Transcript Brain Injury Basics for Families

PARTNERS IN
REHABILITATION
…. After Brain Injury
Adapted with permission
from a presentation by the
Brain Injury Association of New Jersey
2007.11.01
ABIN-PA InfoLine 215-699-2139
Acquired Brain Injury Network
of Pennsylvania
Founded in 2007 by survivors and family
members, ABIN-PA is a statewide
organization dedicated to raising public
awareness about acquired brain injury and to
providing support, education, information,
advocacy and other services for individuals
with acquired brain injury and their families.
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ABIN-PA Programs & Resources
Staying in Touch
 E-List: frequent emails on brain injury
and disability topics.
 Newsletter: free monthly snail-mail on
organization activities, features.
 Website: brochures, PowerPoints,
resources, support groups
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Acquired Brain Injury
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an injury to the brain,
occurring after birth,
causing cognitive, behavioral or physical
changes,
 But not inherited, congenital, or degenerative.
Causes include trauma, anoxia, aneurysm, brain
infection, stroke, drugs, and brain tumors.
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Traumatic Brain Injury
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an injury to the brain,
occurring after birth,
due to an external force,
causing cognitive, behavioral or physical
changes,
not inherited, congenital, or degenerative.
Causes include motor vehicle crashes, falls,
sports injuries, assaults, and blast injuries.
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“The Silent Epidemic”
5.3 million Americans
PLUS 400,000 veterans
returning home with brain injury from
Afghanistan and Iraq.
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Each Year in Pennsylvania

2,000 TBI fatalities
 7,800 hospitalized for TBI
 41,000 TBI emergency room visits
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Changes Over the Years
30 years ago –
50% of those with a
TBI died as a result
of the injury.
Today –
22% die as a result
of TBI.
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Brain Lobes & Functions
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Frontal Lobes
 Planning
 Organization
 Problem
solving
 Reasoning
 Emotions
 Motor skills.
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Parietal Lobes
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Process incoming information such as
being touched, hearing, seeing
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Temporal Lobes
 Manage
auditory processing, attaching
meaning to sounds that are heard.
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Occipital Lobes
 Provide
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meaning to what is seen.
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Brain Stem
 Regulates
life-sustaining functions such as
blood pressure, heart rate, breathing and
body temperature.
 Damage could result in an altered state of
consciousness, such as coma.
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Cerebellum
 Responsible
for muscle coordination
 Responsible for balance
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Mild Brain Injury
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Perhaps brief loss of consciousness,
maybe a few seconds or minutes.
Survivor may be dazed or confused.
Permanent physical, cognitive, and/or
behavioral impairments may or may not
occur.
Testing or brain scans may appear normal.
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Moderate Brain Injury

Loss of consciousness from minutes to a day.
 Confusion lasts days, weeks or longer.
 Permanent physical, cognitive, and/or behavioral
impairments may or may not occur.
 Testing or brain scans may appear normal.
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Severe Brain Injury

Unconscious state or coma lasts days to
months.
 Survivors may improve greatly, but are often left
with permanent physical, cognitive, or behavioral
impairments.
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Severity vs. Outcome
 Severity
does not predict outcome.
 A mild brain injury may cause difficulties
for years while a severe brain injury may
improve greatly over time.
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Effect on Survivor
I
feel like a stranger on an alien planet with
unfamiliar language and customs.
 I feel that I am buried alive.
 I don’t know who I am or who I was.
 I feel totally alone because I don’t
recognize faces or remember my friends
or family.
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Reaction of Survivors
 Nothing
has happened.
 I don’t need or want help.
 I will be back to my old life in a few days,
weeks, or months.
 No sense of time, day/night, weekday vs.
weekend, holidays, weather.
 May misread situations and react too
slowly, too little or too strongly.
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Brain Injury & Families
 Parents
 Siblings
 Spouse
 Child
Roles and responsibilities of family members
may change. Changes in a loved one can
be so drastic that it seems a stranger
came home from the hospital.
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Grief & Loss
for the Survivor
 identity,
self-esteem
 self-control, independence
 expression/communication
 relationships, mobility
 vocational/career, productivity
 income and assets.
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Grief & Loss
for the Family
 Relationship
 Future
dreams for the loved one
 Responsibilities as caregiver
 Personal freedom
 Lifestyle, income and assets.
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Stages of Grief
 Denial
 Anger
 Bargaining
 Depression
 Acceptance
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Cognitive Consequences
 Memory
 Persistence
 Decision making
 Organization
 Planning
 Self-perception
 Attention
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Thinking
Problem solving
Sequencing
Perception
Judgment
Inflexibility
Processing speed
Concentration
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Physical Consequences
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Seizures
 Muscle spasticity
 Fatigue
 Headaches
 Balance problems
 Speech difficulties
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Visual difficulties
Hemiparesis (paralysis)
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Emotional/Behavioral
Consequences
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Depression
 Anxiety
 Mood swings
 Impulsivity
 Irritability
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Social withdrawal
Aggression
Lack of motivation
Egocentric behaviors
Lack of self-awareness
Inappropriate behavior
and/or language
Sexual dysfunction
Feelings of loneliness
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Strategy: Structure
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Schedule.
 Organized environment.
 Calendars, notebooks, wall charts, and visual
aids (but too much information will overwhelm).
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Strategy: Consistency & Repetition
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Be consistent in what you do
Be consistent in what you expect
Model the behavior you expect
Promote calm through predictability.
Use frequent repetition for new tasks.
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Strategy: Break Down Tasks
For every task, small steps with frequent
breaks.
Expecting large projects to be completed all
at once is a prescription for failure.
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Strategy: Minimize Distractions
Remove distractions to minimize
overstimulation and cognitive overload.
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Strategy: Proactive Planning
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FEELINGS: hungry, tired, ill, confused
EVENTS: changes in routine, dealing with
difficult tasks or individuals
 SIGNALS: facial expressions, body language,
choice of words, sighing
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Possible Stress Relievers

eating
 closing your eyes
 resting
 taking deep breaths
 getting a hug
 reading
 TV
 taking a walk
 playing solitaire
 taking a shower
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YES
Sometimes
NO
Don’t
know!
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Make An Action Plan
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Plan together to minimize stress – an advance
plan will help everyone to remain calm.
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Seek suggestions from others when needed.
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Build Resilience
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Activities prevent boredom
Social connections prevent social isolation
Independence creates self-esteem
Positive coaching builds success
Rewards emphasize achievements
Understand that everyone may be doing their
best very in difficult circumstances
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Emphasize Independence
“Family members or caregivers should let
the recovering TBI survivor burn dinner
every night if necessary but step in if the
house is burning down.” – Claudia Osborn
Encourage responsibility with help.
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Planning for Success
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Every individual is different, every injury is
unique, and improvement is gradual.
Work with current abilities and limitations.
Focus on helping with goals.
Model calm behaviors.
Help with reasoning.
2007.11.01
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Acquired Brain Injury
Network of
Pennsylvania, Inc.
InfoLine 215-699-2139
www.abin-pa.org
[email protected]