The title of my post comes directly from Gary Friday morning after getting to experience Joy’s first occupational therapy (OT) session and getting a tour of the Abbott Courage Kenny Rehabilitation space.
I am so overJOYed to provide you all an update on Joy’s incredible first full day of inpatient rehab. I cannot express with words how miraculous her recovery has been so far considering the extent of her injuries AND how eternally grateful we are for everyone’s support getting us to a place like Courage Kenny, a leader in brain injury recovery.
Therapies
Joy rallied her endurance and completed 3 one hour evaluations with OT then PT then Speech. She then had 2 half hour sessions with OT then PT in the afternoon.
OT: This discipline will have its “hands full” (pun intended) helping Joy to target vision rehabilitation for her double vision and possible right visual field restrictions from the accident, increasing independence with self cares, and improving her strength/coordination/sensation in her right arm and hand. OT was able to provide an immediate solution to her double vision yesterday through some pretty rad, low-tech safety glasses with tape blocking out the left central region of her vision. This will allow her brain to still receive peripheral vision info critical for balance, while strengthening her right eye’s muscles and connections to the brain. Our first therapy home program instructions were to alternate the tape between eyes daily so that we can be working on both eyes. Joy was so grateful for this adaptation and specifically reminded us to put the glasses on a few times if we forgot to.
PT:
SHE DID THE THERAPY STAIRS on her first day of inpatient rehabilitation!!!!!! I cannot emphasize how amazing this is because of the complexity of the task walking up/down stairs is and how early she is in her brain recovery. PT challenged her with stairs and walking the length of a hallway, part way with a walker and part without, of course with the therapist holding on. She needed to find Joy’s baseline and her max limit currently. Joy was very fatigued physically and mentally after PT but was able to resume her schedule after a good rest in bed.
Speech: The speech plan of care is going to have ‘a lot to say’ (no hands full on this one since it’s not OT 😜) about all the areas they will be working on. Speech earned their keep for sure assessing her chewing and swallowing skills with lunch approving her for a higher level diet (level 6) woohoo!!!🥳 This will allow her to have slightly more challenging and bigger bites of food to chew hopefully making meals more enticing. Since speech advanced this, when the dietician came in, she provided us an updated menu for Joy to select food from each day. This discussion was very fruitful in that we discussed our goals of improving her hunger as much as able with more enticing foods (advancing texture, ice cream, high calorie gelato) and eventually (maybe week/weeks from now) moving away from night tube feeds to daytime supplementary feeds if possible. It isn’t uncommon for her appetite to be variable at this point in her recovery, so for now we and her care team will monitor with these changes and adapt as needed.
Second, speech will work heavily on the speech production, language processing, and cognitive skills. Since yesterday was the evaluation, the SLP needed to challenge her with standardized assessments to find her baseline and ceiling skills. These tests illuminated one of the most challenging aspects of brain injuries impacting speech/language: at times Joy spoke more freely and answered questions with ease and during much of the assessment (again she was assessing where are the gaps in skills, where is the top range of her skills) Joy struggled to find the correct word which was met with increasing frustration and sadness. This therapist, and all of them, was so wonderful in being both a warm and reassuring presence but also tailoring education to her about her injury in a way that would make sense and cheer her on.
Therapeutic Recreation: she stopped by for more brief introduction, getting to know Joy’s interests, and education on what TR provides in the community. We’re very excited for Joy to be able to participate in any and all activities with them which may include some adaptive crafting as she is so skilled in, gardening, a visit with the therapy dog, and more.
Providers:
While I was at the hospital yesterday, Joy was able to see her rehab doctor (physical medicine and rehab or PMR), internal medicine, dietician as I mentioned above, and even ENT as the day was wrapping up.
Over and over, I was so impressed with the skill provided, their bedside manner and deep care, their comprehensive assessment of her, and how well they both listened to her needs and wants and our advocacy for her. I have learned the hard way in many situations that you need to repeat your key wants/needs to every provider to make sure your needs are addressed thoroughly. While I did this for her providers yesterday, I was grateful to hear things like “yes, as PMR as stated” “yes internal medicine informed me of that.” Coordinated care!!! What a novel concept (sorry FL I may or may not be looking 👀 at you).
Some beautiful memories to cherish as I wrap up.
All day, Joy expressed such gratitude to us and all her staff.
Early in the day, Gary and I were able to hear her beautifully respond to provider asking her what her name was twice “what is your name?” with “My name (pause) is (pause) Joy” !!!
Joy did a wonderful job self-advocating when she needed to rest while also actively participating in all she needed to.
In the evening, I provided Joy a little show and tell of clothes I brought from her home that I wondered if they would help her to feel more supported and warm. She did a wonderful job tracking during my entire conversation and actively participating. We settled on an option to try. After a quick wardrobe quick, Joy expressed “I feel so much better!!! This feels, so….nice!!” We made a plan then about what types of clothing for family to target in bringing/purchasing and she was very please.
Lastly and ever so sweet, Gary provided us this wonderful update last night: “Even after mom’s very good, but very long day, when, in giving her meds, the nurse just asked her her name, she said, “Joy Hanson!” And when asked where she was she said, “I don’t know which hospital.” And when asks what time she said, “Well it’s evening!” I guess all the therapy was stimulating to her brain!! That’s the first time she’s been able to answer those questions.”
Praise be to God! Thank you endlessly!
All my love,
Caitlyn
Daughter-in-law
