Determination and Willpower

By John Mott, Jr.

I experienced a lot in life as a young man and I must admit that I’ve seen better days. With a little effort, I managed to pull through the clutter of misfortunes. However, on March 28, 2009, life took me on a far greater journey. I was helping one of my church members move that morning. I was told to always expect the unexpected, but I had no idea that life would throw me such a surprise. As we moved the furniture, fatigue set in. Then things became even more questionable concerning my condition.  First my right leg went limp, followed by my right arm. At the age of 25, I was diagnosed with a stroke. My life appeared to have turned for the worse. I never encountered such a traumatic experience before. I was a perfectly healthy young man. I didn’t know what to expect next. There had to be some logical explanation.  There wasn’t one.

John Mott Jr. working with Brooks PTA, Michael Greene

John Mott Jr. working with Brooks PTA, Michael Greene

John Mott Jr. using the Bioness for hand movement

John Mott Jr. using the Bioness for hand movement

I spent countless hours in physical and occupational therapy at Brooks. The sessions were intense, but the results were astounding. I was paralyzed on my right side, so I had to relearn how to write, bathe, walk, and even comb my hair. I admit, I had a pride issue before the stroke, but after my encounter, I swallowed my pride and opened up like a book. I partook of the group activities, encouraged others and applied what I learned to my life. My faith played a major role throughout the process. My positive attitude also made a difference. I couldn’t help but give back to Brooks Rehab, so I became a volunteer. With God’s favor, my church family, Brooks Rehab, friends and relatives, my circumstances became tolerable.

John Mott Jr. speaking at the Brooks "Faces of Stroke" Reception

John Mott Jr. speaking at the Brooks “Faces of Stroke” Reception

Even though I had support, the journey still remained challenging—not impossible. I’ve always been up for a challenge. My unexpected change produced what I call a “bundle of stress”. I ended up losing my full-time job, my apartment and my peace of mind. As time progressed, I kept rolling with the punches and stumbled across a job opportunity. My income wasn’t much as a part-timer but some income was better than none. Momentarily I stayed with my relatives until it was no longer feasible, leaving me homeless. My church family quickly stepped in, allowing me to stay at the church building. Things begin to line up for me gradually as I found somewhat of a steady pace. I enrolled in writing school after writing a book about my stroke experience. As for the job, I moved from three different locations and became the assistant manager at the St. Johns Town Center! I know that the best is yet to come and there’s more to look forward to. In addition to being promoted, as of April 18, 2013, I moved into my own apartment. It’s been a long time coming and I know with God, determination and will power, I’ll manage and be all that I can be!

John Mott, Jr. in the Brooks Chapel

John Mott, Jr. in the Brooks Chapel

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December 2-6 is Older Driver Safety Awareness Week

Author: Peggy Gannon


Every month seems to have some type of “awareness month” or “week” attached to it.  December is no different and is actually one that holds some importance to me.  December 2-6 is National Older Driver Awareness Week and it is one topic, no matter who we are, that has the potential to affect us.  The goal of the week is “to promote understanding of the importance of mobility and transportation to ensure that older adults remain active in the community with the confidence that transportation will not be the barrier to strand them at home” (AOTA, 2013).

Each one of us has either a parent, sibling, spouse, aunt, uncle, other relative or friend who we consider elderly.  Most of us also either drive or at some point are a passenger in a car and come in contact with older adults that way.  The focus of the awareness week is as much for the older driver as it is for the rest of us who are on our way.

The focus of the week is both the continuation of driving and the need to recognize when it may be time to stop.  There is a lot of important information on the AOTA website in regards to this event, and I encourage you to read it.  Each day is designated with a topic to discuss with your loved one.  Other agencies that deal with the aging population have also made presentations and given information that may be helpful, such as AAA’s web link or Manatee County in Florida.

decision making stroke recovery driving rehabilitation

Driving is not an easy topic to bring up with someone you care about and it is a painful topic for someone to mull over in their own mind.  Driving is that independence that allows us to feel like we are still in control.  As we age, the need for control over something becomes even more prominent because we are not able to do many of the things of our youth.  You will hear me say this every time I speak about driving…it is a privilege and you were not born with a driver’s license in your diaper!  If you are concerned about someone you love, there are a number of warning signs that indicate an older driver might need assistance.  These include:

  • Does not obey stop signs or traffic lights
  • Fails to yield the right of way
  • Drives too slowly or too quickly
  • Often gets lost, even on familiar routes
  • Stops at a green light or at the wrong time
  • Doesn’t seem to notice other cars, pedestrians, or bike riders on the road
  • Doesn’t stay in his or her lane
  • Is honked at or passed often
  • Reacts slowly to driving situations
  • Makes poor driving decisions

You need to make the right decision and not ignore the signs.  I am a firm believer in meeting things head on and being honest…there is no room for sidestepping when people’s safety is at risk.

If you or someone you love has questions about their driving, check our website or call 904-345-7242 for more information.

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Vision changes after a stroke

Hi, I am Dr. Katelyn Jordan. I am the low vision optometrist at the Brooks Rehabilitation Center for Low Vision Therapy. We see many patients post-stroke who report that their vision is different or reduced since their stroke. However, frequently, it can be hard to explain or understand what exactly what has changed with your vision after a stroke. A stroke can cause a variety of problems with your sight. These include double or blurred vision, loss of central vision in one or both of your eyes, and visual field loss. In fact, up to a quarter of stroke survivors may have vision loss. Symptoms of vision loss due to stroke may manifest in different ways:

1. Frequently bumping into objects like door-frames or people.

2. Difficulty and uneasiness in moving about in crowded areas.

3. Unsure of footing while walking and may trip or stumble.

4. Often startled by moving objects or people appearing suddenly.

5. May have bruises on shoulder or arm from colliding with door-frames.

6. Frequently losing place in reading and becoming frustrated when reading.

7. Struggling to find or misjudging the start or end of a line of print in reading.

8. Withdrawing from most reading.

9. Frequently spilling drinks when eating.

10. Unsteady balance in walking and may report dizziness.

11. Problems in finding things on desks, counter tops, cabinets or closets.

12. Fear or anxiety in walking through unfamiliar areas.

13. Uneasiness or even panic attacks in crowded areas.

14. Withdrawal from going to stores or other crowded areas.

15. Getting around well at home, but avoiding outside activities.

Hemianopsia (also known as hemianopia) is present in about 15 percent of stroke patients. This condition blanks one side or one quadrant of your vision field in each eye. This creates difficulty completing even simple tasks, such as walking straight ahead, reading all the way across a page, or seeing all the food on a plate.

Normal scene

Normal perception of a scene

hemianopsia scene

Perception of a scene by someone with a hemianopsia

Diplopia, or double vision, affects about six percent of all stroke patients. In this condition, the two eyes fail to work together properly. In addition to losing depth perception, patients with diplopia face a reduced field of vision and everyday visual confusion. The condition can be temporarily relieved by closing or covering one eye.

diplopia scene

The left side shows normal perception of a scene while the right side shows the perception of the same scene by someone experiencing diplopia

Other ocular diseases can cause visual symptoms similar to those that develop from a stroke. It is important to have a dilated eye exam performed by an ophthalmologist or an optometrist after the stroke to rule out vision loss from any other condition. Frequent causes of vision loss not related to stroke include macular degeneration, glaucoma and diabetic retinopathy. Identifying these disease processes and initiating the proper treatment is vital in preventing further vision loss.

Once the cause of vision loss has been determined and any medical treatment deemed necessary has been initiated, a low vision examination can be performed to identify rehabilitation potential and to develop a rehabilitation plan. Regardless of the cause of vision loss, the goal of low vision rehabilitation is to maximize the remaining vision to help address the functional needs of the patient and help each patient to achieve their goals.

While most stroke patients with vision loss do not fully recover their vision, partial recovery or natural vision improvement is possible, usually in the first months after a stroke. Proper diagnosis and a vision rehabilitation plan can help improve participation in most daily activities, self-esteem and feelings of independence.

