October 2, 2017 10:00 pm
Josh's classes this week are all "DC" (discharge) classes. DC classes have two objectives: (1) to give Josh the same tests they ran the first week he arrived for comparison sake, and (2) to teach us what activities to do at home to further Josh's growth.
In PT this morning, Barb measured Josh's flexibility. It took the whole hour.
Josh had ST next. Allison did all the tests she ran the first week in about 20 minutes, so the rest of the hour was identifying objects found in a garage and trying to create sentences about those objects (e.g., I use a lawnmower to cut the grass). Josh couldn't compose a single sentence, and he fell asleep about 40 minutes into class.
Mary took Josh on a walk around the building to awaken him before his next class: neuropsychology. Dr. Schraa began by giving Josh a piece of paper and asking him to copy the signs and symbols he saw. Josh complied.
Then Josh was to draw the signs and symbols from memory. He did a fantastic job.
Then Dr. Schraa asked Josh to repeat a series of numbers. Josh could repeat up to six digits, but when he was given seven, he remembered only the first number and jumbled the rest. Then Schraa did the same number set, but Josh was supposed to repeat the numbers backwards. Josh could repeat five numbers backwards.
The number activity took about 15 minutes. Then Schraa asked Josh to draw the symbols and words he drew at the beginning of class. Josh had no idea what Schraa was talking about. So Schraa gave Josh the paper below and asked him to circle the symbols and the words he drew at the beginning of their session. As you can see, Josh remembered the symbols, but not the words.
Schraa concluded that because of Josh's left temporal lobe damage, Josh will be better able to recognize things than to identify them; for example, he will be able to recognize a person's face, but not be able to name the person.
Lastly, Schraa pulled out a white board that had blue blocks attached to the top of the board. Dr. Schraa would tap a series of blocks and Josh was to repeat that series (like the electronic game Simon). Josh imitated a series of six, but he could not do seven. Josh has a much better memory than he did when we arrived!
SIX:
SEVEN:
Then he had Josh do the same thing, but tap the blocks in backwards order. Josh followed up to four blocks, but then he zoned out and began falling asleep. Schraa said he would finish the testing later.
Josh had only an hour break - barely enough time to eat 1/3 of his lunch. So without a nap, he went to OT where he worked on hand-eye coordination. As Josh sat in his wheelchair, Therese gave him a piece of paper that had a series of over-sized notes printed on it. Depending on where the note head was placed on the stem, Josh was supposed to tap either his hand or his foot. If the note head was on the upper left part of the stem, Josh was to tap his left hand. If the note head was on the bottom right part of the stem, Josh was to tap his right foot. The notes began with only one note per stem, but progressively became more difficult. I think the hardest notes for me to follow would have been tapping both hands and one foot, for example. Or maybe the right hand and the left foot.
Then to increase difficulty (and improve rhythm), Josh was to tap his extremities to the beat of a metronome. Josh has great rhythm, so that was no problem for him at all.
Josh hung in there for the first 30 minutes of class, but it was a real struggle to keep him awake the last 30 minutes. So to mix it up, Therese pulled out a simple Sudoku puzzle.
That did NOT keep him awake; in fact, it increased his fatigue. He couldn't take it, and he fell asleep. Therese had no choice; she had to do something that would keep him awake. So she had him play the Makoto game (described on September 29) for the rest of the hour. He loves that game, so her strategy worked.
We went back to Josh's room and left Joshua with the BA while we went to meet with our CCM (clinical care manager), Kent. Kent (she) met with us for thirty minutes to explain insurance, medicare, medicaid ... the business/financial end of going home. Yeesh...
After our meeting with Kent, we returned to Josh's room where Paul quickly fell asleep and Mary worked with Josh on a puzzle. Twenty minutes later, Josh was asleep too. They both slept while Mary continued with discharge preparations until dinnertime.
Mary left when Paul took Josh to the Bistro for dinner. During and after dinner (which took about two hours), Paul and Josh watched football. Since this is independence week, we are completely responsible for Josh, unless we need help. So Paul got him bathed and into bed and then gave him all his medications. Josh was out in about 15 minutes. Which means that he was spared the disappointment of watching the Redskins lose to the stupid Chiefs on a last-minute field goal. Paul was not spared.
