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  • Living Alone with Hemiparesis

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    Safety would be the primary concern of course when people with hemiparesis live alone or are alone for extended amounts of time. Of course your first references are your doctor, physical therapist and occupational therapists especially. This being stated, I can offer insights on some important items to consider in practical aspects of living alone after a traumatic brain injury or a stroke that result in a severe muscle weakness along the left or right side of the body and is sometimes exhibited in slight nerve damage as with me. Perhaps instead of living by them selves, it would be better to consider us living independently. At this writing, I will have reached almost thirty years of living with hemiparesis. Most of this time I was living alone and working as an engineer and writer, author.

    For us, the detrimental effects of hemiparesis are still prevalent even after initial rehabilitation and limited recovery. The effects can change with extreme variation.

    Effects When Tired or Awoken

    When the body is tired, effects can be worse and certainly more dangerous when living alone. An example is if awoken in the night, maybe by thirst, a call, or other concern. Even a healthy person could possibly stumble on sleepy legs or with eyes half open, but for those with left or right hemiparesis, the negative effects are magnified. A stumble can turn into a fall and possibly a head injury since one arm has poor strength, does not react quickly and is not likely to stop a fall. If a foot drags slightly during the day with shoes, then it can be so much worse at night even so unsafe that the person will roll over the toes so as to bruise them and fall forward on the weak side. Lessons learned here emphasize the need for uncluttered floors and hallways. A stray shoe on the floor or even newspaper can prove disastrous. Either could throw off the balance suddenly for a waking person especially in the dark.

    This brings up a suggestion for low level lighting in the home or apartment. Economical battery operated motion detector lights are available at many stores now or a search online. Even if a cane is not needed during the day; it would be wise to have a cane near the bed, even a quad cane for late night awakenings or an early morning rising. In the morning, there are other issues as tightened up leg muscles that need stretching before safely moving.

    Shower and Bathroom Safety

    Morning stretching is important, especially as we who are injured age but more importantly, shower safety needs to be addressed. There is much assistive devices available and occupational therapists can communicate effectively the needs here, however I can give you my thoughts. These are that it can be quite scary at times, especially if you have had an accident, falling in the shower, tub or bathroom before. You will need to be able to have something within reach on your good side to grab onto, basically at all times. Please note that if you can’t use the screwed in support rails and use the bars with suction cups, you really need at least two bars together. Redundant support as these are known t slip and when you have water or soap in your eyes and reach out with the bar slipping, it can be devastating. I would recommend having a bar on the entry or exit and on the opposite side. This way if a person with hemiparesis turns around there is always a bar on the good side.

    But it does not stop there. Bathroom floors are usually smooth surfaces and with one foot having no or minimal grab, then any water on a smooth tile or marble surface is like ice and can easily cause a fall when drying. Rubber backed rugs are most often used but can bunch up under feet. A work around solution for these throw rugs is rubber strips with adhesive on both sides. The local hardware store will have some rug grippers or search the web

    Dressing

    This is an area again where an occupational therapist assures you are prepared with any assistive devices for reaching around the weak side or fastening in back and collar. However, I can emphasize that so much more time needs to be available, just in case. Even though, there are assistive devices and there is ample training in doing this usually available before even leaving the hospital.

    Food Preparation, Cooking Kitchen Safety

    One’s ability to prepare meals will vary. I understand it’s good to be independent but in the kitchen it just may be smarter to minimize preparation with knives or stovetop. Even the oven can cause burns and fire easily. Having a cardboard pizza box fall onto a hot broiler iron can start a fire that is not too easy for someone with a disability to put out quickly. Sure there are now small convenient fire extinguishers available but some often need two good hands to operate correctly and then even finding it quickly can be an issue for trauma, brain injury or stroke victims.

    Fortunately, there has been an improvement In microwave dinners. This certainly would not be your first option in the past. However, I have been at this for almost thirty years now and I really have seen a great variety come on the market and costs go down. Good, healthy dinners can be cooked in one minute. I still bake chicken and pizze plus a few others but safety really needs to bethe forst priority. Losing balance and reaching out to find as hot frying pan to lean on can happen and I have personal experience, it’s not a quick heal having a burn in the palm of your good hand. Agsin here as in the bathroom, a rug with rubber backing and rug grabbers should be required.

    Mind Body Health Needs

    Concentration and Focus are the key in most everything that the person with hemiparesis might have to overcome. That is why ongoing brain training is so important.

    Human interaction, relationships contribute greatly to complex usage of our brain and even helping to stay young. Well living alone minimizes this benefit ad over time can have an adverse effect. Sure, some will say the upward potential may be limited but start with the objective of not losing ability. Without regular exercise, mind or body can atrophy to borrow a term used to describe not using muscles.

    There are free and paid sources on the web. There are now brain improvement magazines at the local supermarket and brain games are popular and effective, most even for one hand use.

