I took today and tomorrow off to help with Mom, and I was there at 10 AM with decaf mocha and paper in hand. Mom had been up for at least two hours doing physical therapy by this point and I found her in the packed TV room watching The 700 Club on a 42" Samsung Plasma HDTV. Seems to be something of a waste of hi-def technology, and Mom wasn't into it anyway, so we went back to her room to chat and hang out.
She seemed in good spirits and I opened her drapes so she could see what a gorgeous day it was outside. The physical therapist was doing an evaluation in the morning and was going to return later in the day for a followup, but Mom wasn't sure how long she was supposed to be staying there and I wasn't either. When I went to look for the PT for a consult, they were off site and unreachable, so when Mom finished her coffee and got settled in with the paper, I went out into the day.
Flash forward to this afternoon, and when I arrived with a crossword puzzle book in hand, Mom had apparently just taken a small spill when getting to/from the bathroom. She was doing OK, but a nurse was taking her vitals to make sure everything checked out. Her blood pressure and heart rate are looking good (heart rate is still somewhat elevated at about 95-105 bpm) and after we chatted for a while, it seems she was pretty worn out from the day's PT sessions, so she got ready for dinner and I went to find the Therapy Manager.
Tanya (the Therapy Manager) had just pulled up Mom's charts and had a lot of information to bestow, most of which were in the forms of various test scores and percentages, but the basic gist is that they have been evaluating Mom's status based on three areas of therapy: Physical Therapy, Occupational Therapy and Speech Therapy.
PHYSICAL THERAPY
In the PT realm, Mom is progressing quite well. Obviously her right side (due to the stroke) is weaker than her left, but both sides are weaker than they could be so they're focusing on the right while incorporating the whole core. Lots of resistance training like pushing herself out of beds and chairs, etc. is being used, and on average, she is able to do most of these tasks 70-80% on her own. She has some balance issues while walking for a stretch, but with a walker she's able to manage just fine.
OCCUPATIONAL THERAPY
Contrary to how this sounds, it's NOT about finding Mom a job--this is about things that occupy one's time, like grooming, hygiene, etc. With feeding herself and brushing her hair and teeth, she's able to operate with about 80% independence once the tools she needs are lined up for her. But in things like bathing, using the toilet and dressing, she needs more assistance, and her percentages fall to the 50% range (meaning she needs more help doing these tasks). The OT will work on these trouble areas and find ways to make things easier for her, whether through augmentation of environment or through techniques learned in conjunction with the PT. The therapist also noticed that reading things seemed to be difficult, so there may be a vision issue afoot that they're going to dig into...whether it's based on the eyes themselves or on how the brain processes the information provided by the eyes. Should have more on that in the next few days.
SPEECH THERAPY
The main areas of work here seem to be comprehension and short-term memory. Tanya noted that she was sometimes not able to repeat things back as requested, or not able to answer complex yes/no questions. I asked if the hearing loss was factored into this and she said it may not have been...I told her that I've had good luck communicating if I speak slowly and clearly (not necessarily more loudly) and make sure I have eye contact. She made a note of that for future evaluation. When asked to remember and complete simple tasks (lift your foot, then blink your eyes), she was able to complete 1-2 tasks, but only sometimes 3 and never 4 or 5, so there is some concern about comprehension and retention. Additionally, listening to and repeating things was nearly impossible, so short-term memory seems to be very limited. Tanya noted her aphasic moments and I mentioned they had occurred for some time. There are a number of exercises lined up to help improve many of the speech and comprehension issues, and possible the short term memory as well.
BOTTOM LINE
Tanya's suggestion was to keep her for 60 DAYS. She said this is a worst case for the insurance company approval (and it's better to ask for the full possible amount up front than modify later), but that's still a LOT longer than we were thinking (1 to 2 weeks tops). I don't know how this jives with the doctors wanting to do the ablation procedure they had in mind for her heart, so that's still to be seen. And I have not given her this news yet since it was obtained on my way out of the facility, so breaking that to her is going to be hard. They're thinking some of that can be cut by substituting in-home care instead, but that a month is probably wisest. We shall see.
More tomorrow!
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