Road to recovery – with the Stroke Club

Passing through a hospital department or rehabilitation center, it is distressing to see the effects of strokes. The long, difficult road to recovery is a challenge for a patient at any age and for the family. But at the Stroke Club in the Ramot Sapir Community Center in Haifa, the positive atmosphere, dynamic energy, buzzing conversation and plentiful laughter show that these stroke survivors are indeed meeting challenges they face. Every Sunday, with the help of family members and special transportation, this group meets for varied activities. On arrival, the social worker, Sara Boxenbaum, facilitates a discussion where members can ask questions and get answers about treatments and medications, relate interesting experiences of the week and discuss current affairs. During my visit, Ilan, aged 69, who suffered a stroke 20 years ago, told the group about his trip to the Negev the previous weekend. Although he needed the aid of his caregiver and wheelchair, he showed stamina that one does not always see even in a healthy person at that age. A group of communication and hearing disorders students from the University of Haifa organized the focal activity of the morning, a quiz, displaying questions on a screen with an opportunity for everybody to call out the answers. The physical disability of the members was no indication of reduced cognitive ability, for the answers came in thick and fast. Sitting with the students later to give feedback on the activity were Boxenbaum and retired speech therapist Brenda Kaplan, who has volunteered in the stroke club since its inception 21 years ago. Kaplan introduced Moshe, a member who has worked together with her on his speech issues for many years. In spite of his physical disability, which badly affected his sight, speech and communication, he responded to the comments and questions addressed to him. Kaplan reported that throughout his recovery, Moshe maintained the role of head of his household, with four children and five grandchildren, making decisions for his family and the family business. Before his stroke, he ran King of the Jeans, a well-known clothing store that is still functioning in Haifa. “Never underestimate the motivation of a stroke survivor and the support of their family,” she says. Kaplan commented that regular rehabilitation units and clinics cannot give this in-depth one-on-one care over such a long period of time, and in Moshe's case he benefited from the continuity and support. Immobility and use of wheelchairs and walking aids for long periods can cause atrophy and stiffness of muscles. An integral activity of the club meetings is an hour of exercises supervised by Esti Arotchas, who has volunteered at the club since she retired from her job as head of physiotherapy at Rambam Medical Center where she worked for 40 years. The first Stroke Club to be formed in Israel was in Haifa, and it is part of the Neeman non-profit organization that now stands behind 16 such clubs throughout the country. Sandra Levy, one of the founders of the club, is a social worker whose husband had a series of small strokes from the age of 52. She had four young children living at home, and in a discussion with another social worker at Flieman Rehabilitation Hospital in Haifa, she realized that there was in fact a younger age group of stroke survivors – and that they and their families needed ongoing support. While the National Insurance Institute offers pensioners subsidized day centers, there was no such facility for younger survivors. More than 120 people attended the inaugural meeting of what became Neeman, a nationwide non-profit organization, and the stroke club was established, intended initially for younger members. Levy made aliya from Australia in 1960 as a social worker and worked at Hadassah in Jerusalem. When she moved to Haifa, she taught at the University of Haifa School of Social Work and helped to set up social worker services in hospitals. “After early retirement I could give the organization more time,” she says, and was active in lobbying for improved conditions for survivors. “Apart from these clubs, an important role of Neeman is to raise awareness so that stroke sufferers get to hospitals sooner and can receive appropriate treatment, which reduces the aftereffects. There is also a help line and website, as many families need guidelines and information to get their rights for aftercare.” Today Levy is vice president of the Stroke Alliance for Europe and on the board of the World Network. “People are living longer and there are more stroke survivors. Their recovery depends a lot on personality and social support.” Levy noted that strokes in younger people are sometimes more severe, and that there are rare but tragic cases of strokes during childbirth and in even younger women who react adversely to the contraceptive pill. There is also the devastating effect on the survivor who may have to give up his or her job and household responsibilities while there are still small children at home and family needs to be provided for. The Stroke Club started 21 years ago for younger survivors, but they have aged and there has not been much success in recruiting the younger age group. “They are put off when they attend meetings where most members are over 70.” says Levy. Boxenbaum, who coordinates the Haifa club and the student project, commented that they could start a second group if younger members were interested, and they are making efforts through the hospitals and rehabilitation centers to publicize this. Asked why the membership was predominantly male and that there were very few women, she replied that although statistically men and women were equally susceptible to strokes, women survivors tended to keep busier with their homes and grandchildren. The club is financed with help from the municipality and participation of the members who pay a small fee to cover refreshments and other expenses. Apart from the weekly meetings, many other activities have mushroomed out of the group, initiated by the families of the members, such as bowling, social events and nature trips. Ilan, mentioned earlier, joined the group after his stroke 22 years previously. He was cared for by his wife. Her death four years ago was a severe blow for him, but he takes great pleasure in the company of his four children and eight grandchildren. At the time of his stroke he was working as an electronic engineer at Rafael Advanced Defense Systems, and he managed to return to work for another 16 years. “There was enormous support from my workplace,” he says. “When I finally retired, I needed to keep to a routine. There is life after an event like this,” he says. For some time he was treasurer of the non-profit organization. He is an enthusiastic swimmer and even after a bad fall and six months in a wheelchair, he attributes his recovery to his daily swim. He can now walk safely with the aid of a stick, but uses a wheelchair when tackling more difficult trips. He spoke of his recent trip to the Lachish region. “For many years I belonged to a group of friends who went hiking every month. Not only I, but many of this circle were aging and becoming more fragile and we tailor our trips to our capabilities.” He has experienced periods of depression; it took time to accept his health issues. Still, he appreciates all the positive things in life. “To be or not to be,” he smiles. For details of clubs and services through Neeman: 077-466-5213 or www.Neeman.org.il

Road to recovery – with the Stroke Club

The Stroke Club started 21 years ago for younger survivors, but they have aged and there has not been much success in recruiting the younger age group.

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