Posts Tagged Stress

[WEB PAGE] Study shows that cannabis combats stress, anxiety and depression

© iStock/OlegMalyshev

A Washington State University study has examined how cannabis combats stress, anxiety and depression by looking at different strains and quantities of cannabis being inhaled by patients at home.

The work, published in the Journal of Affective Disorders, suggests that inhaling cannabis can significantly reduce short-term levels of depression, anxiety, and stress but may contribute to worse overall feelings of depression over time.

This new study is one of the first attempts by United States scientists to assess how cannabis with varying concentrations of THC and CBD affect medicinal cannabis users’ feelings of wellbeing when inhaled outside of a laboratory.

Current research not sufficient

Previous research to see whether cannabis combats stress and anxiety has be done with THC only strains that have been put into a capsule – but this study looks at the impact of cannabis when it is inhaled.

Carrie Cuttler, clinical assistant professor of psychology at Washington State University (WSU) and lead author of the study, said: “Existing research on the effects of cannabis on depression, anxiety and stress are very rare and have almost exclusively been done with orally administered THC pills in a laboratory.

“What is unique about our study is that we looked at actual inhaled cannabis by medical marijuana patients who were using it in the comfort of their own homes as opposed to a laboratory.”

The team found that one puff of cannabis high in CBD and low in THC was optimal for reducing symptoms of depression, two puffs of any type of cannabis was sufficient to reduce symptoms of anxiety, while 10 or more puffs of cannabis high in CBD and high in THC produced the largest reductions in stress.

Cuttler continued: “A lot of consumers seem to be under the false assumption that more THC is always better. Our study shows that CBD is also a very important ingredient in cannabis and may augment some of the positive effects of THC.”

Cannabis combats stress, anxiety and depression

The results of the study showed that patients inhaling cannabis saw a significant reduction in their adverse feelings with depression symptom being reduced in 89.3% of sessions. However, the study also revealed that the symptoms of depression were exacerbated in a total 3.2% of sessions, and there was no change in 7.5% of sessions.

Symptoms of anxiety were reduced in a total of 93.5% of tracked sessions but were exacerbated in 2.1% of sessions, and there was no change in symptoms for 4.4% of sessions. Symptoms of stress were reduced in 93.3% of tracked sessions, increased in 2.7% of sessions, and there was no change in reported levels of stress for 4% of sessions.

The study also compared the impact of cannabis on these symptoms between the sexes and found that women perceived a greater reduction in symptoms of anxiety than men did.

Dosage and the interaction between THC and CBD

The study compared different strains of cannabis that had different levels of THC and CBD to see if there was any difference.

When studying the effects on depression, the study revealed a significant THC and CBD interaction and the greatest reduction in ratings of depression were reported after using cannabis with relatively low levels of THC and relatively high levels of CBD. There was also a nonsignificant effect of dose on change in symptoms of depression.

Contrastingly, when looking at anxiety the study showed that there was no significant interaction between THC and CBD, and neither THC nor CBD alone were predictors of change in anxiety ratings.  Results of models testing change in ratings of anxiety across different doses also revealed a nonsignificant linear effect. However, the team tested several models to explore curvilinear relationships – finding a significant curvilinear relationship. Further contrasts revealed that one puff produced significantly smaller changes in ratings of anxiety than all other doses, but no other differences across doses beyond one puff were detected.

When looking at whether cannabis combats stress, however, the study revealed a significant THC and CBD interaction, whereby ratings of stress were reduced the most after using cannabis with relatively high levels of THC and relatively high levels of CBD. Doses In contrast, strains with high THC/low CBD, low THC/high CBD, or low THC/low CBD, showed no appreciable differences in symptom change. Varying doses revealed a significant linear effect of dose and significant reduction of symptoms when having up to ten puffs.

Collecting cannabis impact data

The study used data taken from an app which provides medical cannabis users a means of tracking how different doses and types of cannabis affect a wide variety of symptoms of wellbeing.

The users rate the symptoms they are experiencing before using cannabis on a scale of 1-10 and then input information about the type of cannabis they are using. Twenty minutes after inhaling, they are prompted to report how many puffs they took and to rerate the severity of their symptoms.

Cuttler and WSU colleagues Alexander Spradlin and Ryan McLaughlin used a form of statistical analysis called multilevel modelling to analyse around 12,000 anonymous app entries for depression, anxiety and stress. The researchers did not receive any of the app users personally identifying information for their work.

Cuttler said: “This is to my knowledge one of the first scientific studies to provide guidance on the strains and quantities of cannabis people should be seeking out for reducing stress, anxiety and depression. Currently, medical and recreational cannabis users rely on the advice of bud tenders whose recommendations are based off of anecdotal not scientific evidence.”

