Therapy for all

Dad, Mom, my younger brother and I met with the therapists today. A sort of "round table" discussion on Dad. Sort of.. because the table was actually rectangular, but you get the idea.

Leading off the discussion was Ruth, the nurse or assistant to Dad's doctor while at Jim Thorpe. She said that everything relating to his medical condition was good. She went through a variety of medications explaining why each was prescribed. It's kind of funny to think of Dad on Ritalin, but it's actually a common prescription for brain injury patients. Helping to concentrate, etc. They also have him on anti-seizure medication. While I'm unaware of Dad suffering from any seizures, it's fairly common for brain injuries.

In terms of the anti-seizure medication, it makes me think of that old joke. The one about the elephant repellent system. Guy goes on about how well it works, other guy says something about there not being any elephants in town, first guy remarks about how well it works.

Second up today was the physical therapist. Dad is walking better, although he clearly (as is to be expected) is suffering from muscle atrophy on his right side. He actually walked 200' with a hemi walker. I think it's a hemi walker. It's smaller than what you typically picture, and designed for someone using only one arm. So, the 200' is good, but Dad is still largely ignoring his right side without encouragement. They kept referring to it as motor planning, awareness, etc. With a little help, he can get out of his wheelchair. With a little more help, he can walk reasonably well, but not quite well enough to go unassisted.

The really good news at this point in the meeting was the consensus among all of the center employees that Dad would continue to progress for another 6 to 12 months. They couldn't say how far he would get, or what limitations would remain. But it was very good news to know that he hasn't reached those limitations yet.

The occupational therapist "Doni" was up next. She really emphasized the "re-directing" and the motor planning issues. Things as simple as brushing your teeth. She said that just earlier this week, he could brush really well, but got confused when he was told to rinse. He'd just start brushing again. I'd point out that he's really really stubborn, but this is related to the stroke. Either way, he's now rinsing without much confusion.

All-in-all his ability to take care of his own hygiene needs is improving better than expected. He's determined to do everything himself, however he'll always need some assistance, or at least special accomodations as it relates to showering, etc. We've all seen those shower seats, or something like them. He just needs a shower that's easy to get into, and then some safe way to sit down while he bathes.

Kimmie, the speech therapist followed occupational therapy. She said that his cognitive expression is suffering right now. Same stuff I've been saying, only more technical. He gets frustrated with his inability to put his feelings, wishes or thoughts into the right words. He is saying many more 'real' words than the jargon he was using at first. She encouraged him to focus on using one or two words to convey what he wanted to say. Oddly enough, he still insists on forming complete sentences.

I'll insert this as it's appropriate for the context, but my eldest daughter called shortly after the meeting came to an end. She does this everyday when getting home from school. I used the opportunity to put Dad on the phone. He talked to her only briefly, but I was surprised how much of it I could understand. What really made me smile was the bubbly voice on the phone when Dad handed it back to me, "DAD, I COULD UNDERSTAND EVERYTHING HE SAID TO ME!" Her enthusiasm was infectious, to say the least.

As a wrap-up, the case worker "Ruth" ran through their recommendations. They still recommend a 24-hour skilled nursing facility at this time. He's close, but still needs help with most daily functions. He shouldn't be left alone, for sure. If not a 24-hour facility, some sort of an adult daycare, or in home aides to assist with his daily needs.

Dad disagrees, and wants to go home immediately. The center is keeping him through the weekend, so we need a definitive plan by Monday. I don't really know for sure what we're going to do at this time. We plan to talk about it more the next few days. It was a good meeting, and certainly encouraging to the family, if not a little disappointing for Dad himself. He still wants to go home. Obviously, sooner than later.