Week 4 CONNECT Brain Injury Presentation PDF

Acquired Brain Injury- Recreation Therapy  Recreation Therapy Agenda Introduction ABI/TBI/Concussion/Stroke - What do I need to know? Supporting Someone With an ABI and Their Recreation Group Activity-Figuring...

Acquired Brain Injury- Recreation Therapy  Recreation Therapy Agenda Introduction ABI/TBI/Concussion/Stroke - What do I need to know? Supporting Someone With an ABI and Their Recreation Group Activity-Figuring It Out! CONNECT Hamilton Life Redesign Rehabilitation Treatment Specification System Recreation at CONNECT  Introductions Ryan Wheeler - Play Coach (Recreation Therapist) Adam Van Sickle - Service Access & Transitions Leader  Acquired Brain Injury- Implications for Recreation Therapy What do you know about ABI? What are some anticipated challenges supporting someone with an ABI?  Brain Injury ∙The leading cause of death and disability for those under the age of 45 ∙165,000 Canadians will have a brain injury this year – 1 person every 3 minutes ∙A concussion is a brain injury ∙You do not have to lose consciousness to have a brain injury ∙50% of all people with traumatic brain injury are affected by depression Those most at risk of brain injury: ∙Children, especially newborn to 4 years old ∙Young adults, 15 – 24 years of age, and ∙Older adults ∙Among First Nation peoples rates are estimated to be 4 – 5 times higher ∙Average age of the people we support at CONNECT is 45 years Top 3 causes of ABI: Falls MVA Violence Good Days vs Bad Think about your own ability to function day to day What impact do things such as sleep, stress, fear, pain, noise, light, autonomy, relatedness have on you? How do you think these things might  A Bump to the Head? Traumatic brain injury (TBI) happens when a sudden, external, physical assault damages the brain. It is one of the most common causes of disability and death in adults. TBI is a broad term that describes a vast array of injuries that happen to the brain. The damage can be focal (confined to one area of the brain) or diffuse (happens in more than one area of the brain). Non-traumatic brain injury (also commonly referred to as an acquired brain injury or ABI) causes The severity of a brain injury damage to the brain by internal factors, such as a can range from a mild lack of oxygen, exposure to toxins, or pressure ABI CHALLENGES BEHAVIOURAL COGNITIVE EMOTIONAL PHYSICAL  Behavioural Changes The way a person acts or makes decisions can change after a brain injury. Behavioural changes can include engaging in risky or impulsive behaviour, having difficulty with relationships, and isolation. This can be stressful and depending on the behaviour, can cause safety concerns. Cognitive Changes This is how the brain learns, processes information, forms memories and makes decisions. Cognitive challenges after a brain injury can include communication, concentration, reading/writing, making decisions, and remembering things. Emotional Changes After a brain injury, a person may experience new or different emotions, including depression, anxiety, and/or anger. Emotional changes can be hard to cope with, and it’s important to have a support system of family, friends, and medical professionals to help. Physical Changes In some cases, a brain injury will have physical effects. These effects can include mobility challenges, headaches, fatigue, pain and sensory changes.  Behavioural Challenges Brain injury can have a profound impact on how you feel (emotions) and act (behaviour). It helps to understand how behaviours may have changed and how to manage those changes. Aggression Anger Frustration Anxiety Denial Depression Disinhibition Grief Lack of initiation Post-traumatic stress disorder (PTSD) Self-image loss Sexually inappropriate behaviour Social dysfunction  Behavioural Challenges - TR Implications Explain what they are doing before they do it Identify and eliminate/reduce aggression triggers (when possible, know before you start) Keep the amount of stimulation in the room low (e.g., light and noise) Redirect to calming activities Use calming tactics such as deep breathing or meditation (know what works) Celebrate the success Do challenging tasks for only short periods at a time or with scheduled breaks.  Cognitive Challenges Individuals with acquired brain injuries experience cognitive impairments that can impact them for the rest of their lives. Attention & concentration Judgement and problem-solving Language and communication Memory Planning skills Self-awareness  Cognitive Challenges - TR Implications Every person is unique, and so is each brain injury. For that reason, it is impossible to predict how recovery will impact cognition (thinking skills). Cognitive TR rehabilitation is a tool that can have a positive impact. You can work to improve a person’s cognitive functioning in everyday life after injury through TR. A variety of different professionals can also support this, but the most common therapists are Speech-Language Pathologists (SLPs) or Occupational Therapists (OTs). For TR interventions to be effective, it must be designed specifically for the needs and goals of the people you support, with a focus on both cognitive strengths and challenging areas. Cognitive Challenges - TR Implications You may have to repeat the things you say and break it up into small bits of conversation. Break tasks into small steps. Engage in what people love. People who have trouble focusing may get tired quickly. Make sure you take short breaks to give the brain a rest. Don’t rush through a task or expect it to be done perfectly.  