need information on stroke

[passiveporcupine]

My Mom just had a "minor" (that's what I was told by my sis) stroke today. She has lost her ability to talk or understand language (so she can't understand what others say to her either). I don't know that I consider that minor, but whatever.

My question is this. Mom has been home for a few months, recovering from a shattered shoulder and shoulder replacement. She is 88 years old (will be 89 in Dec). She has not been recovering well from this injury and surgery. Now my question is, with some physical disability that she needs help with daily, how does she communicate with her "helpers", and how do they communicate with her? Her physical ability was not diminished by the stroke (although it was not great to begin with). She can get up and walk enough to go to the toilet and stuff, with help. She fell in the bathroom about a month ago, but didn't break anything this time...we think it might have been another minor stroke. She had one before the shoulder incident too, and another fall in her church parking lot maybe a year ago with no explanation...I suspect that was also a stroke. So I think she is gradually succumbing to strokes.

If anyone else has gone through this, please try to explain it to me. She was already having some cognitive dysfunction (fluctuating each day) and periodic weakness from her recent surgery (about three months ago)...so how do her family and support staff communicate with her now to even know what she wants or needs? Can she still communicate with language...like with some kind of sign language?

She went back into the hospital tonight, and I know she doesn't have a lot of time left, but until she goes, how will my family manage her care, so she is at peace, if they can't communicate with her?

I appreciate any information others who have "been there" can share with me.

Thanks in advance.

Damn...I hope I die in my sleep. My ex just died in his sleep on July 4th and I'm not over that yet. I'm not sure I'm ready for this.

[grasswire]

1. Hospice

Doesn't this sound like something that hospice people would have answers for? It must happen for others, too.

Take care of yourself. have a lot to process.

[840high]

2. link

of good info.


Overview - Stroke - Mayo Clinic
www.mayoclinic.org/diseases.../stroke/home/ovc-20117264
Mayo Clinic
May 15, 2015 - A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients.
Symptoms and causes
Stroke — Comprehensive overview covers symptoms ...

Expertise and

[PADemD]

3. With speech aphasia, it helps to ask the person "yes" or "no" questions.

See my PM to you.

[passiveporcupine]

6. Thanks so much...I got the PM

[Nay]

4. Could it help to have a set of cards with pictures, so she can point to what she wants?

For example, a photo of a meal to point to when she's hungry, a sleeping person when she's sleepy, a fire if she's too hot, an ice cube if she's too cold, etc.?

[passiveporcupine]

7. I will send this info to my sis.

Things are better now, but we need to be prepared for the next one.

Thanks

[phylny]

5. I'm a speech-language pathologist, and that's what your mom needs.

She will most likely have a referral to speech therapy, if she hasn't already. If not, demand it. The SLP will evaluate your mom and put forth a plan of care.

I'm sorry for the stress you're going through and for your recent loss.

[passiveporcupine]

8. So this is what happened last night

e-mail from my sis today:

Mom appeared to be having a stroke last night around 8pm, incoherent, unable to form words, completely disoriented, not able to respond to EMTs. This lasted about 15 mins. She started improving on the ambulance ride to hospital, then was more her 'latest self' again while in ER. Super tired, but cogent.

I got some great info on music for speech aphasia from PADemD, and am waiting now to hear from my sis this evening after she visits Mom in the hospital. My sis said she's had a bad headache for a couple of days, so I'm thinking TIA.

Mom is still in the hospital right now, and may end up going to a rehab center first and then home.

She does have 24 hour care at home right now, a nurse checking in, phys therapy, etc. She either has a family member or a paid home care person with her at all times. So they may just add speech therapy to her home routine, but probably not until she has more signs of speech aphasia. We need to learn how to handle this now, before this happens. Of course she will still end up going to the hospital first in the event of another TIA or stroke.

Thank you all for your replies. I'm not able to be there for her in person. It's hard from a distance to know this is happening and have to wait for information.

[OKIsItJustMe]

9. Aphasia

This page has helpful strategies for communication in spite of aphasia.
http://www.stroke.org/we-can-help/survivors/stroke-recovery/post-stroke-conditions/physical/aphasia

More helpful information:
http://www.nidcd.nih.gov/health/voice/pages/aphasia.aspx
http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/CommunicationChallenges/Stroke-and-Aphasia_UCM_462875_SubHomePage.jsp

[passiveporcupine]

10. Thank you OK. I appreciate this very much.

[OKIsItJustMe]

11. You're welcome! You may also want to read up on "TIA's"

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024787/
http://www.nlm.nih.gov/medlineplus/transientischemicattack.html
http://www.ninds.nih.gov/disorders/tia/tia.htm
http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/TIA/TIA-Transient-Ischemic-Attack_UCM_310942_Article.jsp

[passiveporcupine]

12. The good and the bad news

The good news is Mom is home now. The bad news is, she is in Hospice now. My sis called this morning to tell me she didn't want to wake up today or get up to go potty or anything. When asked what she wanted, she said "I'm waiting for something else now", almost as if it was a prophecy of letting go.

So...the neurological results are that she has white matter disease and also possibly a small hole in her heart, because she is at the threshold for congestive heart failure. They determined this was a TIA, but her odds of stroke are doubled now because of the white matter disease. And, she did have a small stroke in 2013 that they can see signs of now.

She probably won't be getting out of bed again, except to use the comode (at her bedside), unless something really turns around. My sis said she's been watching a gradual decline for the last two weeks. I think it's been happening for the past few months, ever since she fell and shattered her shoulder and had to have a shoulder replacement. She just never bounced back to herself after that.

Now she says everything hurts and she just wants to sleep. So we are getting ready to let her go. I'm OK with it, because I think quality of life is so important that I don't want her to have to live this way.

I just want her to be able to stay home and die in her own bed, because she is becoming so combative in the hospital to all the poking, prodding, tests, and inability to sleep. I don't blame her. Nobody should have to die in a hospital.

My sis doesn't think she will last long now because she is ready to go. I agree with that. I hope for everyone's sake that she just passed peacefully in her sleep and doesn't end up with pneumonia or something.

Thank you all for your assistance and information. You helped me a lot.