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Stroke Therapy Goals Established
Some new stroke therapy goals were established for Steve. When he meets the goals, he can leave the nursing home where he’s been a resident for 3 weeks. I worked with his therapists to set these goals, because I knew what he needed to do in order to function at home and for me to care for him.
The stroke therapy goals include:
1. Walking up the stairway with one person assisting
2. Toileting by himself
3. Getting in and out of bed by himself.
It may take several more weeks for him to accomplish these therapy goals, but they are something for him to work toward knowing that there’s a big reward at the end…coming home!
He got a good start on climbing the steps when he was at the hospital, but at home he’ll have to climb 16 steps. We have a 2-story home with our master bedroom, bathtub, and shower on the second floor. I could set up a bed downstairs and give him sponge baths, but Steve wants to sleep in his own bed and take showers. So that means he needs to achieve this therapy goal of climbing the stairway. I priced out a stair lift, but for our L-shaped stairway, we needed two lifts. One had to go up 10 steps to the landing, and then another lift was needed to go from the landing up another 6 steps. This required a transfer on the landing from one seat to the other. I didn’t think that was very safe, nor worth the $14,000 cost. I know Steve can accomplish this goal with practice, but endurance is his biggest challenge.
He is walking quite well with a cane, and he makes good placement with the left foot by himself. If you remember just a few weeks ago, it was necessary for someone else to help him move that foot forward. He can go about 175 ft. and then needs to sit down, mostly because his right side is still bearing the weight of his body. It is still hard for him to shift weight to the left side because his knee wants to buckle under. Locking that knee in place will be necessary before he can come home, so please keep that in your prayers.
He is seeing a speech therapist again because his voice is getting so raspy. The side of his tongue and check are bruised and sore from him biting them when he eats because he still can’t feel them. One day for lunch he ate a hot dog with onions, relish, mustard and ketchup…all the flavors he hadn’t had in such a long time. It tasted so good that he bit his tongue and cheek several times. The left side of his throat feels like there’s sand in it, and he feels tingling in his eye, ear, and throat. Remember…that’s what happens before he gets the feeling back, so it’s not a bad thing, just uncomfortable. His breathing seems labored at times also, but his lungs sound clear whenever he’s checked with a stethoscope, so they will pursue the cause of that. It’s possible that the stroke affected his lungs too. But I believe that the present condition is only temporary and all of it will come back to a healthy state.
He is getting some movement back in his hand…very slight grasping with the fingers when I’m working his arm back and forth. That arm movement causes pain in his shoulder, but he needs to work through the pain or the joints and muscles will tighten up. The shoulder subluxation causes him more discomfort than anything else, so please continue to pray about that. To help make those arm exercises a little more exciting, Steve will be taught how to use a fishing program on a Nintendo Wii today.
On April 30th he will see a neurologist to see how things are progressing.
The powers-that-be at Woodside informed us that I may take Steve out for day trips on Saturdays and Sundays as long as he comes back each night by curfew (midnight). They said that is good therapy in itself. And since a friend of Steve’s built a wheelchair ramp for us, it will make it easy for me to get him in and out of the house. He can’t wait to have some BBQ chicken on the Weber…oh, to feel normal again!
Some friends from church are coming to our house on Sat. for a work day to take care of all the things that I haven’t had time to do, or can’t do by myself. Words fail me to tell you how loved we feel by these acts of service! And there have been others who have selflessly done things for us to make things easier for me, like taking my car to get an oil change and car wash, running errands, doing truck repairs, etc. To all of you, I say THANK YOU!!! You have blessed us so much.
“We always thank God for all of you and pray for you constantly. As we talk to our God and Father about you, we think of your faithful work, your loving deeds…” 1 Thessalonians 1:2-3
We appreciate you and all your prayers for us. May God bless you richly in return.
With much love, Kathy
thank you so much for your blog. my father recently suffered a large ischemic stroke on the right side of the brain and has complete paralysis on the left side of his body. he experienced a lot of brain swelling after the stroke so much so that he was in a coma for five days. he has been awake for almost 4 weeks this friday.
he is in rehab right now but his progress has been so slow (he has been there for three weeks). he is sitting up at the edge of the bed and able to balance himself but needs 3 people for a safe transfer to the wheel chair. he has some trace movement in the left leg but nothing in the left arm or hand. he is experiencing a lot of pain.
what we are concerned about is his lack of motivation. he will participate in physical therapy for 20 minutes and then say he is too tired and his back hurts and that he wants to go back to bed. he is also saying that his family is going to take care of him but he just doesn’t realize that we can’t right now. did your husband experience lack of motivation? if so, how did you motivate him? i get worried that the stroke has effected the motivational-center of his brain and that he can’t help his response. his team however doesn’t think this and i guess we just need to rely on their expertise.
i am concerned that they are not getting my dad up onto his feet. i know that they are professionals and know what they are doing-i guess he just isn’t ready yet. thank you again for the blog. any resources or information or inspiration you could provide would be appreciated.