Emotional Challenges When the brain is injured, a person’s emotional processing and responses can change. Major life changes and stressors associated with brain injury can add to emotional difficulties. Some may experience less emotion or more intense emotions. Anger/irritability Anxiety and depression Emotional control Mood swings Personality changes I’m feeling upset over my brain injury Identifying and managing emotional changes  Emotional Challenges - TR Implications Engage in calming activities – listening to music or reading are some examples Pet/Music/Horticulture Therapy Be understanding Show compassion Listen Be aware of triggers Let the person know, It’s normal to feel upset, angry, and sad about your brain injury. Focus on the positives  Physical Challenges Many physical effects of brain injury can impact a person’s activities of daily living (ADLs). Ataxia (jerkiness) and coordination Balance problems Chronic (consistent) pain Fatigue, difficulties with sleeping, and insomnia Headaches Impaired motor control and motor planning Muscle tone Paralysis or weakness Sensory problems, such as sensations on the skin, touch, and vision  Physical Challenges - TR Implications Many physical effects of brain injury can impact a person’s activities of daily living (ADLs). Know the persons limitations and work within them Utilize your team (PT) Person Centered Listen and observe (Look for fatigue/weakness) Celebrate small successes! Utilize Adaptive Aids (Think about this before-hand) Remember with physical challenges come emotional challenges Figuring It Out! What ABI challenges did you observe from the participants? What great strategies did you observe from the Recreationist?  Life Redesign Model The Life Redesign Model is an innovative functional approach to have people participating in real-life activities, which are embedded with rehab activities Services are Planned Culture of Personal A ‘doing with’ Around What People Accountability coaching approach Want More of in Life  CONNECT's Life Redesign Approach CONNECT believes all people are naturally creative, resourceful, whole, and wise. We approach Life Redesign holistically so that all aspects of health are addressed, including a person’s physical, functional, psychological, cognitive, emotional, behavioural, social, and cultural health. We support and coach individuals to design their lives in ways that are meaningful to them. CONNECT aims to prevent the institutionalization of individuals after brain injury and stroke and bridge the gap between hospital care and home life. Our approach involves crafting Life Redesign Plans that integrate rehabilitation seamlessly into everyday life. Our services focus on maximizing a person's interdependence, dignity, and quality of life. The Life Values based Redesign Flexibly structured Nothing about me without me Model: The individual in the driver’s seat as the Intention expert in their own life Creative, resourceful, whole and wise ally Leveraging neuroplasticity Balancing safety with smart risks Different Relevant, real-life activities Social capital, and meaningful community participation How does CONNECT & Life Redesign differ from a traditional care facility? Empower individuals to create a meaningful life in a non-institutional setting. Build a life that is driven by their own interests and goals. Encourages personal responsibility. Freedom to make their own choices and are coached to do so. A doing-with rather than doing-for approach. Eases the transition from hospital to home. Supports smart risk-taking, while supported by a team. Equip them to thrive in their community.  Hey TR’s! We Found A Tool That Helps to Support Individuals With An ABI!  Traditional Rehabilitation Approach Improve stamina PT Improve balance Organize calendar Paul OT Budget finances 29 years old Improve ability to express complex thoughts and ideas 10 years ago ABI after car accident Engage with others in socially welcome ways SLP Had his fair share of therapy and therapists Very depressed and no reason to get up Provide support and counseling to help adjust to new SW Goal-”Just Want To Be Like My Old Self” realities Find something to do with your days other than work Rec  Life Redesign Paul 29 years old 10 years ago ABI after car The Secret Sauce accident Had his fair share of therapy and therapists Very depressed and no reason to get up need to feel proud of myself SLP PT REC OT SW SLP OT REC live in my own apartment PT want to have a friend REC SLP SW get back into work SLP PT OT REC  Rehabilitation Treatment Specification System short term goals (RTSS) long term goals shorter long-term goals longer short-term goals A theory-driven conceptual framework to better specify EXACTLY what is going on in rehabilitation Compare approaches AIMS - The Big Dream Duplicate approaches Research approaches TARGETS - What Are You Keeps people on the same page Doing Today Acts as a map of where a program is headed INGREDIENTS - What do you need to make it happen  APRIL 2024 Life Redesign Goal #1 Make more social connections Aim #1 Plan a pool tournament Target #1 Target #2 Target #3 Create a poster to promote the tournament Plan for food Purchase prizes Ingredients Phone, laptop, or tablet to research where I can buy food, and to make the poster Exercises to strengthen legs for walking around the building Presto card to take the bus, or arrange for DARTS pickup and drop off Scheduled time with Play Coach Cleaning supplies Paper plates, cups, and napkins Google to research the price of prizes (keep under $50) 30