October 12, 2007

Speech Therapy, Physical Therapy - Bad & Good News

To keep Don in aquatic therapy we have to switch rehab centers because the PT that Don has been working is transferring out of town and no one left is strong enough to handle Don in the water. This presented a dilemma because the new center only schedules appointments in the pool on Tuesdays and Thursdays, the same days that Don goes to speech classes. So yesterday I talked with the head of the Speech/Language Pathology Clinic at the college to find out if it would count against Don's chances of getting invited back next semester if he drops out of Thursday group classes until after Thanksgiving. (Our insurance coverage for PT should run out about then.) The good news is that it won't factor into their decision if he drops out group speech therapy, but the bad news is that that decision has already effectively been made.

The professor said that the reason they have Don paired with another client on Tuesdays---instead of the one-on-one speech therapy he's been getting up until this fall---is because they are preparing them both to get discharged from the program. I don't know if it will happen at the end of this semester or in the spring---I was afraid to ask, or maybe I wasn't ready to hear the answer yet. But either way, an end of an era is coming. I did ask if Don would be allowed to return to group therapy for as long as he wants to keep coming as I've always understood to be true for all their discharged clients. She said, "Of course he can" and she said that they are going to expand the group classes. From that remark, I'm guessing there will be a number of clients terminated at the end of this or the spring semester. There is quite a group of them who've been in the program a long time. None as long as Don, though.

On the way home I told Don what the professor had said and I added that this doesn't necessarily have to be a bad thing for him, that we can change our focus to improving his physical health. He can join the YMCA with me and we'll be free to get involved with fun activities at senior center. I asked him if he was disappointed with the news and his answer was, "No." Since the first of the semester, we both sort of saw this coming---I even verbalized my hunch that they were getting ready to discharge him. But I really thought he'd be more bummed out about it. He has not been happy about sharing the therapy hour and from his reaction to this news, I'd say the college's experiment to prepare clients for discharge with this step-down semester is working the way they want it to. With past clients who've been discharged cold turkey, it's often a very difficult and depressing transition for them. No client who is doing well wants to give up a good thing.

Today was Don's last land therapy with his current and great PT. It was exciting to watch. At the Monday land session Don did three steps up and down and this time it was five times up and down before he wiped out. All of them were stronger than his first attempt on Monday. There is one task he has do while laying on his back where Don pushes with his neglect leg as the PT keeps pressure on his foot with his shoulder. The PT said he was surprised at how much stronger Don's gotten in such a short time. I could even see it. What was interesting, too, is on the second set of pushes we told Don to talk to his neglect leg, tell it "MOVE!" When he did that with each push he got much more power behind his actions. God, I hope he gets good PT's at the new location. I can actually see Don not being so wheelchair dependent in the future.

Jean Riva ©


The Bee Folks - Lori Titus said...

My husband's speech therapist has also been hinting about discharging Dave at some unknown but looming point in the future. I am looking at alternatives for him.

One possibility you might be interested in is checking out the local Senior Centers. Around me (Maryland) they are usually located near the libraries. One of them offers speech therapy for stroke patients for free once a month. They assign homework and everything. It might not be as often as my husband is interested in, but it is something.

Please, also check out my blog at http://davescaregiver.blogspot.com/. I started it just to vent some of the feelings I was having at being thrust into the unexpected role of a caregiver.

the aphasia decoder.... said...

Thanks for the comment and suggestion, Lori. I'm pretty tapped into what community resources are available around here for speech but your suggestion might help someone else reading this blog entry. I agree that once a month is not often enough but it's better than a lot of communities have. Here, I know of three attempts to get aphasia support groups going that could have done things like your senior center is with homework, etc., but they just haven't been able to get off the ground.