Posts Tagged survivor

[BLOG POST] Shuffled Neurons, and Other Speed Bumps in The Search for Self-Awareness

By Bill Herrin

Self-awareness after a brain injury

Experiences in life make us who we are – they can intrinsically change who we are for better or worse, sometimes in a temporary way, and sometimes for the rest of our lives. There are things that happen that we’ll cherish, things we look back on and laugh about, things that we’d rather not think about…and then there are things that we won’t even recall. TBI can be like a thief in the night…slipping away with treasured memories and leaving us with little to work with. But take heart, because as the old saying “time heals all wounds” actually rings true, especially in the realm of brain injury. When a brain is injured, the severity really depends on where the injury occurred, the level of the impact, and to some degree – whether the trauma was over the line of being able to overcome or not…not to mention that every person’s brain is as different as their TBI.

Every TBI is Personal

The different levels of self-awareness that arise from having a TBI can spark debate because everyone’s TBI is personal to them, but their self-awareness will never be exactly like someone else’s…although there will be common similarities. That’s where we should focus – on the broad similarities that we can all relate to, and support each other in. For survivors and their friends, families and beyond, there can be friction – often caused by the survivor saying “I don’t need help, I’ll be fine” to someone telling a survivor “you don’t look injured, you’ll be fine.” That’s a hard pill to swallow, especially when the survivor has isolated themselves or if their family has withdrawn from trying to encourage or help them because of previous resistance.

Self-Awareness Doesn’t Come Easy

Awareness of how you’ve changed after a TBI may be harder to do than many realize. I’ll be referencing some points regarding self-awareness from a Lash & Associates “tip card” (an 8-page brochure that they sell) that is packed with great advice for survivors, therapists, clinicians, families, and caregivers. These excerpts will be highlighted in italics.

Why is Self Awareness Important?

Self-awareness is the ability to view ourselves somewhat objectively. It is also the ability to see ourselves from the perspective of other people. It allows us to use feedback from others as we develop our personal identity. We rely on self-awareness when we…

  • interact socially with others
  • decide what situations or information to share
  • make judgments about ourselves, and
  • act in ways that ensure our personal safety.

Brain injury can impair the critical capacity for self-awareness.”

The previous sentence says so much because impairments in self-awareness come from different causes, and can show up at any time – and every person with a TBI will have different impairments or limitations of varying degrees. Hence, their own ability to assess their self-awareness is negligible in many cases. Damage in different parts of the brain can impair self-awareness in ways other than judgment – such as awareness of paralysis of certain parts of the body, awareness of loss of memory, problem-solving skills, reasoning, or being unable to anticipate consequences of decisions (based, in part, by lack of recall of it happening at a prior point in time, etc.)

“What Helps Unawareness?

Working on awareness can help people make better decisions. Efforts to increase a person’s understanding of abilities/disabilities must be done in a manner that preserves self-esteem. A healthy sense of self is critical for recovery. The two primary methods to address impaired self-awareness are education and structured feedback.

Both require an interpersonal bond between the person delivering information or feedback and the individual with impaired self-awareness. It is also important to have an environment that helps the person learn about strengths and weaknesses while still maintaining hope.”

The deficits of self-awareness can be obvious to family, friends, caregivers, and clinicians, and many times be quite frustrating. Helping a survivor to have a clear vision of their actual cognitive and physical abilities should be addressed with patience, positivity, and prudence.

“The goal of feedback is to orient individuals to the aspects of their performance that they do not accurately perceive. It is very important to balance feedback for problem areas with feedback for strengths.

Regardless of the approach used to help someone increase self-awareness, the person in the role of therapist, coach or caregiver needs to have a positive bond or connection with the individual. In order for a person to accept feedback, the person needs to feel that there is a partnership. The clinical term for this partnership is therapeutic alliance.”

In closing, it’s important to realize that everyone has the potential for unrealistic self-awareness – it’s what the long-running TV show “American Idol” was built upon…people whose self-awareness about their vocal abilities may have been bolstered by false praise, or just delusions of grandeur…many times, the people that go on the show with a humble approach are the ones that blow the judges away!!

Help your friend, colleague, partner, family member achieve a realistic understanding of where they are, but help foster a vision for them that will lead them to further improvements through encouragement, suggestions, positivity, strong communication, realistic goals, and love. Dealing with a huge change in self-awareness is complex and there is no “set route” to get to the next level. Understanding this helps both the caregiver and the survivor to make progress on the best terms possible.

