Posts Tagged emotional

[Guide] LIFE AFTER STROKE Our Path Forward – American Stroke Association

THERE IS LIFE – AND HOPE – AFTER STROKE. WITH TIME, NEW ROUTINES WILL BECOME SECOND NATURE. REHABILITATION CAN BUILD YOUR STRENGTH, CAPABILITY AND CONFIDENCE. IT CAN HELP YOU CONTINUE YOUR DAILY ACTIVITIES DESPITE THE EFFECTS OF YOUR STROKE.

If you are the caregiver, family member or friend of a stroke survivor, your role is vital. You should know the prevention plan and help your loved one to comply with the plan. With a committed health care team and a rehabilitation plan specific to their needs, most stroke survivors can prevent another stroke and thrive.

We hope this guide will help you and your loved ones understand the effects of stroke and how to maximize your rehabilitation and recovery.

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[WEB SITE] How to Help Patients in Wheelchairs Express Their Personal Style – Rehab Managment

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disabled-wheelchair

By Rae Steinbach

A physical therapist doesn’t merely help someone recover from an injury or accident by improving their mobility. Physical therapists also pay attention to the emotional experiences of those with whom they work.

For instance, people who have recently begun to use wheelchairs often struggle with depression. Their inability to live a fully independent life can result in negative self-talk. Ideally, a physical therapist working with such a patient would notice their mood and identify ways to provide support.

Marla Ranieri of BetterPT further emphasizes this point, sharing that, “Being able to integrate a person back to their community and social activities physically and mentally is one of the most rewarding aspects of being a physical therapist. We provide them the tools they need to enjoy life again.”

Offering fashion tips such as these is one way they can help. Liking what they see in the mirror can help those in wheelchairs start to feel more confident in themselves and their appearance. The problem is, a person who isn’t accustomed to using a wheelchair may struggle to dress well if this experience is new to them.

That doesn’t need to be the case. If you’re a physical therapist working with patients in wheelchairs, help them be more fashionable by offering this key advice:

Wear a Stylish Belt

Long dresses or jackets that look impressive when a person wearing them is standing can get bunched up when a person is sitting down. Luckily, someone in a wheelchair can still enjoy these types of garments. They simply need to add a belt or waistband to the outfit. This smooths out tops and creates a more tailored look.

Choose Form-Fitting Clothing

Again, wheelchair users can wear longer dresses and jackets if they wish. It may even be advisable. Longer tops create the illusion of a longer torso.

That said, wheelchair users need to make sure their tops aren’t too loose. Too much fabric will look boxy when the person wearing such garments is seated. It’s smarter to choose form-fitting clothing. Additionally, excess fabric can get caught in wheelchair components, making it difficult for a person to easily use their wheelchair.

Display Your Shoulders

Dressing to impress is a lot easier for wheelchair users than some may realize. It’s often as simple as wearing a shoulder-baring top. This is a subtle but effective way to make an outfit a bit more daring.

Don’t Overlook Accessories

Learning how to adjust your personal style appropriately if you’ve recently begun using a wheelchair is a process. Although the advice you give patients will help, there are still likely to be instances when they’re not happy with the way a certain outfit looks.

Encourage them to accessorize when this happens. Adding the right accessories can transform a dull outfit into something much more remarkable. Consider recommending a summer subscription box or one that coincides with the approaching season. That way, your patient is sure to have new accessories and styling pieces that excite them throughout the year.

Again, these are important points for physical therapists to keep in mind. You have the chance to help people in wheelchairs feel much more confident. Providing this type of advice will help.

Rae Steinbach is a graduate of Tufts University with a combined International Relations and Chinese degree. Rae is passionate about travel, food, and writing for Jetty.

 

via How to Help Patients in Wheelchairs Express Their Personal Style – Rehab Managment

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[Factsheet] Understanding TBI: Part 2 – Brain injury impact on individuals functioning – Model Systems Knowledge Translation Center (MSKTC)

Father teaching child with blocks

Written by Thomas Novack, PhD and Tamara Bushnik, PhD in collaboration with the MSKTC

 

A traumatic brain injury interferes with the way the brain normally works. When nerve cells in the brain are damaged, they can no longer send information to each other in the normal way. This causes changes in the person’s behavior and abilities. The injury may cause different problems, depending upon which parts of the brain were damaged most.

There are three general types of problems that can happen after TBI: physical, cognitive and emotional/ behavioral problems. It is impossible to tell early on which specific problems a person will have after a TBI. Problems typically improve as the person recovers, but this may take weeks or months. With some severe injuries changes can take many years.

Structure and function of the brain

The brain is the control center for all human activity, including vital processes (breathing and moving) as well as thinking, judgment, and emotional reactions. Understanding how different parts of the brain work helps us understand how injury affects a person’s abilities and behaviors.

