Cognitive deficit, part I

Earlier on this semester I had a patient on my neuro placement who had had a stroke which affected his cognitive function. He displayed ideational apraxia, decreased concentration, (L) side neglect, perseveration with complex tasks and tasks that had been explained in an abstract way and many other behavious that made treatment a bit of a challenge. He was also regularly not orientated to person, place or time, although as the days went by he started to remember that I was a "very well trained physiotherapist"! (His words, not mine!)
The initial sessions with him were a bit of a disaster due to my lack of experience with such a patient. I had no idea how to communicate to him what I wanted him to do without causing him a huge amount of confusion.What seemed a simple idea to me was actually abstract and complicated for him. What would have been perfectly reasonable to expect from any other of my patient's was cognitively too high level for him. Due to this difficulty with communication he appeared to be a 2 moderate to maximum assist for STS, T/Fs and bed mobility and ambulating was out of the question.
After discussing the difficulty I was having with him with my supervisor, it was suggested to me to make every activity with him a functional one with a purpose and all instructions short and concise. For example, when explaining to him I wanted him to move from the wheelchair to the plinth, instead of giving a longwinded explanation about how I wanted him to do so, I would simply tell him to move from the chair to the bed. I would watch to see what he could do and if he started to have difficulty I would break the task down but explain only one part at a time, allow him to perform that, then explain the next part of the task.
To my astonishment, this patientwas actually quite capable to performing most tasks with stand by assistance or 1 minimal assistance. Ambulating was a two person job due to his tendency to push to the left but otherwise he had the strength and (most of) the coordination required to walk about 100m.
The experience with this patient was invaluable to me. I feel like it is something that an explanation can be helpful but nothing helps as much as experiencing it first hand and seeing how changing your communication slightly can make the biggest difference. I feel as though due to this experience I am now more well-equipped to deal with patients with cognitive deficits and it be a more enjoyable and rewarding experience in the future.
This also showed me the importance of not being afraid to ask questions in difficult scenarios!