Interesting Courses in Finland

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Interesting Courses in Finland

• Terttu Elo, Minna Vanhala, Victoria Zilliacus
• The Finnish Stroke and Dysphasia Association
• LAPH seminar in Dublin, 19th 21th April 2007

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The Finnish Stroke Rehabilitation Model
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Adaptation Training Courses

• The aim is to
• support the stroke patient and his/her family to
  cope with their everyday life
• support the autonomy of the client and help to
  achieve the satisfactory life quality
• The target group
• - stroke patients and their families ½ - 3 year
• poststroke

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• Ten-day Adaptation Training Courses
• 14 courses per year
• Six-day Adaptation Training Courses for clients
  over 65 years old
• - 13 courses per year
• Six- day Adaptation Training Courses for clients
  under 55 years old
• - 2 courses per year
• Communication Courses
• - 4 courses per year

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• Courses are organized in Rehabilitation Centres
  around Finland
• Clients are staying in the Rehabilitation Centre
  through the course
• Scheduled training program during daytime
• In the spare time (evenings, Sunday) possibility
  to socialize and share experiences more informally

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Adaptation Training Courses

• medical ja social rehabilitation
• training in the groups no individual training
• multi-disciplinary working team (ie.
  psychologist, physical therapist, occupational
  therapist, speech and language therapist, nurses,
  neurologist)

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Adaptation Training Courses

• information
• conversational groups
• peer support
• practical exercises

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Communication Courses

• Target group
• people with moderate to severe aphasia who need
  AAC methods
• the significant others of the aphasic clients
• The number of the clients
• eight clients and their significant others (one
  person)
• The duration of the course
• people with aphasia 8 4 days (3 month break)
• significant others 3 4 days

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Communication Courses

• The working team
• two speech and language therapist
• physical therapist
• psychologist
• three nurses

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The Aim of the Communication Course

• to activate the clients use of the AAC methods
  beside speech communication
• find the individual means and strategies in
  communication
• to offer the possibility to interact and take
  part in the conversation
• make it possible to discuss the changed life
  situation and communication difficulties
• to guide the significant others to support the
  communication
• to increase the autonomy of the client
• to increase the activity of the client in the
  every-day life functions

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The Content of the Courseaphasic clients

• lectures (stroke, aphasia, AAC, interpretation
  service for speech impaired)
• conversation in 4 persons groups (using AAC in
  natural conversation)
• computer-aided training
• practical training (ie going shopping, going to
  restaurant)
• physiotherapy, pool therapy
• evening program (voluntary)

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The Content of the Coursesignificant others

• conversation groups with speech and language
  therapist and psychologist
• discussion ie. about aphasia and its influence on
  family
• lectures (stroke, aphasia, AAC, Interpretation
  service for speech impaired)
• communication practice with aphasic clients
• recording (video) and analysis

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The Time Table

• 9.00 beginning of day
• 1000 conversation groups/physiotherapy/lectures/
  computer-aided training
• 11.30-14.00 lunch and break
• 14.00 conversation groups/physiotherpy/lectures/c
  omputer-aided training
• 1630 dinner
• free time

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The Outcome of the Course

• Doctoral Dissertation about the Communication
  Courses
• Pirkko Rautakoski (2005). The change in
  communication abilities of people with severe
  aphasia and their significant others during a
  rehabilitation course a follow-up
  study.University of Helsinki

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The Outcome of the Course

• The results showed that the functional
  communication abilities of people with severe and
  moderate aphasia improved, and that they began to
  use spontaneous augmentative communication
  methods more than they did before the course.
• The significant others began to support their
  communication more, albeit slightly less strongly
  over time. According to these results it is very
  important that significant others participate in
  the rehabilitation of aphasic partners.

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Feedback From the Clients

• feeling better
• good to realize that there are other people with
  the same kind of difficulties
• new ideas to enhance communication at home
• more courage to communicate with others
• not so much use for me

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Communication Cottage (course)

• 3-day course, pilot project
• For the hosts and hostesses at the Communication
  Cottage in Helsinki, Rovaniemi and Vaasa, for
  people working with strokeclients, for stroke-
  and aphasic people and their significant others

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Communication cottage course

• Give the participants basic information of the
  complex symptomes after stroke and increase their
  understanding of stroke patients daily life
• Increase knowledge about aphasic peoples
  communication difficulties and learn how to
  support communication in aphasic people

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Communication cottage courses

• Day 1 The stroke-patient is still a complete
  human being
• - neurologist
• - psychologist
• - physiotherapist
• - occupational therapist
• - social worker

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Communication cottage courses

• Day 2 Communication- and swallowing disorders
  after stroke
• - what is aphasia
• - how to support communication
• - practical communication exercises in groups
• - self portrait of person with aphasia

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Communication cottage courses

• Day 3 AAC and computer programs
• - share information about communications aids,
  High-tec and Low-tec
• - introduction to training programs, e-mail and
  internet

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Other Educational Courses

• National Stroke and Aphasia Seminar
• two- day multidisciplinary seminar for
  professionals, students, patients and the
  significant others
• Local stroke mini-seminars for health and
  social care professionals

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Other Educational Courses

• Prevention the stroke
• Information and education for volunterers and
  aphasiasupport-persons
• Education for stroke-contactpersons on hospitals
  and TK, usually 2-day seminars
• Golf courses for people with special needs

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Courses upon request

• Communication disorders after stroke
• How to support the aphasic persons communication
  
• Dysphagia and stroke
• Cognitive problems after stroke
• Physical activity after stroke
• Sexuality after stroke

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Social vacations

• Social vacations for different patientgroups in
  co-operation with other associations and
  Finlands Slot Machine Association (RAY)
• Social nature-vacations for groups with special
  needs
• - 7-days camps, hikes, fishingcamps, skiing,
  sailing
• - increase the possibility for people with
  special needs to explore the nature in different
  ways

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Social Nature Vacations

• The vacations are usually arranged in the deep
  forests of eastern Finland
• The participants sleep i tents or small hutts, or
  in windshelters
• Possibility to participate in wheelchair, with
  walking sticks or other assistance

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Social Nature Vacations

• Fishing, hiking, paddeling, swimming,
  berry-picking, bird-watching
• Rehabilitation/ education in nature is considered
  a very effective way to enhance social
  participation, increase wellbeing and return to
  everyday life after stroke

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Thank You!
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