Mom's Rehab Update, Week Four

Last week, each of the therapists wanted me to get more involved with Mom's rehab care. Getting hands on training will help me know what I need to do when we're at home. In other words, I've been working with Mom on her speech, occupational and physical developments. And will continue to do so until Mom can completely do things on her own; which in this case, will take awhile for complete rehab, if that.

Here's what I've been assigned to do:

Speech Therapy-- Decide what Mom need to work on the most. For example, should we start the session with counting numerically, or would looking at pictures of household items (and try to trigger her memory) be more productive?

Occupational Therapy-- Assist Mom with grooming and with each of her meals. She is able to feed herself. All I would need to do is place food items and plate/bowl in front of her so she can reach them. Remember not to do everything for her, but help her when she needs it.The goal is to continue to get Mom to some level of independence so she doesn't feel helpless. 

Physical Therapy-- Do arm and leg stretches several times a day. Help Mom get in/out of bed, as well as get in/out of wheelchair. I would also need to assist Mom when she needs to go "potty."

I will admit that some of these tasks are tough. What makes it even more difficult is the "language barrier." Meaning, I can understand maybe 60% of what Mom says. Even then, there have been times when I had to really listen and think about what she had said. Furthermore, I'm not sure how much Mom truly understands me (or anyone else) when she is given directions. So for now, its more of a guessing game (including body language and hand gestures) until Mom can understand and speak clearly. Tough days ahead for sure!

Mom's Rehab Update, Week Three

Good news! Mom's discharge date is set for January 1, 2014. Yay! We are excited and hope things will work out smoothly for everyone involved.

This week's therapies are pretty much similar to last week's. So, I'm going to just include short notes of activities during each session.

Speech Therapy-- Worked one syllable words, identified objects from a flashcard, practiced counting numerically, practiced days of the week, practiced moving her tongue up and down.

Occupational Therapy-- Worked on tasks that she will eventually do daily, such as get dressed, shower (with assistance), comb hair, etc. Also worked on releasing muscle tension in her right arm and stretching/straightening the fingers. OT also did a short session that involved electro convulsion therapy on the right arm ( there were some muscle movements in knuckle joints but not so much in the upper arm).

Physical Therapy-- Worked on transferring from bed to wheelchair, and vice versa. Did strengthening of the leg exercises (leg lifts and bicycling), scooting left and right, standing for about a minute at a time, walking across the parallel bars with assistance, and practiced standing up on her own.

 Along with working on her movements and speech, learning to move around in her wheelchair is another task. So, during her free time, we would go out into the hallways and have her practice "driving" her wheelchair. 

Overall, things are looking good for Mom. Just a little less than two weeks and we can head home!

Mom's Rehab Update, Week Two

Mom is continuing to improve on a daily basis.  With practice and encouragement, she has become more independent.  For instance, she's been able to get most of the food onto the spoon and into her mouth, reach longer to grab something, and push the "call" button when she needs assistance from the RN and CNAs.

Mom have also been able to maneuver her working arm (left arm) and get herself partially dressed, hold onto a bedrail so she could push herself from side to side with ease, and move her wheelchair backward and forward (even though right now all she's been able to do is go in circles with it). In addition, she is able to sit up in bed for longer period of time without any assistance. Also, by just looking into the mirror in front of her, she knows when to wipe away any food particle that land on her chin. And she does a pretty good job at it the first time around.

The therapists suggest we continue to work with Mom on self-care, such as getting dressed, combing her hair, feeding herself, etc. Also, we should continue with helping her identify objects and improve her speech.  A method that the Speech Therapist suggested was to have only one person speak slowly to Mom, as well as have Mom speak slowly to us.  Furthermore, when having a conversation with Mom, try having her finish the sentence.  For example, say something like "My name is ..." or " His name is...".

Reflecting back on therapy sessions and whatnot this past week, I believe Mom have made great improvement. Not only has she been able to pronounce some words clearer than last week, but she is more aware of what is expected of her, in terms of feeding herself and taking medications.  In short, she is getting the hang of things. I think consistency in daily routine is key to her moving one step closer to a quick recovery

Mom's First Three Days at Rehab

Last Friday (December 6) was Mom's first day at the rehab center.  She let it be known that she's going to be difficult to work with; stubborn and opinionated. But I have been told that stroke victims tend to be difficult and grumpy.

The first night an RN placed Mom's legs in compression cuffs to prevent clogged arteries in the leg.  An hour later, she took them off, with only one hand. Then she demanded that her ankle sock and support hose be taken off.

The second day a CNA combed her hair, detangled it, and tied it in a ponytail. She looked great. Clean and refreshed. But that did not last very long. For as long as I could remember Mom have always preferred her hair down and untied.  So, off came the hair tie.  Now I see where my daughter gets it from.

Breakfast usually consist of cream of rice with brown sugar, pureed omelet, pureed banana, and applesauce. 

Lunch usually consist of mashed potatoes with gravy, pureed vegetable (peas or carrots), pureed fruit (banana or pear), and/or applesauce. Sometime pureed meat is included (which is usually beef or pork).

Dinner is very similar to lunch menu items. It usually consist of pureed beef, pork or turkey, and sometime paired with mashed potatoes and gravy, pureed vegetable ( peas or carrots), and pureed fruit (banana or pear), and/or applesauce. 

Drinks that accompanied each meal were usually water, orange juice and/or apple juice.  However,  a recent lab result showed low sodium in Mom's system. So, no more juices; only chicken and beef broth, and some water.

Saturday, December 7... Due to low sodium in her body, the doctor ordered an IV, thinking it would be the easiest method for increasing Mom's sodium level.  But, it turned out that she did not like it, so she made a HUGE fuss, to put it nicely.  After awhile the nurse called the doctor, and the IV got taken out.  Obviously, actions of "anger and non-contentment" is something that can be understood across all nationalities. In other words, you don't have to speak the same language to know when someone is upset.

REHABILITATION UPDATE ( for December 6-8 )

The Occupational Therapist (OT) did some movement evaluation, which included leg and arm stretches. Therapy exercises have included re-learning how to shower, get dress,  comb/brush hair, stand, and walk.

The Speech Therapist (SP) evaluated her eating, chewing, swallowing, communication, and of course, speaking abilities. SP also worked on counting, recognizing and identifying objects, as well as understanding what they are used for.  It took at least three tries before Mom could count numerically. She managed to count up to number five; did it once with a combination of both English and Khmer. And then once again in only Khmer.  For the most part Mom can perform the functions. 

SP recommendation: work with Mom on a daily basis by encouraging her to move her tongue around the mouth for increased muscle strength, encourage her to smile often to work on facial muscle, and lastly, when she feed herself, put a mirror in front of her so she could see the food in her mouth while "chewing" and know that she needs to work on the right side of her mouth.

The Physical Therapist (PT) worked on mobility.  She had Mom do ankle and leg movements, as well as stand up and use the parallel bars for support. The PT said "she's a hard worker."

Overall, Mom has made progress, considering it was only three days of rehabilitation therapy. This week will be a full six days of SP, OT, and PT. I am hoping for more progress. Despite her disability and condition, Mom can be cherry and upbeat most of the time. But just like anyone who has suffered from a stroke and unable to communicate effectively (with a language barrier at that), she does have her moments.