Mom is continuing to recover from her stroke.  She looks forward to her speech therapy with MaryPat at The Villages Regional Hospital three times a week.  She has also joined the local Wellness Center (a.k.a. health club) and takes a MedFit class twice a week.  MedFit is an extension to Physical Therapy with no doctor involvement.  Otherwise, Mom has returned to her active social life with her friends.  Her next hurdle is learning how to drive again. 

Mom has come a long way within months of the stroke.  Here are some of the good things that we learned that we think might be helpful to you.

Pay attention to possible warning signs.  Our mom had symptoms that were most likely TIAs (a temporary interruption of blood flow to a part of your brain or mini strokes) that we didn’t pursue, even though intuition was nagging us.  Mom had serious dizziness and lack of balance that landed her in the emergency room months before the stroke.  She was diagnosed with vertigo and given some pills to take if the symptoms reappeared.  We were left wondering why she would be suffering from vertigo and chalked it up to stress.  A month before the stroke, Mom was sitting outside on her lanai and began to tell us something but was not able to speak – no voice, no words for a couple minutes.  It was definitely odd, but it seemed like a passing event.  Now it is clear that these were warning signs and that we should have followed our instincts.  We would also suggest that if you have questions regarding a diagnosis like vertigo that doesn’t “sit right with you,” ask the doctor “What else could it be?”  Read an excerpt from the Mayo Clinic website on TIAs in our Other Stories section.

Learn how to determine if someone is having a stroke.  One of our mom’s greatest concerns is that she’ll have another stroke.  It is important to educate Mom’s friends and ourselves how to determine if someone is having a stroke and what to do in this event.  See the article, “How To Be Prepared To Act Fast” in this section.

Find the very best rehabilitation center, even if it’s not close to home.  We feel our mom received a huge advantage by going to Rusk Institute of Rehabilitation Medicine in New York City (part of NYU Langone Medical Center and rated in top 10 by US News & World Report).  We were concerned about flying her up from Florida, but it was well worth it.  The rehabilitation center should be specific to those who have suffered from a stroke or neurological problem.  Rusk took into consideration the whole person by offering exceptional speech, occupational and physical therapy as you would expect, and also neuro-psychology, garden, art and music therapy.  But more than that, the people at Rusk are smart, think things through, listen to the patient and the families, follow through, provide encouragement and support.  Rusk developed a nurturing, positive and engaging environment that provided our mother with a firm foundation for her continued recovery. 

Special thanks to those at Rusk who made a difference for our mom - the doctors, nurses, nurses aides, therapists, and specifically, Dr. Julie Kim, Karen Gendal, Alicia Esposito, and Rowena Olifernes.


Take pictures to help your parent communicate.  While Mom was still in the hospital, she was not able to speak more than a few “automatic phrases” like “Hi honey. How are you?”  Otherwise, she only had one word in her repertoire - “bathroom”.  So, instead of “Hand me my purse,” she would say, “Hand me my bathroom.”  We never knew what she was talking about, and she was incredibly frustrated and saddened because she didn’t know any words, no matter how hard she tried.  So we took photos of everything at her home with our iPhone camera.  This way she could scroll through the photos and point to the things she needed or wanted.  We took photos inside drawers and cabinets; in the kitchen, bathroom and bedroom; captured items on the nightstand, dresser and end-table next to her living room chair.  We thought this was a handy tip to share.

Find words through singing.  One terrific nurse, Judi, would help Mom with her words everyday even though this was not expected of her.  Judi suggested that we sing.  It was helpful in a time when there were very few words.  As we mentioned above, Mom would say, “Where is my…?” or “Can I have…?” but could not say the object – book, wallet, phone.  The harder she tried, the more frustrated she got, and the harder it became to retrieve the word.  So we sang, for example, Row Row Row Your Boat – and the words were there.  (These are considered “automatic words” – the words “row” or “boat” may not have been found in another context.)  But we shared the rhythm of singing this song, then changed the words to Read Read Read Your…  If she didn’t fill in the word “book” right away, we just moved on.  And wouldn’t you know it, the word “book” came flying out of her mouth when she was just singing along.  She was so excited – she kept repeating book! book! book! book! – she didn’t want to lose her newly found word.

Apple MobileMe account for sharing access to her calendar, email, contacts and information.  This is not for everyone, but it was a brilliant idea, if we do say so ourselves.  When Mom went back home and was on her own again - still not able to read or write, and dates and times were still a real challenge for her - we set up her iCalendar for her to see all of her appointments.  We synched the calendar, email account and address book to her MobileMe account with Apple, so that we could log in to her account back at our own homes.  This way we could see her schedule, post new appointments, keep track of her caregiver's hours, etc.  If Mom wants us to read an email to her, we can see it.  If we want to call a neighbor, we can get the number by accessing Mom's address book.  We have her medication list and medical history information stored there, too, so we have access, and we can update it and email it to a doctor if need be.  Only one person needs a Mac and MobileMe account for this to work – one can log in from any computer.  You might also open a Google account to share documents and calendar - and it's free.

Use routine to reteach time.  We were quite surprised to learn that Mom not only could not tell the time, she had no sense of time.  Imagine the uneasy feeling of not knowing what time it is, and looking at a clock gave her no help.  And if we said we were leaving in 5 hours, she didn't know how long that was, causing great concern (sometimes panic) about having enough time to get ready.  It was terribly disconcerting for her, so we set up a regular routine.  Therapy appointments were the same time every week; we called her at the same time everyday - Kim called at 9am, our brother, Michael, called at 5pm, and I called at 9pm.  This calling lasted through January, four months after the stroke, and Mom finally started to recover her sense of time.

Patience is important.  When Mom feels rushed or pressured, her words come out all jumbled, which leads to more frustration and further inhibits her ability to find words. We realized long ago that it was important that Mom didn't feel rushed to find her words.  It’s okay to slow down: Most of us are zooming through life at high speed anyway, so now we have an excuse to be relax a bit and actually listen.  Dr. Jill Bolte Taylor, author of “My Stroke of Insight” and a stroke survivor herself, wrote in her book, “Be as patient with me the twentieth time you teach me something as you were the first” as one of the things she needed the most.  This struck us when we read it and we are very conscious to do just that with Mom.

Encouragement goes a long way.  We’ve notice the best therapists give gentle reassurances like “You’re doing great,” and “You're almost there . . . keep going.”  Of course, everyone is motivated in different ways, but consider working this language into your vocabulary.  Think of how you feel when someone is cheering you on.