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Brain Injury Basics for Families

Brain Injury Basics for Families. No Brain Injury is Too Mild to Ignore, Or Too Severe to Lose Hope. What is brain injury?. Brain injury is often defined as either a Traumatic Brain Injury (TBI) OR Acquired Brain Injury (ABI). Traumatic Brain Injury.

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Brain Injury Basics for Families

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  1. Brain Injury Basics for Families No Brain Injury is Too Mild to Ignore, Or Too Severe to Lose Hope

  2. What is brain injury? Brain injury is often defined as either a Traumatic Brain Injury (TBI) OR Acquired Brain Injury (ABI) Family Helpline: 1-800-669-4323

  3. Traumatic Brain Injury Traumatic Brain Injury (TBI) is an insult to the brain caused by an external force that may produce a diminished or altered state of consciousness. Causes of TBI can include motor vehicle crashes, falls, sports injuries, assaults, blast injuries. Family Helpline: 1-800-669-4323

  4. Acquired Brain Injury Acquired Brain Injury (ABI) is an injury to the brain which is not hereditary, congenital or degenerative and has occurred after birth. Causes of ABI include anoxia, aneurysms, infections to the brain, stroke, brain tumors. Family Helpline: 1-800-669-4323

  5. “The Silent Epidemic” It is estimated that 5.3 million Americans live with a disability as a result of brain injury. Family Helpline: 1-800-669-4323

  6. TBI in the United States 50,000 Average annual numbers, 1995-2000 Deaths 235,000 Hospitalizations 1,111,000 Emergency Department Visits ?? Receiving Other Medical Care or No Care ?? From the 2004 CDC Report: TBI in the United Sates: ED Visits, Hospitalizations and Deaths Family Helpline: 1-800-669-4323

  7. Traumatic Brain Injury in New Jersey • Approximately 8,000 adults and children each year are hospitalized or die as a result of a traumatic brain injury. • More than 20,000 people are treated each year in doctor offices or emergency rooms for TBI.* * Conservatively extrapolated from national data Family Helpline: 1-800-669-4323

  8. Traumatic & Acquired Brain Injury in New Jersey Although the cause of injury differs, many programs and services for people with brain injury serve both TBI & ABI. For example, the TBI Medicaid Waiver & TBI Fund both serve individuals with TBI & ABI. Family Helpline: 1-800-669-4323

  9. Changes Over the Years 30 years ago – 50% of persons with a brain injury died as a result of the injury. Today – 22% die as a result of injury. Family Helpline: 1-800-669-4323

  10. Functions of the Brain The best way to understand the affect of injury to the brain is to understand the function of each area of the brain and related systems and structures. Family Helpline: 1-800-669-4323

  11. Brain Stem The brain stem, located at the base of the skull, is responsible for life-sustaining functions such as regulation of blood pressure, heart rate, breathing and body temperature. Damage to the brain stem could result in an altered state of consciousness, such as coma. Family Helpline: 1-800-669-4323

  12. Cerebellum The cerebellum, located behind the brain stem, is responsible for muscle coordination and balance. Family Helpline: 1-800-669-4323

  13. Occipital Lobe The occipital lobes, located at the back of your brain, is the visual processing center in the brain. Damage to these areas may result in neurological visual impairment. Family Helpline: 1-800-669-4323

  14. Temporal Lobes The temporal lobes lie at the sides of the brain and are the auditory (hearing) processing system of the brain. Family Helpline: 1-800-669-4323

  15. Parietal Lobes The parietal lobes, located above your occipital lobes, controls the way your brain responds to information it receives, including visual, auditory and physical information. For example, being touched, loud noises, bright lights. Family Helpline: 1-800-669-4323

  16. Frontal Lobes The frontal lobes, located in the front of your brain, control the processes of planning, organization, problem solving, reasoning, emotions and motor skills. Family Helpline: 1-800-669-4323

  17. Severity of Injury Sometimes, a brain injury is categorized in one of the following three ways: • Mild Brain Injury • Moderate Brain Injury • Severe Brain Injury. Family Helpline: 1-800-669-4323

  18. Mild Brain Injury Not Just A Bump On The Head! • Loss of consciousness does not have to occur—the person may be dazed or confused • If loss of consciousness occurs, it is very brief, usually a few seconds or minutes • A concussion is considered a mild brain injury • Testing or scans of the brain may appear normal Family Helpline: 1-800-669-4323

  19. Moderate Brain Injury • A loss of consciousness lasts from a few minutes to a few hours • Confusion lasts from days to weeks • Physical, cognitive, and/or behavioral impairments last for months or are permanent. Family Helpline: 1-800-669-4323

  20. Severe Brain Injury • Severe brain injury occurs when a prolonged unconscious state or coma lasts days, weeks, or months. • Persons who sustain a severe brain injury can make significant improvements, but are often left with permanent physical, cognitive, or behavioral impairments. Family Helpline: 1-800-669-4323

  21. Severity of Injury Severity of injury does not guarantee outcome. Persons who sustain a mild brain injury may have ongoing difficulties for years to come and persons with a severe brain injury may make marked improvements over time. Every brain injury is unique. Family Helpline: 1-800-669-4323

  22. Brain Injury & Families Just as each brain injury is unique, brain injury will affect each family differently. Brain injury often changes the roles and responsibilities of family members. The change can be so drastic it can be similar to bringing a stranger home from the hospital with you. Family Helpline: 1-800-669-4323

  23. Parental Relationships Parents of children, adolescents, and adults with brain injury may become lifelong caregivers of their sons and daughters. Family Helpline: 1-800-669-4323

