The three most important pieces of information I tell everyone post stroke…

There are three crucial bits of information I give my patients / families / whanau after an Acute Stroke that can be overlooked…

  1. A stroke can effect your emotions. You can experience changes in your ability to regulate your feelings (emotional lability), you may find yourself more tearful than normal, this can be hard especially for men who don’t cry often, or you may find yourself more short tempered.  Conversely you may find that you swing like a pendulum between emotional states: tearful – ‘normal’ – short tempered and everywhere in-between. This is quite normal post stroke, both because you are adjusting to a life changing event and the stroke also shakes up the chemicals in the brain and can upset the parts regulating emotions. In many cases this will settle over time. Have you experienced / noticed if your family member is experiencing anything like this after your /their stroke?
    (At this point many people break down into tears and confess that they have been so upset and could not understand why / feeling ashamed to talk about it etc. – this often leads to a discussion about how the stroke has effected them and talk of strategies to use to manage this side-effect of a stroke).
  2. Fatigue is to be expected – many people find they are much more tired than normal, they may need to take naps during the day or struggle to concentrate for long periods of time, this is a natural side effect of a stroke initially – the brain is busy trying to heal itself and it requires energy to do this – it is important to have regular rests during the day in the Acute phase after a stroke if your body is telling you this is needed. Some people need to schedule their therapy sessions / visitors / rest periods to ensure that they get the most benefit of their time in hospital. Have you noticed any changes in your energy levels post-stroke?
    (This leads into fatigue management education / pacing / energy conservation education / managing large numbers of visitors etc.).
  3. Post-stroke depression is fairly common and not always openly talked about – some people may notice that as time goes on they don’t feel like themselves, their mood may be lower than usual or that their personality has significantly changed. It doesn’t happen to everybody but it is good to be aware that this is a reasonably common side effect post stroke and to periodically check-in with yourself and see how you are doing. If you notice that your mood has changed in the weeks post-stroke is can be a good idea to discuss this with your General Practitioner / nominated health professional.

In my experience these simple pieces of information can reduce feelings of isolation, embarrassment, even of failure in people post-stroke.

What other bits of information have you felt makes a difference for people immediately post-stroke?

#8 When an over toilet frame or a shower stool is literally life changing

I love the days when something small, like say an Over toilet frame (OTF) or Shower stool (S/stool) or a kitchen perching stool can literally change someone’s life!
Something so seemingly simple and routine in the world of an Acute OT can make someone’s day / week / month or even year!
Recently I recommended an OTF to a patient (who had been struggling for a long time with toilet transfers and felt too embarrassed to discuss this with her family) and she lit up with an inner-light – so excited that going to the toilet was not going to be such a struggle / chore any more.
A perching stool in the kitchen coupled with advice around pacing / energy conservation enabled a patient to return to cooking full meals at dinner versus frozen microwave meals (which she didn’t like very much) – she practically danced from her bed out the door planning the new meals she would make when she returned home…
A shower stool enabled my other patient to be independent and not need carers to come into the home to assist her – her excitement was palpable!

A simple piece of equipment changed these people lives! All they needed was someone to listen to them and problem solve potential solutions to enable them to meet their goals.

Mentors – why I love them and why they are essential!

Many times we encounter therapists that inspire us, some one we look up to, aspire to be like, someone that helps you take your practice to the next level, to help you plot out your next step…

I have been very fortunate in my career to have worked with so many wonderful therapists, who I quote in everyday practice and with my own students (many years down the track), and I want to pay tribute to them here, and the key lessons I learnt from them!

Coral – my first supervisor, was a wonderful experienced therapist, she explained to me how the hospital worked, how we were all equals and part of the overall machine, she said – learn everyone’s names from the cleaners to the doctors and nurses, no one is more important than the other, say hello to everyone, the system would fall apart if one of the parts was missing! Great advice by the way!

Marlies – an amazing supervisor I had when on placement as a student in a residential care facility. she had amazing empathy, a calm manner and warmth and respect for the residents. And a highly skilled and experienced therapist.  She fired in me my love of working with older adults and particularly in residential care. She showed me how great it could be, how OT was essential in care homes and the valuable contribution we could have. She introduced me to mindfulness and explained how important it is and how it can be a useful tool in practice. I have strived to emulate her manner and her skills in the years I have been working with older adults.

Sandy – a gifted OT who has had a huge influence on my practice (and continues to do so today).  I had the honour of working with her in the Acute hospital setting during my second year of practice.  She truly introduced me to occupation centred assessment and understanding the impact of cognition on occupational performance.  Fired my interest in posture management and promoting occupational performance through building a stable posture to work from. She continues to blow my mind – most recently when she taught on a post-grad paper i was enrolled in. I quote her almost daily! She remains my go-to person 8 years on when it comes to OT!

Clare – opened my eyes to what was possible to achieve within a hospital setting, demonstrated how to develop professionally within the system, how to grow my ideas, encouraged my passion for OT, showed me how to set up projects and to dream big!

Ros – a wonderful Physiotherapist I work and share an office with, challenged me one day early this year to look outside the hospital I work in, even outside the country I live in, to share my passion and knowledge in OT, and to listen and learn from people around the world. She said the world is a large place – be a small fish in a big pond! From this discussion I created this site!

We are lucky as therapists to come into contact with a variety of people who can inspire us.  I don’t think they have to be OT’s either, it can be someone who has skills that you would like, whether it is just that you like their bedside manner or seen how they negotiate the hurdles in daily practice… I believe that we should tell these people, these positive influences, how important they are.