STEPHANIE’S TIPS FOR CAREGIVERS:
Stepping Back

A stroke has a way of magnifying personality traits in the caregiver as well as the survivor. My need for control was pumped up, possibly because our lives felt like they were spinning out of control. I looked for ways to exercise
control. One way was learning everything I could about stroke. Another was keeping lists and notes on everything the doctors, nurses and therapists said and did.

As Paul recovered, I couldn’t stop myself from needing more control, particularly over little details. If those details didn’t go as I had planned, if I wasn’t in control, I would get stressed out.

I usually drive because I am a control freak. Of course, I explain that if I drive, “Paul is more rested,” and so more able to fully engage with whomever or where-ever we’re going. The loss of control when the traffic slows down (which happens all the time where we live), makes me frustrated and angry, so maybe I should let Paul drive more.

Recently, Paul’s brother spent a week with us for the first time in many years. I wanted to be sure that Paul and his brother had time alone, without a control freak micro- managing the scene, so I planned to work most of the week. On Wednesday, Paul drove his brother to his Rotary Club without me. They spent the day together and had a great time.

I have met many caregivers who were or became control freaks, perhaps more compulsive than me. They would do everything for their survivor, make all the decisions, try to be in complete control. They wouldn’t let the survivor learn to get a snack for himself, or help with the household chores,
because the survivor was too slow or “couldn’t do it right.” They were totally stressed by all the work, with no end in sight.

I have learned that the more independent I helped Paul become, the more time and independence I gained for myself. I know that loosening control and stepping back helped Paul to be more self-sufficient and self-assured, and helped me find perspective. And last week proved this in a very positive way.

For more tips for caregivers, please visit:

http://www.strokesurvivor.com/articles_and_tips.html.

*** Looking for even more inspiration & solutions for spouses and families? Read, “Conquering
Aphasia & Stroke for Caregivers,” the special E-book by Stephanie Mensh. Details and to order your
copy, anytime, anywhere: http://tinyurl.com/CaregiverE-Book

Stroke Cents Facts and Tips

 A recent study found that men with increased levels of lycopene were 55 percent less likely to have a stroke. Lycopene can be found in tomatoes as well as watermelon, pink grapefruit and guava.
 Thirty minutes of moderate exercise every day can reduce the risk of stroke by up to 57 percent in women and 30 percent in men.
 People who consume more than 4,000 milligrams of salt per day double their risk for ischemic stroke.
 People who consume six or more ounces a day of white-fleshed fruits and vegetables, such as apples, pears, cauliflower and cucumbers, are 52 percent less likely to have a stroke.
 A recent study found that drinking 1 to 3 cups of coffee per day protected against ischemic stroke.
 People who eat one bar of dark chocolate per week have a 19 percent reduced risk of stroke.
 People with prehypertension, or a slightly elevated blood pressure rating, have a 55 percent increased risk of stroke.
 Smokers are twice as likely to have an ischemic stroke and four times as likely to have a hemorrhagic stroke than nonsmokers.
 Women can lower stroke risk 30 to 40 percent by eating high levels of whole grains.
 Research shows a link between chronic stress and high stroke risk.
 Many people report yoga reduces stress levels. Chronic stress is associated with a
greater risk of stroke.
 Lower your stroke risk by making smart eating choices. Start by substituting sweet
or salty snacks with an all-natural alternative.
 If finding time for a workout is a challenge, set a goal to walk 10,000 steps a day. It
will increase your energy, help you maintain a healthy weight and reduce your risk
for stroke.
 Taking medications as prescribed is central to recurrent stroke prevention.
 Taking 2 to 4 grams of fish oil per day can help lower stroke risk.
 High cholesterol is a significant risk factor for stroke. Introduce foods with healthy
fats, such as flaxseed.
 B Vitamins and Vitamin C have both been linked to a decreased risk for stroke.
 Drinking at least three cups of green or black tea a day can reduce the risk for
stroke by as much as 21 percent.
 A recent study showed that people who exercise five or more times per week have
a reduced stroke risk.
 Taking folic acid lowers stroke risk by 18 percent.

Magic for Stroke Patients: The one-sided work-out, an Article by Christopher Wanjek, a columnist for LiveScience Bad Medicine.