  24. Sibling Relationships Siblings live with the consequences of having a sibling with a disability. They may receive less attention from parents and may take on a lifelong responsibility of worrying and caregiving. Family Helpline: 1-800-669-4323

  25. Spousal Relationships A spouse’s relationship may shift mildly or drastically from one of partner to one of caregiver. Family Helpline: 1-800-669-4323

  26. Child-Parent Relationships The child of a parent with a brain injury may experience a role reversal. They may end up caring for their parent early in their lives, and receive less attention from the parent providing caregiving. Family Helpline: 1-800-669-4323

  27. Grief & Loss for the Individual Potential loss of identity, self-esteem, self-control, expression/communication, independence, relationships, mobility, vocational/career identity, productivity, income and assets. Family Helpline: 1-800-669-4323

  28. Grief & Loss for the Family Potential change in relationships, dreams for loved one, responsibilities as caregiver, personal freedom, lifestyle, income and assets. Family Helpline: 1-800-669-4323

  29. Stages of Grief There are several stages of grief that are common following a brain injury that both people with brain injury and family members go through. Family Helpline: 1-800-669-4323

  30. Stages of Grief • Denial • Anger • Bargaining • Depression • Acceptance Family Helpline: 1-800-669-4323

  31. Denial After a terrible experience, a person may act as if it did not happen. “This could not have happened to me.” “She’ll be her old self again soon.” Family Helpline: 1-800-669-4323

  32. Anger Once the person accepts that the event occurred, anger and frustration are the next emotions. The anger can be directed at doctors, family, friends, God, and even at self. “The doctor doesn’t know anything.” “No one is helpful.” Family Helpline: 1-800-669-4323

  33. Bargaining Trying to make deals. “I’ll be a perfect person if my son is able to be normal again.” “I will never do ____ again if you let me return to my old self.” Family Helpline: 1-800-669-4323

  34. Depression This is a very difficult and painful stage of recovery for both people with brain injury and family members. “What’s the use? Nothing will ever be the same again.” “Why bother with rehab?” Family Helpline: 1-800-669-4323

  35. Acceptance As time passes, individuals and families can come to accept the changes that have taken place. Nothing can make life as it was before, but life can be new and worthwhile. Family Helpline: 1-800-669-4323

  36. Living With Brain Injury Brain injury will affect each individual differently, but there are many common consequences. The following consequences and strategies are offered to help both you and your loved one cope with brain injury. Family Helpline: 1-800-669-4323

  37. Difficulty with... Memory Persistence Decision making Organization Planning Self-perception Attention Thinking Problem solving Sequencing Perception Judgment Inflexibility Processing speed Concentration Cognitive Consequences Family Helpline: 1-800-669-4323

  38. Seizures Muscle spasticity Fatigue Headaches Balance problems Speech difficulties Visual difficulties Hemiparesis (paralysis) Physical Consequences Family Helpline: 1-800-669-4323

  39. Anxiety Depression Mood swings Impulsivity Irritability Social withdrawal Aggression Lack of motivation Egocentric behaviors Lack of self-awareness Inappropriate behavior and/or language Sexual dysfunction Feelings of loneliness Emotional/Behavioral Consequences Family Helpline: 1-800-669-4323

  40. Strategies for Living with Brain Injury One of the most important things family members can do is establish structure, consistency, and repetition in their family members routine. Family Helpline: 1-800-669-4323

  41. Structure, Consistency & Repetition • Establish a schedule. • Keep your family member’s environment organized. • Utilize calendars, notebooks, wall charts, and visual aids as reminders, but be careful not to overstimulate with too much information. Family Helpline: 1-800-669-4323

  42. Structure, Consistency & Repetition • Remain consistent in what you do and what your expectations are (for example, always remaining a model of calm behavior during outbursts) • Repetition will provide a feeling of safety, and be the key to new learning for your family member. Family Helpline: 1-800-669-4323

  43. Breaking Down Tasks It is always best to break tasks into steps, whether it be completing paperwork for Social Security Disability or preparing a meal. Expecting large projects to be completed all at once will be setting your family member and yourself up for failure. Family Helpline: 1-800-669-4323

  44. Minimizing Distractions Providing as much of a distraction free environment as possible will minimize overstimulation and cognitive overload. Family Helpline: 1-800-669-4323

  45. Anticipating Stressful Events Anticipate situations that may be stressful for your family members, and try to avoid or minimize the stress. For example, large family gatherings could be overwhelming and trips to the store when they are crowded and noisy could be cognitively overwhelming. Family Helpline: 1-800-669-4323

  46. Watch for Depression Signs of depression to watch for include: • Changes in eating habits • Changes in sleeping habits • Remarks about the futility of life • Dwelling on the past • Excessive time spent in non-active ways like watching too much television Family Helpline: 1-800-669-4323

  47. Behavioral Challenges An estimated 90% of all people who are severely disabled by a brain injury may experience some related emotional, behavioral or psychiatric problems. 40% of these individuals still have behavioral issues 5 years after the injury.* *Brain Injury Association of America Family Helpline: 1-800-669-4323

  48. Behavioral Challenges Individuals with milder brain injuries can also experience behavioral challenges, including mood changes, irritability and fatigue, which might be more difficult to identify as being related to the brain injury. Family Helpline: 1-800-669-4323

  49. Behavioral Challenges Behavioral challenges can range from mild personality changes to persistent difficulty controlling emotions, lack of inhibition, managing one’s behavior, and even violent outbursts. Family Helpline: 1-800-669-4323

  50. Behavioral Challenges Behavioral problems can cause: • Marital discord • Problems with social relationships • Family difficulties • School or workplace problems And should never be ignored Family Helpline: 1-800-669-4323

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