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Personal Experience

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What I can handle, I want to do by myself.

Karin Branikova
Language: English
Country: Slovakia
Typology: health care professionals
Text:
Mrs. Iva is 52years old. Two weeks ago she suffered from a sudden brain stroke. She can think and talk but she cannot feel and use the left side of her body. Mrs. Iva was spending a weekend with her husband and daughter and her family at their cottage. She bended down to her 3 years old granddaughter with whom she was playing when she got dizzy and after she remembers nothing else. She woke up in the hospital and they told her she is 3 days after the stroke. The first days she was recovering. It was not sure what damage the stroke made. Now she knows that the left part of her body is completely non-sensitive but doctors reassure her that her state can improve during the precious rehabilitation. It is important trying to involve the affected parts of her body at maximum. For the physiotherapy there comes a physiotherapist to Iva. She explained to her the risk of immobilization of the joints and tendons which are not being used. Nurses help Iva with hygiene, eating and with excretion. At the beginning she had a problem with swallowing so her food is mixed. She uses protective underpants, showering and dressing up is in charge of nurses. It seems that she is going to be dependent on the help of others and that worries her. She has always been active and independent. With a help she can sit on the bed and sit with her legs hanging down the bed. She can also stand up on the healthy leg even though she is losing her balance. The nurse suggests Iva to start trying her independence. In a motivational talk she explains to Iva that her body will easily remember the things it used to know when she will activate herself and start involving herself in the self-care. The nurse helps Iva to stand up, go to the wheelchair and encourages her to move it by herself. After a while of attempting Iva is happy for her first success and she starts to enjoy picking up a new skill. When she gets to the wash basin with the help of the nurse, the nurse encourages Iva to try to get up, she supports her just slightly. Then she helps her to lift the night dress above her buttocks and Iva sits down and tries to take it off on her own. Activities which used to be a routine are now the difficult ones. Iva is looking for ways how to deal with this new situation. Then the nurse encourages her to clog the basin with the stopper, turn on the water at the temperature she wants and offers her a sponge with which Iva can start to wash herself. Then the nurse washes only the parts Iva cannot reach or cannot get to. The similar procedure repeats when drying, moisturizing and dressing up. The nurse emphasizes to Iva that she is doing great and if she will continue like this soon she won’t need much help. Iva tries really hard but she still needs time to rest. Sometimes she is so concentrated that she forgets to breath , so the nurse leads her and compliments her. When the hygiene is done Iva is tired but satisfied. The expression on her face has changed, you see there will and a little bit of pride. They continue together every morning and at the basis of the nurse’s experiences, the whole nursing team continues like this. After a few days Iva can sit and get up just with a slight help. She can wash herself, dry herself and change the top clothes. This gives her a hope that her state can improve. She also describes that sometimes she can move her arm and fingers but she does not know it for sure. She is so excited about it that she tries it all the time in order to help remembering the movements of the paralyzed side. She can better orientate in movements, she can do movements with some help and so the risks of falling and injury have decreased. With the help of the healthy hand she rises the paralyzed one over her head and so she exercises both of them. In a few days she understands that she is not dependent on the help of professionals in exercising, that she can try also on her own. She needs help only when trying to walk. She is happy for her success and exhaustion. Her mood has improved and she supposes that she will walk again and play with her granddaughter in the garden. She is going to an intensive rehabilitation spa therapy after the release from the hospital. OBJECTIVES: Gradual regaining of self-sufficiency within the range allowed by her conditions after the stroke. Promoting confidence. Creating substitute motion patterns for the disappeared function. Activation of disappeared functions with the help of the mental map and preserved functions. Prevention of falls and injuries. MEANS AND STRATEGY: Clarifying interviews, practicing the use of movement of the healthy side of the body and safety moving. Train supporting the paralyzed limb by the healthy one. Training of the use of conserved mobility and moving the center of gravity when changing positions in bed and during the transfer to the wheelchair. Ongoing physiotherapy. CONCLUSIONS: With help Mrs. Iva is able to transfer herself from bed to the wheelchair, move with it to the sink and to the dining room. She can cut soft foods by one hand and eat by herself. She is able to pour prepared drink and drink it by herself. She is still learning to walk. On regular basis she exercises her paralyzed arm. She moves the shoulder upfront slightly and with a help of the healthy hand she can interlock her fingers. And she does not give up. She believes it will be even better.


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