Steve's Story
Steve, aged 57, from Wrexham, was getting ready to walk his dog when he collapsed in August 2024. Steve was taken to Wrexham Maelor Hospital where he had a CT Head scan which showed that he had suffered a left middle cerebral artery (MCA) stroke caused by a blood clot. Steve received thrombolysis treatment which is a process to dissolve the blood clot using medication. This can often lead to improved recovery after stroke for patients.
Steve was admitted to Bersham Acute Stroke Unit at Wrexham Maelor Hospital.
Steve’s wife, Jo said: “It was all a blur at the time. It was quite scary”.
The left MCA stroke had left Steve with significant right-sided weakness affecting his arm and leg. This meant Steve was unable to sit upright without support or walk. Steve was reliant on a hoist to transfer out of bed and was dependent on therapy and nursing staff to meet his physical needs. The stroke had also affected Steve’s ability to safely swallow, which meant that he needed a naso-gastric tube (from nose to stomach) to provide his nutrition. Due to the nature of his stroke, Steve had difficulty with understanding language and expressing himself.
After receiving his medical management and early therapy intervention at Wrexham Maelor Hospital, Steve was then transferred to Deeside Community Hospital to the Stroke Specialist Inpatient Rehabilitation unit in September 2024. Following a period of rehabilitation from the stroke specialist team, it was agreed with Steve and his family that he would return to a home environment to further continue his recovery.
The Stroke Early Supported Discharge (ESD) team supports patients in their homes and is made up of occupational therapists, physiotherapists, speech and language therapists and technical instructors, supported by a consultant therapist. The team is based at Deeside Community Hospital working with patients and their families across Wrexham and Flintshire. The ESD service allows patients to access intensive stroke-specialist rehabilitation over a period of 6 weeks, facilitating earlier discharges from hospital environments. Therapists work closely with patients and their families to identify what matters to them and work together towards meaningful goals.
When Steve was first discharged from hospital, he and his wife Jo, set short term goals which were meaningful to them. Steve was sleeping downstairs with limited access to bathing facilities and transferring with a quad stick and the assistance of one person. Therapists first focused on Steve progressing to walking with the quad stick downstairs, which he soon achieved. Steve and Jo wanted to look at the possibility of returning to sleeping upstairs. Accessing and using the stair lift presented some initial challenges, but with repetitive practise and some innovative problem-solving, this goal was soon achieved much to Steve and Jo’s delight.
The next steps in Steve’s rehabilitation was repetitive practise of negotiating the challenging space in the downstairs toilet and the difficult front access.
In the last week of ESD team’s support, Steve was able to step out of the house, transfer in his wheelchair and get into the family car with support, enabling Steve and Jo to go on their much-anticipated trips out.
Jo said: “I’m very proud of him. The ESD team have helped us to achieve our goals”.
When Steve first arrived home, he was using a paper-based communication book (a form of Augmentative and Alternative Communication) to express his wants and needs with his family. He had difficulties with understanding verbal and written language, and also difficulties with his ability to produce speech.
Alongside this, Steve also focussed on the goal of improving his ability to follow more complex instructions and his ability to produce functional speech with the support of Jo. Steve and Jo remained motivated throughout the ESD block, regularly completing therapy programmes independently between sessions.
Due to the nature of Steve’s communication difficulties, he continues to rely on support from a communication partner. Jo engaged in therapy sessions and quickly learned the strategies used to support Steve when experiencing a communication breakdown. Steve’s awareness into his communication difficulties has improved and he is able to use strategies to support him engaging in conversations.
As Steve is continuing to show progress with his rehabilitation, he has been referred for ongoing therapies including Speech and Language and Physiotherapy.
Steve and Jo said: “the ESD team have given us a template to continue with the rest of our lives”.
On behalf of the ESD Team, it’s been a pleasure working with Steve and Jo and we all wish him the best in his ongoing recovery.