Left vs. Right Brain

  • The brain is divided into two halves (hemispheres). The left half controls movement and sensation in the right side of the body, and the right half controls movement and sensation in the left side. Thus, damage to the right side of the brain may cause movement problems or weakness on the body’s left side.
  • For most people, the left half of the brain is responsible for verbal and logical functions including language (listening, reading, speaking, and writing), thought and memory involving words.
  • The right half is responsible for nonverbal and intuitive functions such as putting bits of information together to make up an entire picture, recognizing oral and visual patterns and designs (music and art), and expressing and understanding emotions.

Brain Areas & Associated Functions

The brain is made up of six parts that can be injured in a head injury. The effect of a brain injury is partially determined by the location of the injury. Sometimes only a single area is affected, but in most cases of TBI multiple areas have been injured. When all areas of the brain are affected, the injury can be very severe.

Image of Brain with Lobe Information

Six parts Functions
Brain Stem
  • Breathing
  • Heart Rate
  • Swallowing
  • Reflexes for seeing and hearing
  • Controls sweating, blood pressure, digestion, temperature
  • Affects level of alertness
  • Ability to sleep
  • Sense of balance
Cerebellum
  • Coordination of voluntary movement
  • Balance and equilibrium
  • Some memory for reflex motor acts
Frontal Lobe
  • How we know what we are doing within our environment
  • How we initiate activity in response to our environment
  • Judgments we make about what occurs in our daily activities
  • Controls our emotional response
  • Controls our expressive language
  • Assigns meaning to the words we choose
  • Involves word associations
  • Memory for habits and motor activities
  • Flexibility of thought, planning and organizing
  • Understanding abstract concepts
  • Reasoning and problem solving
Parietal Lobe
  • Visual attention
  • Touch perception
  • Goal directed voluntary movements
  • Manipulation of objects
  • Integration of different senses
Occipital Lobes
  • Vision
Temporal Lobes
  • Hearing ability
  • Memory aquisition
  • Some visual perceptions such as face recognition and object identification
  • Categorization of objects
  • Understanding or processing verbal information
  • Emotion

Physical Problems

Most people with TBI are able to walk and use their hands within 6-12 months after injury. In most cases, the physical difficulties do not prevent a return to independent living, including work and driving.

In the long term the TBI may reduce coordination or produce weakness and problems with balance. For example, a person with TBI may have difficulty playing sports as well as they did before the injury. They also may not be able to maintain activity for very long due to fatigue.

Cognitive (Thinking) Problems

  • Individuals with a moderate-to-severe brain injury often have problems in basic cognitive (thinking) skills such as paying attention, concentrating, and remembering new information and events.
  • They may think slowly, speak slowly and solve problems slowly.
  • They may become confused easily when normal routines are changed or when things become too noisy or hectic around them.
  • They may stick to a task too long, being unable to switch to different task when having difficulties.
  • On the other hand, they may jump at the first solution they see without thinking it through.
  • They may have speech and language problems, such as trouble finding the right word or understanding others.
  • After brain injury, a person may have trouble with all the complex cognitive activities necessary to be independent and competent in our complex world. The brain processes large amounts of complex information all the time that allows us to function independently in our daily lives. This activity is called executive function because it means being the executive or being in charge of one’s own life.

Emotional/Behavioral Problems

Behavioral and emotional difficulties are common and can be the result of several causes:

  • First, the changes can come directly from damage to brain tissue. This is especially true for injuries to the frontal lobe, which controls emotion and behavior.
  • Second, cognitive problems may lead to emotional changes or make them worse. For example, a person who cannot pay attention well enough to follow a conversation may become very frustrated and upset in those situations.
  • Third, it is understandable for people with TBI to have strong emotional reactions to the major life changes that are caused by the injury. For example, loss of job and income, changes in family roles, and needing supervision for the first time in one’s adult life can cause frustration and depression.

Brain injury can bring on disturbing new behaviors or change a person’s personality. This is very distressing to both the person with the TBI and the family. These behaviors may include:

  • Restlessness
  • Acting more dependent on others
  • Emotional or mood swings
  • Lack of motivation
  • Irritability
  • Aggression
  • Lethargy
  • Acting inappropriately in different situations
  • Lack of self-awareness. Injured individuals may be unaware that they have changed or have problems. This can be due to the brain damage itself or to a denial of what’s really going on in order to avoid fully facing the seriousness of their condition.

Fortunately, with rehabilitation training, therapy and other supports, the person can learn to manage these emotional and behavioral problems.

Disclaimer

This information is not meant to replace the advice from a medical professional. You should consult your health care provider regarding specific medical concerns or treatment.

Source

Our health information content is based on research evidence whenever available and represents the consensus of expert opinion of the TBI Model Systems directors.

