Keeping Things Moving


LBMMC Acute-care professionals Jackie, Lydia and Kenneth

On Tuesday, July 16, 2019, three acute-care medical professionals from Long Beach Memorial Medical Center visited the support groups for stroke survivors and caregivers at Stroke Support Association in Long Beach to answer questions about post-stroke care.

Jackie Starks, a speech therapist, Lydia Cheung, an occupational therapist, and Kenneth Barcelona, a physical therapist, arriving in work scrubs, took questions from the floor after asking the group members what issues were most important to them.

The team all work in the acute setting at the hospital, primarily seeing patients with stroke from the date of hospitalization to two to three weeks into their recovery. The patient will then move on to in-hospital acute rehab, to another medical setting, or to home with a plan of pursuing therapies as an out-patient.

Lydia, the occupational therapist, is primarily concerned with two goals at the acute level of recovery: 1) positioning the patient in the hospital bed to preserve joint integrity and mobility; 2) improving seated posture while incorporating the use of the affected arm for balance in order to maximize independence in accomplishing daily activities.

Jackie, the speech therapist, works mainly with post-stroke cognitive and speech difficulties, as well as issues with swallowing.

Kenneth, the physical therapist, works hand-in-hand with Jackie and Lydia to prepare the patient as much possible for release to acute rehab or to home. The team provides education and exercises in anticipation of the patient’s discharge from the hospital.

The presenters emphasized to the caregivers that they need to encourage the survivors, once home, to do as much as they can throughout the day by themselves. For instance, if the survivor is capable of getting out of bed alone, the caregiver should allow him to do so, or help minimally, even if the task requires extra effort and time.

Jackie, the speech therapist, suggested that the stroke survivors do as many household activities as they are capable of doing, even if their ability is impaired post-stroke. Such activities might include doing the finances, tracking medication, and handling some chores. Doing tasks that are difficult but doable will help improve cognition. As for language, Jackie suggests the stroke survivor be encouraged to contribute to conversations as much as possible. The members of SSA know that even if speech is impaired, or slowed, the survivor still has as much to say as he or she always did.

The team mentioned that most improvements occur within the first six months after stroke. Members of SSA gave examples of how improvements occurred well after that, even years afterwards. Said stroke survivor, Gary H., “A stroke survivor is like a fish swimming upstream. If you stop swimming, you don’t just stay there; you fall back. If you keep up the swimming, even though it’s a struggle, you will keep moving forward.”

Jackie, Kenneth, and Lydia agreed and stressed the importance of continuing speech, occupational, and physical therapy at home, even if formal therapy outside the hospital setting is not currently available. Kenneth suggested 30 minutes a day of some movement, which can be broken up into smaller periods of time, and can include such enjoyable activities as walking or gardening. Lydia said that playing cards can improve dexterity and help with concentration.

The presentation concluded with the passing out of helpful handouts and exercise guides, including the following: Aphasia Apps; Mobile Apps: Tools for Patient Empowerment; Self-Range of Motion Exercises for Shoulders, Arms, Wrists, and Fingers; Fine Motor Coordination Exercises; and Active Range of Motion Exercises.

Many thanks to Jackie, Lydia, and Kenneth for their presentation, as well as to Angie West (Program Director for the Comprehensive Stroke Center, Long Beach Memorial, SSA facilitator and Board Member) who made all the arrangements.

– Betsy Hardiman, Support Group Administrator

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