Overcoming stroke for victims and carers

Recovering from a stroke – my family’s story

It was on 14 September 2015, when my life changed forever. My mother at the age of 69 suffered a massive stroke. This is my family’s story of not only the initial incident, but the journey we continue on as Mum still recovers from her stroke. It’s been a really steep learning curve for me but I believe by sharing our story in the following detail, we can assist other people in similar situations.

Mum’s stroke was major. In technical terms, the Stage 4 subarachnoid hemorrhage was brought on by a ruptured anterior communicating artery (ACoA) aneurysm, caused by hypertension, a common side effect of renal failure patients. According to Harvard Health, “many patients with a subarachnoid hemorrhage do not survive long enough to reach a hospital”.

Just to give you a little insight into my family, my parents are Italian immigrants who migrated to Australia in the early 1970s. Like with many immigrants at the time, Australia was perceived as a “land of opportunity” and an ideal place to raise a family. In 1974, my brother was born. After many mishaps which included a miscarriage, a stillborn and postnatal depression, Mum gave birth to me in 1986. Both my brother and I grew up assisting and translating for both my parents whose limited understanding of English prevented them from being able to effectively communicate and comprehend general health practitioners.

Throughout our childhood and adulthood, like with most first-generation Australians, it was inevitable that we accompanied our parents to every doctor’s appointment or assisted our parents with day to day activities such as completing government forms or arranging specialist appointments.

About my Mum

My mother was diagnosed with Type 2 Diabetes at the age of 49 and for the next twenty years, never properly controlled her blood sugar levels. It was maybe a decade later where she became insulin-dependent and despite relentless medical advice from her endocrinologist, refused to administer the appropriate amount of insulin. As a consequence of this, Mum developed kidney disease which then spiralled into end-stage renal failure by the time she turned 66. In 2013, Mum was left with no option but to commit to dialysis five hours a day, three times a week in order to survive.

She was prescribed medication to manage her high blood pressure but was either inconsistent or refused to take it as it made her ‘sick’. To say that Mum was already in dire straits would be an understatement. The fact that she refused to closely follow the advice of all medical professionals only exacerbated the issue. As Mum’s renal specialist reiterated at the time Mum had the stroke, “the cards are stacked against her”.

The last five or so years have not only been emotionally and physically gruelling but also mentally challenging for my entire family. Dealing with a disabled parent wasn’t foreign to either myself or my brother. Two years before I was born, Dad became legally blind, and for most of my life, also suffered from a severe hearing impairment. So Mum’s stroke was a massive blow to us, not only because she was the matriarch of our family, but mainly because she was Dad’s primary carer. The fact that Mum is still alive is a miracle in itself and we’re incredibly grateful for all the neuro trained medical professionals at Royal Prince Alfred who contributed to saving her life.

Emergency, emergency

At the time of Mum’s stroke, I was 28 years old (two weeks shy of turning 29) and had only just moved out of the home. My phone had run out of battery and it wasn’t till 11 pm when I’d charged my phone enough to switch it back on that Dad finally succeeded in contacting me. He told me over the phone that Mum had developed sharp neck pains and was vomiting blood. Mum had asked Dad to call me at around 9:30 pm as she’d been feeling unwell.

For a woman who at the best of times never followed medical advice, I knew that if Mum wanted Dad to desperately get through to me, it was serious. I called triple 000 immediately. Luckily, I hadn’t moved too far from my family home so I was able to get there in less than a couple of minutes. By the time I arrived, Mum was still conscious but it wasn’t long until she lost consciousness. Knowing the severity of Mum’s condition at the time, I knew she was in a critical state. I called triple 000 again and was on the phone with them until the paramedics arrived a few minutes later (I suspected this was protocol in case I needed to perform CPR). Not just one ambulance arrived, but three. I distinctly recall seeing the grave and frantic looks on all six paramedics’ faces as they rushed into my parent’s bedroom noticing Mum’s critical state. I knew at that moment that there was a high probability that we were going to lose her. The paramedics swiftly placed an oxygen mask on her and attached a heart monitor wires over her chest. Everything after that was a blur.