Our health information content is based on research evidence and/or professional consensus and has been reviewed and approved by an editorial team of experts from the TBI Model Systems.

Authorship

Understanding TBI was developed by Thomas Novack, PhD and Tamara Bushnik, PhD in collaboration with the Model System Knowledge Translation Center. Portions of this document were adapted from materials developed by the University of Alabama TBIMS, Baylor Institute for Rehabilitation, New York TBIMS, Mayo Clinic TBIMS, Moss TBIMS, and from Picking up the pieces after TBI: A guide for Family Members, by Angelle M. Sander, PhD, Baylor College of Medicine (2002).

via Understanding TBI: Part 2 – Brain injury impact on individuals functioning | Model Systems Knowledge Translation Center (MSKTC)

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[ARTICLE] Course of Social Participation in the First 2 Years After Stroke and Its Associations With Demographic and Stroke-Related Factors – Full text

Background. Many persons with stroke experience physical, cognitive, and emotional problems that contribute to restrictions in social participation. There is, however, a lack of knowledge on the long-term course of participation over time post-stroke.

Objective. To describe the time course of participation up to 2 years post-stroke and to identify which demographic and stroke-related factors are associated with this time course.

Methods. This was a multicenter, prospective cohort study following 390 persons with stroke from hospital admission up to 2 years (at 2, 6, 12, and 24 months). Multilevel modeling with linear and quadratic time effects was used to examine the course of the frequency of vocational and social/leisure activities, experienced restrictions, and satisfaction with participation.

Results. The frequency of vocational activities increased up to 1 year post-stroke and leveled off thereafter. Older and lower-educated persons showed less favorable courses of participation than younger and higher-educated persons, respectively. The frequency of social/leisure activities decreased post-stroke. Participation restrictions declined up to 1 year post-stroke and leveled off thereafter. Persons dependent in activities of daily living (ADL) kept experiencing more restrictions throughout time than independent persons. Satisfaction with participation increased slightly over time.

Conclusions. Changes in participation occurred mostly in the first year post-stroke. Particularly older and lower-educated persons, and those dependent in ADL showed less favorable courses of participation up to 2 years post-stroke. Clinicians can apply these findings in identifying persons most at risk of long-term unfavorable participation outcome and, thus, target rehabilitation programs accordingly.

Stroke can lead to long-lasting physical problems such as mobility limitations,1cognitive problems such as attention or memory deficits,2 and emotional problems such as anxiety,3,4 depressive symptoms,35 and fatigue.4,6 The population of persons surviving a stroke7,8 increases, consistent with major improvements in acute stroke care (eg, stroke units, thrombolysis, and thrombectomy9,10), but this also means that more people have to deal with the long-lasting consequences of stroke.11,12 These consequences contribute to the deterioration of social participation post-stroke.1317 Importantly, persons with stroke view social participation (participation hereafter) as a central aspect of their recovery.18,19

Participation can be defined as involvement in a life situation such as paid work, family, or community life,17 which consists of actual performed activities,20 such as the frequency of observable actions and behaviors,2123 and the subjective experience of persons,20 such as experienced restrictions and satisfaction.2123

In previous studies, it was observed that the frequency of activities decreases in persons with stroke, relative to their premorbid levels.16,2428 This particularly applies to vocational activities (work, unpaid work, and household activities), but social activities decrease after stroke, too.28 Four months after discharge from outpatient rehabilitation, 50% of persons with stroke still experienced participation problems.29Social activity levels have been reported to be lower in persons with stroke at 1 year post-stroke than in healthy controls,30 a level that remained stable up to 3 years.31Past studies showed that only 39% of persons with stroke were satisfied with their lives as a whole after 1 year,16 which might be even lower up to 3 years post-stroke,32 especially in socially inactive persons.33

Although studies have shed some light on the course of participation over time post-stroke, it is difficult to get a good understanding of how levels of participation develop and change over time. This is a result of the use of cross-sectional designs,16,24,26,27,33 longitudinal designs limited to either only the first 6 months13,25,28,29 or only the long-term levels of participation after stroke,31,32,34studies only incorporating 2 time points,35 and many different participation measures, some measuring the frequency of activities and others the subjective experience of participation.36

Research into factors associated with participation post-stroke could lead to identifying possible risk factors of an unfavorable outcome. Earlier studies showed that demographic factors such as older age at stroke onset,14,37 lower levels of education,29,38 and female sex37 were related to a less favorable outcome in terms of participation, along with stroke-related factors such as dependence in activities of daily living (ADL),39,40 more severe stroke,37 and lower levels of cognitive functioning.26,29 However, these factors are yet to be examined in relation to the course of participation over time and as such to be identified as possible risk factors.

