#108 Overcoming Stroke Therapy Resistance - Finding Hope and Progress

a wife reached out to me through my website she booked a consultation and in the comment section she mentioned something that really struck a cord her husband had a stroke a few years ago and he's been very resistant to treatment ever since she hasn't yet met with me and I haven't met with him but we're scheduled to talk next week what's clear from her message is that her husband is likely carrying the weight of past experiences experiences where he was told that he's as good as he's going to get maybe it was a physician or a previous clinician who said he'd reached a plateau her message indicated that he had been in therapy for quite a while so my assumption is he did all the work went through all the therapy but didn't see the kind of progress that would make a real difference in his daily communication and now he's skeptical he's resistant and who who could blame him welcome to the listen for Life podcast with Genevie Richardson Genevie is a speech language pathologist rehabilitating adults with communication challenges after a stroke or due to a neurological impairment get equipped with knowledge from experts in the field and professionals you need to know we'll hear stories and experiences from others who are navigating life with ap fasia so put your earphones in and take a walk outside this isn't just a podcast this is a community a resource and a support system we're in this together do life Welcome to the listen for life of fasia podcast my name is geneveve and we are diving into a topic that I know many survivors with ap fasia struggle with they are resistant to therapy so so the story I led this episode about got me thinking about what are the different reasons someone with a phasia might resist therapy so let's go through some of those first we want to understand the root of resistance it usually stems from a past experience where progress in therapy didn't meet expectations right if you were going to the gym and and you were paying for a physical trainer to train you and you felt like after three months of working with this trainer two three times a week you'd have some more muscle you'd have some more skill you'd have uh weight loss whatever it is you're there to do but if all of that effort and therapy didn't translate into your clothes fitting better feeling stronger where you can move things around having better flexibility if your progress doesn't meet those expectations that's going to leave a bitter taste in your mouth about hiring another trainer or doing it all again so that's one reason what could be another reason there is the topic about Plateau many speech pathologists are under the impression that you can't do more progress after 6 months maybe your neurology or your primary care physician is under the mistaken understanding that after that first six months of spontaneous recovery period that the brain is not able to make new Pathways well it's just not the case but if the Aphasia Survivor has been told that go live this is all you can do why would they consider doing therapy again then there is the lack of tangible improvements in Daily communication this is tied to that first reason I explain if you can't see how your time and effort is actually helping you to connect with and talk with the people that are most important in your life there you get frustration and you feel skeptical that you can make any progress what we do know from the research and from my 10 years of working in the area of chronic Aphasia via telepractice progress is possible even years after a stroke but it requires the right approach one that focuses not on isolated skills but on applying those skills in ways that matter to the individual with Aphasia and to their family another story that comes to mind is from a consultation I had a few weeks ago the wife reached out to me on the recommendation of her husband's Physical Medicine doctor the doctor believed her husband had a lot of potential and there was a wait list at the Outpatient Center at that local hospital Plus for them to travel there it was going to be more than an hour each Direction so when she filled out my intake paperwork she mentioned that her husband was four months after his stroke that he was severely depressed and just every time she would talk to him he would cry she just didn't know what to do to help him they had tried a little bit of speech therapy at home but he just didn't respond to his wife being the therapist so let's talk about some key points before I go on with this story depression and emotional distress can impact a person's willingness to engage in therapy the clinician's role is to instill hope and show that progress is possible and I am doing my darnest as a speech pathologist in this space of chronic Aphasia to educate other speech pathologists that the brain is an amazing resilient organ that with intention and a plan and consistent practice that new con ctions can be made and that progress is possible and personally I subscribe to taking a strength based practical approach to therapy that is focused on real life goals because when you focus on what's important to the person with ap fasia they are engaged it overcomes that resistance they feel seen heard and understood and so they are much more more likely once you've built rapport with them to engage in treatment to try new things to have faith in the process so back to this story with the wife who said her husband you know just didn't have faith that he could do more with therapy and that she wasn't a good fit for him to be doing the speech therapy work at home so I went into this consultation with my mindset clear that I wasn't there to convince him to work with me however my goal was to show him that there is hope that there is a way forward and that we can make progress when we tap into