Students stared at the shoe laid out in front of them, working out in their minds how to approach the problem.

The fifth-grade students at Custer Baker Intermediate School had been asked to hold their dominant hand behind their backs. With their less skillful hand, they had to figure out how to tie a shoe.

Other students had different tasks to complete one-handed: buttoning a shirt, trying to play a card game and writing a short sentence.

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“It was really hard,” said Joseph Kraeszig, a fifth-grader at Custer Baker. “Strokes are very bad. You can die, or it can just be very hard to do things after you have one.”

The exercise was designed to show the students how a stroke can impact your everyday life. As part of an ongoing effort to raise awareness about strokes, Custer Baker and other Franklin schools have partnered with Johnson Memorial Health to educate students.

Blending statistics, basic information about strokes and hands-on demonstrations, the program presents students with knowledge such as how to prevent a stroke, what happens in the body during and after a stroke, and what to do if someone you know has one.

“We focus on the elderly, but anyone can have a stroke,” said Joey Hollis, stroke coordinator and emergency department manager for Johnson Memorial Health. “They could be in here and one of their teachers could have a stroke, or their parents or their grandparents. It’s a good idea to learn this, even at this age.”

Strokes, which occur when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts, are one of the most prevalent causes of death in Indiana. Nearly 3,000 Hoosiers died from strokes in 2015.

In Johnson County, the hospitalization rate between 2012 and 2014 for strokes was 12.1 people per 1,000 county residents who receive Medicaid benefits. That’s higher than the state rate of 11.7 people, as well as the national rate of 10.9.

In October, Johnson Memorial Health received stroke-readiness through the Healthcare Facilities Accreditation Program, the country’s original independent accreditation organization. As part of that certification, the hospital is required to do outreach regarding stroke education.

That was part of the impetus for the school program, which was born in discussion between Johnson Memorial Health officials and Franklin school nurses. Though the hospital’s stroke awareness program is active at senior-focused events such as WHAT and the Johnson County fair, the hope was to branch out and reach a younger audience as well.

“We go out into the community and take blood pressure and give out information, but I wanted to do something more kid-related,” Hollis said.

The Johnson Memorial Health team approached principals and teachers at Custer Baker and Franklin Community Middle School about their idea for the educational presentation.

For Brian Harbin, the fifth-grade physical education and gym teacher, the program was opportunity to tie different aspects of the curriculum together into real-world learning.

Lessons on the effects of tobacco, drugs and alcohol gain a more hard-hitting component when you can see how strokes, one of the largest risks associated with those things, impact your life, Harbin said.

“We talk to them so much about promoting healthy lifestyles and prevention, being able to apply it in their lives is the biggest thing,” he said. “I can get on my soapbox and talk about this stuff education-wise, but it’s nice to get health professionals in here.”

Students are given a test gauging what they know about strokes initially. School nurses then work through the different types of strokes, facts about the disease and some of the signs that someone is having a stroke.

At Custer Baker, nurse Megan Morrison showed a short video taken from a news broadcast. The reporter starts talking, but her words are jumbled and make no sense.

The slurring, nonsensical wording, in addition to the reporter’s confusion as to what is coming out of her mouth, are some of the symptoms of a stroke, Morrison said.

If you see signs like this, or others such as drooping facial features or the inability for someone to raise one arm above their head, call 911 immediately, Morrision said.

“Every minute counts,” she said.

In each class that Hollis and his team works with, the highlight are the demonstrations. Students rotate between three different stations. One asks them to do simple daily tasks such as folding a shirt with their non-dominant hand.

Another has them practice writing with their off hand. Lastly, they gather and try to play a game of UNO, figuring out how to hold their cards, hide them from other players and actually complete the game with the use of one arm.

“What we’re telling them is that they’ve had a stroke, and it’s affecting their dominant hand,” Hollis said. “There are other deficits that happen after a stroke, but that’s the easiest one to demonstrate.”

Students that go through the program get information to take home, including smoking cessation tips and magnets advocating the FAST acronym: face drooping, arm weakness, speech difficulty, time to call 911.

They also are given a letter to bring to their parents. The students whose parents sign the letter and bring it back are entered into a drawing for movie tickets, Hollis said.

“It’s a way to try and pull the parents into the education aspect as well,” he said.

This is the first year of the stroke education in the schools, and with the success they’ve seen so far, Johnson Memorial Health plans to expand and alter the curriculum next year. Different programs for each grade level will make sure that the students learn new information and receive a different perspective each year.

“We’re going to try to build different curriculum,” Hollis said. “We want to add to it, and for those who have been through it, give a refresher course.”

At a glance

Signs of a stroke

  • Face drooping: One side of the face droops or is numb, and the person’s smile is uneven or lopsided.
  • Arm weakness: One of the person’s arms seems weak or numb, and when the person raises their arms above their heads, one drifts downward.
  • Speech difficulty: Speech is slurred or difficult to understand. When asked to repeat a simple sentence, they are unable to correctly repeat the words.
  • Time to call 911: If someone shows any of these symptoms, even if the symptoms go away, call 911 and say that it’s a stroke to help get the person to the hospital immediately.

Stroke prevention

  • Keep your blood pressure low
  • Lower your cholesterol
  • Eat healthy food
  • Exercise regularly
  • Treat sleep apnea
  • Control blood sugar
  • Drink in moderation
  • Stop smoking
  • Avoid stress
  • Maintain a healthy weight

— Information from the American Stroke Association

Author photo
Ryan Trares is a reporter for the Daily Journal. He can be reached at or 317-736-2727.