To get a more detailed and comprehensive understanding of participation over time, it is necessary to include repeated measurements of objective (ie, frequency of activities) as well as subjective (ie, experienced restrictions and satisfaction) aspects of participation. Furthermore, it is important to identify persons in the early stage after stroke, who are at risk of an unfavorable outcome in the long term. At this point in time, potential risk factors can be easily determined through available information, including demographics and stroke-related information, and rehabilitation care can be provided. Consequently, we studied participation over a 2-year follow-up in a clinical cohort of persons with stroke in order to answer the following research questions: how does participation develop over the first 2 years after stroke in terms of frequency, restrictions, and satisfaction? Moreover, which demographic and stroke-related factors are associated with this time course?[…]

 

Continue —> Course of Social Participation in the First 2 Years After Stroke and Its Associations With Demographic and Stroke-Related Factors – Daan P. J. Verberne, Marcel W. M. Post, Sebastian Köhler, Leeanne M. Carey, Johanna M. A. Visser-Meily, Caroline M. van Heugten, 2018

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[WEB SITE] 7 signs of executive dysfunction after brain injury

7 signs of executive dysfunction after brain injury Main Image

 ‘Executive dysfunction‘ is not, perhaps, a particularly well known term, but the effects of brain injury that it covers are very common indeed. It is used to collectively describe impairment in the ‘executive functions’ – the key cognitiveemotional and behavioural skills that are used to navigate through life, especially when undertaking activities and interacting with others.

Although executive dysfunction is a common problem among many brain injury survivors, it is most commonly experienced following an injury to the frontal lobe.

The importance of executive functions is shown by the difficulties caused when they don’t work properly and someone has problems with executive dysfunction. Since the executive functions are involved in even the most routine activities, frontal injuries leading to executive dysfunction can lead to problems in many aspects of life.

Here we list the most common effects of executive dysfunction, with some examples of common issues that brain injury survivors can face:

Difficulties with motivation and organisation

  • Loss of ‘get up and go’, which can be mistaken for laziness
  • Problems with thinking ahead and carrying out the sequence of steps needed to complete a task

Rigid thinking

  • Difficulty in evaluating the result of actions and reduced ability to change behaviour or switch between tasks if needed

Poor problem solving

  • Finding it hard to anticipate consequences
  • Decreased ability to make accurate judgements or find solutions if things are going wrong

Impulsivity

  • Acting too quickly and impulsively without fully thinking through the consequences, for example, spending more money than can be afforded

Mood disturbances

  • Difficulty in controlling emotions which may lead to outbursts of emotion such as anger or crying
  • Rapid mood changes may occur, for example, switching from happiness to sadness for no apparent reason

Difficulties in social situations

  • Reduced ability to engage in social interactions
  • Finding it hard to initiate, participate in, or pay attention to conversations
  • Poor judgement in social situations, which may lead to saying or doing inappropriate things

Memory/attention problems

  • Finding it harder to concentrate
  • Difficulty with learning new information
  • Decreased memory for past or current events, which may lead to disorientation

Find out more

If you or someone you care for is affected by executive dysfunction, it is important to seek support. Speak to your doctor about your symptoms, and ask about referral to specialist services such as counselling, neuropsychology and rehabilitation.

You can find out more and get tips and strategies to help manage your condition on our executive dysfunction after brain injury page.

Headway groups and branches can offer support in your area, and you can contact our helpline if you would like to talk things through.

via 7 signs of executive dysfunction after brain injury | Headway

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[WEB SITE] Executive dysfunction after brain injury

Executive dysfunction after brain injury

Executive dysfunction is a term for the range of cognitiveemotional and behavioural difficulties which often occur after injury to the frontal lobes of the brain. Impairment of executive functions is common after acquired brain injury and has a profound effect on many aspects of everyday life.

This page explains what executive functions are, why they are so important and which part of the brain is responsible for controlling them. It then provides an overview of the causes, effects, assessment and rehabilitation of executive dysfunction. Some general coping strategies are also suggested to help brain injury survivors to compensate for impairments.

What are executive functions?

Executive functioning is an umbrella term for many abilities including:

  • Planning and organisation
  • Flexible thinking
  • Monitoring performance
  • Multi-tasking
  • Solving unusual problems
  • Self-awareness
  • Learning rules
  • Social behaviour
  • Making decisions
  • Motivation
  • Initiating appropriate behaviour
  • Inhibiting inappropriate behaviour
  • Controlling emotions
  • Concentrating and taking in information

Most of us take these abilities for granted and we effortlessly perform extremely complex tasks all the time in our everyday lives. Let us consider, for example, the role of some executive functions in a ‘simple’ activity like cooking a meal:

Motivation – Wanting to make a nice meal and making the decision to start doing it.

