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Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
March, 2010, Vol. 10, Issue 03
Communicating With Stroke Survivors: What Matters Most?
By Ann Catlin, LMT, NCTMB, OTR
It is likely that at some point, someone you know - a grandparent, parent, sibling, friend, neighbor or client - will suffer a stroke. It is one leading cause of long-term disability in the United States.I've met literally hundreds of stroke survivors while working as an occupational therapist in rehabilitation programs, and my grandfather suffered a stroke when I was a child. Even though I've had all this experience, the one thing that stands out as challenging, yet critically important, is communication. The topic of stroke, or cerebral vascular accident, is very complex, and people who suffer a stroke commonly experience physical, behavioral and communication effects.
The focus of this article is communication, so it's important to have a basic understanding of what happens during a stroke that leads to serious communication impairment. The term stroke refers to a situation that occurs when blood flow to the brain cells is interrupted. There are basically two types of stroke. An ischemic stroke is when an artery becomes blocked by a blood clot, depriving cells of oxygen. About 83 percent of strokes are ischemic. Hemorrhagic stroke is when there is actual bleeding from the arteries into the brain tissue, accounting for about 17 percent of all strokes. The resulting functional impairment or disability following a stroke depends on the location of the vascular lesion in the brain. Speech and language is a function primarily of the left hemisphere of the brain, so when the stroke occurs in the left hemisphere, communication - the ability to speak, understand, read and write - will possibly be affected. The extent is determined by the severity of the damage to the brain.
This brings me to the point I really want to make. What does the stroke survivor experiencing communication disorders need from us? I know what my own observations tell me, but I wanted to see what others say about it so I set off to find out. In the process, I found a jewel of an evidence-based report called "The Psychosocial Spiritual Experience of Elderly Recovering from Stroke." The elders recalled that the early period following the stroke was terrifying. Connection with others was important in recovery, and communication difficulties led to feelings of isolation. They stressed that the work of recovery requires a great deal of physical and psychological effort, and that hope and inner strength were important.
What people who survive strokes may need most from us is not found in any kind of therapeutic technique or approach. It's found in our ability to show up and be real in our caring. It's found in the simple gift of touch and heart-to-heart connection. It's found in acknowledging that the stroke survivor is a person whose life has been altered, but the individual inside the body remains the same. It's found in shared hope. I'll leave you with this poignant story called "Poor Thing" by Judith A. Russo, who cared for her husband following his stroke.
"Did you hear that Joe had a stroke?" asks Person A.
"Oh yes, poor thing!" says Person B.
"He was such a good person and a good worker," says A.
"Yes, too bad, isn't it?"
My husband had a stroke in February 2000, which left him with Broca's aphasia. Do you know what Broca's aphasia is? What you need to know is that he is not a "poor thing." And he still is, not was, a good person. He is a survivor who is living a richer life now than he was before. He was in the rat race of existence, going round and round with the dizzying effects of a non-stop merry-go-round. Now, he has time to smell the lilacs, watch the egret fish for its dinner and marvel as his granddaughter grows inch by inch. How poor can that be?
He is, perhaps, disabled, but the same person he was before the stroke. Most folks become so intimidated with the affliction "stroke" that they forget there is a real person living in that body, a person who thinks, hurts, laughs and cries just like you.
"I don't know," replies Person B.
"Well, I won't bother him now, or call or visit. After all, he's probably busy, and I don't know how much he understands anyway."
"I agree," says B. "He probably wouldn't know who we are, and we don't want to embarrass him."
By the way, Broca's aphasia is the inability to communicate effectively by speech. What is the therapy for people with aphasia? Talking to the survivor and encouraging them to respond. You might have to wait for two or three awkward moments for them to think about what to say. In the meantime, you may see the egret fish for its catch of the day. You may see the lush brown velvet cat-o'-nine tails waving in the wind, or the rabbits playfully goading each other on the lawn, or the huge turtle crawling along the banks of the pond with a goldfish in its jaws. Come at dusk and perchance you will see the deer as they come to the pond to drink. You will go away richer for the visit because you will have escaped the runaway merry-go-around, if only for a few moments. You will feel rich and will have blessed the heart of the "poor one who was such a good person."
When a stroke happens to a relative, friend or co-worker, please do not put them into an isolation they never asked for. Reach out and touch someone today.
Click here for previous articles by Ann Catlin, LMT, NCTMB, OTR.
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