    Geographic Area Specific Issues

    Depending on your locality, power outages can occur during natural events mostly as snow or ice storms, hurricanes, tornadoes. When living on the eastern coast, I lost power even when their was a high windstorm. Natural events as this can have an impact on people living with hemiparesis just as they do for others with a disability, elderly or families in general. However preparedness is the key here and living alone increases importance of having battery lighting, food, water, cell phone, radio, all available and easily attainable in possibly in the dark.

    The power loss may be worse in cold weather for this condition as detrimental effects can disable some people with this extreme muscle weakness and possibly nerve damage. This varies of course depending on person or injury but in general arms and legs can start shaking uncontrollably and a serious limitation to mobility. Poor effects are also exhibit in sudden changes of weather. Each person may experience this differently but a check with your physician is best.

    To assist in times as these, warm clothing, even a safe generator where it can be installed in a home as a backup are suggestions with heat packs available at sporting good stores or camping supply shop.

    Summary

    Some of the techniques and tips outlined here may seem obvious to some or simple but they are not always thought of ahead of time before they are used. This is evident in support forums online, knowing individuals and my own thirty years of living with hemiparesis. There are of course more but in general, consideration that movements can be slow at times as can thinking. An important point is if there is a loss of balance or tripping, it will most likely be on the weak side which of course doesn’t react fast nor have enough hand strength usually to hang on to something firmly. This is why safety is the first priority when living alone with this injury.

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    Source by Leon Edward

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  • Waking the Tiger, Healing Trauma, by Peter A, Levine

    Waking the Tiger, Healing Trauma, by Peter A, Levine

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    Many people who have suffered tremendous emotional trauma (for example, the recently bereaved, people in war-torn countries, those who have been tortured or sexually molested) or physical hurt (e.g. severe neglect, debilitating injuries) recover entirely or near completely from their tragedy. However, others do not fare as well and continue to relive the same horrific experiences of morbid fear, anguish, and anxiety for a prolonged period of time. These latter groups of people have been traumatized by their bad experiences.

    In their book, “Waking the Tiger: Healing Trauma,” Levine and Frederick (1997), said that this is a result of bottled-up somatosensory symptoms emanating after trauma. There are three main ways people respond when faced with a traumatic experience, said Levine and Frederick (1997). They can fight (confront the situation), flee (get away from the situation), or freeze (be totally overwhelmed by the predicament to the point of immobility). Victims who apply a fight or flee solution to a traumatic experience fare better in dealing with trauma than people who freeze in response to shock (Levine & Frederick, 1997). This state of suspended animation and paralysis occurs unconsciously and involuntarily. During this state of freeze, the victim has no way of going through all the typical reactions associated with traumatic events (Levine & Frederick, 1997). Because they are not adequately discharged by the victim, the trapped emotions wreak havoc on the traumatized individual.

    The solution to trauma is, therefore, to guide the victim along a path (Experiential Sensation-FELT SENSE) that allows them to perceive and release those trapped emotions (Levine & Frederick, 1997). This approach to healing trauma was garnered by learning how animals recover from traumatic experience (Levine & Frederick 1997). Confronting trauma, said Levine and Frederick (1997), should be mostly on an emotional, limbic brain level, and not solely on the rational, executive brain level.

    Levine and Frederick’s trauma theory is also supported in some ways by the polyvagal theory, which suggests that trauma has a somatic experiential component. If, as indicated by the polyvagal theory and by the Levine and Frederick (1997) theory, that trauma has strong emotional roots, one can apply elements of relationship models such as the DIR model in addressing trauma. After determining the victim’s functional emotional development capacity level, a DIR practitioner can begin to appeal, build and strengthen discovered areas of weaknesses, thus allowing the victim to escape the shackling phenomena of a past traumatic event. Calming the traumatized individual is a tool in the DIR toolbox with which to regulate traumatized individuals. A calmed mind creates an opportunity for further regulation of emotions and understanding of deep-rooted feelings, all of which are needed for trauma victims to extricate themselves from the shackles of the past and begin to attain new heights of functional capacity.

    Other applicable trauma theories include the NARM model, which, focusing on the mind, suggests that trauma is associated with a maladaptation in the victim’s attachment history. The PTSD model suggests that trauma victims are applying to their current problems solutions which had worked and were appropriate in the past.

    In my opinion, while attachment and trauma appear as opposite ends of the same emotional realm, it is apparent that whereas attachment is mostly positive, except, for example, in cases of extreme attachment/dependency, trauma is almost always negative, at least until it resolves. Treatment of trauma requires a dedicated practitioner, who is ready to learn from their victims and understand their challenges in order to develop an appropriate management strategy.

    Recognizing the signs and symptoms of trauma, making timely referrals to a trauma specialist, and integrating several of the modalities mentioned would likely give the best result in the management of traumatized children and adults.

    Reference

    Levine, P. A., & Frederick, A. (1997). Waking the tiger: Healing trauma: The innate capacity to transform overwhelming experiences. Berkeley, CA: North Atlantic Books.

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    Source by Anselm Anyoha

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