The study is among several cannabis-related research projects currently underway at WSU, all of which are consistent with federal law and many of which are funded with Washington state cannabis taxes and liquor license fees.

via Study shows that cannabis combats stress, anxiety and depression

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[WEB SITE] Coping with Post-TBI Anxiety & Stress – BrainLine

Brain Injury Anxiety and Stress“Social engagements became opportunities for embarrassment and ridicule, causing Melissa terrible personal conflicts. She wanted to be out among the crowds, but simultaneously felt vulnerable and frightened by them. Melissa sank into long sulks and quiet withdrawals. The invitations stopped coming and the phone rarely rang,” writes author and TBI case manager Michael Paul Mason about Melissa Felteau who sustained a brain injury in a car crash.

Anxiety can come in many colors and textures following a brain injury. It can bubble up in crowded, noisy places. It can surface when there is too much quiet — when worries seem to snowball and there is no place to hide.

What exactly are anxiety and stress?

Following a life-changing event like a brain injury, it’s normal to feel intense stress. But sometimes stress can build up and lead to anxiety. The main symptoms of anxiety are fear and worry. In turn, anxiety can cause or go hand-in-hand with other problems including:

People can express anxiety in both emotional and physical ways — from being inordinately irritable to experiencing shortness of breath or feelings of panic. Anxiety becomes a significant concern when these feelings intensify to a point where they interfere with the tasks of life. Anxiety can also be a symptom or effect of post-traumatic stress disorder.

Treatment

Like depression, chronic anxiety can cause low self-esteem and poor quality of life, and without treatment, symptoms can last longer or return. Anxiety is usually treated with medication and/or psychotherapy (counseling) by a trained professional. Treatment is usually quite successful, so there is little reason to delay seeking help. Here are a few strategies that people with anxiety after TBI have suggested:

  • Share things that worry you with others.
  • Set up a routine for your day and try to stick with it.
  • Stay involved in life. Find activities that give you pleasure — ones you used to enjoy, or new ones.
  • Be open to the support of others. Healthy relationships with family and friends are healing.
  • Acknowledge your feelings, and then find ways to accept them. There is no shame in feeling anxious or depressed after a life-changing event like brain injury.

Learning from anxiety

Sometimes facing your darkest emotions, like anxiety and depression, can help you better understand yourself. Melissa Felteau started meditating to help combat her own anxiety and depression; she found a new clarity. “That was my biggest problem,” she says. “I realized that I was always comparing myself to my pre-injury self. I was trapped in a vicious cycle of rumination and depression.”

Six years after her injury, through meditation and mindfulness, Melissa was able to shed her anxiety and use what she had learned to help herself — and others.

via Coping with Post-TBI Anxiety & Stress | BrainLine

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[Abstract] Improving Healthcare Access: A Preliminary Design of a Low-Cost Arm Rehabilitation Device

Abstract

A low-cost continuous passive motion (CPM) machine, the Gannon Exoskeleton for Arm Rehabilitation (GEAR), was designed. The focus of the machine is on the rehabilitation of primary functional movements of the arm. The device developed integrates two mechanisms consisting of a four-bar linkage and a sliding rod prismatic joint mechanism that can be mounted to a normal chair. When seated, the patient is connected to the device via a padded cuff strapped on the elbow. A set of springs have been used to maintain the system stability and help the lifting of the arm. A preliminary analysis via analytical methods is used to determine the initial value of the springs to be used in the mechanism given the desired gravity compensatory force. Subsequently, a multibody simulation was performed with the software simwise 4D by Design Simulation Technologies (DST). The simulation was used to optimize the stiffness of the springs in the mechanism to provide assistance to raising of the patient’s arm. Furthermore, the software can provide a finite element analysis of the stress induced by the springs on the mechanism and the external load of the arm. Finally, a physical prototype of the mechanism was fabricated using polyvinyl chloride (PVC) pipes and commercial metal springs, and the reaching space was measured using motion capture. We believed that the GEAR has the potential to provide effective passive movement to individuals with no access to postoperative or poststroke rehabilitation therapy.

 

via Improving Healthcare Access: A Preliminary Design of a Low-Cost Arm Rehabilitation Device | Journal of Medical Devices | ASME Digital Collection

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[WEB SITE] Triggers and Epilepsy

Some common epileptic triggers are stress, eating certain foods, flashing lights, or even lack of sleep. Knowing what your triggers are may help when coping with epileptic seizures.

On MyEpilepsyTeam, the social network and online support group for those living with epilepsy, members talk about a range of personal experiences and struggles. Triggers are one of the top 10 topics most discussed.

Here are a few question-and-answer threads about triggers:

Has anyone noticed food triggers?

Who thinks that doing physical labor or exercise is a trigger?

Stress, lack of sleep, adrenaline rushes… what are other triggers you experience?

