Z2 · Ignoring one side of the body
Actual Brain and senses
Definition
After brain injury the person may not notice one side of the body or space.- Stroke in one side of the brain
- Ignores one side
- bumps into things
- eats from one side of the plate
- neglects a limb
📋 Scenario
A stroke patient eats only the right half of his plate.
Subjective (S): "I finished eating."
Objective (O): Eats only the right half of the plate; ignores the left side; neglects the left arm.
Assessment tools for this scenario: CP-NEURO Brain & Senses Check
Validated scales to consider: GCS, pupils, NIHSS
**CarePath diagnosis:** Ignoring one side of the body related to stroke affecting one side of the brain, as evidenced by eating only the right half of the plate and ignoring the left arm.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Approach from the affected side. | Approaching from the affected side draws attention toward the neglected side and helps him notice people and objects there. |
| Cue him to scan. | Cueing him to look across the whole space trains the habit of scanning toward the neglected side. |
| Arrange items. | Placing food and items where he can see them, and moving them gradually toward the left, helps him use what he is not noticing. |
| Teach awareness. | Helping him learn about the problem makes him more likely to protect the neglected side and use strategies. |
| Refer to therapy. | A therapist can provide specialist retraining to improve attention to the neglected side. This gives structured practice in a safe setting. |
**Expected outcomes**
- Scans the left side.
- Eats the whole meal with a cue.
- No injuries on the left side.
- Therapy started.
**Linking the data to the diagnosis**
The patient says, 'I finished eating.' After a stroke he eats only the right half of the plate, ignores the left side and neglects the left arm. He is not aware of what he is missing, so this is an actual problem and not a risk, and it differs from simple weakness because he does not notice the left side. It rests on a stroke on one side of the brain. The plan aims for him to scan the left side, eat the whole meal with a cue, avoid left-sided injuries and have therapy started.
CarePath diagnosis
Ignoring one side of the body related to stroke affecting one side of the brain, as evidenced by eating only the right half of the plate and ignoring the left arm.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Approach from the affected side. | Approaching from the affected side draws attention toward the neglected side and helps him notice people and objects there. |
| 2. Cue him to scan. | Cueing him to look across the whole space trains the habit of scanning toward the neglected side. |
| 3. Arrange items. | Placing food and items where he can see them, and moving them gradually toward the left, helps him use what he is not noticing. |
| 4. Teach awareness. | Helping him learn about the problem makes him more likely to protect the neglected side and use strategies. |
| 5. Refer to therapy. | A therapist can provide specialist retraining to improve attention to the neglected side. This gives structured practice in a safe setting. |
Expected outcomes
- Scans the left side.
- Eats the whole meal with a cue.
- No injuries on the left side.
- Therapy started.
Linking the data to the diagnosis
The patient says, 'I finished eating.' After a stroke he eats only the right half of the plate, ignores the left side and neglects the left arm. He is not aware of what he is missing, so this is an actual problem and not a risk, and it differs from simple weakness because he does not notice the left side. It rests on a stroke on one side of the brain. The plan aims for him to scan the left side, eat the whole meal with a cue, avoid left-sided injuries and have therapy started.