When the World No Longer Makes Sense
Jeannette’s stroke recovery
When Jeannette Bonner Secrest arrived at Kessler Institute for Rehabilitation – West Orange, her world was fractured. She couldn’t find words to express herself. Sitting upright made her feel tilted, even though she wasn’t. Objects on her right side seemed to vanish – though they were actually still present. If someone asked her what was wrong, she couldn’t respond to the question.
Jeannette had suffered a cerebral hemorrhage also known as a brain bleed. Everything that happened before her arrival to Kessler — the ambulance ride, the month-long hospital stay — was gone. She couldn’t remember a thing.
Jeannette was rushed to Jersey City Medical Center. Physicians worked to control her blood pressure and reduce the fluid building in her injured brain tissue. Once they stabilized Jeannette, it became clear that the 66-year-old social worker would need specialized neurological rehabilitation to regain the function and skills she needed to live one her own again.
Jeannette resided in her Jersey City condo and had a close relationship with her sisters — one in Texas and the other, her twin, in Oregon. When Jeannette needed help, they swooped in overseeing her immediate acute care needs and, after that, researching inpatient care programs and outcomes. They chose Kessler for its neurological rehabilitation reputation and physician-led, team-based approach to care.
Relearning how to understand, move and communicate
Upon arriving at Kessler, Jeannette could not walk, stand or sit without help. She was experiencing multiple issues: pushing syndrome, which distorted her sense of an upright posture and impaired her balance and safety. She also had aphasia, a communication problem that affected her ability to understand others and express herself. The care team would need to determine how much Jeannette could understand or engage.
Physically, Jeannette had pain in her left arm and shoulder caused by nerve damage. The pain made it hard for Jeannette to move her arm and shoulder. Additionally, her stroke had caused her to lose awareness of the right side of her body, a condition called spatial neglect.
Jeannette’s inpatient rehabilitation team built a plan around what mattered most to her: regaining awareness, movement and communication so she could get back to daily life. Speech, physical and occupational therapists worked side by side, adjusting her care as she progressed.
At first, it was unclear how much Jeannette understood. But nurses and therapists gently engaged her, always letting her know where she was, why she there and how they were helping. As she became better oriented to her surroundings and more aware of her condition she was able to more fully participate in therapy.
Speech-language therapy helped Jeannette eat safely again and find her voice. Initially, Jeannette communicated with simple yes-or-no responses. Gradually, her language skills returned, starting with breaking words into syllables, blending sounds and using strategies to help her recall the words she wanted to say. Her therapists incorporated visual cues, rhythm and singing, which can activate different areas of the brain and support language recovery. Singing became especially motivating for Jeannette, giving her a structured and familiar way to practice speech while building confidence.
By the end of her stay, when Jeannette was asked why she was at Kessler Institute for Rehabilitation, she processed the question, searched for the words and answered clearly:
“Aphasia… big time.” Then, slowly and thoughtfully, Jeannette verbalized her goals: “Get rid of the aphasia; be able to walk; get down the stairs.” Stairs were an important focus, as they were part of daily life in the condo to which she hoped to return.
Speech therapists also helped Jeannette rebuild the strength and coordination she needed for safe swallowing. Through targeted exercises and techniques she learned to better protect her airway. With therapists monitoring her swallowing abilities, Jeannette gradually began eating again. Her team slowly expanded her diet moving her from ice chips, to thicker liquids, pureed to soft foods and eventually standard, bite-sized, solid foods.
Within four weeks, Jeannette was eating, could participate in simple conversations understanding both what was said and replying in short sentences, read simple text and write basic words with help. She could also follow multi-step directions and take part in more complex conversations.
Physical therapy centered on helping Jeannette move safely and confidently. Early sessions focused on using a tilt table to acclimate Jeannette to an upright position and a standing frame to reintroduce her body to standing while supporting her. With the help of a body-weight support system — a harness that supported her weight while she practiced stepping — and hands-on guidance from her therapists, she began relearning how to walk.
Therapists also used compression wraps and ankle weights to provide added sensory input, helping Jeannette better understand where her body was in space. This increased awareness, known as proprioception, was an important step toward improving her balance, coordination and overall safety as she moved.
As she grew stronger, Jeannette progressed from walking in a weight-supported harness to taking steps using a bedside table, then a walker. By discharge, she was walking with a wide-based quad cane and moderate assistance. She could climb stairs and transfer in and out of a car with some help.
Occupational therapy focused on turning Jeannette’s gains into everyday independence. Her therapists used visual anchors (such as a red therapy band), scanning exercises and touch cues to help her consistently look toward and engage with her right side. They also used specialized goggles to limit visual input on her stronger side, encouraging her to attend to the side affected by her stroke. Together, these strategies helped improve her awareness, making daily tasks safer and more manageable.
Jeannette practiced real-life routines like dressing, bathing and toileting, talking through each step and asking for help when needed. By the time of discharge, she could manage her daily activities with a minimum amount of help.
Throughout Jeannette’s stay, progress was marked not only by major milestones, but by smaller moments. The first time she said the names of her three primary therapists from memory — Jeannette cried. Another day, she used the bathroom independently for the first time — and cried again.
Those moments reflected more than progress. They marked a return of self.
Preparing for the next level of care
As discharge approached, the changes felt steady and real. What began with no words to express herself, turned into a full sentence from Jeannette when asked what she looked forward to most. “Being one step closer to home,” she said.
Jeannette transferred to a skilled nursing facility, where she planned to continue therapy and build on the gains she had made.
“I couldn’t have done it without you all,” Jeannette said to her care team with gratitude. “Seriously, it makes me emotional.”