Here are some conversations about triggers:

I am stressing because I worry about my job and stress is a trigger for me.

•. Some of my triggers are overheating, eating MSG or citrus.

Christmas lights are a trigger for me.

Have another topic you’d like to discuss or explore? Go to MyEpilepsyTeam today and start the conversation.
You’ll be surprised just how many others may share similar stories.

via Triggers and Epilepsy | MyEpilepsyTeam

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[WEB SITE] Traumatic brain injuries could be healed using peptide hydrogels

Traumatic brain injury (TBI) –– defined as a bump, blow or jolt to the head that disrupts normal brain function –– sent 2.5 million people in the U.S. to the emergency room in 2014, according to statistics from the U.S. Centers for Disease Control and Prevention. Today, researchers report a self-assembling peptide hydrogel that, when injected into the brains of rats with TBI, increased blood vessel regrowth and neuronal survival.

The researchers will present their results at the American Chemical Society (ACS) Fall 2019 National Meeting & Exposition. ACS, the world’s largest scientific society, is holding the meeting here through Thursday. It features more than 9,500 presentations on a wide range of science topics.

“When we think about traumatic brain injuries, we think of soldiers and athletes,” says Biplab Sarkar, Ph.D., who is presenting the work at the meeting. “But most TBIs actually happen when people fall or are involved in motor vehicle accidents. As the average age of the country continues to rise, the number of fall-related accidents in particular will also increase.”

TBIs encompass two types of injuries. Primary injury results from the initial mechanical damage to neurons and other cells in the brain, as well as blood vessels. Secondary injuries, which can occur seconds after the TBI and last for years, include oxidative stress, inflammation and disruption of the blood-brain barrier. “The secondary injury creates this neurotoxic environment that can lead to long-term cognitive effects,” Sarkar says. For example, TBI survivors can experience impaired motor control and an increased rate of depression, he says. Currently, there is no effective regenerative treatment for TBIs.

Sarkar and Vivek Kumar, Ph.D., the project’s principal investigator, wanted to develop a therapy that could help treat secondary injuries.

We wanted to be able to regrow new blood vessels in the area to restore oxygen exchange, which is reduced in patients with a TBI. Also, we wanted to create an environment where neurons can be supported and even thrive.”

Biplab Sarkar, Ph.D., New Jersey Institute of Technology

The researchers, both at the New Jersey Institute of Technology, had previously developed peptides that can self-assemble into hydrogels when injected into rodents. By incorporating snippets of particular protein sequences into the peptides, the team can give them different functions. For example, Sarkar and Kumar previously developed angiogenic peptide hydrogels that grow new blood vessels when injected under the skin of mice.

To adapt their technology to the brain, Sarkar and Kumar modified the peptide sequences to make the material properties of the hydrogel more closely resemble those of brain tissue, which is softer than most other tissues of the body. They also attached a sequence from a neuroprotective protein called ependymin. The researchers tested the new peptide hydrogel in a rat model of TBI. When injected at the injury site, the peptides self-assembled into a hydrogel that acted as a neuroprotective niche to which neurons could attach.

A week after injecting the hydrogel, the team examined the rats’ brains. They found that in the presence of the hydrogel, survival of the brain cells dramatically improved, resulting in about twice as many neurons at the injury site in treated rats than in control animals with brain injury. In addition, the researchers saw signs of new blood vessel formation. “We saw some indications that the rats in the treated group were more ambulatory than those in the control group, but we need to do more experiments to actually quantify that,” Sarkar says.

According to Kumar, one of the next steps will be to study the behavior of the treated animals to assess their functional recovery from TBI. The researchers are also interested in treating rats with a combination of their previous angiogenic peptide and their new neurogenic version to see if this could enhance recovery. And finally, they plan to find out if the peptide hydrogels work for more diffuse brain injuries, such as concussions. “We’ve seen that we can inject these materials into a defined injury and get good tissue regeneration, but we’re also collaborating with different groups to find out if it could help with the types of injuries we see in soldiers, veterans and even people working at construction sites who experience blast injuries,” Kumar says.

via Traumatic brain injuries could be healed using peptide hydrogels

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[Brochure] Understanding TBI Part 4: The impact of a recent TBI on family members and what they can do to help with recovery

How does brain injury affect family members?

For most family members, life is not the same after TBI. We want you to know that you are not alone in what you are feeling. While everyone’s situation is a bit different, there are some common problems that many family members experience such as less time for yourself, financial difficulties, role changes of family members, problems with communication, and lack of support from other family members and friends. These are just some of the problems that family members may face after injury. Sometimes these problems can seem too much and you may become overwhelmed, not seeing any way out. Family members have commonly reported feeling sad, anxious, angry, guilty, and frustrated.[…]

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[BLOG POST] 38 Ways to Relieve Stress Quickly

38 Ways to Relieve Stress Quickly

We all experience stress – sometimes a lot and sometimes not so much. Stress, your body’s reaction to change, can be related to positive changes like starting a new job or having a baby. But usually, when we talk about stress, we mean distress. This type of stress overwhelms your ability to cope and when it’s chronic or intense it can negatively affect your health, relationships, and emotional wellbeing.