what's important to him what his goals are when we take into account who he is as a person what he did for a living what his hobbies are and the people and Families that are most important in his life so approaching it from a strength perspective I could directly convey to him and his wife how therapy would impact his ability to communicate and engage in the activities he enjoys he plays an instrument and was in a band for fun and had been doing this instrument for 50 years yeah he said he started at six years old so I have to as his potential future clinician I have to take that musical interest that ability that drive to practice because to be able to play in a band even if it's not professional that takes hours and hours of practice and I can tap into that mindset and apply it to speech therapy right so both he and his wife were able to see that when we take this whole person approach or a holistic approach where we focus on real life goals they could see that this could make a difference so some key points to reinforce therapy should focus on improving the quality of life by addressing real life activities like using the smartphone perhaps getting back to playing an instrument or doing something with music for whatever you know he may have a physical limitation getting back to that musical instrument but we can find away we can integrate in music therapy we can make recommendations for that but we need to give him some control back this stroke blindsided him of course it did right the the gentleman is only in his mid-50s he had no medical conditions before the stroke took out the right side of his body and gave him a fasia so we have to look at who he is what's important to him and what are the first things that we need to focus on to get him back to because it is about establishing those quick winds the right clinician doesn't just work on isolated skills although that is part of treatment but we have to really be sure we tie these isolated skills like being able to read at Word level phrase level sentence level we have to help them apply that in functional practical ways that they see that it improves their life gives them control gives them choices and possibilities therapy isn't just about doing exercises or filling out worksheets it's definitely not busy work it's about quality of life are you getting the take-home message in this episode we have to as clinicians help individuals with Aphasia get back to the things that matter the most texting FaceTiming getting back to work resuming household chores right chores doesn't sound like fun right as kids we try to get out of chores and as adults we know we have to do the chores and we get them done but isn't that still part of life and if we can't engage in those things that are familiar to us it still impacts the identity getting back to Hobbies like playing an instrument these are all things that can be addressed and worked into speech therapy whether we're having to work on the impairment level or something bigger it's not about checking boxes passing tests it's about tangible improvements we can help them believe that there is hope and show them the steps forward to give them their lost faith back that Speech Pathology treatment when applied holistically it can help it can give them their faith it can give them their hope so I want to bring your attention to a new tool that I've created it's called the communication strengths wheel and this is a tool that is free to you you can download it from the homepage of my website at doif speechpathology.com but I believe so much in this tool in that I am incorporating it into my intake process so let's say a family finds my website through a search on Google if they decide to book a consultation with me to talk about what their loved one or their strengths are as far as language and communication this communication strengths wheel is part of that intake process it's a way to get the person thinking about what's working what's not working it gives them a starting point to also pin down what is most important so the communication strengths wheel is my gift to you if you're curious about it please go to doli speechpathology.com and download it for yourself today and if you are ready to jump in and have a consultation this is a no obligation consultation you don't have to work with me or with my company but if you would like another perspective if you would like hope and a Way Forward please schedule a free consultation you can do that from the homepage of the website so before I leave you today there is a way forward to improve your connection and communication by working with a clinician that focuses on what truly matters to the individual progress is about getting back to life whatever that looks like for each person there is a way forward there is hope with the right support progress can be made I encourage you to visit the website read about what we do at doif speechpathology.com and when you're ready to take the next step we're ready to take it with you as always thank you my audience for listening I hope you've gotten value out of this episode please be sure to check out our podcast website listen for life aasia podcast.com on that website you'll see all of our episodes many of them from episode 33 forward I think we're somewhere in the low 100 episodes you can watch listen get a transcript and see the key takeaways from each episode thank you thank you thank you for being a part of this community until next time have a fabulous week thanks for tuning in to the listen for Life podcast we hope you feel empowered and supported head over to listen forlife podcast.com to see the show notes with links and information from today's episode do you have a topic a resource to share or a guest recommendation inquiring minds want to know let us us know in the comments section wishing you a fabulous week