Week 1

The CBR experience has asked for a view of my role and my clients using a different pair of eyes, a different lens.An introduction to the caseload at Ngwelezane hospital made me expect the usual; systematic screening,assessment and treatment of communication disorders utilizing pre-existing knowledge and frameworks.

I was soon proven wrong.

Day 1 involved me getting my first neuro patient, a daunting experience indeed.This however was particularly daunting due to the diagnosis of global aphasia, the ‘worst’ of the aphasia’s in terms of severity. What I was met with, a supportive family invested in the termination of more hospital visits and an elderly male who required assistance wit communicaton, in this case, receptive language at word level.Mr M proved to be hard working and motivated patient, eventhough motivation was for the session to end.

He managed to surpass goals set by my co-clinician and I.This experience proved to us how a close family network and motivation affect progress but also how we can somehow limit our clients capabilities,placing the bar low in some instances standing in the way of their progress. Day 1 proved to be the day where i realised how much my expectations can affect my clients progress and how I have to be ever flexible to truly transition to where the client is not where I think he is at.As in real life you don’t get cookie cutter patients with the strengths and at the level you expect them to be.

Day 3, our day in the community was a sweltering but certainly rewarding one. This setting required even more from us as we had to see a patient without anything to go on.Or so we believed. The home visits not only required us to be confident in our ability to connect and communicate not as ‘professionals’ but people first.This was the first time that we truly got a picture of what our role is in the community setting and what advocacy, prevention and promotion really look like, We were required to liase with the CCG’s and truly work in MDT setting where we might have had different roles and assessments but worked together in the rehabilitation process. It was when we realised this that we were able to service our clients effectively and efficiently. A range of difficulties was seen but the most important role we appeared to play was one of an educational counseller and supporting families as the CVA’s affected not only their family members lives but theirs as well.In general the community setting has constantly challenged my thinking as a clinician, the experience different, exposing me to a wide world i might not have seen with my old eyes.