depression after stroke; rehab

My dad had a stroke 12 days ago.  He cannot speak and has right side paralysis.  He does communicate with us and cognitive skills appear to be good.  However, he "tunes out" when therapy people come by and shook his head "no"yesterday when I asked if he wanted to go to rehab, kind of rolled his eyes like it was useless.  He is 68 and was very active before his bypass surgery and stroke (3 days later) and this attitude was very surprising.  He has always been a VERY upbeat person, very on the go.  I think he is depressed, esp. since he is being fed with nasogastric tube and therapy people have not helped him with going to the bathroom by himself.  They did a swallow test yesterday and he could swallow, but even after therapy told nurse to take out tube they left it in (nurse had told me she didn't think he could swallow).  I think my dad picks up on this attitude.  He had an episode of turning red once when I fed him some pudding, I tried to do it very slow, and he was o.k. after that and swallowed well, but nurse made me stop and reinstituted tube feeding.

Rehab people connected with hospital came by and put on their notes that he was not ready for acute rehab and would not follow directions (although he did part of the time --- unclear whether he could and didn't or just couldn't follow their directions).  The medical personnel just seem to have little empathy for his situation.  Their notes have caused another rehab facility to turn him down.
They want us to take him to skilled nursing and we are afraid he will really give up then.

They are trying to push my dad out of the hospital but acute rehab will not take him.  How can we help him overcome depression and get him on the road to rehab?  We asked yesterday for depression treatment and they said they putting in an order for that.  He does seem to like it when we read the paper/current events to him.

Any advice will be sincerely appreciated.

[Liltazz]

My family and I experienced the same thing that you are experiencing.  We tried to get dad into an acute care facility but were told he did not meet minimum requirements.  Acute care for rehab centers normally require a minimum of three hours rehab 5-6 days a week.  When my dad was tested, he did not consistently respond to commands.  I am positive that he could hear, and he responded some days much better than other days.

Keep telling your father that you are working on getting him to a higher level of care.  Explain to him on a daily basis that you have to keep working on small steps of progress starting with consistent actions.  Try to get your dad in a routine of following small commands.  If his arm is able to move, each time you enter the room work on him raising his arms.

I feel that they have to believe they are going to get better by hearing over and over again that you are doing everything you can to improve the situation.  

Vital Stim Therapy is our next step to help my father.  I have researched and from what I have seen, it has an extremely high success rate for improvement.  

Dad is now in a skilled nursing home and is receiving Great Rehab.  He is given rehab according to what he can handle.  

tlctazz  760-590-3338

[Liltazz]

One more thing.  Do you know if he is uncomfortable from the feeding tube?  My father had a NG tube (tube inseted into the nose down into the stomach) a few years ago and it was very uncomfortable.  We had a PEG tube put in for my father to receive nutrition.

The doctors also tried to RUSH my father out of the hospital.  We appealed the early discharges and Medicare did not allow my father's release to a skilled nursing facility until the Medicare doctors felt he was medically stable and ready  to be released.  He was in the hospital fo about a month.

Don't forget to keep reiterating rehab, hope, recovery and improvement over and over and over again.

[millertime78]

Your experience is very similar to mine. Dad is 69 and had a stroke 10 days ago. He's improved a fair bit, is eating but can't speak and doesn't rightly recognise his family yet. He seems very frustrated and depressed. Its like he knows where he is but can't express his frustration. We took him out in the wheelchair around the hospital corridors etc this evening to give him a change of surroundings. He seemed to perk up.

Just keep encouraging, keep talking to him and please God he will improve.