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?
7 Comments »
Leave a comment
| Next »
-
Flickr Photos
More Photos
You have two good questions here and I hope you have some people tracking to your site who will be keen to talk with you about this – we’ll work next on getting some good tags on your site etc that will hopefully lead to more traffic!
*disclaimer: Im no expert in this!*
Take a quick look at some citations I’ve *really* quickly gathered at http://www.citeulike.org/user/willwade/tag/tbi (not all related to this subject – some are tagged with TBI for my own reference!)
Now that list is neither a) comprehensive nor b) on the subject – it was purely a starting point (and, I might like to add, a blatant advert for citeulike – fantastic for keeping your citations tidy). (As usual for neuro it seems to me) quite a bit in this area comes from psychology: MTBI subjects performed significantly worse on a large number of cognitive measures. On a physical front the effects are less clear – perhaps because of the client group investigated. Take for example “Effect of mild brain injury on an instrumented agility task.”
Rant begins: Function is a funny word. I see it with my OT glasses on – the things that a person can do that have meaning to them. A physio however, or a medic will often see it as “how far a person can reach”. So what? Would they actually reach like that for a milk jug or to pick up an object from the table? My tip-du-jour then is be careful of applying “functional” outcomes from other studies to real ADL tasks. : Rant ends
From this I have found a paper that I really must read what looks like a good summary “recovery from mild head injury” (although a bit old) : http://www.citeulike.org/user/willwade/article/1286327
You have some great questions here. I am especially interested in the one about strokes as my father-in-law has recently had a major one. I guess the best we can do is go with how the person has viewed their roles previously and how they now see themselves (as best as we can ascertain). If a person has insight into their present condition we can try and ascertain how they see their new role, but if there is no insight then that person will only recognise their old role in life.
One of the issues as a therapist is that we do not know the person prior to their stroke. Thus any gains the client makes is seen as a real positive by the therapist but often the family does not veiw it this way as they remember the old person who is still often “not back”.
I am most impressed and obviously you and your mate are SENIORS!!!!!! Yipppppeeeeeeeeeeee!!!!!!!!!!!
Kia Ora!
I’ve only just found your blog, via a wild and woolly ride…
This post about PCS is very interesting for me – I’ve had now 18 months of recovery since I hit my head on my 4WD. NOT a happy experience – clear neuropsych testing changes, nothing ‘hard’ on scan, but what a profound impact on my life.
I’ve posted about my recovery a wee bit on my blog – which actually started as a result of speechlanguage therapy treatment for my PCS.
I hope you take a look!
cheers
Bronnie
http://healthskills.wordpress.com
Hi! I was surfing and found your blog post… nice! I love your blog.
Cheers! Sandra. R.