I exited the room and stood more or less helpless and in disbelief outside my parent’s bedroom. A paramedic shortly approached me and told me I needed to get Mum’s affairs in order as it was likely she was going to die. No one knew at that point what was happening to Mum. She was taken out onto a stretcher into a separate ambulance from the one Dad and I entered and was rushed to hospital. I remember the paramedic telling me and Dad that Mum was in critical condition. It was best if we travelled in separate ambulances in case Mum needed to be resuscitated on the way to the emergency. The experience of seeing an immediate family member in such a state would have been far too traumatic. Mum luckily survived the trip to the hospital but it took hours in an emergency before doctors confirmed Mum had a stroke.

At first, when I asked doctors why Mum was throwing up blood, they confirmed that the blood was from peptic ulcers. The remaining symptoms Mum was experiencing were unrelated to the stomach ulcers which baffled the doctors and prolonged their immediate diagnosis. We waited patiently in the emergency intensive care waiting room as a doctor approached us to again relay the details of what happened. The night Mum had the stroke, she had a fall after dinner but because of Dad’s limited vision impairment, he couldn’t quite tell how hard she’d hit her head. This coupled with the “sharp neck pains” triggered the doctor to request a CT scan of Mum’s head. The brain scans confirmed a massive bleed of the brain which caused a subarachnoid hemorrhage. A cerebral angiography identified the source of the bleed. All this time Mum was in an induced coma and was placed on a ventilator to assist with her breathing. Afterwards, Dad told me that Mum had been taking panadol four to six times daily for months leading up to the stroke due to severe headaches.

Mum was rushed into emergency surgery which took a couple of hours. We were told by doctors that the survival rate for someone in Mum’s predicament was very low. We were advised to notify close family and friends of the possibility of Mum passing within six to twelve hours. The severity of the bleed in the brain made it impossible for neurosurgeons to clip the aneurysm so Mum was fixed with an external draining tube to remove the excess cerebrospinal fluid and relieve pressure in the brain.

Signs of a subarachnoid stroke can include:
• Severe and sudden headache
• Nausea and vomiting
• Neck pain or stiff neck
• Dizziness
• Confusion
• A seizure
• Loss of consciousness

More hospital procedures

Two days later, a craniotomy was performed and the aneurysm was successfully clipped. Post this procedure doctors ruled out paralysis and confirmed Mum could move her limbs. She was, however, only semi-conscious and continued to be for most of her stay in Neuro ICU. The first 21 days post-surgery were the most crucial as vasospasms were likely to occur. Doctors and nurses needed to ensure Mum was obeying commands hourly. A second surgical procedure involved the insertion of an intraparenchymal intracranial pressure (ICP) monitor (see image below) which enabled doctors to closely monitor the pressure inside Mum’s brain and treat for vasospasms. Maintaining Mum’s hydration levels was key to treating vasospasms, but this proved to be challenging, not only due to Mum’s 1.2-litre fluid restrictions as a renal patient, but also because she was surviving off intravenous fluids. As a consequence Mum was required to have dialysis for a couple of hours daily.

ICP monitor Image is taken from: https://www.egypt-business.com/ticker/details/1706-global-intracranial-pressure-icp-monitoring-devices-market-research-report-of-top-countries-2017-2022/86321

After a week in ICU, the immediate family were invited to have a meeting with the neuro trained team looking after Mum. At the time, Mum was only in and out of consciousness. When she was conscious it was only for a very short period of time. The doctors confirmed that Mum would be permanently disabled and she would have physically aged twenty years. It was too early, however, to diagnose the extent of Mum’s disability but it was highly probable she would never walk or drive again. If by some miracle she were to recover, rehabilitation could take up to two years. Mum’s recovery, therefore, looked very bleak.

This confronting news was only worsened by the fact that Mum encountered a couple of mishaps during her stay in Neuro ICU. Mum contracted VRE (vancomycin-resistant enterococcus) a bacteria infection that further complicated her recovery. Mum had also been vomiting often and due to her bed-ridden state doctors were worried about aspiration which was life-threatening. Moreover, nurses also noticed a slight swelling of the ventricles in Mum’s brain. Luckily, this was unrelated to vasospasms. It was due to Mum’s incapacity to effectively drain excess cerebrospinal fluid in her brain, a condition that is called hydrocephalus.

Mum spent a total of four and a half weeks in ICU where she was closely monitored 24 hours a day, normally by two nurses who worked 12-hour shifts. At the time Mum had the stroke, there were only a few ICU nurses who were trained to operate the hemodialysis machine. The same nurses were more or less rostered on a weekly basis to monitor her. I will never forget the determination and support of these amazing health professionals. Even though Mum was unconscious for most of that time, there wasn’t a day that went by where they didn’t encourage us to continuously talk to her so she was reminded of our presence. I honestly believe that it made all the difference and contributed to saving Mum’s life.