 

Recognize the signs of stress

Stress, like many things, is easier to deal with when we catch it early. So, being aware of how stress shows up in your body and mind means you can use stress-relieving strategies before your stress gets out of control.

Common symptoms of stress include:

  • Irritability or anger
  • Headaches
  • Gastrointestinal issues (stomach aches, constipation or diarrhea, etc.)
  • Insomnia or trouble staying asleep
  • Excessive worrying
  • High blood pressure
  • Rapid heart rate
  • Grinding your teeth
  • Muscle tension (stiff/sore back and neck are common)
  • Lack of sex drive
  • Pessimistic thoughts
  • Fatigue
  • Forgetfulness
  • Trouble concentrating
  • Feeling overwhelmed

You may also find it helpful to identify situations that you regularly find stressful (such as meeting with your boss) and behaviors that you engage in when you’re stressed (such as overeating or biting your nails).

Ways to relieve stress in 10 minutes or less

Below, you’ll find a list of simple and quick ways to relieve stress. These are particularly helpful for acute stress and aren’t intended to be the solution to chronic or intense stress.

  1. Listen to your favorite music
  2. Get some fresh air
  3. Stretch or do some yoga poses
  4. Do a grounding exercise
  5. Disconnect from technology
  6. Talk to someone supportive
  7. Meditate
  8. Look at photos that make you smile
  9. Squeeze a stress ball
  10. Read for pleasure
  11. Walk, bike, or skateboard around the block
  12. Count to 10 slowly and repeat
  13. Dance
  14. Journal
  15. Write down 10 things you’re grateful for
  16. Doodle, draw, color, or Zentangle
  17. Chew a piece of gum
  18. Watch a funny video on YouTube
  19. Punch a pillow
  20. Slow, deep breathing (I like the “breathe bubble on the Calm app.)
  21. Read an inspirational quote
  22. Spend time with your pets
  23. Do 20 jumping jacks
  24. Do something nice for someone else
  25. Sit in the sun
  26. Visualize a safe, comforting place
  27. Pick some flowers (or pinecones or leaves or seashells or rocks)
  28. Give yourself a neck massage
  29. Take a shower
  30. Kick a soccer ball
  31. Diffuse essential oils or use scented lotions or candles (Bergamot, lavender, and yuzu are a few to try.)
  32. Tend your garden; water and talk to your plants
  33. Hug a loved one
  34. Knit
  35. Savor a cup of decaffeinated tea or coffee
  36. Repeat a mantra
  37. Do a progressive relaxation exercise 
  38. Make a list of your worries and identify which you can do something about

Make your own list of ways to relieve stress

When you’re feeling stressed or anxious, it can be hard to think of effective, healthy coping strategies. Having a list of stress-relieving activities at hand can be very helpful. This way, you’re ready whenever your stress level spikes.

I find it’s helpful to have a variety of stress management strategies. You will need to use different strategies when you are at work, school, or home. Sometimes you have more time and other times you are limited. And, of course, we have personal preferences and all find different strategies more or less helpful.

To get started, you can choose a few of your favorite ideas from the list above, write them down, and add or subtract ideas as you try them.

You can also print a PDF of my 38 ways to de-stress quickly and hang it on your refrigerator or bathroom mirror. You want to have healthy coping strategies readily available, so you don’t have to think too much about it when stress is at hand. The more you practice them, the more automatic they will become.

This PDF is available as part of my free resource library. To access 30 free emotional wellness worksheets, tips, and articles, just sign-up HERE for my weekly updates and free resources.

 

via 38 Ways to Relieve Stress Quickly | Happily Imperfect

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[BLOG POST] Benefits Of Magnesium For Traumatic Brain Injury treatment

magnesium tabletMagnesium is a vital nutrient that the human body requires in order to function healthily. It’s important for a range of bodily processes, including regulating nerve functions, blood sugar levels, blood pressure, and making protein, bone, and DNA. It’s one of the 24 essential vitamins and minerals critical for a healthy body.

Magnesium cannot be produced by the body itself – in other words, it needs to be sourced elsewhere, such as from food or supplements. The levels of magnesium needed for each person varies on gender, age and size. However, when a Traumatic Brain Injury occurs, magnesium becomes a nutrient you should strive for with its many mental and physical health benefits.

Many ordinary people today use Magnesium supplements to help with their energy, flexibility, muscle strength, and even sleep or stress management. In particular, people who have a love for fitness or sports take regular Magnesium tablets to assist with recovery and performance.

