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After Stroke Developing the Winner's Mindset
6 CEUs After Stroke Developing the Winner's Mindset

Section 19
Appendix: Client Reproducible Worksheets


Answer Booklet | Table of Contents
| Geriatric & Aging CEU Courses
Social Worker CEU, Psychologist CE, Counselor CEU, MFT CEU

Caregiver Technique: Smooth Communication in 8 Steps
Review CD Track 1 for more information regarding this technique.

1. Prepare an area for conversation.  Quiet, calm surroundings with few distractions will help the stroke sufferer concentrate on communication, and will help you focus on understanding him or her better as well.
2. Use simple sentences, but be careful to avoid a condescending tone.
3. Unless the stroke sufferer has a hearing impairment, a normal tone of voice is more effective for enhancing communication than an excessively loud one.
4. Don’t pause between words, as this can be confusing.  On the other hand, clear pauses between sentences or phrases can help the stroke sufferer grasp the meaning more easily.
5. Phrase questions simply, so that they can be responded to with yes or no answers.
6. Never force a response; rather, encourage a response.
7. Because it takes a great deal of energy for someone with aphasia to talk and process information, try to time conversations for when the stroke sufferer is well rested and relaxed.
8.  since communication is the goal, it is inappropriate to correct grammar or pronunciation.  Focus on the ideas he or she is expressing.  Correcting the mechanics of his speech may be distracting, or even upsetting.

The Time Orientation Strategies Technique
Review CD Track 3 for more information regarding this technique.
1. Record together with your caregiver how much time it takes you to accomplish daily activities, like dressing, bathing, or eating.  The idea not to do so as a test of your abilities, but as a way to gather information and add quality to your day.  With this information, you can then estimate the time you need for your daily routines without ever feeling rushed.  This can also help you maintain more independence in creating and managing your own schedule.
2. Use a structured schedule to help orient herself to the time of day.  Even if you have difficulty with the concept of time, if you connect the things you do, like dressing or eating dinner, with time, it will help you develop a structure to your day.  Such structure has a built-in responsibility and accountability, so you may find that you give yourself more chances to feel good about yourself when you own your own  time.
3. Use calendars and daily reminders.  A monthly calendar to remind you of coming events and appointments, and crossing off the days in the evenings can help orient you to the passing of days.  A daily reminder or calendar can be useful to help you keep track of daily schedules, activities, and medication times.  In addition, you may discuss with your caregiver a specific handy location for family notes and reminders.
4. Use digital watches and clocks.  Digital clocks can be easier to interpret. You may also consider using a digital alarm clock to help orient you to medication times or other tasks you wish to remember.”
5. Set realistic goals when focusing on time.  Using these other strategies can help you better prioritize those tasks that are truly important, and apportion time accordingly.   The goal is to help yourself keep a positive attitude towards time, not see time as something to compete with.

The 4-Point Security Technique
Review CD Track 4 for more information regarding this technique.

This technique is specifically designed for stroke sufferers who return to living alone.
1.  Arrange for someone to call you once per day.
2. Develop a signal system with a trusted neighbor that will alert him or her is you find yourself in trouble and unable to speak.
3. Inform the fire department of your condition, to improve their ability to assist you in an emergency.
4. Consider entering the US Postal Alert program through your local postmaster.  If mail accumulates the postal carrier will notify the appropriate agency or service to check on you.

The Affirmation Statements Technique
Review CD Track 5 for more information regarding this technique.

1.  I will not ask my caregiver for anything that I can do for myself. 
2.  I thank my caregiver every time he or she provides me with assistance.
3.  When my caregiver suggests we go out shopping, or to eat, I make every effort to go.
4.  I do my best not to complain about my stroke or my limitations.
5.  I try on my own to improve my skills to improve my quality of life and my caregiver’s quality of life.
6.  I try to never feel sorry for myself, and I do my best to keep my sense of humor.
7.  I express my appreciation of my caregiver through giving him or her compliments and telling him or her I love them.

The Structured Dressing Technique
Review CD Track 6 for more information regarding this technique.

1.  Lay out all of the clothes you will need in order.  Clothes that you need first, like socks or underwear, should go on the top of the pile.
2.  Put the weaker limb in the sleeve or leg of the article of clothing first.  Then arrange the clothing a bit before putting the stronger limb, or your head, through the appropriate openings. 
3.  Use your body weight to arrange the clothing around yourself
4.  Sit, rather than lie down, to dress yourself.

The Energy Management Technique
Review CD Track 6 for more information regarding this technique.

1.  Assign priorities to your activities.  Decide in the morning what are the most important things for you to accomplish in a day.  On days when you feel you do not have much energy, only do those things of the highest priority.  On days when you feel that you do have more energy, add some of your lower priority items to your schedule. 
2.  Use your energy wisely.  Don’t spend time and energy on things you cannot change.  Make sure you use aids that are appropriate for your level of ability.  It may be that your abilities may change from day to day.  If walking without your cane makes you feel too tired on a particular day, use your cane.  If you don’t find the cane the next day, try walking without it.
3.  If you feel tired from thinking, remind yourself that this is a normal experience.  Try taking a break from your activity and moving around.  Try swinging your arm, walking a bit, or have your caregiver help you move around a bit if you feel physically tired.
4.  Develop the best communication skills you can.  You might try developing a script for a clear, brief way in which you could explain your limitations without expending a lot of energy.  Consider carrying printed cards that you could pass out explaining your specific limitations if you do not feel that you have the energy to verbally explain at that time.

The Reclaiming Intimacy Technique
Review CD Track 6 for more information regarding this technique.

1.  Stay as attractive as you can through good grooming and hygiene.  This is important because it can help increase your self esteem, decrease a sense of embarrassment, and help you feel more comfortable with your own body.
2.  Talk openly with your partner about different needs and other changes that the stroke may have prompted.
3.  Plan in advance for sex or other intimacy.  Choose times when you both are rested, and set aside plenty of time with no interruptions.
4.  Try relaxing together before you begin.  Soak in a bath together, listen to music, or give each other massages.
5.  Be realistic.  Old positions may no longer make sense.  Find comfortable positions that support the weaker side and conserve energy.
6.  Consider using water soluble lubricants to make penetration easier and more comfortable.  Petroleum jelly is not water soluble and can increase the risk of vaginal infections.
7.  Consider alternative intimacy.  Hugging, kissing, caressing, and touching can all be satisfying ways to show love and affection.  Using these alternatives can also reduce stress and tension about performance, which can make the experience more satisfying for both partners.

Sample Family Task Chart
Review CD Track 7 for more information regarding this technique.

The Family Task chart is divided into four sections down the left side, and covers the general task areas of personal care for the stroke victim, household tasks, nursing care, and therapy.  Across the top of the chart are listed the three categories of “provided by family or friends,” “provided by personal care aide”, and provided by other. 


Week of:

 

Provided by Family or Friends

Provided by Personal Care Aide

Provided by Other

Personal Care

 

 

 

Combing Hair

 

 

 

Dressing

 

 

 

 

 

 

 

Household Tasks

 

 

 

Preparing Meals

 

 

 

Taking out Trash

 

 

 

 

 

 

 

Nursing Care

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Therapy

 

 

 

PT

 

 

 

Transportation

 

 

 

 

 

 

 

 

 
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