Planning and organisation – Getting all the ingredients and thinking about the right times to start them cooking so they will be ready at the same time.

Monitoring performance – Checking the food is cooking properly and the water isn’t boiling over.

Flexible thinking – Lowering the heat if the food is cooking too quickly or leaving it longer if it is not cooked.

Multi-tasking – Washing the laundry and putting it out to dry, while still remembering to attend to the food at the right times.

These complex skills require advanced brain functions. The brain areas involved are described in the next section.

Which part of the brain controls executive functions?

Executive functions are controlled by the frontal lobes of the brain. The frontal lobes are connected with many other brain areas and co-ordinate the activities of these other regions. They can be thought of as the conductor of the brain’s orchestra. Injury to the frontal lobes is the most common cause of executive dysfunction. Occasionally, damage to other brain areas which are connected to the frontal lobes can also impair executive functions.

The frontal lobes cover a large part of the front of the brain, directly behind the forehead. The diagram below shows their location:

The frontal lobes can be damaged by any form of acquired brain injury, such as stroketumourencephalitis  and meningitis They are particularly vulnerable to traumatic brain injury, due to their location at the front of the brain and their large size. Even a blow to the back of the head can cause frontal lobe injury because the brain is knocked back and forth in the skull and the frontal lobes bang against bony ridges above the eyes.

What is executive dysfunction?

The importance of executive functions is shown by the difficulties caused when they don’t work properly. Since the executive functions are involved in even the most routine activities, frontal lobe injuries can lead to deficits in cognitive (thinking) skills, personality and social behaviour.

The most common effects of executive dysfunction are summarised below:

Difficulties with initiating, organising and carrying out activities

  • Loss of ‘get up and go’.
  • Problems with thinking ahead and carrying out the sequence of steps needed to complete a task.

This can often be mistaken for ‘laziness’ or a lack of motivation and energy.

Rigidity in thoughts and actions

  • Difficulty in evaluating the result of actions and reduced ability to change behaviour or switch between tasks if needed.

Poor problem solving

  • Finding it hard to anticipate consequences.
  • Decreased ability to make accurate judgements or find solutions if things are going wrong.

Impulsivity

  • Acting too quickly and impulsively without fully thinking through the consequences. For example, spending more money than can be afforded.

Mood disturbances

  • Difficulty in controlling emotions which may lead to outbursts of emotion such as anger or crying.
  • Rapid mood changes may occur. For example, switching from happiness to sadness for no apparent reason.

Difficulties in social situations

  • Reduced ability to engage in social interactions.
  • Finding it hard to initiate, participate in, or pay attention to conversations.
  • Poor judgement in social situations, which may lead to saying or doing inappropriate things.

Difficulties with memory and attention

  • Finding it harder to concentrate.
  • Difficulty with learning new information.
  • Decreased memory for past or current events, which may lead to disorientation.

You may hear different names for these symptoms. They are commonly referred to as executive dysfunction but many people use the term ‘dysexecutive syndrome’ or simply ‘frontal lobe problems’. They are sometimes referred to as a syndrome because several of the symptoms usually occur together.

It is important to remember that not everyone with executive dysfunction experiences all of these problems. The symptoms can range from subtle effects, which only close friends and family members may notice, to extreme and problematic behaviour.

The effects of executive dysfunction on day-to-day life

It is often hard for people with frontal lobe injuries to explain the difficulties they are experiencing, often because they may be unaware that their behaviour is inappropriate. Their behaviour may appear to be very anti-social and can be misunderstood as depression, lack of motivation, selfishness, or aggression. Relationships with others may be negatively affected as a result.

Executive functioning problems may also have a significant emotional impact and can lead to feelings of frustration, exhaustion, embarrassment and isolation. It can also be very difficult to return to work due to problems with multi-tasking, organisation and motivation. An inability to prioritise and complete tasks also makes working life difficult.

It is important to be aware of the fact that these behaviours occur as a result of brain injury and are not intentional. Specialised input from rehabilitation specialists, such as neuropsychologists and occupational therapists, can help to compensate for the problems.

The following sections provide an overview of assessment and rehabilitation, before providing some practical coping strategies.

Assessing executive dysfunction

The initial assessment of executive functioning after brain injury will usually be carried out by a clinical neuropsychologist. The assessment provides detailed information about an individual’s cognitive, emotional and behavioural deficits. The results can then assist in planning rehabilitation strategies to manage the problems.

During an assessment, the neuropsychologist will consider the following questions:

  • What are the main problems for the individual and their family?
  • How do the problems affect functioning in everyday life?
  • What are the person’s goals and can they go back to work/college/school?
  • To what extent are the executive deficits related to other problems in areas such as language, memory and perception?
  • How do the person’s abilities compare with others of the same age, background, gender and with injury to a similar area of the brain?
  • How are the person with brain injury and their family coping?
  • What kind of rehabilitation should be offered?