Stroke recovery and rehabilitation

Phase 1. Prehospital discharge

Once Mum was admitted into the neuro ward, she remained in hospital for a further five weeks. She transitioned from intravenous fluids to a gastric feed RIG (radiologically inserted gastrostomy). She was also fitted with a (refer to FIGURE 1 below), tube that assists with the drainage of excess brain fluid and prevents the pressure in the brain from getting too high.

Image of VP shunt taken from: https://www.uspharmacist.com/article/review-of-the-treatment-management-of-hydrocephalus

Every surgical procedure came with risks and miraculously Mum was able to avoid all of them. During this time Mum slowly gained consciousness, but the longer she remained in hospital, the more susceptible she was to infection and other complications.

Doctors were left with two options:
1. Admit Mum into rehabilitation at Balmain Hospital
2. Admit Mum into an aged care facility as a Level 4 high care patient

After nine and a half weeks, Mum was bedridden and had limited mobility. Her speech was slurred and she could only move her limbs slightly. An occupational therapist came to access her and deemed her ineligible for rehabilitation as Mum was unable to follow three consecutive commands. I desperately tried to convince the medical professionals otherwise. Mum’s alertness was significantly better in the morning and she required an Italian interpreter in order to overcome any language barriers. Our persistent efforts proved futile as Mum was repeatedly knocked back for rehabilitation. With the assistance and guidance of a social worker at RPA hospital, we looked at admitting Mum into a nursing home.

It’s imperative that you seek the advice and support of family as well as friends when selecting an appropriate aged care facility for your loved one. As a family, we had decided that we wanted Mum to be as close to home as possible and preferably at a facility that could be accessible by either foot or public transport for my Dad. It was also important that we made an informed decision as a family of a facility that best suited our expectations and Mum’s social, cultural and emotional needs. After visiting seven nursing homes within a two-kilometre radius of our family home, it was incredibly difficult to find a facility that best fitted Mum. Out of desperation, I confided in my neighbour, who recommended the nursing home that was located directly across the road from where I was living at the time. I called the admissions representative at the nursing home and promptly scheduled an appointment. After a brief meeting and a quick inspection of the nursing home, I knew this was the best facility for Mum. We were immediately placed on the waiting list and within 3 weeks Mum was admitted into Bethel Nursing Home in Ashfield on 19 November 2015.

The documents required for admission into a nursing home include:
• Aged Care assessment report which includes a My Aged Care income and means assessment
• Hospital discharge letter
• Nursing home residential agreement

Phase 2. Nursing home admission

I ended up developing a really close relationship with the nursing home Residential Services and Care Manager. Again, if it weren’t for their persistent efforts and support, Mum wouldn’t be where she is today. Within the first 5 months of Mum’s admission, the nursing home arranged for her to be reviewed and assessed by speech pathologists, occupational therapists, dieticians and physiotherapists. Mum wasn’t able to eat or drink orally, so needed to be fed directly into her stomach via a PEG feed.

Image of PEG feed taken from: https://www.acquiredbraininjury-education.scot.nhs.uk/impact-of-abi/nutrition-and-hydration/nutritional-support/enteral-feeding-methods/

The PEG feed did, however, come with its own complications. Within six months, I accompanied Mum three times to emergency due to blockages or infections associated with the PEG tube. By late December 2015, I contacted Metropolitan Rehabilitation Hospital in Petersham at the insistence of a paramedic I had encountered on one of Mum’s PEG tube malfunction expeditions to the hospital. The hospital requested that I send them the following:
• GP referral letter
• Physiotherapist assessment
• Speech pathologist assessment

I passed this information onto the Residential Services Manager who unfortunately didn’t have much luck with getting through to the admission coordinator at Metro Rehab (maybe due to the time of year as it was post-Christmas and most admin staff/specialists were on leave).

