Saturday, June 28, 2008

Service with a smile

Therapy centre provides a physical, mental boost


Updated 21 days ago

A heart attack and stroke three years ago not only robbed Dora Anderson of her health and mobility, but also stole much of her spirit.

Her outlook has changed since she began visiting the Adult Recreation Therapy Centre about two years ago.

"I really like it here. It's such an optimistic place," Dora, 73, said in an interview at the Henry Street centre.

The ARTC offers social, therapeutic and recreational activities for adults coping with the effects of stroke, Parkinson's disease, multiple sclerosis, early stages of Alzheimer disease and other progressive disorders.

"Everyone has a smile.

No matter how bad you feel, they make you feel better," Dora said. "It's something to look forward to. It's a great place."

Her husband, Ron, said that attending the centre has "been a godsend."


He said that Dora enjoys the increased social interaction, card playing and light rehabilitative exercise while he gets a much needed respite.

There is a lot of pressure involved in being a caregiver and all the worries about the details of home-care quickly mount up, he said.

Twice a week, Ron drops Dora off for a morning of activity and therapy.


"It's a good break for me," he said. "When she's here I have no worries at all."

The ARTC operates day programs Monday through Saturday, along with a Tuesday evening program. It also runs full days of programs on Mondays, Wednesdays and Fridays at the Willett Hospital in Paris, recognizing that 25 per cent of clients live in the county.

The centre receives funding from the province, as well as from the Brant United Way, said executive director Lori Santilli.


Most of the clients are seniors, but a few are in their 40s or 50, she said.

"We try to maintain their level of independence," Santilli said.

The centre offers clients a variety of activities and therapies, individually and as a group.

Activities include discussions of current events, reading the newspaper and playing cards, as well as crafts and other recreational therapies.

Even something as simple as a game of bingo can be therapeutic, Santilli said.

Stroke victims often lose not only a field of vision but also the very sense that they have lost that vision. They must be taught to turn their heads to scan from side to side to make up for the lost perception and vision, Santilli said.

Kinesiologist Jan Phillips guides clients through the motions of individual physical therapy that can include stretching, practice walking between a set of parallel bars, exercising arms and legs and even receiving a hot wax treatment to the hands for arthritis.

She also ensures clients are properly positioned in wheelchairs and are using walkers and canes safely and effectively.


The centre's aphasia program offers something extra for people who have suffered damage due to stroke that mars their ability to communicate verbally or to translate their thoughts into words.

Each participant has a binder filled with personal photographs, calendars, maps, drawings, and exercises designed to help them relearn or recognize the words that correspond to everyday objects.

Aphasia patients "know more than they can say, so they need a way to get the message out," said speech pathologist Jan Roadhouse.

Stroke survivor Marianna Wolter, 82, was skeptical about attending the centre's programs at first, but the friendliness of the staff soon changed her mind.

"I came out of my shell," she said. "I really enjoy it here."

For more information, visit or call 519-753-1882.

Avera Medical Minute: Aphasia and Speech Therapy

By Nancy Naeve

Aphasia affects 1 in 250 people in this country. More than 100,000 of you will acquire it this year, and yet most of us have never heard of it. It's a disorder that impairs a person's ability to process language and most of the time it happens after a stroke or after a head injury.

One man in Sioux Falls is fighting tooth and nail to get his speech back with the help of outpatient therapy at Avera Physical Medicine and Rehabilitation.

46 year old Dave Gluyas is hammering away re-learning words to everyday objects that would come out without second thought. He has aphasia. A common communication disorder resulting from a stroke or head injury. Dave had a stroke in April 2008.

Dave says, "I know what I want to say... (he stops)
His longtime girlfriend Linda Tenneson helps finish his sentence and says, "It's in his head but it won't come out his mouth. It's very frustrating for him."

Three times a week for 45 minute sessions, Dave works with Tina Jacobson, a speech and language pathologist with Avera.

Dave says, "Tina she's great." He looks at Linda and says, "Tina, right?" Linda smiled and said, "That's right, Tina. She's been a great help."

Tina says, "Initially he used single words and a lot of gesturing. Everything was all jumbled up. But he has the best attitude. He's so happy and laid back and is very motivated to improve so he works hard when he's not with me by doing home projects."

Tina says some people are so impaired when she first sees them that she has to use a communication board to figure out what they need. It has pictures with words on it so the patient can point to what they want or what they are trying to say.

Tina says, "He still has trouble with word retrieval, coming up with words. So what we do is work on repetitive exercises and positive feedback."