Neuropsychological assessments involve a range of different standardised tests, which are designed to measure different aspects of cognitive functioning. Some of these tests are in a questionnaire, puzzle or game format, while others take place in a real-world environment. It is very important that the tests are completed without prior knowledge or preparation in order for them to accurately reflect an individual’s abilities. For that reason, no details of specific tests are included here.

It is important to remember that there are no passes or failures in the assessments. They simply provide an indication of areas that need help and rehabilitation, so there is no need for people to worry about their performance but simply to complete the tasks as best they can.

Rehabilitation of executive dysfunction

Rehabilitation of executive dysfunction can be challenging and requires an individualised approach to treatment. The rehabilitation programme for each patient will depend on their goals, the nature of their difficulties, selfawareness, readiness to engage in treatment, level of social support and presence of other issues such as mood disturbances.

An important part of the rehabilitation process is educating the person about the effects of their injury. This can help increase the person’s insight and understanding of what has happened. For that reason, reading this factsheet or other Headway information materials may be helpful for both survivors and their family members.

If you feel that you or someone you know would benefit from rehabilitation then the first step is to ask a GP if a referral is available, preferably to a neuropsychologist initially. If there are no NHS referrals available then it may be possible to visit someone in private practice.

For more information on this subject see the Headway booklet Rehabilitation after brain injury, or visit the ‘Rehabilitation after brain injury‘ section using the link on the right. Also, the Headway helpline can talk you through the referral process and signpost you to organisations that can help.

Coping strategies for brain injury survivors

Because executive functions are such a vital part of our everyday lives, it is important to find ‘survival strategies’ when problems arise. Here are a few suggestions of strategies that may help if you have difficulties yourself:

Planning

Allow yourself plenty of time to plan activities and record your plans, using as many aids as you find helpful (such as calendars, diaries, electronic timing devices, mobile phones and pagers).

  • When planning your day, week, or a particular activity use a step-bystep approach, dividing the activity into manageable ‘chunks’.
  • Use checklists and tick off each part of the activity that you have accomplished. This will help you to stay on track.
  • Mentally rehearse your plans.
  • Discuss your plans for the day with others. They can help you to write down a step-by-step checklist of the different actions for that day.
  • Similar strategies can be used for longer term planning, such as appointments you need to make. Discussing your plans with others will make you more likely to remember and the other person can remind you of things if necessary.
  • Step-by-step checklists can be placed in key locations in the house in order to remind you of the different sequences to go through to do a task, such as preparing a meal.
  • Prepare a weekly routine for tasks like shopping, washing and tidying the house. Knowing that, for example, Monday is shopping day, will make you more motivated to get the task done.
  • Try to develop back up plans in advance, rather than when problems arise.

Many strategies for overcoming memory problems can also be helpful for difficulties with planning. See the Headway factsheet Coping with memory problems – practical strategies for more information.

Mood

  • If you feel unable to manage your emotions, it may help to talk to your doctor about this. They may be able to refer you to a form of therapy that will work for you, such as cognitive behavioural therapy (CBT).
  • It may be helpful for others to make allowances for the difficulties you may experience in controlling your mood. When you feel very upset, it may be better for the other person to try to calm the situation in the short term and discuss it with you later.
  • Others may need to make allowances for changes in your behaviour and personality. It is important for them to remember that the changes are a result of the injury and not because you are being lazy, self-centred or difficult.

Social difficulties

  • Trusted friends or family members could help you by reminding you of what may be the most appropriate thing to do or say if you are struggling in social situations.
  • It may help to mentally prepare for social situations and to think about any difficult situations that have occurred before in similar environments.

Executive dysfunction from a carer’s point of view

Caring for a person with executive deficits can be a full-time job and living with personality and behaviour changes in a relative or friend can be very distressing.

Problems that carers may experience include:

  • Stress, anxiety or depression
  • Increased responsibility
  • Strained relationships
  • Reduced communication with partner
  • Restricted leisure/social life
  • Reduced sexual and emotional intimacy with a partner
  • Feeling tired and frustrated

It is important for family members, carers and friends to access support for their practical and emotional needs. Input from the rehabilitation team can help and some people find peer support groups for carers useful. Headway’s Groups and Branches offer valuable support for both survivors and family members. It is also important to see a GP, who will be able to refer to local counselling and therapy services where they are available.

For further information see the Headway booklet Caring for someone with a brain injury, which can be obtained free-of-charge from the Headway helpline, or visit the ‘Caring‘ section for more information. The helpline can also provide support and refer to local Groups and Branches.

Conclusion

The frontal lobes are commonly affected by acquired brain injury. Damage to the frontal lobes is likely to cause symptoms which are collectively termed executive dysfunction.

