It was September of 2013, and Jennifer and Ed Swaren were busy prepping their yard and pool for winter. Suddenly Jennifer stumbled, fell, and broke her hip.

She was taken by ambulance to a nearby hospital, where she was operated on a few days later. Because she was slow to recover after the surgery, the medical staff assumed she was having a reaction to the anesthesia.

When Ed saw her, he suspected something worse. “She was very disoriented, and couldn’t say hi to me,” he says. “I knew instantly it was more than a reaction.”

Jennifer had suffered a stroke.

Her prognosis was good. The stroke had affected only a small area of the brain, leaving her with full mobility and cognition, but her speech was impaired.

“The following day, she was writing out the months of the year, and when she got to September, she circled the twenty-fifth, for my birthday,” Ed recalls. “Over the next week, the words started coming back. It was really positive. I remember the speech-language pathologist asking Jennifer, ‘Who wrote Tom Sawyer and Huckleberry Finn?’ And Jennifer said, ‘He’s known as Mark Twain, but his real name is Samuel Clemens.’”

Setback

Jennifer’s rapid gains made her an ideal candidate for transfer to a high-intensity rehabilitation clinic less than two weeks after she broke her hip.

“She went down there talking away,” Ed says. “But when I went to visit her the next day, she was quiet. I talked about our nephew’s plans to visit her, and she had this funny look on her face, like she didn’t understand who he was or what I was talking about.”

Ed then accompanied Jennifer to her occupational therapy session, and watched in horror as she struggled to build a child’s puzzle. “She didn’t have a clue where the pieces went. Clearly, she’d had another stroke.”

A call from the neurologist later that night confirmed their fears. The second stroke had set Jennifer back.

“She went from a point of being able to tell me my birthday, talking well, and knowing what was going on to still knowing what was going on, but not being able to say anything,” Ed explains. “We had a picture of our five grandchildren, and I asked Jennifer, ‘Who’s this?’ and she couldn’t tell me.”

“I knew,” Jennifer is quick to add. “But couldn’t say.”

Diagnosis

Jennifer was diagnosed with aphasia.

Often caused by a stroke, aphasia is an impaired ability to produce or comprehend language—or both. It ranges from difficulty finding words to complete inability to speak, understand, read, and/or write.

Jennifer’s thinking and reasoning abilities were unaffected, and she could understand people, but she couldn’t speak to them.

She spent the next four weeks working on intensive inpatient rehab. On Halloween night, she went home.

“She looked terrific, and it was really good to have her home,” Ed recalls.

But Jennifer quickly objects. “It was not good . . . not good. I just couldn’t . . . what is that . . . speak,” she says, shaking her head, disappointment and frustration evident.

Over the past year, Jennifer has benefitted from continuing her physical, occupational, and speech therapy as an outpatient.

She feels her recovery has been enhanced by the Tactus Therapy apps she uses. She spends about three hours a week with a group of therapists, and complements this work by working at home with the apps for at least an hour a day. “You have to do it,” Jennifer explains of the homework. “It’s very good.”

PWA_iPad_ConversationTherAppyTechnology

Jennifer’s early motivation was to learn to say and recall the names of all her grandchildren. Even with the name printed underneath each picture, she struggled to say “Sam” or “Ben.”

“Our kids were onto us right away about getting Mom an iPad and using technology,” Ed explains. “Our son drove the app engagement, and got us Language Therapy.”

Jennifer uses the apps independently to support what happens during her therapy sessions. Language Therapy targets all four language modalities— listening, speaking, reading, and writing. The app uses proven techniques to help Jennifer relearn to identify and communicate single words.

The app consists of two receptive tools (Comprehension Therapy and Reading Therapy) and two expressive tools (Naming Therapy and Writing Therapy). Research shows that people who use it regularly can make significant improvements.

“We firmly believe that this is something that will continue to improve over a lengthy period of time,” Ed says. “There will be speed-up zones and slow-down zones. It’s not a steady pace.”

In the meantime, Jennifer continues to push forward. She’s made great progress. She can communicate well enough to get her ideas and thoughts across, and she uses various techniques to augment her conversations. She uses a dog-eared notebook, for example, to write down things she’s done, places she’s been, and people she knows. She refers to the notes to make socializing and conversing easier and to help her recall facts and dates. An alphabet chart helps cue her on people and place names.

Along with her speech therapy gains, Jennifer is also experiencing significant memory improvements and enjoying a better quality of life. But she yearns for independence.

Independence

Jennifer taught primary school for 25 years, and had a busy social and volunteering life after retiring. She finds the isolation of her condition difficult. She doesn’t like having to rely on her husband and on family and friends so much. She wants to be able to talk freely on the phone, schedule her own hair appointments, drive herself there, and travel. “I want to be more . . . what is it that name . . . independent,” she says.

An upcoming visit from a longtime friend gave Jennifer the excuse she was looking for. Her family helped her come up with a plan for travelling alone from the suburbs to downtown to meet with Jeannette, who was coming in from a neighboring province.

Armed with notes written by her husband, a list of phone numbers, and a cell phone, Jennifer followed her plan, which included an overnight visit with her daughter and more time navigating public transportation. Jennifer hadn’t seen Jeanette since before the stroke.

“I was early, so I went for a bit of a walk,” Jeannette recalls. “I saw her get out of the cab from about a block away, and I walked up to her and said, ‘Hello Mrs. Swaren.’ We hugged, and it was like we’d never been apart. It was good.”

They visited for more than four hours, catching up on old times the way good friends do. When Jennifer pulled out her notebook and alphabet chart, the former teachers both laughed. “It was like teaching grade one again,” Jeannette says.

Jennifer then left her friend Jeannette at the hotel and travelled back to the suburbs, ending her successful Independence Day back home. A relieved husband met her at the train station.

“It was good,” Jennifer agrees.

 


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