Making progress

Within two months of residing in the nursing home, Mum progressed significantly. By the end of November 2015 the speech pathologist recommended the following oral intake:
• PEG regime as per dietician
• Limited teaspoon amounts of pudding thick fluids (extremely thick, level 3)- only thickened water or juice
• Meds via PEG
• No thin fluids
• No food
• 90 degrees upright/alert for all oral intake and remain upright for 30 minutes afterwards to prevent aspiration.
• Regular oral care

In late December 2015 the speech pathologist reviewed Mum and there were significant improvements. The following oral intake was recommended for Mum to build her appetite:
• PEG regime as per dietician
• Meds via PEG
• Soft diet (puree red meat/chicken and cut up vegetables/fruit
• Nectar thick fluids (mildly thick, level 1)
• Single fluid sips via a cup- thick fluids were to be offered regularly throughout the day
• Small slow mouthfuls of food
• Soft cut-up vegetables (e.g. potato in pieces) and soft fruit (e.g. banana, mango & pear). Skins removed and no oranges/grapes/cherries.
• Soft cut up pasta, soft cake and flaked fish in pieces.
• No straws or thin fluids
• No bread or hard/dry foods
• 90 degrees upright/alert for all oral intake and remain upright for 30 minutes afterwards to prevent aspiration.
• Full supervision for all oral intake
• Regular oral care

Resources available to help

By February 2016, I was worried we weren’t being proactive enough with Mum. We noticed a decline in Mum’s morale. She was depressed not only due to her unappetising diet but also because her bed-bound state made her feel constricted. I’d engaged in a fair bit of reading on stroke recovery and something which constantly came up was the fact that families were encouraged to access a wheelchair so they could take family members to familiar surroundings and places. I knew that once we did this, Mum’s morale and confidence to recover would improve significantly. The longer we prolonged Mum’s recovery, the harder it would be for her to improve.

The following stroke recovery resources were helpful:
• ‘Stroke Recovery Handbook’- I ordered this text by filling in a form attached to a pamphlet I retrieved from RPA’s NEURO ICU.
• Stroke Recovery Association NSW – stroke.nsw.org.au
• The Brain That Changes Itself by Norman Doidge- although some of the case studies weren’t really applicable to Mum, this book does give you insight into neuroplasticity (the brain’s ability to reshape and create neural pathways).

What all of these resources have in common is the importance of acknowledging that there is always hope and that the role of the carer is pertinent in acting as a patient advocate. Both are integral to stroke recovery. This, together with the carers’ persistence and determination as well as working collaboratively with medical professionals will ensure optimum results for stroke victims.

The recovery of functional and motor skills is fundamental for subarachnoid hemorrhage patients and is best achieved within the first year of experiencing a stroke. Finally, in March 2016, Mum was admitted as an in-patient at Balmain Hospital. A month later, Mum received rehabilitation for four weeks from April to May 2016. After Mum’s first round of rehabilitation, carers/nurses could assist Mum with:
• Standing and balancing
• Walking using a rollator frame. Mum walked twice a day.
• Eating solid foods. Mum no longer required a PEG tube so it was surgically removed.
• Coming out and going into bed using a hoist.
• Sitting upright without losing her balance. This meant Mum could use a wheelchair but needed to be transported using a wheelchair taxi.

Financial support and assistance for stroke victims

Synapse funding

Synapse (formerly Brain Injury Society) can provide stroke victims with up to $2500 in funding, provided that they meet the specific requirements of a written application.

It is imperative that when carers complete an application they outline specific short term goals that focus specifically on community-based and quality of life achievements.

I’ve modelled some answers for the application below…..

Mum would like to improve her endurance in being able to walk further and enjoy social gatherings at home as well as go out in the community. Prior to her stroke she enjoyed doing ……. and if she could walk further she would be able to enjoy these activities.

If Mum was able to be more independent with toileting she would be able to enjoy trips into the community…

By following the above-written examples it will improve your eligibility for financial assistance from Synapse.

Becoming more independent

In July 2016, Mum had an appointment with a neuro trained medical specialist who was really impressed with Mum’s progress and the nursing home’s overwhelming support. The following goals to further develop Mum’s independence were discussed:
• Toileting and bathing. Mum needed to be assisted and taken to the toilet every four hours. She would normally go half an hour after breakfast. We wanted to further develop her independence with toileting and bathing especially as she often felt embarrassed in the presence of the carers who assisted her and insisted that only female carers could help her.
• At the time, the hoist was used to transfer Mum in and out of bed. The hoist was to be used minimally and where possible Mum was encouraged to walk using a rollator frame.
• Metro Rehab in Petersham. Mum was to be admitted as an outpatient so she could eventually progress onto a smaller four wheel walker frame. The day program required Mum to complete two hours of intensive rehab (physio & occupational therapy). In October 2016, Mum was required to attend rehab once a week for four weeks, after which specialists would review her progress. Due to Mum’s significant improvement, she was readmitted as an outpatient in February 2017 and an inpatient in February 2018.
• Private physiotherapy sessions were covered by a $2500 Synapse funding grant Mum successfully qualified for (alternatively, depending on your level of cover, health funds can cover the cost of private physiotherapists as well). I liaised with the specialists at Metro who recommended a few of the following service providers for neurological physiotherapists (I’ve included Concentric Rehab for those people conveniently located in the inner west).
• Walking. Mum was encouraged to walk on non-dialysis days: Monday, Wednesday, Friday and Sunday. We wanted Mum to transition from a rollator frame to a four-wheel walker.
• It was important Mum had access to a recliner chair to eliminate any issues of lower leg swelling caused by fluid retention, a common symptom of acute renal failure.