The tip card “Changes in Self Awareness” is written by written by McKay Moore Sohlberg, Ph.D. and is available for just $1.00 at www.lapublishing.com/brain-injury-self-awareness-survivor/  – it’s a great resource for families or clinicians.

via Shuffled Neurons, and Other Speed Bumps in The Search for Self-Awareness

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[BLOG POST] Talking About Your Injury

First, let’s review some general ideas. Many survivors initially think that few people know about their injury. After all, if the survivors did not tell others, how would they know? The reality is usually different. Sometimes, the injury event was on the news. For instance, if a survivor was in a major car accident or shooting, it generally made the news. Also, following an injury, family members may make prayer requests through social media or religious institutions. In this case, everyone who is connected via social media or anyone is part of the religions institution is aware of the injury event. Moreover, a brain injury is a big piece of news. Once one person hears about it, they are likely to “share the news” with friends from work, school or other social environments. Overall, information often makes the rounds to people you know quite quickly. However, the information is often piecemeal and occasionally, inaccurate.

With this in mind, the guiding principle when talking to others about your injury should that you give honest information in a manner that will engender others to have appropriate confidence in you. In some cases, people may be truly confused or concerned how you are doing and are using questions as a sort of gauge of health. The better you handle the situation, the more likely the other person will walk away with confidence in you.

Here are a few pieces of advice regarding talking about your injury:

  1. Always keep in mind who the person is that you are speaking with. For instance, is this a friend or an acquaintance? Is this person trustworthy to keep information private or likely to share it with everyone? Do I have a personal relationship or a professional relationship with this person? These factors will influence what you will share (or not share) with the other person.
  2. Whenever possible, keep information short and with limited detail. Remember, once you have said something, you cannot take back the information and the person you are speaking with may share that information with many others. Also, the less details you give, the less opportunity you are giving the other person to ask probing, sometimes uncomfortable, questions.
  3. Be sure to have a good exit/”no thank you” line. Not everyone has a right to your information and there are times you will not want to talk about your injury. A good exit line usually involves saying something nice, making your request and ending with something nice. For example: “Thank you for your concern but I really don’t enjoy talking about my recent health issues. However, I really appreciate that you cared so much to check on me.”
  4. Always tell the truth. If you tell a lie, there are two possible unpleasant outcomes. One, if the other person finds out that you deliberately lied, this can ruin the relationship. Second, if you tell a lie and the other person realizes the information is wrong but falsely thinks that you actually believe the lie, the other person will assume that you are quite confused.
  5. Be aware that you know a lot of medical/health terms that other people will not know, will not understand or even misunderstand. The average person on the street does not know terms such as “hemiplegia” or ” homonymous hemianopsia .” Using terms that other people do not understand may overwhelm the other person. Also, there are some terms that others may misunderstand. For instance, if you say that you are in “rehabilitation”, other people may falsely assume that you have a substance abuse problem. It may be better to say, “I have been working on my recovery from my injury” or “I have been in injury rehabilitation” rather than saying “I have been in rehabilitation.”
  6. Do not exaggerate or embellish your injury experience. Your story is already powerful and does not need any help. Also, exaggerating or embellishing may make the experience seem worse and cause other people to lose confidence in you.
  7. Be careful about using humor. Many people will not find much humor in your injury experience and may take too much humor to mean that you do not appreciate the seriousness of your injury. Again this could lead to a loss in confidence in your skills.
  8. Always ask questions of the other person. If the other person gets to ask all of the questions and you have to give all of the answers, eventually the friendly conversation may feel like an interrogation. The best way to balance the power is to ask questions of the other person, such as how are things going for their spouse, children or job.
  9. Practice your responses. When you are asked questions, the way to engender confidence is to have great responses. The best method to ensure you have great responses is to practice, out loud, your responses. This way, you can hear how your answers actually sound when coming from your mouth (which often sound different than how you imagine them in your mind) and practice different potential responses. It is often helpful to practice with a trusted loved one and/or to record and review your responses. This will help you find the best and most natural responses to questions.

These were just a few ideas and suggestions when talking to other about your injury. Always remember the key principle of giving honest responses that engender confidence!

Learn about brain injury treatment services at the Transitional Learning Center! Visit us at: http://tlcrehab.org/

 

via Talking About Your Injury

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[BLOG POST] Guide to Helping Young People Recovering From a Stroke – Saebo

If someone in your family has a stroke, you may experience a significant change in your life. That person will need great care and support, and there may be a variety of emotional and behavioral changes that you’ll have to be prepared for. This can especially be the case if the stroke occurs at a young age. Not only will a stroke survivor need guidance and encouragement, but a young person recovering from a stroke will need assistance with a wide range of other tasks. According to an article published by Stroke Research and Treatment Magazine, there are many outcomes that “are attributable to the effects of stroke on age-normative roles and activities, self-image, and the young person’s stage in the life-cycle, especially family and work. ‘Hidden’ cognitive impairments, a disrupted sense of self, and the incongruity of suffering an ‘older person’s’ disease is salient.”

