02 What are these boundaries?

All mammals, including Homo sapiens, live their lives within boundaries. These define our lives and, within these boundaries, give us freedom. Two obvious boundaries are that we cannot fly (easy for birds) and we do not have the echolocation ability of bats (enabling them to ‘see’ in the pitch dark). We have good eyesight (but, in different ways, not as good as hawks or owls); we are mobile on two legs (but cannot move as quickly as a cheetah); we have an extraordinary use of language (which can be limited by, for example, dyslexia); like many other young mammals we learn to be continent (mice do not learn this ability); and so on. There are hundreds of boundaries defining, and limiting, how we live our lives.

The most obvious effect of a serious stroke is that a random selection of our boundaries is suddenly violently constricted. These constrictions can be so bad that they encroach on our well-planned lifestyles, limiting our freedom. It is common for the resulting limitations to require a great deal of help from others, often referred to as ‘long-term care’. Rita’s collection of constricted boundaries included loss of balance, meaning she continually fell over and had poor mobility, partial loss of use of her left side (she stopped using her left hand), loss of continence training, her body reverted to the behaviour of a baby and urinated or defecated when it felt the need, various aspects of brain damage, causing her to behave irrationally, plus serious memory loss, personality changes, severe tiredness, inability to perceive danger, and probably several other difficult-to-identify mental problems. 

With hindsight, it was obvious that the need was to push these constricted boundaries out again, so allowing her to regain her former life. This process is known as “rehabilitation”. Rehabilitation treatment is not easy. It can take a long time, needs help from trained therapists, and also the determination to keep going in the long-term despite apparently slow progress. How to go about it is well documented in the UK – if only it were implemented as well as it is documented, a great many people would live more satisfying lives. 

Rita failed to recover under her UK rehabilitation treatment, but success was later achieved in South Africa by use of a progamme designed specifically to meet her needs. This was a time-unlimited programme (meaning it continued for as long as it was needed), as described in Pushing the Boundaries, Part 2.