 

So, what could it do for TBI?

Magnesium For TBI
Following a traumatic brain injury, the side effects of anxiety, stress, brain swelling, cramping and tightening of muscles, stiff muscles, and insomnia are quite possible.

That’s where magnesium comes in to save the day.

Increase Flexibility, Decrease Tone, Reduce
Considering magnesium can assist with flexibility and loosening tight muscles, increasing your magnesium intake after a traumatic brain injury can likely help alleviate your stiff, cramped muscles.

Low magnesium levels can also cause a large build-up of lactic acid, which results in workout pain and tightness.

Taking magnesium for this particular problem allows your muscles to relax correctly before and after exercise.

 

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Stress & Anxiety
Magnesium can also help to control stress hormones. Serotonin, in particular, depends on magnesium for production.

This is responsible for relaxing your nervous system and encouraging positive moods, thus stabilizing you mentally.

Low magnesium levels are linked with anxiety behaviours and heightened stress – all the more reason to ensure you are taking in adequate amounts after your injury.

Brain Swelling
Magnesium is an anti-inflammatory, and as such, it can help to reduce brain swelling from a traumatic brain injury.

It increases cardiac output and cerebral blood flow. When the body has appropriate levels of it circulating throughout the body, people can experience improved neurological and cognitive outcomes.

It has also shown to possibly reduce pain intensity and headache severity.

Insomnia
Serotonin also helps encourage a good night sleep. Low magnesium levels can affect the sleep-regulating hormone melatonin, too.

Insomnia is indeed a common symptom of magnesium deficiency seen in many people today. They experience restless sleep and constant waking during the night, which leads to unhealthy sleep.

By maintaining the correct magnesium levels, people can enjoy deep, undisturbed sleep. Along with the melatonin, magnesium plays a role in maintaining healthy levels of “GABA” which is a neurotransmitter that promotes optimal sleep quality.

How To Take Magnesium

Magnesium can be taken in the form of a tablet supplement, but there are many magnesium-rich foods that can be incorporated into your daily diet, as well.

Try this list of power foods to hit your daily magnesium intake.

Dark leafy green vegetables
Flax seeds and pumpkin seeds
Almonds
Seaweed
Brown rice
Avocado’s
Walnuts, cashews, pecans

 

Other Sources of Magnesium

Magnesium Cream: Magnesium cream delivers the nutrients full spectrum of benefits, soothes muscle tension and increases flexibility in the applied area.

Magnesium Oil: Magnesium oil is  a no mess, easy-to-absorb, form of magnesium that may be able to raise levels of this nutrient within the body when applied topically to the skin.

 

In Conclusion

Ensuring that you have optimal levels of magnesium is the first step towards a healthy recovery following TBI.

It will help your muscles improve in flexibility, reduce pain, balance hormone levels, encourage positive moods, and sleep more soundly.

via Benefits Of Magnesium For Traumatic Brain Injury – treatment

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[Factsheet] Understanding TBI: Part 4 – The Impact of a Recent TBI on Family Members and What They Can Do To Help With Recovery – Model Systems Knowledge Translation Center (MSKTC)

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

How does brain injury affect family members?

For most family members, life is not the same after TBI. We want you to know that you are not alone in what you are feeling. While everyone’s situation is a bit different, there are some common problems that many family members experience such as less time for yourself, financial difficulties, role changes of family members, problems with communication, and lack of support from other family members and friends. These are just some of the problems that family members may face after injury. Sometimes these problems can seem too much and you may become overwhelmed, not seeing any way out. Family members have commonly reported feeling sad, anxious, angry, guilty, and frustrated.

Ways to reduce stress

Since the injury, you have likely been under a great deal of stress. A little stress is part of life, but stress that goes on for a long time can have a negative effect on the mind and body.

Stress is related to medical problems such as heart disease, cancer, and stroke.

  • Stress can make you do things less well because it affects your ability to concentrate, to be organized, and to think clearly.
  • Stress also has a negative effect on your relationships with other people because it makes you irritable, less patient, and more likely to lash out at others.
  • Stress can lead to depression and/or anxiety.

If you are under constant stress, you are not going to be as helpful to your injured family member or anyone else. If you do not take the time to rest and care for yourself, you will get fewer things done, which will lead to more stress. If you won’t do this for yourself, do it for your injured family member. They will be better off if you are healthy and rested. Here are some suggestions for ways to reduce stress and stay healthy. These things have worked for many people, but not all of them may work for you. The important thing is that you begin thinking about ways to improve your life.

Learn to relax

Taking a few moments to relax can help you be more ready for the things you need to do. Learning to relax is not easy, especially in your current situation. There are relaxation techniques that can help you such as breathing deeply and focusing on your breathing, stating a word or phrase that has positive meaning (e.g. peace), or visual imagery. In order to train your body and mind to relax, you need to practice often. Don’t give up if it doesn’t work right away. If you keep practicing these techniques, you will feel more relaxed in the long run, and you will find that you’re able to function better in all areas of your life.

