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    • Regaining the Abilities to Speak and Swallow are Among Stroke Recovery’s Biggest Challenges
      December 20, 2012

      A recent study in Canada found that an alarming number of people are not aware of one of stroke’s most common and challenging consequences: aphasia, a communication disorder affecting speech, reading, writing and comprehension. About one-third of stroke victims suffer some degree of aphasia, which occurs when there is damage to the left side of the brain, its communications hub. The Canadian researchers found that only two percent of those surveyed in public places in a major city could correctly identify what aphasia is, and, the researchers conjecture, this lack of understanding could be detrimental to the recovery of stroke patients who suffer with this condition. 1

      Indeed, without social and familial support, stroke patients suffering with aphasia, and with dysphagia, which affects the ability to swallow, often isolate themselves which fuels the fire of depression, according to Sonia Beltran, Rehabilitation Program Director at Kindred Transitional Care and Rehabilitation -- Eagle Creek, located in Indianapolis, Ind.

      At Eagle Creek, and at other similar Kindred skilled nursing facilities, speech therapy is an important component of the Stroke Recovery Program, an interdisciplinary approach to stroke rehabilitation that includes physical, occupational and speech therapy; use of specialized, on-site equipment and technology; patient and family education; healthy lifestyle programs; a progressive exercise regimen tailored to fit each patient’s needs and abilities; individualized plans of care to meet patients’ specific needs and on-site case management.

      “Our challenge is to re-build the neural connections for the affected areas,” Ms. Beltran said. “We have patients with expressive, or spoken language, deficits and others with receptive, or comprehension, deficits which impede their ability to communicate their wants and needs to their caregivers.”

      This can lead to a great deal of frustration.

      Speech therapists do many exercises with patients, including counting; going through the days of the week and the months of the year; naming tasks; and showing pictures and asking patients to name the item and its function. The therapy is undertaken five to six days a week for 40 minute sessions.

      “We’re most concerned with carryover,” said Ms. Beltran. “How is this going to make the patient more functional? Will they be able to communicate that they are in pain or tired?”

      Difficulty swallowing, or dysphagia, is another common effect of stroke. Many Kindred facilities are now using Vitalstim (www.vitalstim.com) as part of the therapy for this condition, which involves stimulating the muscles associated with swallowing.

      About 50 percent of stroke patients experience some amount of dysphagia and the condition can be extremely debilitating, and can lead to further complications. According to published research, about half of stroke patients with dysphagia become malnourished, and many develop pneumonia. They may also be at risk for longer hospital stays.2

      One of the most important components to stroke recovery is getting to patients early, Ms. Beltran said.

      “If we can catch the patients in the first three to six months post-stroke, we really try to maximize on that period of spontaneous recovery to get the patients as close to their prior level of function as possible,” she said.

      Family support is also key.

      Said Ms. Beltran: “In my experience, the patients that do the best are those who have excellent family support.”

       

      1 Heart and Stroke Foundation of Canada. "Hidden stroke impairment leaves thousands suffering in silence ScienceDaily, 1 Oct. 2012. Web. 4 Dec. 2012.
      2 Cola M, Daniels S, Corey D, Lemen L, Romero M, Foundas A. Relevance of Subcortical Stroke in Dysphagia. Stroke. 2010;41:482-486; originally published online January 21, 2010.

       

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