I love you, Daddy

Admittedly, I made an audible gasp when I signed into my blog to write this post and noticed that I haven't been here since Halloween!  So much has happened since then that caused me to direct my attention elsewhere. Just prior to the national speech and language conference in Boston last November, the man who means the world to me, the one who sacrifices everything for his family, was formally diagnosed with Parkinson's Disease.  

For the last few years, my daddy has been losing weight and slowing down.  We all assumed it was old age settling in, but over the last few months, the hand tremors became a little more noticeable and then came the shuffling walk and breathy voice quality.  Living in Illinois has made it difficult for me to help care for Pops as he still lives in the home that I grew up in with my mom in Rhode Island.  I felt lost, sad, and guilty for not being closer to home.

Then, along came the annual ASHA conference and it was exactly what I needed and in a location where I could spend some time with family.  Another added bonus was that I could network with professionals closer to my daddy to educate myself on his care and hopefully find the "best of the best" for him.

For those of you not familiar with my blog and work as a speech pathologist, I have been practicing since 1995, primarily with pediatrics.  Shortly after my practicum at the Rhode Island Veterans Hospital, I worked per diem when the greatest mentor in the world was on vacation.  Needless to say, it had been a while since I serviced adults.  What better way to learn about the most current treatment programs for Parkinson's than at the national ASHA conference?  So, in between sessions on tele-therapy, stuttering, and augmentative communication, I took courses in cognitive and voice therapy for people with Parkinson's.  I also spent some time researching Big and Loud therapy in poster sessions and at booths, and made a fabulous connection with Steven Darroh, who is in the process of releasing his "Loud and Clear" app.  More on that affordable resource for patients with Parkinson's when Steven visits this blog in a few months for a guest post!

The most informative course was the very last one that  I attended at ASHA on cognitive therapy.  While this course was geared towards cognitive group therapy in a nursing home setting, I started thinking about ways to modify the plans for my daddy.  To summarize the ASHA session, the presenters discussed functional lesson plans that incorporated conversations about recent and past historical events.  The purpose was to help with memory and retrieval skills and facilitate making connections with personal accounts. 

 It dawned on me that my daddy and I could use our Amazon Alexa to inquire about historical events by asking: "Alexa, what happened on this day in history?"  You can even further probe with a follow-up question: "Alexa, what else happened on this day in history?"  The plan has been for each of us to ask our respective Alexa's this information and then I call Pops first thing in the morning to review the material.  Later in the day, when my treatment sessions are completed in Illinois, I call Pops in Rhode Island and ask him to recall 1-2 historical events we discussed that morning.  When possible, I try to include personal perspectives to assist in recall.  For example, I may point out that the year was notable for a family member's birth or I may ask what his favorite movie/singer/entertainer is depending on the historical notation that day.  

Besides assisting with memory retrieval, this daily interaction supports voicing goals such as: projecting your voice to ask Alexa the command clearly and concisely and increasing vocal volume on the phone to improve listener understanding.  What the therapist in me didn't realize when I initiated this treatment plan was the greatest benefit of all: taking the time to talk with someone you love a couple times a day can improve affect and mood.  My daddy, being the kind soul that he is, has thanked me numerous times for calling and spending a few minutes talking with him.  Since we started this interaction months ago, his tone has a little more rhythm in it and I hear glimpses of the man that I have always known and loved.  That fun-loving, jitter-bugging, life of the party guy who had slipped away makes a brief appearance on those daily phone calls.  

Some days are better than others and the therapist in me (because I can never fully turn that off) assesses the conversation.  When his day is busier and he hasn't had time for regular meals, then his voice quality is breathier at the end of the day and he struggles with recalling information.  On those days, language cues aren't effective, so I just review the information again.  I also noticed that he retrieves more detail when he listens to his Alexa's recount versus when we just discuss what I heard on mine.  Regardless, we just pick up a new fact the next day and move forward.  We talk about how it's OK to listen to the historical recount a few times throughout the day or take notes as I have had to do on occasion.  The last thing that I want to do is make him feel sad for not remembering, so I remind him periodically that at the end of the day, it isn't about what we can recall, but it is about something he taught me growing up.  Be kind to people you love whenever you have a chance and avoid living with regret that you didn't take the time to show you care.