Dad's Progress...21/7/12

Saturday 21st July

This week has been a productive week - full of highs and lows.

We've met with the Speech And Language Therapist, Nutritional Nurse, as well as reviewing places where Dad can go for the next phase of his recovery.

We didn't learn a great deal from the SALT lady.  Dad is speaking well, he understands what is being said, he is relearning and using the new information he learns, however his short term memory is still poor. The fact remains Dad has cognitive and behavioural issues.

The Nutritional lady was really impressed with Dad's progress.  On previous visits she had seen Dad in bed, struggling to stay awake.  She said seeing Dad in a wheelchair, sitting upright and listening to what was being said was a big improvement. She said we should encourage Dad to feed himself, we know he can do it, and it must become habit for him.  In a stroke where the left side of the body is left immobile, it isn't uncommon for a person to lose their appetite - but this can come back.  She explained how many things will taste very different to Dad, compared with before the stroke. For example a cup of tea may taste bitter to Dad because his swallowing is slow and the bitterness of the tea will stay in his throat longer than we are used too.  She will work with us over the next couple of weeks with the aim of reducing Dad's nutritional feed.  We are pleased to hear that Dad has been eating more of his meals at lunchtimes as well as his evening meals and he has also been feeding himself the latter part of this week.

We are getting Dad in to the habits of washing his hands, shaving, brushing his teeth and combing his hair.  He has had a couple of fantastic days this week sitting in a wheelchair from 8.30 am in the morning until about 5.30 pm - this is excellent progress as Dad has struggled to sit out for even two hours over the last couple of weeks.  This shows his tolerance levels are improving and his stomach muscles strengthening.  Dad will lean forward on to a pillow to rest, however he is able to pull himself back up using his core strength. Dad is remaining upright when sitting and not leaning to the left  - this is all very good, subtle progress. He does at times, slide forward in his chair, and we have to work with him to lift his bottom towards the back of the chair - not easy, but we persist.

Dad's behavioural issues are a concern.  He gets frustrated during physio and we have been told he raises a hand - though we are not aware of him hitting out?  He has started to hit his poor hand and arm saying come on wake up. Although there are many instances of Dad's personality showing through, there are instances where traits of the stroke effects are showing - and this is with regard to inappropriate comments that Dad would never normally have made.

With regard to Dad's physio - this week we witnessed the physios spend 45 minutes trying to encourage and support him to move from the bed to a wheelchair. Dad was unable to find the strength and trust to do it, which resulted in the large hoist having to be used.  However, Dad's OT did tell us that he managed it later in the week.  They also worked on his balance by getting him to stand.  Rather than Dad holding on to the physio with his good arm, he wanted to lean against the wardrobe - is this a bit of Dad's independence and determination showing...or is this classed as behavioural issues because he is not listening to what he is told to do...?  Due to Dad's short term memory we were told he forgets instructions which hinders his progress.  Dad also kicked a ball across the lounge with another patient - passing from one side to the other.

Following a couple of intense days where Mum and I visited several ' nursing homes', we met with the social worker yesterday.  Many of you will know my views of our social worker. I explained that where my Dad was concerned I will do anything possible to ensure he has every opportunity to make the best recovery he can.

Dad is clearly too young to go to an old peoples nursing home - although some were better than others, we feel Dad may give up on the progress he is making if not continuously challenged.  It was emotional to even imagine Dad sitting with the residents and being 'one of them', with Mum becoming overwhelmed on several occasions.  Thankfully, we found an alternative option - a newly opened Rehabilitation Unit.  They have cleverly identified a niche in the market where not all people suffering brain damage are old and at the end of their lives - patients need stimulating and rehabilitating before moving back home and back to the community.  This place has more of a hotel feel to it than a home, which goes someway to making it feel more like an interim measure.  Their aim is to work with Dad on a daily basis, they have a resident neurophysio and a team of assistant therapists as well as a gym on site.  If Dad were to go into a 'Nursing Home' he would have a visit from  the Stroke Community Team once a week if lucky and potential visits to a local hospital for physio sessions - but he would have to travel there and wait for his turn before even doing any physio work. We are not naive enough to think there won't be teething problems - it is a newly opened unit and we will all have to get used to the set up, as well as the carers, nurses and physios familiarise themselves with Dad.  

So how long until Dad moves....well it is likely to be next week...and that is when the NHS stop funding and we start paying!  It is a costly option - but we believe it will be worth it. We will monitor the progress and continue to have review meetings over the next few months and hope and pray that Dad is able to make the progress to enable him to come home where he belongs. 

Love you Dad x