Josh's classes this week are all "DC" (discharge) classes. DC classes have two objectives: (1) to give Josh the same tests they ran the first week he arrived for comparison sake, and (2) to teach us what activities to do at home to further Josh's growth.
In PT this morning, Barb measured Josh's flexibility. It took the whole hour.
Josh had ST next. Allison did all the tests she ran the first week in about 20 minutes, so the rest of the hour was identifying objects found in a garage and trying to create sentences about those objects (e.g., I use a lawnmower to cut the grass). Josh couldn't compose a single sentence, and he fell asleep about 40 minutes into class.
Mary took Josh on a walk around the building to awaken him before his next class: neuropsychology. Dr. Schraa began by giving Josh a piece of paper and asking him to copy the signs and symbols he saw. Josh complied.
Then Josh was to draw the signs and symbols from memory. He did a fantastic job.
Then Dr. Schraa asked Josh to repeat a series of numbers. Josh could repeat up to six digits, but when he was given seven, he remembered only the first number and jumbled the rest. Then Schraa did the same number set, but Josh was supposed to repeat the numbers backwards. Josh could repeat five numbers backwards.
The number activity took about 15 minutes. Then Schraa asked Josh to draw the symbols and words he drew at the beginning of class. Josh had no idea what Schraa was talking about. So Schraa gave Josh the paper below and asked him to circle the symbols and the words he drew at the beginning of their session. As you can see, Josh remembered the symbols, but not the words.
Schraa concluded that because of Josh's left temporal lobe damage, Josh will be better able to recognize things than to identify them; for example, he will be able to recognize a person's face, but not be able to name the person.
Lastly, Schraa pulled out a white board that had blue blocks attached to the top of the board. Dr. Schraa would tap a series of blocks and Josh was to repeat that series (like the electronic game Simon). Josh imitated a series of six, but he could not do seven. Josh has a much better memory than he did when we arrived!
SIX:
SEVEN:
Josh had only an hour break - barely enough time to eat 1/3 of his lunch. So without a nap, he went to OT where he worked on hand-eye coordination. As Josh sat in his wheelchair, Therese gave him a piece of paper that had a series of over-sized notes printed on it. Depending on where the note head was placed on the stem, Josh was supposed to tap either his hand or his foot. If the note head was on the upper left part of the stem, Josh was to tap his left hand. If the note head was on the bottom right part of the stem, Josh was to tap his right foot. The notes began with only one note per stem, but progressively became more difficult. I think the hardest notes for me to follow would have been tapping both hands and one foot, for example. Or maybe the right hand and the left foot.
Then to increase difficulty (and improve rhythm), Josh was to tap his extremities to the beat of a metronome. Josh has great rhythm, so that was no problem for him at all.
Josh hung in there for the first 30 minutes of class, but it was a real struggle to keep him awake the last 30 minutes. So to mix it up, Therese pulled out a simple Sudoku puzzle.
That did NOT keep him awake; in fact, it increased his fatigue. He couldn't take it, and he fell asleep. Therese had no choice; she had to do something that would keep him awake. So she had him play the Makoto game (described on September 29) for the rest of the hour. He loves that game, so her strategy worked.
We went back to Josh's room and left Joshua with the BA while we went to meet with our CCM (clinical care manager), Kent. Kent (she) met with us for thirty minutes to explain insurance, medicare, medicaid ... the business/financial end of going home. Yeesh...
After our meeting with Kent, we returned to Josh's room where Paul quickly fell asleep and Mary worked with Josh on a puzzle. Twenty minutes later, Josh was asleep too. They both slept while Mary continued with discharge preparations until dinnertime.
Mary left when Paul took Josh to the Bistro for dinner. During and after dinner (which took about two hours), Paul and Josh watched football. Since this is independence week, we are completely responsible for Josh, unless we need help. So Paul got him bathed and into bed and then gave him all his medications. Josh was out in about 15 minutes. Which means that he was spared the disappointment of watching the Redskins lose to the stupid Chiefs on a last-minute field goal. Paul was not spared.
I'm so impressed by how well Josh does the assignments given to him. I'm not sure I could do any better. Well done Josh! I also think that Paul and Mary will make great "life" therapists and that the added love that they have for Josh will help him progress so much more as time goes by. Well done you all!
ReplyDelete