How do I help Dad recover from his stroke if his healthcare professionals seem to have written him off?

A fellow caregiver asked...

My 83 year old father had a "big stroke" six weeks ago on the right side of his brain. His left arm and leg have been affected but his right arm and legs are okay and he has a very strong grip. I'm not sure it is voluntary, but he can break your fingers. However he is left-handed and I'm having a hard time understanding what part of the brain has been affected, I thought that the left side was the speaking side. Can you help me understand this as it pertains to handedness?

Additionally, I was told he would be mute, he appears to have global aphasia, he doesn't respond to commands but he is starting to make words again, not regularly but he can. I asked him something and he answered "yes" and he's asked the nurses "help me please" so he knows what's going on at least sometimes but he really can't focus.

I think he has the ability to recover but the therapists at the nursing home where he has been all along won't give him any therapy because he doesn't respond to commands. No speech, swallow or physical therapy and I think they are writing him off because of his age. Because he has Parkinson's he hadn't been the most responsive all the time anyway but he did walk and talk and know what was going on.

Meanwhile he is on a feeding tube because he doesn't respond when they evaulate him but he can swallow because I've started giving him ice cream everyday when he is alert.

My question is, how can I get information on how to help him start to speak again even without a speech therapist and how to get him to start eating again more than ice cream?

I see a lot of things advertised online but it's very confusing. I'm just looking for some techniques to cue him on how to start speaking again and what he can start eating etc. How can I find these things out? If he's starting to speak on his own, is this a sign he will just snap out of it?

Thank you for you help

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

It sounds like your father suffered a right middle cerebral artery stroke. In most people, this would not effect speech, but in a fairly sizeable portion of left handed individuals, the language center is in the right hemisphere.

Improvement can go out to six months or even longer after a stroke. Therefore, if your father is now speaking a little bit, and eating a little bit, I would apply pressure on your physician and/or the therapists to get the Speech Therapists involved again. They can work with him on both issues, and are trained extensively in both speech and swallowing related problems. With time, he may even be able to get a feeding tube removed, and swallow on his own. It is still early after his stroke. If the therapist does not want to see him anymore, I would ask if a different therapist is available, or if he can be transported to a different therapy location for speech and swallow training sessions.

Finally, unfortunately, his strong grip with the left hand is probably reflexive - coming from the spinal cord - and not indicative of normal cortical functioning.

Good luck!