Stroke sufferers often face a long road to recovery, particularly when their damaged limbs are too weak to exercise. Such damage usually manifests itself laterally, with one side of the body more affected than the other.
But scientists at the University of Victoria in British Columbia, Canada, have found that strength training for stroke patients solely on their stronger side will somehow, almost magically, strengthen the weaker side.
They report on this advance in post-stroke recovery in the journal Experimental Brain Research. The result could have huge potential for stroke rehabilitation, because the positive effect was seen even years after the initial stroke and the strength gain was equal on both sides.

Training the “other” side
Doctors have known for more than 100 years that short-term, high-intensity resistance training on one side of the body causes some degree of strength gain in the contralateral, untrained limb — for example, the left leg when only the right leg is exercised. The phenomenon is called cross-education, and the strength gain in the untrained limb is up to half of what it is in the trained limb.

No study has applied cross-education after stroke, said Zehr and his co-author, Katie Dragert, who recently completed her doctoral degree in Zehr’s lab. So they applied cross-education to 19 stroke sufferers who, on average, had experienced a debilitating stroke 80 months before the study.

The study focused on the legs and ankles with an eye toward walking recovery. The participants spent six weeks rigorously exercising their less-affected ankle dorsiflexors, the muscles that flex the foot and enable natural walking. The training was in 25-minute sessions three times weekly.

To their surprise, the scientists found equivalent strength gains in both legs, about 30 percent. Four participants who were barely able to flex their feet on their more-affected side before training could do so post-intervention.
Zehr said his next step is to test cross-education for strengthening the arms and wrists, which also often are severely affected by stroke.

“We went after the ankle dorsiflexors because of the huge weakness issue post-stroke and how it affects walking,” Zehr told LiveScience. “We presume we could do the same in the upper limb.”
Lasting effects

Zehr said the initial strength gains found in the four to six weeks after people start strength training are neurological adaptations, as the brain and nervous system create new connections to the muscles.
“Up until the kind of work we’ve done in stroke, this cross-education phenomenon has really been just that: a kind of weird asymmetrical response to training,” Zehr said. “Why would someone who could use both sides of the body ever want to do it? Why not just train both sides and get about the same strength gain in each limb? It only has real value when you already have an asymmetry, like in stroke.”

Zehr added that a group led by Jonathan Farthing at the University of Saskatchewan has performed complementary research in cross-education for limbs in casts, to prevent muscle atrophy in the immobilized limb.
As to the phenomenon of cross-education, Zehr said this might go back early in our evolution to when our pre-human ancestors walked on all fours. “It likely represents a useful compensatory mechanism when there is damage like in a stroke or spinal cord injury,” he said. Read full article

Author: Mayoclinic.com

Mayo Clinic’s website has great information for the aphasia community and their caregivers, please go to their website at: Mayoclinic.com.

If you have aphasia, the following tips may help you communicate with others:

Carry a card explaining that you have aphasia.
Carry paper and pencils or pens with you at all times.
Use drawings, diagrams or photos.
Use gestures or point to objects.
Tell or show people what communication style works for you.

Family members and friends can use the following tips when communicating with a person with aphasia:

Simplify your sentences and slow down your pace.
Allow the person time to talk.
Don’t finish sentences or correct errors.
Keep conversations focused on one topic at a time.
Avoid distracting noises.
Keep paper and pencils or pens readily available.
Help the person with aphasia create a book of words, pictures and photos to assist with conversations.
Use drawings or gestures when you aren’t understood.
Involve the person with aphasia in conversations as much as possible.
Check for comprehension or summarize what you’ve discussed.
Talk about the frustrations that the person with aphasia is experiencing.
When conversations break down, decide together whether to continue or return to the topic later.

For the complete list of “skills” or strategies, please Click Here .

Author: Paul Berger

Telephone calls are very hard for people with aphasia and other speech problems from stroke, like me. One way to succeed is to plan ahead–before you pick up the phone, know what you want to say.

One of the courses offered by the aphasia center I attend (the Stroke Comeback Center) helps you relearn how to make a phone call and leave a message.

We memorize some simple scripts. I have mine by the phone so I can refer to it when I start a call. This gives me confidence to call my friends and
business colleagues.

For networking meetings, I use an index card with a brief script describing my small business and goals.

A copy of the telephone script will be posted to my website at: www.strokesurvivor.com/tips.

Other insights and tips for coping with life and taking control of your recovery after stroke are available on my website at http://www.strokesurvivor.com and in my books, “How to Conquer the World With One Hand…And an Attitude,” and “You Can Do It! 105 Thoughts, Feelings & Solutions to Inspire You.”