The diverse ways executive difficulties present themselves mean that assessment and rehabilitation are not straightforward. However, with appropriate rehabilitation and the use of coping strategies, many people can make good recoveries and learn to manage their difficulties.

via Executive dysfunction | Headway

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[WEB SITE] Coping With Emotional Changes After Stroke for Families

Coping With Emotional Changes After Stroke-blog

As a stroke survivor, you can face major life changes. In the aftermath of a stroke, you may experience a sense of loss that is rooted in the feeling that you’ve lost the life you had before your stroke, or your independence. These strong emotional reactions take a toll.

It is normal to experience emotions ranging from frustration, anxiety, and depression to a sense of grief, or even guilt, anger, and denial after such a monumental change. Realizing that these emotions are normal, and that you are not alone in experiencing them, is an important step to acknowledging and coping with them in a healthy way. By doing this, you avoid becoming overwhelmed, thus avoiding further difficulties during your recovery.

Reasons for Emotional Changes After a Stroke

Young Man At Balcony In Depression Suffering Emotional Crisis And Grief

A stroke causes physical damage to your brain. Feeling or behaving differently after a stroke may be connected to the area of your brain that was damaged. If the area of your brain that controls personality or emotion is affected, you may be susceptible to changes in your emotional response or everyday behavior. Strokes may also cause emotional distress due to the suddenness of their occurrence. As with any traumatic life experience, it may take time for you to accept and adapt to the emotional trauma of having experienced a stroke.

Emotional Changes a Stroke Might Cause

PseudoBulbar Affect

crying

Sometimes referred to as “reflex crying,” “emotional lability,” or “labile mood,” Pseudobulbar Affect (PBA) is a symptom of damage to the area of the brain that controls expression of emotions. Characteristics of the disorder include rapid changes in mood, such as suddenly bursting into tears and stopping just as suddenly, or even beginning to laugh at inappropriate times.

Depression

depressed

If you are feeling sad, hopeless, or helpless after having suffered a stroke, you may be experiencing depression. Other symptoms of depression may include irritability or changes to your eating and sleeping habits. Talk to your doctor if you are experiencing any of these symptoms, as it may be necessary to treat with prescription antidepressants or therapy to avoid it becoming a road block to your recovery.

Anxiety

anxiety

Anxiety is quite common after a stroke. You may have feelings of uneasiness or fears about your health; this is normal and healthy. However, if your anxiety does not subside in time and you feel overwhelmed, you may be dealing with an anxiety disorder, which requires help from your doctor or a mental health professional.

Medical staff will perform an informal evaluation to check for anxiety while you are in the hospital. Often, this involves a quick discussion with hospital staff, during which they will ask you if you have any worries or fears about your health. This evaluation may also involve hospital staff asking your family members if they have noticed a change in your mood or behavior. It is important that you are kept in the loop about any issues that may present themselves, and that you are provided with as much information about your health and treatment options as possible.

Symptoms of anxiety to watch for may include irritability or trouble concentrating. You may also experience trouble sleeping due to your mind racing about your health. Sometimes, you can become tired easily, even if well rested.

Physical symptoms may also present themselves. These symptoms include a racing heart and restlessness and are often coupled with a sense of overwhelming worry or dread. If you find yourself avoiding your normal activities, such as grocery shopping, visiting friends, going for walks, or spending a large portion of your day dwelling on things you are worried about, you may have an anxiety disorder. Your doctor can recommend that you visit a psychologist to help cope with and eventually overcome anxiety.

Other Emotional Reactions

You may experience a range of other emotional reactions after a stroke, including anger and frustration. Additional symptoms may be a sense of apathy or a lack of motivation to accomplish things you typically enjoy.

Coping With Changing Emotions

Physician Ready To Examine Patient And Help

There are many ways to treat the emotional changes associated with a stroke. The first step is discussing how you feel, as well as any concerns you may have about your health with your doctor. One treatment option is counseling, which involves speaking about your distressing thoughts and feelings with a mental health professional or therapist. Simply talking about the way you are feeling can be helpful when coping with overwhelming emotions after experiencing a traumatic event such as a stroke.

Your doctor may also prescribe antidepressants or anti-anxiety medication to help you deal with the emotions involved with a stroke. While they are not a cure-all for emotional troubles, antidepressants change the levels of certain chemicals in your brain, alleviating the symptoms of depression and anxiety, lifting your mood, and making life feel more bearable while you’re recovering. It is important to stay in contact with your doctor if you decide to take medication, as it will not be effective for everyone and may have unpleasant side effects.

