1. Living With Stroke Reducing Risk of Stroke and Moving Forward
Trainer: Prior to conducting this training workshop, it is essential that you become familiar with both the facilitator manual and participant manual for the Living with Stroke (LWS) program. It is also vital to have a good understanding of the Facilitator Training Workshop materials and the way that the content and the exercises are designed to explain and build facilitation skills. Two trainers, or a trainer plus an assistant, are required to conduct this workshop effectively.
To avoid confusion between this workshop and the LWS program, the individuals participating in the workshop are referred to as facilitators and the individuals participating in the LWS program are referred to as participants. Similarly, the training is referred to as a workshop, whereas LWS is referred to as a program.
As you conduct this workshop, it is crucial that you engage the facilitators by modelling the facilitation approach you are teaching the facilitators. Therefore, wherever possible, break up the content review with questions asking for personal experiences and with examples from your own facilitation experience. Sample questions are provided for many areas, but you may wish to develop your own examples or questions as you prepare for the workshop. The more interactive the session and the more relevant the information to the facilitators, the easier it will be for them to understand the principles and the process involved in facilitation and to develop confidence in leading LWS.
Facilitator Training Workshop, 2007

2. Topics Module 1: Understanding stroke
Module 2: Physical changes and challenges
Module 3: Swallowing and nutrition
Module 4: Cognition, perception and communication
Module 5: Emotions, roles and relationships
Module 6: Reducing the risk of stroke and
moving forward

3. Follow-up
How are you doing on the goals you committed to?

4. Follow-up
What has worked and what has been difficult?

5. Follow-up
What barriers (things get in the way) of achieving your goals?

6. COPING

7. Coping

8. Coping

9. Coping

10. Coping

11. Coping
If you are more focused now on coping than on having fun, it is important to your physical and mental health to take pleasure in life.

12. ADAPTING AND MAKING CHANGES
Living With Stroke
ADAPTING AND MAKING CHANGES
Trainer: This is a good interactive and thought-provoking icebreaker. Ask each person to answer a question such as the following:
What do these quotations mean to you?
How do you think they apply to your role as a facilitator?
Share your answer first to demonstrate. (Here’s an example: After hearing for a long time about the importance of healthy eating, I was able to change my eating habits because I changed the way I thought of food. Previously, I thought of food primarily as a pleasure. Now, I think of food primarily as fuel for my body. This change in thinking changed my attitude to food and eating and the way I shop for food and cook.)
You may wish to have different people answer different questions to introduce some variety and stimulate discussion.
Facilitator Training Workshop, 2007

13. Adapting and making changes
Adjusting to the new reality of life after stroke
How stroke can change the way you do some things

14. The most difficult time for stroke survivors and caregivers is AFTER DISCHARGE due to :
EXPECTATIONS upon returning home
The REALITY that things have changed
FEELINGS OF LOSS (loss of ability, loss of independence)

15. Adapting daily routines
Frustration often occurs because you cannot do things the way you did before the stroke.
That does not mean you cannot do those things…

16. Adapting daily routines
It just means that you need to do them DIFFERENTLY
Using tools and aids and finding new ways of adapting your routine will help you stay in control of your everyday life.

17. Adapting daily routines
“I can’t do what I used to” really means “I can’t do what I used to do the WAY I used to do it”.
Must try to recognize your underlying BELIEFS and address them so that you can try new ways of doing things.

18. VIDEO: Adapting and making changes

19. What are some of the techniques we saw in the video that people used to help them do things differently?

20. Adapting favourite activities and finding new ones
The most important thing is your ATTITUDE
Try to ADAPT the way you do your favourite activities or if not find new ones
PARTICIPATING in life, engaging in PLEASURABLE ACTIVITIES, and enjoying COMPANIONSHIP of friends is important for everyone

21. REDUCING RISK OF STROKE

22. Reducing the Risk of Stroke
Some unhealthy coping strategies, such as smoking, drinking alcohol or overindulging in food increase stroke risk.
These maladaptive coping behaviors are barriers to adopting healthier lifestyle habits.
Healthier coping strategies reduce stress and reduce stroke risk.

23. Reducing Risk of Stroke
Education and advice are often insufficient to change behavior.
Lifestyle change is a complex and difficult process.

24. Stroke Risk Factors
High blood pressure
Heart disease
High cholesterol

25. Stroke Risk Factors Diabetes Smoking Excessive alcohol consumption
(9 glasses per week for women
14 glasses per week for men)

26. Stroke Risk Factors Decreased physical activity Being overweight
Stress

27. Reducing Risk of Stroke
MEDICATION PHYSICAL ACTIVITY DIET
REDUCE STRESS OVERCOME BARRIERS

28. Reducing Risk of Stroke

29. Medications
Taking prescribed medication is an important way to maintain control over your health
Use strategies to help you manage your medications (e.g., blister packs, pill boxes, a timer)

30. Diet You control your food choices.
You can still enjoy your favourite treats but maybe in smaller amounts and less often.
Foods that contain TRANS FATS or a lot of SALT should be avoided.