Astoundingly, 10% of stroke patients are under the age of 50. The rehabilitation process after a stroke is difficult at any age, and this younger demographic of stroke patients often goes unnoticed, so it’s important to pay special attention to the particular challenges that arise in these cases. With the information provided here, combined with a proactive mindset, you can better a young survivor’s recovery experience.

7 Challenges to Consider for Younger Stroke Patients

Someone who is just starting out in life — beginning a new career, embarking on a new relationship, pursuing a degree, parenthood — must deal with the pressures of finding success and, when you add in the severity of a stroke, the weight of that pressure can be insurmountable. To gain a better perspective of what they’re going though, here are a few things to consider:

1. Loss of Employment

Having a job that provides a sense of responsibility and independence is crucial for a young person trying to find their way in the world. Working gives people purpose and fulfillment, but unfortunately, when a young person experiences a stroke, they will most likely require a substantial amount of time off. In some cases, an individual may not be able to perform their job in the same way, or they may need to stop working altogether. On the bright side, studies have shown that “most of the investigations in long-term prognosis have described good functional recovery in young adults with ischemic stroke, since most patients are independent and at least 50% return to work.

2. Financial Debt

When a stroke is experienced by someone who doesn’t have the support of a retirement fund, the financial toll can be devastating for both the individual and their family. Combine this strife with the frustration of not being able to work — not to mention that a spouse or other family members may have to stop working as well — and the task of recovery becomes even more daunting. To alleviate this issue, there are disability programs that can aid in paying for medical bills, but the approval process can be arduous, and the wait time can result in the accrual of exorbitant debt.

3. Young People Think They’re Not at Risk

One of the biggest misconceptions young people today have about strokes is that one could never happen to them. They believe that they are simply too young to have health problems that are typically associated with older people, but this is exactly why strokes are on the rise. Risk factors such as tobacco use and hypertension are prevalent among young adults and adolescents, which directly relates to a spike in ischemic strokes throughout this demographic.

4. Misdiagnosis

In conjunction with number three, medical professionals and family members are quick to incorrectly diagnosis a stroke as something else entirely, because the individual is so young. Because of this error, a person may not receive the care they need to survive. An extreme example of this occurred when a 24-year-old named Lauren Rushen suffered a stroke, and for two weeks her doctors wrote off her symptoms as an infection and inflammation. Finally, after she collapsed on the floor of her home, she was rushed to her local hospital where yet again her attack was ruled a result of substance abuse. Luckily for Lauren, she was able to recover, but others should be aware that there is only a small window of time available for a patient to maximize their chances of rehabilitation.

5. They Have a Long Life Ahead of Them

It’s important to remember that young people who experience a stroke will have time on their side, but a lot of that time will be spent adapting to their setbacks. Arrangements for physical care, mental redevelopment, and financial needs could be necessary for an extended period, especially since the rehabilitation process can last many years (or for a lifetime).

6. Insurance

Because many people are not eligible for Medicare until the age of 65, countless young people who experience a stroke may be left without coverage due to multiple factors. First of all, a young person may not even have had insurance prior to their stroke, and if they did, they will most likely become uninsured from not being able to work. The cycle of applying for Medicare and SSDI is difficult to endure, let alone while facing a debilitating ailment.

7. Family Life

For a stroke survivor who is older, family life is typically already structured around support for themselves. This means that an older person has raised their children and now has no immediate responsibility to care for someone else. However, for a younger person, the case is entirely different. A younger survivor may have small children to look after, or might have dreams of one day starting a family. Having a stroke as a young person means these plans are put on hold, or other family members may have to take on more responsibility at home. This can be incredibly stressful to deal with and affects everyone involved.