Learn which coping strategies work for you

No matter what was going on in your life before, the injury has caused changes. You may never have experienced anything similar to the injury, and some of your usual coping strategies may not work in your current situation. The best thing that you can do for yourself is to be open to trying new ways of coping and find out what works for you.

Some coping strategies that others have found helpful:

  • Taking time for yourself
  • Keeping a regular schedule for yourself
  • Getting regular exercise such as taking a 20-30 minute walk each day
  • Participating in support groups
  • Maintaining a sense of humor
  • Being more assertive about getting the support you need
  • Changing roles and responsibilities within the family

Learn how to reward yourself

Everyone needs something to look forward to. You’ll probably say, “I have no time; it’s impossible.” Just remember that you will be more ready to do the things you have to do if you take some time to do some things that you want to do. Even if you have very limited time, you can find some small way to reward yourself. Promise yourself a cup of your favorite coffee or an opportunity to watch a good TV show or read something you enjoy.

Problem-solving for caregivers

Sometimes you may feel overwhelmed by problems. There may be so many problems that you’re not sure which one to tackle first. You can only solve one problem at a time, so pick one. Use the problem solving steps below to find a good solution. Try to choose a smaller problem to solve first. This will give you practice and make you more confident about solving bigger problems. If you deal with problems in this way, they may seem easier to handle.

Steps in Problem Solving

  1. Identify the problem: What is the problem? Define it as clearly and specifically as possible. Remember that you can only solve one problem at a time.
  2. Brainstorm solutions: What can be done? Think of as many things as you can. Don’t worry about whether they sound silly or realistic. This is the time to think about all possibilities, even the ones that you don’t think will happen. Be creative.
  3. Evaluate the alternatives: Now you will start thinking about the consequences of the ideas you came up with in Step 2. For each idea, make a list of positives on one side of the page and a list of negatives on the other side.
  4. Choose a solution: Pick the solution with the best consequences based on your list of positives and negatives. Keep in mind that more positives than negatives is not always the best rule. Sometimes you will have one negative that outweighs many positives.
  5. Try the solution: Try out the idea you have chosen. Give it more than one chance to work. If it doesn’t work right away, try to figure out why. Was there some consequence you didn’t think of? Is there another problem in the way that could be easily solved?
  6. If your first solution doesn’t work, try another one: Don’t give up. Everything doesn’t always work out the first time. You can learn from your mistakes; they may help you to choose a better solution next time.

Ways family members can help the injured person

The treatment team can provide you with guidance in how to help the person while not giving them too much or too little assistance. Attending therapy when possible and working with the therapists and nurses are the best ways to learn to help the person before discharge from the hospital.

The following recommendations are intended to help families and caregivers care for their loved one once they have returned home. Not all of the following recommendation may apply to your situation.

Provide structure and normalcy to daily life

  • Establish and maintain a daily routine – this helps the person feel more secure in their environment.
  • Place objects the person needs within easy reach.
  • Have the person rest frequently. Don’t let the person get fatigued.
  • Be natural with the person and help them to maintain their former status in the family.
    Communication is important to the person’s recovery. Although they may not be able to speak, they should continue to be involved in as normal a social world as possible.
  • Include the person in family activities and conversations.
  • Keep a calendar of activities visible on the wall. Cross off days as they pass.
  • Maintain a photo album with labeled pictures
    of family members, friends, and familiar places.

Provide support in a respectful way

  • Try not to overwhelm the person with false optimism by saying statements like “You will be alright” or “You will be back to work in no time.
  • Point out every gain the person has made since the onset of the injury. Avoid comparing speech, language or physical abilities prior to the injury with how they are now. Look ahead and help the person to do the same.
  • Treat the person as an adult by not talking down to them.
  • Respect the person’s likes and dislikes regarding food, dress, entertainment, music, etc.
  • Avoid making the person feel guilty for mistakes and accidents such as spilling something.
  • If the person has memory problems, explain an activity as simply as possible before you begin. Then as you do the activity, review with the person each step in more detail.

Avoid over-stimulation –

Agitation can be heightened by too much activity and stimulation.

  • Restrict the number of visitors (1 or 2 at a time).
  • Not more than one person should speak at a time.
  • Use short sentences and simple words.
  • Present only one thought or command at a time and provide extra response time.
  • Use a calm, soft voice when speaking with the person.
  • Keep stimulation to one sense (hearing, visual or touch) at a time.
  • Avoid crowded places such as shopping malls and stadiums.

