It's all about character

I was asked to assess an 81-year-old lady in Neuro ICU. I will call her Mrs. B and she had recently suffered a stroke. I found a little old lady asleep in her bed with tubes attached and machines beeping quietly in the background. I quickly read her file and then tentatively tried to wake her up. "Hi Mrs. B., my name is Claire and I am the Speech Therapist", I said gently. With her eyes barely open, Mrs. B. responded, "My speech is perfectly fine, thank you!". And so our amazing conversation began.

This lady proceeded to reveal a personality with such presence and spunk it was astonishing. She had been preparing for her weekly game of bridge when the stroke happened and it was most frustrating. She told me how she had recently been on holiday to Victoria Falls with her son and how she used to play golf "fairly well, I might tell you although I didn't have my name in the papers". In between these wonderful stories, I was able to assess her swallowing, although she seemed to have it all figured out already. "It is much easier if I drink with a straw as my lips are too weak if I use a cup," she said authoritatively. My job was fairly straight-forward.

Then she said, "I can't believe that this has happened to THE GREAT MRS. B. I will not let the doctor win this round!" And I thought, imagine how wonderful it would be if we all had a self-concept that was so strong and solid as to refer to ourselves as being GREAT. Her essence was one of pure determination and wilfulness and she was not going to let a stroke get the better of her.

Having worked with many individuals with strokes or head injuries, I know that personality is a huge factor in how the person recovers. That, and family support, play very important roles in the recovery process. Mrs. B. is not going to take this lying down and she is going to fight to get better and to get back to her life as soon as possible. She is realistic about some of her abilities that have been affected. For example, she won't be able to drive anymore but she, in close collaboration with her family, has already come up with the idea of employing a driver. Her personality is going to play a huge role in the positive outcome of her recovery.

We can't change anyone's personality but knowing what a person is like does help in setting and reaching realistic rehabilitation goals. For some people, being able to speak and to be understood by family members is all they require. While for other people, the slightest slurring of a sound or word is painful to hear and they push themselves to improve their speech to be as close to perfect as possible.

Some people are determined to return to a fairly active social life and will take every opportunity to join a group, participate in an activity or share their story. While other people are happy to accept the changes their stroke has brought about and relax into a home-based life that is solitary but comfortable.

Everyone is different and certainly, very few people have such a powerful personality as Mrs. B. But, as a therapist, I rely greatly on finding out about an individual's personality and interests in order to direct and shape the therapy intervention. Certainly, interacting with someone who is willing to share their interests, hobbies, ideas and thoughts is easier to work with than someone who is reclusive, lazy or secretive. There again, it is up to me as a therapist to adapt to each personality style and to get the best results possible through our interaction. It might also explains why some therapists are not right for some patients and vice versa. You need to find the therapist that understands you and works well with you because not every therapist is the same, just like not every patient has the same personality or stroke.

    Claire Ashford

    Claire has assisted in the rehabilitation of many individuals who have experienced a stroke or head injury and over the years, these are some of the topics that individuals and families have raised.

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We have a special interest in treating individuals who experience communication and swallowing difficulties as a result of a stroke, traumatic brain injury or degenerative disorder.