org.uk*; American Stroke Association. (2009). Behavioral Changes after Stroke. Retrieved April, 12, 2009, from: http://www.strokeassociation.org*; Trelogan, Stephanie. (2009). Difficult Behaviors after a Stroke. Retrieved Friday, May 8, 2009, from: http://www.caring.com/*; Senelick, RC, Rossi, PW & Dougherty, K. (1999) Living with Stroke: A Guide for Families. (Revised Edition) NTC Contemporary Publishing Company.


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These materials were created for the project:

Web-Based Informational Materials for Caregivers of Veterans Post-Stroke

Project Number SDP 06-327 funded by VA HSR&D Quality Enhancement Research Initiative (QUERI); Supported by the
Stroke QUERI

Visit the Stroke QUERI Website