2 Key Ways to Be Proactive about Stroke Recovery in Young People

As a family member, caregiver, or stroke patient, you need to be ready to deal with the fact that stroke recovery is a serious, delicate, and lengthy process. Not only does it demand attention in all developmental areas, but it also comes along with a severe risk of mortality. In a journal published by the National Institute of Health, studies show that “the long-term prognosis for ischemic stroke in the young is better than in the elderly, but the risk of mortality in young adults with ischemic stroke is much higher than in the general population of the same age.” Taking charge of the situation can make a huge difference in ensuring a stroke survivor’s future, and two things in particular have proven to make the greatest improvements:

Put Stroke Survivors in a Position to Succeed and Prevent a Second Attack

After someone suffers a stroke, they will be faced with a tremendous array of challenges that may seem impossible to overcome. They may feel hopeless and unsure of where to begin their recovery, but this is where the diligence and support of others can make all the difference. If a loved one is going to have a successful recovery, they must be put into a position to succeed. This means that they will require a strong system of mental, physical, and emotional support from family and healthcare professionals, and it also means that certain precautions must be put into place to combat future complications. For example, practicing good habits like eating healthy foods, properly managing medication, engaging in physical activity, and monitoring current conditions can greatly lower the risk of a second attack, while improving a survivor’s current state of health. With over a quarter of stroke patients undergoing a second attack within their lifetime, maintaining good habits is essential and combining them with a consistent rehabilitation program is the surest way to generate positive and lasting results.

Address Rehabilitation as Soon as Possible

Instilling good health practices is always something to keep in mind, but what really makes an impact on a person’s recovery is the rehabilitation process. Rehabilitation is important, because it actively fights against the damage a stroke has caused. Stimulation of the muscles and the mind will aid the body in repairing its impaired functions, and over time, abilities that were lost have the potential to resume normal operation. With the help of rehabilitation, a process known as cortical plasticity begins to take place. Also referred to as neuroplasticity, cortical plasticity is the process the brain undergoes in order to form new neural connections, which leads to regained physicality. The sooner this development can begin, the better a patient’s odds of recovery will be, so working with a healthcare professional and setting goals is a top priority.

The 3 Biggest Things You Can Do to Help Young Stroke Survivors

You have to accept that a person is going to be different after a stroke and, no matter how old they are, they are going to face enormous challenges. The recovery process will no doubt be an uphill battle, but there are three things you can do that will drastically improve a young person’s chances of rehabilitation.

1. Keep Them Motivated

One of the issues that a survivor will face during stroke recovery is lethargy, so it’s important for you to impassion and motivate them whenever possible. A great way to do this is to combine their personal interests with their rehabilitation program. For example, if part of their routine is getting dressed in the morning, you can play a favorite song that will motivate them through the process and make it fun. Even the smallest displays of thoughtfulness can go a long way, so do whatever you can to make them feel loved and supported.

2. Help Them Counteract Learned Non-Use

A difficult thing to overcome for any stroke survivor is the process of learned non-use. After a stroke occurs, a person may not be properly able to move their limbs, and if their extremities aren’t exercised on a consistent basis, they are susceptible to atrophy, or muscle degeneration. To combat this issue, daily movements of the affected areas are highly encouraged. A specific method that has shown success in physical recovery is a form of therapy called Constraint-Induced Movement Therapy (CIMT). This technique restrains the healthy limbs while the survivor works at improving use of the damaged ones however, the survivor must meet specific criteria in order to qualify for this approach.

3. Watch Out for the Recovery Plateau Stage

A stroke survivor’s recovery will always have ups and downs, but something to be wary of is the possibility of a loved one experiencing a plateau phase during their rehabilitation. A recovery plateau refers to a period during which a stroke survivor may encounter a slowed progression in their recovery. This can happen especially if a survivor is dealing with severe physical impairments or cognitive disabilities. The most dramatic phases of recovery tend to occur during the first three to six months after a stroke, and this stage is not a given, so take heart in all the successes of that sub-acute phase to maintain enthusiasm and motivation moving forward.

We Can All Help Young Stroke Survivors Help Themselves

Regardless of a survivor’s age or degree of impairment, stroke recovery support should be offered with the utmost patience and care. Nobody can perfectly predict when a stroke will occur or how survivors and their loved ones will react, but anyone can learn how best to handle the situation, to give survivors the help they need. With the information listed above, you can become a source of encouragement for anyone who has experienced a stroke and, more importantly, you can help them regain lost abilities with dignity.


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 Guide to Helping Young People Recovering From a Stroke | Saebo

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[BLOG] What is Left Neglect?

The Transitional Learning Center's Blog

Left neglect, also known as unilateral neglect or hemispatial neglect, is one of the oddest symptoms of a brain injury.  It can also be one of the most troublesome symptoms.  Left neglect is a deficit that occurs following an injury to the right side of the brain.  Due to the injury, the brain has difficulty paying attention to items on the left side.  This is generally most apparent in difficulties noticing items visually on the left side.  For instance, a survivor with left neglect may bump into frames of doors on the his or her left or miss eating food on the left side of his or her plate.  It appears as if he or she is blind to items on the left but this is not a true vision issue.  It is an attention issue.  The brain is not attending to information on the left.  The survivor can have…

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