Author: Medical News Today

An Article found on Medical News Today dated 07 May, 2008

The Stroke Association believes that everyone should have the same holiday choices, so the charity has partnered with Accessible Travel & Leisure to provide tailored holidays for stroke survivors and their families.

Following a stroke, a holiday can be therapeutic, but travelling is a lot more stressful and tiring when your mobility is limited. However Accessible Travel and Leisure are specialists in providing quality holidays for the less mobile. Accessible Travel look after every detail of the holiday from airline reservations to arranging care in the resort, to allow stroke survivors and their families to enjoy their break.

Martin, a stroke survivor who booked a holiday through Accessible Travel, said:

“After my stroke and having difficulty walking, I didn’t think I would cope with travelling abroad again. Accessible Travel dealt with all my concerns and needs and gave me and my family the holiday of my dreams.”

Monika Milne, Account Manager – Commercial Ventures at The Stroke Association said:

“The Stroke Association are delighted to be able to offer stroke survivors and their families tailored holidays. Some stroke survivors may have thought they would never have the chance again, but because Accessible Travel look after every detail of organising a holiday, all stroke survivors have to do is sit back, relax and enjoy their trip”.

Accessible Travel & Leisure will make a 5% donation to The Stroke Association for each completed holiday booked through the partnership. For more information on this please visit The Stroke Association shopping pages or call Accessible Travel & Leisure on 01452 729 739, quoting ‘The Stroke Association’.

To read, print or email the complete original article, please click here .

Author: Linda Wells, MA, CCC-SLP

A speech-language pathologist at Mary Free Bed Rehabilitation has developed a special ID card to make it easier for people with speech impairments to notify others of their condition.

Linda Wells, MA, CCC-SLP created the Communication Impairment Alert Card to help them clearly identify their condition during an emergency or routine activities like shopping or banking.

“The idea for the card came after a patient shared with me his story of being pulled over for a minor traffic violation and how difficult the experience was because of his communication impairment,” Wells said. “He had a brain injury that left him with slurred speech, leading the officer to believe he was intoxicated.”

The card has two components: a pocket/wallet card and a notification that can be attached to the visor in a car. The cards identify the person’s condition and the best method of communication, such as writing, speaking slowly, or asking yes-or-no questions.

“The card should eliminate some of the frustration that occurs when an individual who is slow to answer or sounds slightly different needs to interact with someone for the first time,” Wells said.

The Communication Alert Card has been endorsed by all Michigan law enforcement agencies. Cards can only be obtained through a physician or speech pathologist. For more information, contact Linda Wells at (616) 242-0425 or visit www.maryfreebed.com .

Author: Ellen Bernstein-Ellis MA, CCC-SLP

Stroke Connection Magazine is a free publication of the American Heart/Stroke Association. Click Here to sign up for this free publication.

To help a loved one with aphasia, your resource basket might include the tips and items below. No single strategy or resource is right for every person, situation or conversation.

Personal portfolio: Create a binder to show off significant mementos like letters, photos of special events or people, newspaper clippings or anything else you want to share. Include a personal record of past achievements and personal milestones. A visual record can make it easier to share memories and inspire activities that are hard to express due to aphasia.

Communication book: Create your own communication book or buy one ready-made. It can be full-sized for home, purse- or pocket-sized for trips. Start with personal, medical and emergency information. Include a list of family and friends and their photos. Use business cards from a favorite restaurant or hairdresser. You can also add pictures, words or photographs grouped by category to help with clothing, food, places, feelings, numbers, days of the week, months and so on. Include information about special hobbies, interests or highlights from the week’s activities.

Maps: Collect maps of your state, the United States and the world. A smaller map of your local area or neighborhood is quite useful. Pointing to a place on a map is usually much easier for a person with aphasia than recalling the name of a specific location.

Picture resources: “The Wordless Travel Book” published by Ten Speed Press is a great resource for everyday pictures organized by categories. Picture dictionaries also help share ideas. The Aphasia Institute offers booklets to make it easier to communicate in specific situations, such as with a doctor or clergy.

Resource Cards: People with aphasia may confuse related groups of words like yes/no, numbers or colors. Make a card with the words “Yes” and “No” written in large letters and paired with a drawing of a happy (YES) and sad (NO) face. Also it’s helpful to have a number card with 1 – 10 on one side and 10, 20, 30, etc on the other. Use crayons or markers to create a color card.