Seek Support or Professional Advice

A stroke can come on suddenly and have a monumental effect on your life. For this reason, it is common for many patients to struggle with emotional side effects following a stroke. You may suffer damage to the section of your brain that affects emotions, causing a change in personality or emotional expression known as Pseudobulbar Affect. You may also experience symptoms of anxiety or depression, along with feelings of anger, frustration, or uncharacteristic apathy.

It is important to discuss your emotional concerns with your doctor. You may need a prescription for antidepressants or anti-anxiety medication, or a recommendation to see a mental health professional who can help you form healthy coping mechanisms.


All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.

via Coping With Emotional Changes After Stroke for Families

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[WEB SITE] Transcranial electrical stimulation shows promise for treating mild traumatic brain injury

 

Credit: copyright American Heart Association

Using a form of low-impulse electrical stimulation to the brain, documented by neuroimaging, researchers at the University of California San Diego School of Medicine, Veterans Affairs San Diego Healthcare System (VASDHS) and collaborators elsewhere, report significantly improved neural function in participants with mild traumatic brain injury (TBI).

Their findings are published online in the current issue of the journal Brain Injury.

TBI is a leading cause of sustained physical, cognitive, emotional and behavioral problems in both the civilian population (primarily due to , sports, falls and assaults) and among military personnel (blast injuries). In the majority of cases,  is deemed mild (75 percent of civilians, 89 percent of military), and typically resolves in days.

But in a significant percentage of cases, mild TBI and related post-concussive symptoms persist for months, even years, resulting in chronic, long-term cognitive and/or behavioral impairment.

Much about the pathology of mild TBI is not well understood, which the authors say has confounded efforts to develop optimal treatments. However, they note the use of passive neuro-feedback, which involves applying low-intensity pulses to the brain through transcranial  (LIP-tES), has shown promise.

In their pilot study, which involved six participants who had suffered mild TBI and experienced persistent post-concussion symptoms, the researchers used a version of LIP-tES called IASIS, combined with concurrent electroencephalography monitoring (EEG). The  effects of IASIS were assessed using magnetoencephalography (MEG) before and after treatment. MEG is a form of non-invasive functional imaging that directly measures brain neuronal electromagnetic activity, with high temporal resolution (1 ms) and high spatial accuracy (~3 mm at the cortex).

“Our previous publications have shown that MEG detection of abnormal brain slow-waves is one of the most sensitive biomarkers for mild  (concussions), with about 85 percent sensitivity in detecting concussions and, essentially, no false-positives in normal patients,” said senior author Roland Lee, MD, professor of radiology and director of Neuroradiology, MRI and MEG at UC San Diego School of Medicine and VASDHS. “This makes it an ideal technique to monitor the effects of concussion treatments such as LIP-tES.”

The researchers found that the brains of all six participants displayed abnormal slow-waves in initial, baseline MEG scans. Following treatment using IASIS, MEG scans indicated measurably reduced abnormal slow-waves. The participants also reported a significant reduction in post-concussion scores.

“For the first time, we’ve been able to document with neuroimaging the effects of LIP-tES treatment on brain functioning in mild TBI,” said first author Ming-Xiong Huang, PhD, professor in the Department of Radiology at UC San Diego School of Medicine and a research scientist at VASDHS. “It’s a small study, which certainly must be expanded, but it suggests new potential for effectively speeding the healing process in mild traumatic injuries.”

Source: Transcranial electrical stimulation shows promise for treating mild traumatic brain injury

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[Abstract] Music-based interventions in neurological rehabilitation

Summary

During the past ten years, an increasing number of controlled studies have assessed the potential rehabilitative effects of music-based interventions, such as music listening, singing, or playing an instrument, in several neurological diseases. Although the number of studies and extent of available evidence is greatest in stroke and dementia, there is also evidence for the effects of music-based interventions on supporting cognition, motor function, or emotional wellbeing in people with Parkinson’s disease, epilepsy, or multiple sclerosis. Music-based interventions can affect divergent functions such as motor performance, speech, or cognition in these patient groups. However, the psychological effects and neurobiological mechanisms underlying the effects of music interventions are likely to share common neural systems for reward, arousal, affect regulation, learning, and activity-driven plasticity. Although further controlled studies are needed to establish the efficacy of music in neurological recovery, music-based interventions are emerging as promising rehabilitation strategies.

Source: Music-based interventions in neurological rehabilitation

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[VIDEO] Effect of Brain Injury on Personality – YouTube

How does personality change after brain injury? In this video, NeuroRestorative’s Dr. Gordon Horn explains the cognitive, emotional and social components that impact personality. As a Neuropsychologist, Dr. Horn works with individuals and families to evaluate, stabilize, and optimize personality changes so individuals can continue their rehabilitative progress.

Interested in learning more? Watch the other videos in our “Effects of Brain Injury” series!

Feel free to rate, comment on and share these videos with others!

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