Reflections on Practice

I have two questions to ask if anyone has a comment…

The first question leads on from a discussion I had with a colleague who does not believe in the functional affects of mild TBI/concussion. Particularly as there is often no evidence of injury on scans. It is interesting because in my daily practice I work with people who are dealing with the effects of the index injury such as impaired memory and concentration, as well as significant fatigue. Has anyone come across research that supports the affects of mild TBI on function?

My second question is for people working in the community with clients who have had strokes. I am finding that once people are home a huge barrier to rehab is often family and previous life roles. These clients can no longer fulfill these roles however they are still “stuck” in these roles because that is how the relationship operated prior to the injury. Obviously working alongside the client and their families to achieve their goals is one of the main priorities but how do we over come these barriers while maintiaining a theurapeutic relationship?