Our preferred service provider ended up being Advance Rehab:
• Advance Rehab Centre: www.archealth.com.au
• Rehab on the Move: www.rehabonthemove.com.au
• Lighthouse: http://lighthousehealthgroup.com/
• Concentric Rehabilitation Centre: https://www.concentricrehab.com.au/

Mobile neurological physiotherapy

In August 2016, Mum commenced rehabilitation with Advance Rehab. A mobile neurological physiotherapist came to see her once a week for an hour. The physiotherapy consisted of improving balance, strength and mobility. On initial assessment Mum was able to accomplish the following:
• Stand with standby assistance of one person to a rollator frame (RF) with a wide base of support
• Walk 25 metres with a rollator frame, with standby assistance of one person and lots of encouragement. When walking with the RF, Mum had a small step length and leant heavily on her hands on the frame. It took Mum 2.38 minutes to walk 25 metres. The limiting factor was due to back pain (Mum was diagnosed with Parkinson’s by the doctor overseeing her at Metro Rehab).
• Walking using a rail with minimal assistance of one person. When walking with the rail her gait pattern was much more fluid, she had larger steps and there was no complaint of lower back pain
• She scored 10/56 on the Berg Balance scale. Mum had no altered sensation and demonstrated good dexterity in her upper limbs.

After completing four weeks of physiotherapy Mum’s achievements included:
• Standing independently to her RF
• Walking 100 metres with her RF with standby assistance for confidence only
• Successfully trialling a four-wheeled walker which became a focus for ongoing therapy sessions
• Successfully completing car transfers with prompting only. A handy bar (a bar that is inserted into the U-shaped striker plate on a vehicle’s door frame to help support getting out of the car) was purchased for Mum to assist with transfers. Refer to the following website for purchasing disability aids http://patienthandling.com.au/

These sessions were without a doubt invaluable to Mum’s improvement as they provided her with the necessary confidence required to improve her mobility, balance and strength. The following article written by Mum’s private physiotherapist in October 2015 is a testament to her willpower to succeed by defying all odds and overcoming any challenges:
https://archealth.com.au/patient_stories/for-angela-the-sky-is-the-limit/

Mum continued with Advance Rehab once a week for an hour for approximately four months before transitioning to an hour of therapy once a fortnight. She also continued with on and off therapy at Metro Rehabilitation from October 2016 for two consecutive years. Over this time Mum’s confidence improved, she successfully transitioned from a rollator frame to a four-wheel walker. However, her hesitance to transition from a four-wheel walker to a quad stick was due to a fall she had during one of rehabilitation sessions at Metro Rehab.

By the end of February 2018, Mum was able to walk independently for approximately 300 metres with a four-wheel walker without stopping, walk on a treadmill, cycle slowly on an indoor bike, brush her teeth and wash her hands unassisted, stand and sit with the assistance of a four-wheel walker and climb approximately fifteen steps before resting. To maintain Mum’s improvement she was instructed by the Metro physiotherapist to complete bed exercises and practise walking as well as standing up/sitting down daily.

My story

Mum’s stroke undoubtedly took its toll on everyone in my family, especially me. It affected my relationship with family, colleagues, students as well as my friends. Being a high school teacher, it didn’t take very long until I exhausted all my sick leave and had to resort to unpaid leave on the days that Mum was either required to attend post-operation checkups or physiotherapy sessions at Metro Rehab. This financial and emotional strain as well as my initial reluctance to reveal the extent to which my mental health had been impacted to my immediate family, colleagues and closest friends prevented me from getting the necessary help and support I required.