Safety Tips

The person who has confusion or impaired judgment may be unable to remember where dangers lie or to judge what is dangerous (stairs, stoves, medications). Fatigue and inability to make the body do what one wants can lead to injury. Therefore it is very important that a brain injured person live in an environment that has been made as safe as possible. The following are some safety guidelines to use in the home:

  • Keep clutter out of the hallway and off stairs or anywhere the person is likely to walk. Remove small rugs that could cause tripping or falls.
  • Remove breakables and dangerous objects (matches, knives, and guns).
  • Keep medications in a locked cabinet or drawer.
  • Get the doctor’s consent before giving the person over-the-counter medication.
  • Limit access to potentially dangerous areas (bathrooms, basement) by locking doors if the person tends to wander. Have the person wear an identification bracelet in case he or she wanders outside.
  • Keep the person’s bed low. If they fall out of the bed, you may want to place the mattress
    on the floor or install side rails.
  • Make sure rooms are well lit, especially in the evening. Night-lights can help prevent falls.
  • Have someone stay with the person who is severely confused or agitated.
  • Keep exit doors locked. Consider some type of exit alarm, such as a bell attached to the door.
  • Consider a mat alarm under a bedside rug to alert others if the person gets up during the night.

Things that can be more dangerous after a TBI and should be resumed only after consulting a health care professional: contact sports, horseback riding, swimming, hunting or access to firearms, power tools or sharp objects, riding recreational vehicles, and cooking without supervision.

Individuals with brain injury should receive permission from a health care professional prior to using alcohol or other substances at any point after their injury. Also, NO DRIVING until approved by your doctor.

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 Mayo Clinic TBIMS, Baylor Institute for Rehabilitation, 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 4 – The Impact of a Recent TBI on Family Members and What They Can Do To Help With Recovery | Model Systems Knowledge Translation Center (MSKTC)

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[BLOG POST] Basic Survival Guide For Caregivers – H.O.P.E TBI

Before you take your loved one home from the hospital or care facility, there are things you can do in advance to help prepare them for their transition home, and prepare YOU for one of the most important roles in your life.   Absolutely, if at all possible, spend a full few days and nights following your loved one through their routines so you can see what they are actually capable of, what their routines are, and what may be expected of you as their caregiver at home. Know that you will be burning your candle at both ends for an undetermined amount of time.

It will be important to create a notebook, binder, or file with important information that will be available to you without a lot of stress and searching.  It may even be helpful to purchase a Planner that includes daily and monthly pages to include everything on. Make a typed or written list of the following:

  • Medications needed and schedule of medications (what gets taken when)
  • Names and numbers of providers to call with questions, appointment scheduling, or emergencies
  • If your loved one has a traumatic brain injury, the name and number of the Brain Injury Association for your area, support groups available, their hours and location.
  • Write down ALL questions as you think of them.  You may have every intention of remembering them.  However, I promise you – you will remember these questions at the most inopportune times if you don’t have them written down.
  • Purchase one or more “white boards” with dry erase markers to hang up at home.  These are very handy for keeping track of all kinds of things.
  • Have a documented list of all medical equipment, supplies, toiletries, and assistive devices you may need at home for your loved one, BEFORE you bring your loved one home.  Keep in mind there will ALWAYS be something you didn’t think of at the time, learn about after the fact, or discover in your advocacy for your loved one. That’s okay, don’t be hard on yourself.
  • Have a support system in place for yourself.  Counselor, social worker, therapist, other family members willing to help, home health agency, medical case manager, etc.   Keeping yourself healthy first, will allow you to do your very best for your loved one.

So your loved one is ready to come home from the hospital.  You may feel excited, nervous, impatient, and mostly prepared.  Nothing can prepare you for all the dynamics and changes you are about to take on, other than first hand experience.  Structure is imperative.  Especially if your loved one has a traumatic brain injury. The first two weeks home will most likely be the toughest to adjust to.  Don’t get caught up in the idea that they need a “break” and no routines, schedules, or therapies.  Recovery is enhanced with structure and consistency.

You may have realized by the end of the first week that you are feeling exhausted and scattered. You may feel like maybe you weren’t ready to take this on at all.  Who is this person you brought home?  They are so different. They may be painful, irritable, demanding, and impatient. It may be hard not to take this personally.  Your time is no longer your own and you are now responsible for every aspect of this person’s safety, health, and recovery process. You may become so focused on what you should be doing next to help with all the things that need to be done that you cannot sleep or slow down your thoughts. You may be feeling like you cannot do anything right….or perhaps you realize you are doing everything right, yet your loved one is not responding in the way you were anticipating they would.  You may find yourself tiptoeing around them, being cautious of everything as each hurdle presents itself.

caregiverstrain

By the end of the second week, you are fully aware of the time commitment that is involved now.  You may be losing track of time as your days now seem to run together. You may now be thinking of a thousand things you should have asked, learned about, or prepared for BEFORE your loved one came home. You may be feeling a bit overwhelmed and may even realize that you are not able to do EVERYTHING on your own.   It’s okay, you are not alone in this realization.  You also may actually be getting a better grasp of the schedule that is going to work the best for you to survive being a caregiver, while helping your loved one progress through their recovery at this point. You will most likely be beyond exhausted and unsure how you are going to be available to your loved one and still meet the demands, responsibilities, and obligations in your own life – that exist outside of your new caregiver role.

