Mr McTavish has left homonymous hemianopia and left visual inattention. Most stroke patients push towards the hemiplegic side because they fear falling to the unaffected side (i.e. where they perceive the danger of falling to be). Providing adequate base of support on the unaffected side will reduce the tendency to push. Mr McTavish tends to use his right arm and hand, and his right trunk muscles to fix himself on this side in sitting which orientates him toward his non-affected side and causes him to be asymmetrical. He needs to be positioned so that he receives stimulation from the left and with his weight distributed evenly.
Management plan- To re-orientate the patient to the mid-line by:
- Using appropriate positioning
- Providing adequate base of support
- Approaching the patient from their affected side
- Providing stimulation on their affected side
- Explaining to the patient the rationale for these management strategies to maximise compliance
- Discussing management strategies with MDT to ensure a coordinated and consistent approach
Page last reviewed: 01 Feb 2021