Linda says, "He's come a long way from not knowing what the ER doctors meant in the when they asked him to raise his arms. He didn't know his birthday. He didn't know my name. And now he does. He knows all those things so I don't feel as bad leaving him alone so I can go to work. "

He now puts 2 to 3 word sentences together, but Linda says Aphasia is still hard on both of them. Dave was lucky in a sense because he recovered very quickly from his stroke physically. Other than aphasia, he has no impairment, but his speech pathologist credits his hard work and starting therapy immediately.

Linda says, "It is hard. In a sense, I've lost my best friend because it's so hard to communicate with him. It's frustrating for him too. To tell me what he wants to eat it becomes a game of charades and sometimes I don't get the charade. But with Tina's help we'll keep working on it. We are working through it."

And the hope is, his communication will once again be as sharp as the pencil he is learning to identify all over again.

HEALTH MATTERS: Recovery and rehab following a stroke

No two strokes are alike, and the physical and emotional impacts, along with the rehabilitation and recovery process, vary from person to person. Much depends on the area of the brain that is affected, the severity of the stroke and the patient’s overall health.

Patients who experience a stroke in the right hemisphere of the brain, which controls movement on the left side and controls analytical and perceptual tasks, may experience the following effects:

• Weakness or paralysis on the left side of the body.

• Trouble with spatial and perceptual abilities that may cause problems judging distance or may create challenges in guiding their hands to pick up objects or button their shirt or tie their shoes.

• Impulsive behavior and impaired judgment that often causes some stroke survivors to dangerously believe they are able to perform the same activities they could prior to the stroke, including driving a car and walking without assistance.

• Left-sided neglect. Some stroke survivors will experience left-sided neglect, which causes them to forget objects or people on their left side.

• Short-term memory loss.

Stroke survivors who experience a stroke in the left hemisphere of the brain, the part that controls movement on the right side of the body and controls speech and language abilities, often experience different effects such as:

• Weakness or paralysis on the right side of the body.

• Trouble with speech and language, known as aphasia. Aphasia can impact a person’s ability to communicate whether through speaking or writing and can affect the ability to understand words.

• A slow and cautious behavioral style that may cause a stroke survivor to require frequent instruction and feedback.

• Shortened attention spans and difficulty understanding new information.

In addition, strokes in the cerebellum of the brain may cause unsteady walking due to difficulty with balance, dizziness and nausea. Strokes in the brain stem can be especially debilitating as the brain stem controls the body’s life support functions.

While recovering from a stroke takes time — generally, anywhere from six months to two years — rehabilitation is helpful and enables many patients regain skills they possessed prior to the stroke.

Rehabilitation often requires a multi-disciplinary approach that involves physical therapy to strengthen and retrain muscles; occupational therapy to help survivors with daily living skills; speech therapy; swallow therapy, and therapeutic recreation therapy, which helps stroke survivors reintegrate socially.
Rehabilitation nursing is also an integral part of the process for close patient monitoring, education and medication teaching. The patients work with nursing staff throughout the day and night on applying skills taught during rehabilitation therapies.

The ultimate goal of inpatient rehabilitation is to provide patients with the building blocks to continue their recovery either at home with or without assistance or in a longer-term care facility.

After a loved one experiences a stroke, it is often left to family members to determine where the patient will receive treatment. Finding the best rehabilitation program, especially during a stressful and emotional time, can be an overwhelming and daunting task.

In evaluating rehabilitation programs, the National Stroke Association recommends choosing a program that is accredited by the Commission on Accreditation of Healthcare Organizations (CARF). Requirements for CARF accreditation include:

• A medical director and doctors who are board-certified in rehab-related specialties, such as physiatry or neurology.

• A team approach for patient care.

• Regular rehab team meetings to evaluate each patient’s progress.

• Involvement of family members in the program, and regular family meetings to keep them up- to-date with the progress of their loved ones.

• Patient and family education and support.

• A defined process for handling emergencies.

• Ongoing assessment of each patient’s progress in terms of abilities and level of independence in activities of daily living, such as dressing and walking.

Experiencing a stroke is a significant life change for survivors and their families, and rehabilitation and recovery take time. With patience and commitment, however, many people realize there is life after stroke.

For more information about University Medical Center at Princeton’s CARF-accredited Acute Rehabilitation Unit or to find a physician with Princeton HealthCare System, call (888) 742-7496 or visit If you would like to receive a free magnet card listing the signs and symptoms of stroke to place on your refrigerator or near your phone, please call UMCP at (609) 430-7107.

Dr. Carol Sonatore is the medical director of the Acute Rehabilitation Unit at University Medical Center at Princeton and is chair ...........