31. The keys to healthy eating
Make healthier choices more often
Eat three meals a day plus healthy snacks
Drink enough water
Enjoy a varied diet
Have treats only occasionally

32. The keys to healthy eating

33. Physical Activity Physical activity is important to:
reduce your risk of stroke
improve your cardiovascular fitness
reduce blood pressure, cholesterol,
blood sugar and weight

34. Physical Activity Go to the gym or a community centre
Do household chores
Walk
Garden
Go shopping

35. Developing healthy coping strategies
You may have been advised to:
stop smoking
cut back on alcohol
lose weight
These are hard habits to change as many people use them to help them relax or manage stress

36. Ways of Relaxing and Reducing Stress
Physical activity: walking, yoga, housework
Meditation, prayer
Deep breathing
An absorbing task: crossword puzzle, sudoku
Sharing your worry with a friend
Working to resolve a problem
or argument

37. Managing your Risk Factors
You will need to continue working on reducing your risk of another stroke.

38. VIDEO: Reducing the risk of stroke

39. Warning signs of a stroke
Weakness
Loss of Speech
Vision problems
Headache
Dizziness, sudden loss
of balance

40. Managing your Risk Factors
What do you need to do to reduce your risk of
another stroke in the future?

41. Managing Risk Factors
MEDICATION PHYSICAL ACTIVITY
DIET REDUCE STRESS

42. Change
All these positive efforts you make are important in your recovery and in the prevention of another stroke.

43. Change You make a choice to change Change can be difficult
Change takes time
Change is a process, not something you finish in one day
Lifestyle change is a long-term
commitment

44. MOVING FORWARD Living With Stroke
Trainer: Review the objectives of the facilitator training workshop. Ask if there are any questions or clarification required for any points. Ensure that the group understands all the points.
Facilitator Training Workshop, 2007

45. VIDEO: Life After Stroke

46. What have you learned about dealing with stroke?

47. The need to …
Take an ACTIVE role in your recovery and better understand stroke
Take MEDICATIONS as prescribed
EAT HEALTHY
Stay PHYSICALLY ACTIVE
Handout page 41

48. The need to … Teach others about aphasia and helpful COMMUNICATION
STRATEGIES
Maintain connections with
FAMILY and FRIENDS
Reduce STRESS
Handout page 41-42

49. The need to … OVERCOME BARRIERS to making changes
Set GOALS and work toward them
Handout page 42

50. Has your attitude to stroke and your recovery changed? How?

51. Attitude toward stroke and future
BETTER
NO CHANGE
WORSE

52. What did you get out of this program?

53. What did you get out of this program?
Support Education
Setting goals Managing and coping

54. Strategies for the future
Use the information you have learned
Review your workbook or handouts
Make a priority to take care of yourself
Take an honest look at yourself, your attitude and any other things that get in the way of making changes - this is your first step to overcoming barriers

55. Strategies for the future
Work on barriers one at a time
You may return to unhealthy habits, and you will have to address this as you go along
You may be more successful some weeks than others but keep your objectives in mind and keep moving forward

56. Strategies for the future
Participating in your recovery takes work and your attitudes and habits can either help or get in the way
Stay engaged in your life to have the life that you want. This isn’t always easy but the rewards are worth it.

57. Support groups
This has been a support group for you over the course of the program
Many people who are trying to make changes and adjust to complex situations find support groups helpful.
If you feel that meeting regularly with a group is helpful, you many want to join an existing group or set up your own group

58. Support groups
Stroke Recovery Canada help stroke survivors join or set up support groups
You may want to subscribe to Heart and Stroke’s Healthline. Healthline is a monthly e-newsletter

59. Handout page 43

60. Handout page 43

61. Handout page 43

62. CONGRATULATIONS
You have made significant strides in learning how to DEAL WITH the chronic effects of STROKE and in identifying ways you can IMPROVE YOUR HEALTH and reduce the risk of another stroke.
You now have the knowledge and skills to continue MAKING CHANGES in your life, SETTING GOALS and achieving them, and focusing on the things that add meaning and ENJOYMENT to your life.

63. What goal(s) would you like to focus on now?

64. Self Care Goal Be more physically active
Join a community centre or gym
Eat a healthier diet
Take your medications as prescribed
Reduce unhealthy habits
Reduce stress
Socialize more
Handout page 44

68. Acknowledgements
Aphasia Institute
Providence Healthcare