This weeks #Otalk is on the topic of “Stroke and Executive Dysfunction” and will be hosted by Charlie Chung and members of the Stroke Forum committee, RCOT Neurological Specialist Section (@chungsongyau and @OTstrokeSSNP).
Here is what they had to say…
We are the Stroke Forum committee of the Specialist Section Neurological Practice and for our session, we wondered how case study work would look on OTalk.
The questions this week relate to Jane, a lady with stroke and executive dysfunction. We hope that this will be an opportunity to share ideas freely, but in 140 characters or less, of course! Even if your practice does not include working with people with stroke, executive dysfunction is experienced by many people with a range of conditions and we would love to hear from you, too.
Executive function (EF) is a series of inter-related cognitive processes that we need for responding to novel, difficult, complex or dangerous situations. Impairment of executive function (executive dysfunction (ED)) is a frequent consequence of stroke and often limits people’s ability to adapt to their new situation, reducing their participation in occupation.
The Case Study
‘Jane is 72 years old and she was discharged home from the acute stroke unit following a 10 day admission with a left hemisphere partial anterior circulatory syndrome stroke. She experienced a right sided weakness and word finding difficulties. Both improved daily and at the time of her return home, she was walking distances of 50 metres with a stick and was able to participate in conversations with only occasional difficulties finding words.
During the first two weeks at home, Jane received visits from the early supported discharge team who worked with her to establish a daily regimen of exercises and ensured that she was participating in her necessary activities of daily living (ADL). The service was discontinued when it was clear that Jane was independent with ADL.
All seemed okay over the next two months until a referral was received by the community rehabilitation team from Jane’s GP. Her husband had made an appointment which he had accompanied her to. He explained that although Jane had the ability, she was not completing ADL when he was not at home. She was leaving dishes unwashed and was often not washing and dressing. When out together, she avoided paying for items in shops and remained dependent on her husband to do this. Supermarket shopping was a particular challenge as Jane would put items in the trolley which were unrelated to their meal plan or on their list’
The objective of this session is for participants to share their thoughts on how to work with Jane, and more information will be provided with each question.
- What do you understand about executive function?
- How has Jane’s executive function been affected by the stroke?
- What Occupational Therapy interventions would you suggest?
- What further knowledge about executive function do you feel you need?
514 Avg Tweets/Hour
11 Avg Tweets/Participant