Good suggestions.

As for the aphasia, I believe it's not the impressive type, because he seems to understand everything I say to him. Unfortunately there's no speech therapist available. He's at a geriatric nursing home (not sure if that's the right term?), and I'm the sole physiotherapist there as well as a bunch of other places, which severely limits my rehabilitation time with individual patients.

I've tried to emphasize to him the importance of mental practice and trying to activate the arm himself in addition to the rehabilitation, but I can't be sure how much of that he actually does. He was in a pretty bad shape even before the stroke, and right now he can't really move at all himself. He needs total assistance for getting out of bed into a wheelchair, etc. Also, he gets exhausted really fast, even when the assistant nurses do passive movements to prevent contractures...

One peculiar thing is that I once saw him move his hand from his side to his belly when he was lying down in bed. That was perhaps 3 weeks ago. The assistant nurses have said that he has done that a few times, although not in the past weeks. There was never any discernable muscle activity before and after those moments though.