Your loved one has gotten used to certain schedules, expectations, routines,  push to be independent and compelled to focus on their recovery  in the hospital or rehab facility and will come home expecting those same things to be in place at home.  They may feel distant, resistant, challenging, and develop unrealistic expectations about what you are able to accomplish for them both directly and indirectly.   caregiverandworkstress

Sometimes your loved one, if they have a traumatic brain injury, may have a skewed view of reality.  They may have mood changes you are not used to dealing with, have difficulty adjusting to their “new normal”, and may have difficulty accepting the changes they are now facing every moment of every day.  You may be having difficulty adjusting to the expansive and growing list of needs and accommodations they now require.

You may have become overprotective at this point. You may be able to anticipate your loved one’s needs before they even ask for it.  You may micromanage every aspect of their day.  You may also be doing things for them, that they are able to do for themselves with a little supervision or prodding. This is not not good for your loved one in the long term to have you doing EVERYTHING for them.  It is imperative that you encourage independence as much as possible.  Help them with what they need help with, of course.  However, encourage them to do as much on their own as possible.  This will take them out of their newfound “comfort zone” and will not always be successful in the first attempt. HH_SEO_Graphics_CBDon’t get angry if they attempt something and do not succeed, or if they are unable to complete something they have attempted. This effort may takes weeks, months, and in some cases years of consistent attempts for this to happen succesfully.  For some caregivers, there is no mastering this aspect of the caregiving process.  You may have a loved one who is incapable of independence.  In that situation, set small goals for yourself, for them, and partner with providers to celebrate even the littlest victories or accomplishments.  Sometimes just getting up for the day, getting bathed and dressed for the day is the best that can be accomplished that day.

It is imperative to eventually include your loved one in as many life activities as is possible.  They may not be ready for this in the first few weeks home. Consider trying to take them on very brief, small outings with you a little at a time.  Even if just to a convenience store and then back home, the library and back home.  Perhaps even just a ride around the block after getting dressed for the day can be a huge accomplishment.  You can build to other places, longer times, and more challenging things as time progresses and they are ready.  Some things to consider when leaving the house with your loved one:

  • Have a “travel bag” ready to go with you on each trip that includes their medications,  a change of clothing (maybe two changes of clothing), items that help them cope, and notebook (with pen or pencils and higlighters in different colors)
  • Have something for them to drink with you (bottled water, thermos, juice box, etc)
  • Carry ear plugs, headphones, sunglasses, lap blanket, and any other things that may help your loved one when they are away from home based on their personal needs.
  • Allow tons of extra time for getting ready to leave the house with your loved one.  Allow extra time to make it to appointments on time.  I would suggest at least an hour wiggle room. Folks with traumatic brain injuries have a real challenge with being rushed, given too many tasks at once, or last minute changes.  Even though they may make many last minute changes in their level of participation, effort, and coping ability.
  • Be prepared to turn around and go home.  You loved one may have a meltdown, panic attack, behavioral outburst you are unable to manage safely away from home, or they may feel “flooded”or voice their desire to be home NOW.  Sometimes, when they have a medical appointment, going home is not a possibility until after the appointment.  Often times, going to a medical appointment will be the only outing they can do that day.

compassionfatigueThe largest part of recovery will take place within the first two years.  However, this is not where recovery ends. Research continues to show that healing, strength, behavior, body changes, and rerouting of the brain continues – even years later.

It is common to feel sad, depressed, or disappointed if your loved one has not reached the recovery level you anticipated at the one or two year mark in their recovery.  Your loved one also may be having some struggles around this time as well.  They may have expected to be further along in their own recovery, or reliving the time of year their accident happened and comparing it to their life before their injuries.  Families often misjudge the amount of time it will take for their loved one to recover or plateau ; especially if their obvious physical injuries/fractures have healed by this time and you are unable to “see” the traumatic brain injury.

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[Potential Providers may include the following:  physicians, physiatrist, nurses, physical therapists, occupational therapists, speech therapists, recreational therapists, respiratory therapists, counselors, psychologists, neuropsychologist, social worker, specialists, nurse’s aids, home health aids, medical case manager, family caregivers, volunteers, and/or clergy.]

~Compiled By: Caren Robinson

 

via Basic Survival Guide For Caregivers | H.O.P.E TBI

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