June 26th, 2008 at 3:11 pmMichelle, I’m so sorry to hear about your father’s stroke, but I’m glad he’s out of the coma. My husband slept so much for the first 7 wks. that he had a hard time doing therapy too. But that is quite normal for stroke survivors and it will get better as his brain heals.
One thing that helped me understand the effects of a right-brain stroke was a book that the hospital gave me published by the Natl. Stroke Assoc. It’s called Hope: The Stroke Recovery Guide. You can read it free at the following link:
http://www.stroke.org/site/PageServer?pagename=HOPE
All of it is excellent and talks about the pain he’s working through, the lack of motivation, depression, etc. Page 31 talks about the effects of a right-brain injury. Just understanding all of this really helped me.
Steve said it was my love for him that motivated him the most…that he knew I would be there for him. I never wanted him to feel like I abandoned him. It was also important that he never lose hope for recovery, so I printed off some scripture verses on 9 x 11 paper and taped them up in his room where he could read them every day. Verses like: “I can do all things through Christ who gives me strength” and “My grace is sufficient for you, for My strength is made perfect in weakness.”
Steve said it was very difficult working through the pain. He had several good neuro-trained therapists who knew exactly how to relieve the pain in his back and sciatica with a few minutes of stretching his legs before he got out of bed. But there were other pains in his shoulder, and the pins and needles he felt when I touched his arm or leg.
It’s been 4 mos. since Steve’s stroke and he’s walking with a cane, can climb stairs, and has very nice movement in his arm and hand. I think it was 8 wks. before there was any movement in his hand at all. So don’t be discouraged.
Is your father in the hospital in inpatient rehab? How old is he? Are there other family members visiting?
My daughters were a big help, and I’ve asked two of them to respond to your post as well so you can hear their point of view.
I’m glad you like the blog and I hope it helps you. Since it’s fairly new, I’m curious as to how you found it. Did you use a certain search word?
Please let me know if I can help in any other way. I’m praying for you and your father.
Kathy
June 28th, 2008 at 1:13 amMichelle,
I’m Kathy and Steve’s daughter, Jennifer.
It’s been 4 months since my dad’s stroke and we are thankful every day that he’s here with us.
The first 2 months were on and off with his health. My dad had a broken ankle prior to the stroke and then while in the hospital for inpatient rehab, he developed cellulitis of the eye. One thing on top of another and it was discouraging that his pain from the ankle and sickness prevented him from really being aggressive in his therapy.
What motivated my dad, despite all these obstacles, was the love of our family and our strong commitment to God. People would wonder why we weren’t nervous wrecks and it truly was the grace of God as mom mentions several times in her blog.
It was hard not knowing all the time what to say to my dad about the stroke. I can only imagine that he felt emasculated. Having worked with his hands all his life as a builder, to lose that left side is difficult. We were concerned, like you, that the therapy wasn’t aggressive enough. But then we reminded ourselves that “they are the professionals” and God is the ultimate healer. It didn’t matter what all the reports said — that the first 6 weeks or so after the stroke usually are the most telling of recovery.
When I would talk to my dad, I would just encourage his little progresses. I tried to help him focus on setting mini goals. Like walking 75 ft. versus 50 ft. So then it seemed like he was making progress every day. And he did.
Even encouraging your dad to go an extra 2 minutes in therapy instead of the full time is progress.
Attitude is everything too. I don’t know what kind of support system you have, but I hope you have someone else to lean on/especially God. It’s important that your dad doesn’t hear you being upset or angry or down. It’s okay to feel those feelings, but it can really affect his rehab. Make sure you vent to someone other than to your dad. His emotions will be erratic and you will most definitely see him being out of it, down in the dumps and he will probably be weeping or angry. There are meds to help keep the chemical imbalance stabilized so make sure to watch out for atypical behavior. You know him more than the nurses/docs do.
It’s a long journey and we celebrate every ssuccess dad has. We don’t know what the final outcome will be – if he’ll continue to make progress or if it will plateau. We just remain strong and hope you can too.
June 28th, 2008 at 7:29 pmJennifer