Author: Kathy Martin, Manager of the Brooks Clubhouse
Greetings from the Brooks Clubhouse. With a lot of help and support from Brooks Rehabilitation we were able to open the Clubhouse in 2008 to help meet the long term recovery needs of individuals who had experienced (or suffered) from strokes and other types of brain injuries.
When I was growing up, one of my friends had a father who had a stroke and I thought everyone who had a stroke was just like him. After having worked with hundreds of people who have had strokes or brain injuries (I have worked as a Cognitive Rehabilitation Therapist since 1984), I have learned that this is absolutely not the case. I know now that no two injuries, just like no two people, are exactly the same. While many survivors have similar types of problems that result from having a stroke, each situation is a unique combination of the severity of the stroke, the type of stroke (blockage of a vessel vs. rupture of a vessel), the location in the brain of the stroke, and the pre-injury personality and intellect of a person. I would like to share some things that I have come to learn about the general effects of a left hemisphere stroke and some suggestions on the best ways to help a survivor and encourage recovery.
It is important to know that the left side of the brain controls the right side of the body and the left hemisphere of the brain is the “language” center of the brain. The left side of the brain:
- Is responsible for many functions and behaviors including expressive and receptive language, right-sided body movement, the ability to solve problems, do math, read, write and spell.
- A stroke on the left side of the brain may:
- cause changes in some or all areas of functioning including: communication, vision and touch, behavior, movement, memory, and general thinking skills.
- effect receptive language; that is they may have trouble understanding speech, written words and/or gestures. For example, a person can hear what is said, but is unable to understand the message or a person cannot identify letters or understand written words.
- effect expressive language. A person with an expressive language problem may have trouble expressing themselves through speech, writing and/or gestures. For example, a person may know what he/she wants to say, but cannot get the words out verbally and cannot express thoughts into the written form. A person may say left when they mean right or yes when they mean no. A person’s speech may be difficult to understand and they may have slurred speech, trouble pronouncing words correctly and/or a tendency to use words that do not make sense and appear to be made up (jargon).
I would like to share an example of a person who has experienced a left brain stroke. Currently the Brooks Clubhouse has a member that had a left brain stroke. For the sake on anonymity I will refer to him as J.W. Twenty five years ago, J.W., now 57 years of age, was the victim of a random shooting. He was on a pay phone in Jacksonville Beach and was shot in the throat. He then had a subsequent stroke which disrupted blood flow to his left hemisphere. His stroke was considered extremely severe and resulted in many problems with functioning. For several years, J.W. was unable to communicate any of his thoughts and ideas. J.W. reports that the only words he could say for over a year were “what cover”, which he thinks meant “What Happened?” He underwent extensive inpatient and outpatient rehabilitation and even went to Michigan to attend a residential Aphasia treatment program. He had no use of his right arm and leg, he was unable to walk, talk, read, write, calculate math problems, or take care of himself. But J.W. was not a quitting kind of guy…he continued to do everything he could to recover from the stroke and he never gave up hope or effort. He participated in as much therapy as his insurance would allow, followed all home exercise program recommendations for speech and physical therapy (and then some), he participated in research projects, and he slowly improved with the passing of each year. Since J.W. has been attending the Brooks Clubhouse (3 years now), he has seen more improvement in his recovery than ever before. He attributes this (and research demonstrates it) to being immersed in a stimulating and social environment where he is constantly challenged to think, speak, listen and work.
If you met J.W. today, you would not believe how severe his deficits once were. He is happy and healthy, lives independently in a very nice and well kept home, he drives, he has many friends, loves to go out dancing and ride his bike at the beach. He is one of the most productive and active members of the Brooks Clubhouse. Every day you can find him here, bright and early, cutting up with other members and working extremely hard in the kitchen to help plan, shop for, prepare, serve and clean-up our daily lunch at the Brooks Clubhouse.
Although he still has notable difficulties with his expressive language; he frequently starts a conversation by saying “can’t talk”, but everyone reminds him that he never shuts up and he can almost always convey what he wants in some way. J.W. is one of the most admired and well loved members at the Clubhouse.
Some things to remember and keep in mind if someone you know has difficulty with expressive and/or receptive communication:
- Just because someone can not speak their thoughts, they can still think. Never treat them as if they are “stupid” or don’t know what is going on.
- Just because someone can’t speak well does not mean they can not hear; it is not necessary to speak more loudly or yell.
- Try to keep questions and comments fairly short and do not overload a person with rapid and detailed instruction/information.
- Avoid rushing a person and give them time to try and express themselves.
- If a person has severe difficulty with expressive language, try to format questions as “yes or no” answers.
- Remember to encourage a person about recovery and always treat them as an adult who has choices.
- Remember recovery can last a life time and there is always the capacity for continued improvement.
- The more active, productive and engaged a person is, the greater the potential for recovery.
- Repetition can be good, good, good!
Do you know someone who experienced a stroke on the left side of their brain? What types of difficulties did they have?