For more information on vision rehabilitation services following stroke, please contact us at:

Brooks Rehabilitation Center for Low Vision Therapy

2519 Riverside Avenue

Jacksonville, FL 32204


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Celebrate Aging and Community Open House

At Brooks Rehabilitation, we know that seniors have unique healthcare needs. Whether it is gaining physical strength and coordination, increasing mental stimulation or receiving emotional and social support after a life-changing illness like a stroke, Brooks is committed to furthering our services to transform the lives of seniors in our community. With the development of our Brooks Rehabilitation at Bartram Park campus, we are creating a place where seniors can receive the customized care they need while living life to its fullest.

Our 100-bed skilled nursing facility, Bartram Crossing, opened in July. Later this month, we’ll open our 61-unit assisted living community, Bartram Lakes, along with THE GREEN HOUSE® Residences.  THE GREEN HOUSE® Residences have been developed using the nationally recognized best practice guidelines of THE GREEN HOUSE® Project – an organization that has pioneered the creation of intimate, residential style homes that recognize the individuality of senior residents. These two 12-bedroom homes will provide specialized care to individuals with Alzheimer’s and other dementias.  These will be the first Green House homes in the state of Florida!

We invite you to join us for our Celebrate Aging and Campus Open House on Saturday, October 26th.

Celebrate Aging for Facebook 2013

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When is the Right Time to Look for a Job Post-Stroke?

Authors: Jennifer Maher and Kathy Martin

Things can change after a stroke making it difficult to return to work. Before you start filling out job applications, ask yourself ‘Am I ready’? Answering these questions about your situation will give you a better idea if the time is right.

success ahead

Do you receive disability benefits?

Depending on the type of disability benefits you are receiving, additional income from a job could impact your current benefits.  Your disability benefits could change depending on   the number of hours you can work and the amount of income you make.

Do you have problems managing stress?

Many times stroke survivors experience increased stress levels following a stroke.  This life changing event can cause stroke survivors to have increased stress due to fatigue, loss of memory and adjusting to life.

job interviewDo you have prior work experience?

Many times the skills and experience you had prior to your stroke are still applicable following a stroke.  However, there might be opportunities to gain new stills through training and volunteering.

Are you afraid you can’t work?

After having a stroke it can be hard to identify what you are good at and areas that need improvement.  Find someone to talk to, like a vocational counselor, who can help you realize jobs that may be appropriate for your level of recovery and skill level.

Can you afford to work?

A job is a commitment which takes up time and has certain requirements.  If you have to pay for transportation, clothing and childcare to go to work, you need to know if you still have enough money left over to make having a job worth it.

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Driving After A Stroke: For the Survivor

Author: Peggy Gannon

If you are a stroke survivor and did not read my last posting…do it now! The tips I wrote were more for family members, but you could benefit yourself from reading and taking them to heart. It is always good to have an idea of what our caregivers may be thinking and going through.

With that in mind, I want to address to address a few areas that I have seen over the years that either help or hinder, depending upon how you are affected, a safe return to driving. Most people are able to return to driving following a stroke. Some may do it very quickly, while others may take years. I am always amazed at a person’s desire to return to this task and the work they will put in to achieve it.

Some of the areas affected that you may need to address are:

vision driving rehabilitation stroke recoveryVision

Following a stroke, it is not uncommon for someone to have a change in vision. It may be their acuity (how clearly they see things), it may be their visual fields or it may be a perceptual issue. It is important that if you have had changes in your vision that you address them prior to driving. A new pair of glasses may be a quick fix for some. If you have more significant changes or problems with your vision you may need to address it in therapy. Unfortunately, some visual issues, such as a field loss, can’t be changed by therapy. It may or may not resolve and improve. Therapy can help you learn to compensate, but it cannot change the problem. Florida has some specific rules regarding driving and peripheral vision. If you have questions on this, your vision specialist should be able to provide more information.

reaction time driving rehabilitation stroke recoveryReaction Timing/ Processing Speed

When we think about driving, we can’t help but think about speed. It is a fast task. I have met many people who, following their stroke say to me, “ I am not as fast as I used to be. It is hard to focus on multiple things.” Well, driving demands that you do all that and more. It is hard to tell someone how to think quicker. It doesn’t work that way. You can, however, try to engage in tasks and activities that force you to think quicker. Computer games, some board games, sports etc…can all push us in that direction. If you are still in therapy, let your therapist know you feel this is an issue for you and they should be able to incorporate tasks that address it. If you try to visualize how this can affect driving, think about going up the ramp to merge onto the interstate. You know how frustrating it is to have someone ahead of you going slow and not merging like they should. That is a prime example of someone with slowed processing. They can’t take in the cars approaching, keep their car moving rapidly and get into that traffic. It can be dangerous for all drivers, not just the one going slowly.

