Home-based rehabilitation helped Aunty Milli’s mental health and stroke recovery

Mildred Swanepoel (69) also known as “Aunty Milli” from New Woodlands, Mitchells Plain loved baking for her family and her community. Unfortunately, Aunty Milli succumbed to a stroke on 3 August 2022 which severely weakened the right side of her body. Mildred suffers from hypertension and cholesterol, and eventually, due to her condition and home circumstances, depression started to settle in. Added stressors included insufficient support from her family, her inability to move around, and her unhealthy weight gain. 

Mildred was treated for her stroke by Mitchells Plain District Hospital and referred to the Western Cape Government Health and Wellness Mitchells Plain Intermediate Care (MPIC) facility for six weeks to receive rehabilitation care. Unfortunately, she requested to leave the facility early due to her longing to be home with her family and did not complete her six-week rehabilitation treatment plan. After completing a form stipulating her early discharge, she was discharged and sent home.

“I was not in the right mental space, and after I was discharged from the hospital after having the stroke, I could not move and was bedridden for weeks just staring at the four walls. My one daughter works, and I had to wait for my family to come and take care of me. I am a very independent person and I felt helpless and depressed,” says Mildred.

To ensure that Mildred was mobile again, Mitchells Plain Hospital requested the assistance of the Department’s Rehabilitation Team in Mitchells Plain to conduct a home visit and measure her for a wheelchair. However, due to her being a bariatric (obese) patient, the team had challenges transporting her for the measurement of her wheelchair.

“The Initial measurement in the hospital indicated that a 26-inch wheelchair would be needed. However, in liaison with the Rehabilitation Manager, it was decided that this would not be practical as it would not fit through her doorways and passages at home,” says Ruwayda Hull, Occupational Therapist for the Department of Health and Wellness in Mitchells Plain.

“I was losing hope, I lost a lot of weight, I was left alone at home and became even more depressed, and prayed to the Lord to send help,” says Aunty Milli with tears in her eyes.  

The Rehabilitation team tried their best to assist Mildred and conducted a holistic assessment of her home, her functional capabilities, and her and the family’s needs.

“Based on our home assessment, Mildred had a few social challenges at home which we often find in other households. Due to her stroke, she was unable to attend church and other community activities. She could not bake anymore as she was unable to move her right arm and hand. Her family was becoming tired and overstretched and unable to work because they needed to care for her. Her other two children were unemployed and could not provide the care she needed. Arguments ensued among the siblings and Mildred became emotionally depressed. She cried a lot and stayed in bed until someone could assist her with her healthcare and ablution needs,” says Ruwayda with concern.

Mildred was referred for home-based care, and a Rehabilitation Care Worker (RCW) from Arisen Women, a contracted non-profit organisation with the Department, conducted three sessions with her per week for the first two months at her home, and the health team reassessed her condition and progress after two months. The Rehabilitation team provided Aunty Milli with a meal plan, ensured that the home-based carers delivered her chronic medication to her home, provided a rollator (walker)to assist with her mobility, and provided the family with training to assist with passive and active exercises and education regarding her medical condition.

Mildred’s challenges proved to be a good motivation to get better. A family member who is very dear to her, assisted in placing an advert on community platforms in aid of finding a live-in carer that would assist Mildred in her recovery. Robin Harker headed the call in March 2023 and moved in with Mildred to commence with her recovery process. “At first it was not easy getting Mildred on the road to recovery because she was depressed, set in her ways, and had challenges at home, but I managed her and within two weeks we started getting her mobile and walking to the bathroom,” says Robin.

“I watched how the therapist and rehab workers assisted Mildred and then continued with her rehabilitation care using those methods,” says Robin.

With Robin’s compassion for caring for people, her patience, and the support from the Rehabilitation team from the Department of Health and Wellness, Mildred is walking on her own, and taking better care of her health, baking again, visiting her neighbours in the street, and becoming more sociable. Mildred's weight loss has resulted in her now fitting into a 20-inch wheelchair.

Mental health is a huge challenge in Mitchells Plain and it is not just related to substance abuse, people diagnosed with schizophrenia, or other more severe mental health complications requiring them to be admitted to a mental institution. Mental health is seen in many forms, such as families in need of support with loved ones who are bedridden due to various health-related reasons and are stressed out because they don’t know where to go for help. People suffer from depression because they don’t have anyone to care for them, like the case of Aunty Milli. Parents suffering from anxiety because they don’t know where to seek help for their child who suffers from learning or developmental disabilities.

During Mental Health Month in October, we are placing even further emphasis on the importance of your mental well-being, and we encourage people to make use of the social worker and mental health nurse at the Mitchells Plain Community Health Centre. Our home-based care teams conduct home visits for people requiring care who are unable to access their local healthcare facility due to being bedridden or having disabilities which prevent them from accessing healthcare services. These types of services offered by the Department can assist in alleviating many minor mental health challenges for patients and their families and help them cope with stressful situations.

The Department’s Rehabilitation or Home-Based Care Services team can be contacted at DoH.cbskmpss@westerncape.gov.za or telephonically at 021 370 5000.