Picture scale: Make a card with a 1 – 10 scale. Put a sad face over the 1, a neutral face over the 5 and a happy face over the 10. This helps a person give more than just a yes/no response. It is a great way to get an opinion, by asking the person with aphasia how much he or she liked or disliked a movie, restaurant, etc., or to get someone to describe how they’re feeling.

Pad & Paper: Writing or drawing offers another avenue when talking is not successful. You can draw or write key words and phrases during discussions to help someone with comprehension problems. For example, instead of giving five choices aloud, list them on a sheet of paper and encourage the person with aphasia to point.

Calendar/personal organizer: Keeping track of appointments, times and details can be particularly difficult for the person with aphasia. Use a calendar updated with appointments and family events whenever you are discussing schedules. Take time to review the daily highlights together so everyone is “on the same page.”

Leave instructions in written form: A person with aphasia is more likely to understand a written list of details or instructions than a long verbal message. Write a note that clearly lists the chores or information you need to convey.

Personalized phone messages. Taking messages can be challenging for a loved one with aphasia, and frustrating for the caregiver who needs the information. Create a phone message pad that offers multiple choices. For example, list “family, friend, medical, business” at the top so the identity of the caller can be easily circled. Leave a script of useful phrases by the phone like “Please talk slowly” or “Please spell your name” or “Please call back and leave a message.”

RECOMMENDATIONS FOR IMPROVING COMMUNICATION:

Control Distractions: Try to keep distractions and background noise to a minimum. Turn off the TV during a conversation. In a restaurant, pick a quiet booth.

Be a partner, not a therapist: Don’t turn conversation into therapy by correcting the person with aphasia or asking for unnecessary repetition. Encourage all communication methods that work for them. Treat the person with aphasia as a competent adult.

Maximize your own communications: Speak slowly and clearly. Try to give one idea at a time and confirm that the person with aphasia understands. Use facial expressions and natural gestures. Use resources mentioned above to help convey your message. For example, if a friend is coming to dinner, show a photo and write their name and the word “dinner” on a calendar.

Educate yourself and others: Take advantage of Web sites that offer education about aphasia and guidelines for communicating. Share these resources with others. Work as a team with a speech therapist to learn which strategies are most appropriate for helping you and your family member communicate.

Pulling a map out of a basket, using gestures or referring to a communication book may seem awkward at first. Keep using these resources to support your efforts to communicate. Perhaps the most important resources of all will be humor, practice and patience.

Author: Bill Connors

Here is the Tip of The Month from Bill Connors of the Aphasia Toolbox

Hope for the patient with aphasia is critical to the rehabilitation process. Hope is what drives the patient to persevere both when the patient is making progress and when the effectiveness of the aphasia treatment has reached a plateau. As caregiver or speech therapist how do you know when the patient has hope or when hope is flagging? One obvious sign is the patient’s response to treatment. If the patient has a focused look in their eyes and is gesturing or using other body language in a positive way, hope is alive and well. If the patient isn’t making good eye contact, appears unfocused or distracted, and is gesturing or using other body language in a negative way, hope may be the missing emotional ingredient.

Simply Smart Aphasia Therapy works to keep hope alive within the patient, caregiver, and therapist at all times in a number of ways. The SSAT protocols are designed to fit each unique therapy situation. This allows the treatment to be focused on the patient’s needs of the moment. The protocols all allow the patient to begin practice at a relatively simple level and progress to more complex therapy tasks within the same protocol. This is what Vertical Stepping and Horizontal Tweaking is all about. The suggested materials all match the protocols, diminishing any gap between expectation and execution.

If the aphasia patient’s hope can be kept alive, progress will be made. To learn more, or to sign up for the monthly newsletter, contact Bill Connors by clicking on his name or bill@aphasiatoolbox.com.

Author: Sandy Caudell

A neurologist says that if a Stroke victim can get to the hospital within 3 hours generally the effects of a stroke can totally be reversed. The trick is to get a stroke recognized, diagnosed and then getting the patient medically cared for within 3 hours, which is tough.

REMEMBER: Recognize a STR*oke:

*S = Ask the individual to SMILE (check to see if their smile droops to one side)
*T = Ask the person to TALK (speak a simple sentence such as “It is sunny out today”)
*R = Ask him or her to RAISE both arms (check to see if one arm drops down)

If he or she has trouble with ANY ONE of these tasks, call emergency services immediately and describe the symptoms. This is URGENT!