I became resentful and bitter and believed that my Head Teacher and colleagues were unsupportive. Throughout Mum’s recovery, I unexpectedly had to take days off work and became increasingly paranoid that I was being judged by colleagues who at times needed to “pick up my slack”. I was consistently arriving to class late as I frantically tried to get on top of my class prep during work hours. I struggled to meet our faculty’s two-week marking deadline. I was unable to assist my students in the after school homework centre and I couldn’t commit to supervising students at after school Showcase events due to regularly visiting mum or taking dad grocery shopping most afternoons. This then affected my ability to apply for any internal promotions offered at my school as I wasn’t engaged enough in “whole school initiatives”.

I limited my social interaction to my housemates, one of whom I’d luckily known since Year 1 and was all too familiar with how to navigate my unpredictable moods. I found talking about Mum’s stroke increasingly distressing and tried to keep it separate from the rest of my life. The only way I avoided thinking all day every day about the impact of Mum’s stroke was the fact that not many people knew the details of it. So, no one thought to ask me about it. Instead, I chose to seek refuge in strangers (including my future sister in law and my partner’s friends) who barely knew my situation or my Mum. It took maybe three months before I took on a friend’s advice to see a psychologist.

Steps to applying for a Mental Health Care Plan:
1. Book an appointment with your GP and inquire into a Mental Health Care Plan. If you have a mental health care plan, the Australian Government will pay some or all of the cost of up to ten sessions with a mental health expert in a year. You can get that through the Medicare rebate.
2. Be as open as possible with your GP and tell them what’s been going on in your life.
3. Your GP will ask you to complete a questionnaire about how you’re feeling to determine how best to support you.
4. The GP will then refer you to either a psychologist or psychiatrist who specialises in mental health.

The ten sessions I had with the psychologist helped immensely and I saw a significant improvement in my mental health. I gradually reconnected with my closest friends and realised how dependent I was on them in order to maintain a healthy headspace. Other strategies I employed to improve and maintain my mental health included:
• Regularly exercising at my local gym
• Swimming laps at my local aquatic centre
• Attending book clubs at my local independent bookstore
• Creative writing courses through the Centre for Continuing Education-University of Sydney
• My engagement with students or colleagues. Being in the presence of my students in the classroom helped me to stay grounded and sane.
• Developing stronger relationships with friends, family and my partner. My future husband was the brother of a colleague from work. We met two weeks before mum had her stroke but didn’t actually start dating until February 2016, exactly five months after mum had her stroke. His relentless support, love and care contributed significantly to helping me maintain a healthy headspace and made me realise the importance of focusing more on my own individual needs.

2021: Where Mum is now

It goes without saying that Mum’s a miracle story. With the persistence of both Mum, Dad, my brother and myself, we were able to get Mum to where she currently is today. Since the day Mum had the stroke, Dad’s unwavering support is reflected in his daily visits both to the nursing home and the hemodialysis unit at RPA Hospital. Dad makes a conscientious effort to bring Mum home-cooked meals daily, keeping her company for hours at a time.

There was never a moment growing up where Mum never failed to reiterate how much she wanted to see her only daughter in a white wedding dress. Due to my grandmother’s strong disapproval of my Dad marrying her second eldest daughter, Mum was left with no option but to elope in 1971. At the time, elopement was taboo and very different to how it’s generally perceived today. Basically, my Mum’s strict and traditional Catholic upbringing prevented her from wearing a white wedding dress as she consummated her marriage with Dad before it was officially recognised by the Catholic Church.

So in January 2020, Mum’s wish finally came true and she was able to see me in a white wedding dress. My wedding also enabled Mum to reconnect with her eldest sister and niece from Italy, both of whom Mum hadn’t seen in 20 years. Currently, Mum is the expectant Nonna of her first grandchild, who is due to be born in December of this year.

The 2020 COVID lockdown came with its own challenges. Mum was soon diagnosed with dementia by a geriatric doctor who visits her annually. I also noticed, post-COVID restrictions easing, that Mum’s endurance, strength, balance and general mobility had deteriorated slightly. Since March of this year, Mum has recommenced seeing a mobile physio through Concentric Rehabilitation Centre for 30 minutes on a weekly basis. From March till June, we’ve been able to improve Mum’s endurance, strength and balance with the following physio exercises:
• Walking
• Seated knee extensions
• Seated marching on the spot
• Sit to stands
• Standing calf raises

Unfortunately, due to the current 2021 lockdown of Great Sydney we’ve had to postpone Mum’s weekly sessions until further notice.