decision making stroke recovery driving rehabilitationDecision Making

Should I go or should I not? This ties in somewhat to processing speed, but it is also making the decision to whether or not it is safe to enter into traffic. The above two areas can greatly affect one’s ability to make a sound decision, but it can also be that the stroke has affected the frontal lobes where our executive skills are maintained. Making a bad decision can be very dangerous and can cost lives.

Spatial Awareness

To put that in words we can sink our teeth into, it means knowing where you, your body or the car are in relation to each other. I can’t tell you how many times I have been in the car and the person is driving off the road, on the other side or down the middle. They may or may not be able to find the pedals easily. Sometimes, it is not totally evident that a person has a deficit in this area until they are actually driving. I had a gentleman that I saw several years ago who had a stroke that affected the right side of his body. He went through inpatient and outpatient therapy and progressed well. He walked, talked and for all outward appearances, you could not tell he had had the stroke. When he got behind the wheel, however, for his driving evaluation, we both discovered that he had no idea where his right leg was unless he could see it. So, he had a lot of difficulty getting back and forth to the gas and brake. He scared himself enough to realize that this was not the way he should be driving. His future goal was to use a left foot accelerator.

I must restate again…prior to returning to driving, you must be released by your physician. It is extremely important that this is done so there is documentation that states you have his/her approval. You can not operate off the assumption that just because you have a license you are able to do so. The thought behind it is that you have been ill enough to require an extended hospitalization. The brain has been affected by the stroke and although you may feel great, your physician is responsible for giving his approval on this. One last thought…I use this analogy all the time when speaking. You are like a cake that is not quite baked after your stroke. Your batter is still a little wiggly. Given time and therapy, your cake begins to “bake” and you become solid again. Driving is the icing on the cake. It takes all the other areas to be fully baked before you should attempt it. So…go get cooking!

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Neuroplasticity and The Brain After a Stroke

Authors: Rhonda Felice

Hi I am Rhonda.  I am the Stroke Therapy Manager at Brooks Rehabilitation Hospital. Those studying rehabilitation are frequently asked questions about the types of therapies that should be included when treating a stroke patient. In neuroscience research, the approaches to improving function after a stroke fall into two major categories:

neuroplasticity therapy options stroke brooks rehabilitationNeuroplasticity refers to the brain’s flexibility to adapt to changes and learn new experiences and the ability for an affected brain to relearn lost behaviors. There is overwhelming evidence to indicate that the brain continuously remodels its neural circuitry in order to encode new experiences and enable behavioral changes.

Some of the factors that researchers have found to be of significance to rehabilitation outcomes are some of the following principles based on their control of neuroplasticity on the brain.

  • Use it or lose it- If you do not work the brain, it is likely going to result in a decline in functionality; the more a person attempts to use the affected extremities, the greater the chance of recovery.
  • Use it and improve it – By training the brain to perform a specific function, it can also result in an improvement of that function.
  • Specificity- The way one is taught, is the way in which he will learn.
  • Repetition matters- To promote relearning in the damaged/stroke brain, high repetition is required.
  • Intensity matters- The rehabilitation training has to be intense for neuroplasticity to occur.
  • Time matters- Research indicates that rehabilitation is much more effective if it is implemented right after the accident than if the same program is started 5 days post-stroke.
  • Salience matters- For plasticity to occur, the task or action has to be important or relevant to the patient for what he has to relearn. Research has shown that when the task is of importance to the patient, there is an increase in the release of acetycholine which helps to stimulate neuroplasticity.   

There is still much that needs to be done to fully understand how the brain works when faced with something like a stroke, however research is pointing us in the direction that the brain is capable of adapting to changes. In order to receive the most effective rehabilitation services, we still have to learn more about neural reactions to the brain affected by a stroke.

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