Surviving a stroke with occupational therapy

The month of October highlights World Occupational Therapy and the significant role Occupational Therapists (OTs) play in communities and healthcare facilities. Occupational therapists treat injured, ill, or disabled patients through the therapeutic use of everyday activities. They help these patients develop, recover, improve, as well as maintain the skills needed for daily living and working.

Venus Mazamisa is an Occupational Therapist from the Western Cape Government Health contracted non-profit organization Philani and is relieved to be providing an OT service to her patients again after six months of lockdown.

“In New Woodlands, five out of ten patients that myself and the Rehabilitation Care Workers (RCWs) treat monthly when conducting home-based care are stroke sufferers,” says Venus.

“To stay safe and move forward with community-based healthcare services and continue with the Department’s Community Orientated Primary Care (COPC) plan during the COVID-19 pandemic, all community health care workers practice strict hygiene and wear their personal protective equipment before entering a patient’s home,” says Venus.

One of the patients receiving care from Venus and the RCWs is Adam Herling, age 70 from New Woodlands in Mitchells Plain who suffered a stroke in July 2018 driving home from the gym. “My left hand went limb when changing gears in my car on my way home from a rewarding gym session, but luckily I made it home safely,” says Adam.

Adam was not aware he suffered a stroke even after losing sensation in his left hand, arm and leg. He decided to go for an examination at the Mitchells Plain District Hospital’s Emergency Centre the following day.

“I was shocked when the doctor told me I had suffered from a stroke because I felt fit and was health-conscious with no chronic illnesses. My mother passed away from a stroke and my 47-year -old son suffered a severe stroke. It was difficult to process the information I received about my health,” says Adam.

“I was admitted to hospital for a week after a few tests were conducted and later referred to an intermediate healthcare facility for two months where I received rehabilitation care and discharged to receive treatment at home by Venus and her team of RCWs,” says Adam with content.

Adam’s bedroom was converted into a ward where he received rehabilitation treatment and physiotherapy to regain mobility in the left part of his body to function and gain a certain level of normalcy in his home and eventually get back to his daily routines.
“When a referral is received, I schedule an assessment with the patient at the home to determine the level of mobility and plan a programme within an eighteen-month treatment period to get the patient rehabilitated and functioning in a capacity which enables the person to cope with their daily activities again,” says Venus.

“I would conduct exercises, OT activities for brain development and physiotherapy activities with the patient using practical tools in the home which the patient was able to use before the stroke,” says Venus.

“After his eighteen-month programme, Adam’s mobility has improved immensely, and he is ready to start exercising at the gym again, which I know he loved doing before his stroke. I still encourage him to exercise his left hand by getting back to his gardening,” said Venus.

Venus and the RCWs have detected that a few of their stroke patients have regressed with their mobility programme during the lockdown as many have lost the desire to continue with rehabilitation due to frustration and their families too strained and exhausted to assist them as the OTs and RCWs were unable to enter their homes for the past six months.

Insaaf Mohamed is the Department’s OT at Hanover Park Community Day Centre and mentions that the first few hours once the patient has suffered from a stroke is crucial for treatment and rehabilitation within a twelve week to a year rehabilitation window period for basic functioning, then approximately two years with consistent rehabilitation to improve mobility where the patient can enjoy their daily activities, functioning and leisure time once more.

“Having a stroke affects the brain and most patients have various levels of impairments be it physical or cognitive, hence the crucial rehabilitation methods must take place within the first year of the patient having a stroke,” says Insaaf.

Since March 2020, Insaaf has 46 stroke patients who require OT assistance and rehabilitation services in the areas of Manenberg, Athlone, Gugulethu and Hanover Park.

“Most of the patients I treat who have suffered from a stroke have uncontrolled chronic illnesses such as hypertension, diabetes and obesity with poor nutritional diets. Younger males are also being treated from a stroke due to multiple drug use,” says Insaaf with concern.

“We visit and assess each patient twice a month for an hour and work out a rehabilitation programme for the RCW to continue using with the patients and will review each patient after six months of treatment and will either continue with the home-based care or refer to an intermediate care facility if no improvement is made”, says Insaaf.

Most patients recover from their stroke because they are determined to heal but will, unfortunately, have a disability for the rest of their lives. Occupational Therapists will ensure that their patients are rehabilitated and continue to function in their living environment without the full dependency on family members. “Our OT teams are creative, dynamic and passionate about the service we provide to the communities we serve, and we will continue to live out the values of the Department for a well-balanced and healthy lifestyle and quality care,” says Insaaf proudly.