Colin, I read your post with interest. My Mum had a TIA about 8 weeks ago and four weeks ago collapsed with a stroke. She lay on the floor for, we think 10 hours, before being taken to A&E and then stroke Unit. At 80 she was very very lucky and suffered comparatively few effects !!
4 weeks on ... on the face of it she is fine, talking to visitors, engaging in conversations, etc etc but seems to have made little progress and is in a very noisy ward (which is not helping as her exhaustion is making her symptoms worse). The Speech Therapist, Physio and Dr think she is pretty much ok .... BUT the OT (a few very close friends, my sister and I) are gathering evidence of the actual challenges she is facing ... Mum has some personal care/dressing issues, is argumentative (frustration), sometimes vacant during conversation, dismissive, and is fighting tiredness a lot of the time, etc. Physically Mum is relatively back to normal and is perhaps at 95% of previous mental capacity (if that isn't judgmental) ... but the OT is right in saying the 5% is the difference between being safe at home and not. We feel we are almost dealing with nuances of character change, aside from the obvious limitations, and are thankful the OT seems to be the baton holder at the moment.
Your comment about the patient accepting there is a problem to deal with it an interesting insight. We are beginning to consider whether or not Mum knows she can't 'do it' and is in denial OR whether she doesn't know she is actually struggling.
The OT talks about 'cognitive processing' and we have been advised she is probably looking at another 6-8 weeks of rehab in hospital, but is telling visitors she's completing all the OT tests perfectly and is getting out soon ... "But the Dr's won't tell me when !". So we are having to assure everyone she is not as well as they may perceive and the 'cup of tea test' is part of an holistic assessment... and she is failing !
We are struggling to get anyone other than the OT to give us any prognosis, and feel we are in limbo whilst Mum's getting more frustrated in a hospital ward that is not helping her recover. Although, we are assured that she will be moved to a quieter ward when a bed becomes available.
I've forgotten my question now ... but I guess it's something around how can we help Mum accept she has a problem !? I guess, the simplistic answer would be to let her up to fail and force the issue but I'm not sure what that would do to her overall confidence or is actually a fair/dignified strategy.
Anyway, any thoughts would be appreciated as getting any information is proving challenging as she is currently deemed 'ok' and not 'bad enough for a care pack'. Which begs the question if is Mum's not bad enough for a 'care pack', but is deemed not 'safe' to be sent home to live alone ... we have Catch 22 !!
Thank you in advance for reading the above, I hope it makes a little sense . . . Stuart