Finding dad’s voice after his stroke

A powerful example of how a one-page profile can help someone who has suffered an acute stroke to communicate how best to support him as well as helping his daughter advocate on his behalf.

Written by John’s daughter, Lisa Orme

chipMy dad, always known as ‘Chip’ was 65 when he suffered an acute stroke. It was in April 2012 and he experienced a massive bleed on the right side of his brain. He was admitted to the Derby Royal Hospital. It was one of the most fearful days of my whole life. I knew then that things were going to change forever. What I didn’t know, was that we were about to embark on a person-centred journey and that I was no longer just going to be his daughter, I was going to need to be his advocate too.

Dad lost his voice, his normal bodily functions and his pride that day. The first 24 hours were the hardest. Dad could only nod or shake his head and it was down to me to interpret this and advise the nursing team on his behalf. It was heart breaking and frustrating but I had a coping mechanism. I knew about person-centred thinking and used my understanding of him and the tools I’d learnt to advise the nursing team how best to support him. This was particularly important because I couldn’t be there all the time and it was essential that they were still acting on his wishes without me there to advocate them.

Every day in hospital highlighted another challenge for us. I sat with dad talking through his communication and decision making approaches identifying with him what he understood and what he wanted to share. He was able to nod or shake his head enabling me to capture his thoughts into his one-page profile. Once it was completed I shared this with the immediate nursing team. Every day I reviewed the one-page profile with Dad and my Sister to ensure we added new information gathered from his rehabilitation handovers.

I placed Dad’s profile laminated by the side of his bed as well as giving it to sit alongside his care plan. Nursing staff began asking me about our approaches and quickly recognised what was important to dad. Importantly they recognised when he chose not to engage with them as this remained in his control.

Helping dad to remain in control of his situation was my priority. His profile enabled this to happen. Chips connection to his family and the nursing team was so important in the seven weeks he was on the ward. Relationships were developed as the nursing team read and understood more about him from his profile. They learnt to engage with him using the information to promote conversations, laugh, joke, make him smile when he was having a bad day.

Despite his stroke dad was making choices and had capacity. Staff understood what made him more settled and more importantly they understood how he wanted to be supported. The one-page profile quickly progressed and became more detailed ensuring the right decisions were made when agreeing his continuing health care funding for his future nursing care.

Dad was going into a home in the centre of Derby. It was near to his friends and the places he grew up. I felt satisfied that dad would be happy there and made sure I shared pictures and information about the home with him to help him prepare. Sharing dad’s one-page profile with the nursing manager really helped me to engage with the assessment and referral process. It meant that I could clearly say what his needs were and ensure that they had the capacity to support him in the way he wanted to be supported.

Dad’s stroke had been incredibly sad for the whole family but throughout the journey I have been able to support him and help him to communicate by using the person-centred thinking tools. The nursing team briefly knew Chip. To me he will always be dad.