When Jeannette Bonner Secrest arrived at Kessler Institute for Rehabilitation – West Orange, her world was fractured. She couldn’t find words to express herself. Sitting upright made her feel tilted, even though she wasn’t. Objects on her right side seemed to vanish – though they were actually still present. If someone asked her what was wrong, she couldn’t respond to the question.
Jeannette had suffered a cerebral hemorrhage also known as a brain bleed. Everything that happened before her arrival to Kessler — the ambulance ride, the month-long hospital stay — was gone. She couldn’t remember a thing.
Jeannette was rushed to Jersey City Medical Center. Physicians worked to control her blood pressure and reduce the fluid building in her injured brain tissue. Once they stabilized Jeannette, it became clear that the 66-year-old social worker would need specialized neurological rehabilitation to regain the function and skills she needed to live one her own again.
Jeannette resided in her Jersey City condo and had a close relationship with her sisters — one in Texas and the other, her twin, in Oregon. When Jeannette needed help, they swooped in overseeing her immediate acute care needs and, after that, researching inpatient care programs and outcomes. They chose Kessler for its neurological rehabilitation reputation and physician-led, team-based approach to care.
Relearning how to understand, move and communicate
Upon arriving at Kessler, Jeannette could not walk, stand or sit without help. She was experiencing multiple issues: pushing syndrome, which distorted her sense of an upright posture and impaired her balance and safety. She also had aphasia, a communication problem that affected her ability to understand others and express herself. The care team would need to determine how much Jeannette could understand or engage.
Physically, Jeannette had pain in her left arm and shoulder caused by nerve damage. The pain made it hard for Jeannette to move her arm and shoulder. Additionally, her stroke had caused her to lose awareness of the right side of her body, a condition called spatial neglect.
Jeannette’s inpatient rehabilitation team built a plan around what mattered most to her: regaining awareness, movement and communication so she could get back to daily life. Speech, physical and occupational therapists worked side by side, adjusting her care as she progressed.
At first, it was unclear how much Jeannette understood. But nurses and therapists gently engaged her, always letting her know where she was, why she there and how they were helping. As she became better oriented to her surroundings and more aware of her condition she was able to more fully participate in therapy.
Speech-language therapy helped Jeannette eat safely again and find her voice. Initially, Jeannette communicated with simple yes-or-no responses. Gradually, her language skills returned, starting with breaking words into syllables, blending sounds and using strategies to help her recall the words she wanted to say. Her therapists incorporated visual cues, rhythm and singing, which can activate different areas of the brain and support language recovery. Singing became especially motivating for Jeannette, giving her a structured and familiar way to practice speech while building confidence.
By the end of her stay, when Jeannette was asked why she was at Kessler Institute for Rehabilitation, she processed the question, searched for the words and answered clearly:
“Aphasia… big time.” Then, slowly and thoughtfully, Jeannette verbalized her goals: “Get rid of the aphasia; be able to walk; get down the stairs.” Stairs were an important focus, as they were part of daily life in the condo to which she hoped to return.
Speech therapists also helped Jeannette rebuild the strength and coordination she needed for safe swallowing. Through targeted exercises and techniques she learned to better protect her airway. With therapists monitoring her swallowing abilities, Jeannette gradually began eating again. Her team slowly expanded her diet moving her from ice chips, to thicker liquids, pureed to soft foods and eventually standard, bite-sized, solid foods.
Within four weeks, Jeannette was eating, could participate in simple conversations understanding both what was said and replying in short sentences, read simple text and write basic words with help. She could also follow multi-step directions and take part in more complex conversations.
Physical therapy centered on helping Jeannette move safely and confidently. Early sessions focused on using a tilt table to acclimate Jeannette to an upright position and a standing frame to reintroduce her body to standing while supporting her. With the help of a body-weight support system — a harness that supported her weight while she practiced stepping — and hands-on guidance from her therapists, she began relearning how to walk.
Therapists also used compression wraps and ankle weights to provide added sensory input, helping Jeannette better understand where her body was in space. This increased awareness, known as proprioception, was an important step toward improving her balance, coordination and overall safety as she moved.
As she grew stronger, Jeannette progressed from walking in a weight-supported harness to taking steps using a bedside table, then a walker. By discharge, she was walking with a wide-based quad cane and moderate assistance. She could climb stairs and transfer in and out of a car with some help.
Occupational therapy focused on turning Jeannette’s gains into everyday independence. Her therapists used visual anchors (such as a red therapy band), scanning exercises and touch cues to help her consistently look toward and engage with her right side. They also used specialized goggles to limit visual input on her stronger side, encouraging her to attend to the side affected by her stroke. Together, these strategies helped improve her awareness, making daily tasks safer and more manageable.
Jeannette practiced real-life routines like dressing, bathing and toileting, talking through each step and asking for help when needed. By the time of discharge, she could manage her daily activities with a minimum amount of help.
Throughout Jeannette’s stay, progress was marked not only by major milestones, but by smaller moments. The first time she said the names of her three primary therapists from memory — Jeannette cried. Another day, she used the bathroom independently for the first time — and cried again.
Those moments reflected more than progress. They marked a return of self.
Preparing for the next level of care
As discharge approached, the changes felt steady and real. What began with no words to express herself, turned into a full sentence from Jeannette when asked what she looked forward to most. “Being one step closer to home,” she said.
Jeannette transferred to a skilled nursing facility, where she planned to continue therapy and build on the gains she had made.
“I couldn’t have done it without you all,” Jeannette said to her care team with gratitude. “Seriously, it makes me emotional.”