Awakening the Lethargic Patient

Stroke survivors in the acute care hospital may have difficulty waking up for each therapy session.

Factors contributing to lethargy may include: acute medical conditions, medications or even the lack of sleep caused by multiple disruptions. Determine any necessary precautions, then try the following if your patient is difficult to arouse.
Raise the height of the bed and get your patient in a more upright position to help increase their level of alertness. While raising the bed speak to your patient and call them by name.
If there are no cardiac, sternal or other medical precautions, gently rub your patient’s sternum with a closed fist. This may be enough to help them wake up.
If your patient continues to be lethargic, apply a cool washcloth to their face. Place a washcloth in your patient’s hand and guide the hand to the face. Your patient may begin to take over the movement, becoming more alert.

For more practical tips on managing the stroke survivor in the acute care setting refer to: Treatment Strategies in the Acute Care of Stroke Survivors.