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Use of Cognitive and Communication Strategies to Maximize Function for Persons with Acquired Brain Injuries

Use of Cognitive and Communication Strategies to Maximize Function for Persons with Acquired Brain Injuries. Presented By: Amy Karas, MS, CCC-SLP Janet McBride-Roy, CTRS Community Rehab Care, Inc. March 27, 2014. Acquired Brain Injury. Definition Characteristics Types Co-Morbitities:

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Use of Cognitive and Communication Strategies to Maximize Function for Persons with Acquired Brain Injuries

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  1. Use of Cognitive and Communication Strategies to Maximize Function for Persons with Acquired Brain Injuries Presented By: Amy Karas, MS, CCC-SLP Janet McBride-Roy, CTRS Community Rehab Care, Inc. March 27, 2014

  2. Acquired Brain Injury • Definition • Characteristics • Types • Co-Morbitities: • Intellectual functioning • Past medical history • Learning style • Mental health • Substance abuse • Statistics

  3. Types of Impairments • Cognitive • Communication • Social Pragmatics • Emotional • Behavioral • Physical

  4. Impact on Environment • Impulsivity • Poor decision making • Inability to advocate for self • Social isolation • Feelings of hopelessness or disinterest • Withdrawal from interests • Changes to relationships • Modifications or inability to work • Modifications or inability to drive NEED FOR CASE MANAGEMENT!

  5. What makes a good case manager? • Ability to develop a therapeutic relationship • Understanding of client skills, challenges and barriers to progress • Recognition of change and ability to adjust and adapt to needs • Flexible thinking • Ability to advocate for client and with client/family as needed • Knowledge of your limits and when to seek assistance

  6. Building the Therapeutic Relationship: • Trust • Honesty • Patience • Ability to listen • Compassion • Providing support documentation/literature • Integration of strategies • Determine best mode of communication • Follow through • Frequency of check-ins

  7. Assessment • Interview • Demographics • Diagnosis/ Present illness • Past Medical History • Social/Vocational History • Legal Status/Guardian • Medical Providers/ Insurance • Financial Resources • Client/Family goals • Daily Structure • Behaviors/Mental health • Physical Abilities/Safety Risk • CognitiveSkills • Communication Skills • Recommendations

  8. Types of Supports • Family • Friends • Medical/ rehab providers • Case management - ongoing • Counseling • Support groups (Survivor, Care Giver, AA/ NA) • Local community resources/supports • Money/insurance/rep payees • PCA/home health aides/home makers

  9. Types of Transitions • Premobid living environment • New apartment (elderly/disabled housing, subsidized) • Rooming/boarding house • Friend’s apartment • Shelter/streets • Sober house • Skilled nursing facility • Assisted living facility • Adult Foster Care • Rest Home • Residential/group home • Set back/modifications/improvements

  10. Creating a Plan of Action: • Refer back to assessment. • Create an open dialogue. • Request input from client caregivers, family and other close providers. • Identify key team members and roles. • Create short and long term goals that are client –centered. S.M.A.R.T. Goals: S = Specific M = Measurable A = Attainable R = Realistic T = Timely / Tangible

  11. Implementation of Plan • Ongoing training and communication needs • Type of brain injury • Functions of the brain • Signs and symptoms • Living with brain injury • Specific strengths and weaknesses • Accommodations/ modifications/ strategies • Identify “Red Flags”

  12. When and How to Use Strategies

  13. Functional Strategies: • Calendar: track appointments, orient to day/date • Smart Phone: track appointments, set alarms, take notes, memory log • Notebooks: track appointments, phone log, transportation needs, things to do, medical timelines • Establishing Routines: increase organization (sorting mail, filing paperwork), increase involvement (meal prep, ALDs, IADLs) • Phone Log: expressing needs, recording information, for follow up, returning calls • Internet: set up banking, explore resources, job hunt, self advocacy and collaboration on goals

  14. Functional Communication and Promoting Self Advocacy: • Involve others to assist with sharing information • Offer opportunities to provide education and training • How to communicate and share information accurately? • Establish best modality: verbal or written • Determine amount of assistance needed • Establish frequency of contact and how to maintain

  15. Functional Communication & Promoting Self Advocacy Continued • Establish systems for medical appointments -Determine amount of assistance with preparing for appointments -Develop written template -Rehearse script prior to appointment -Identify what to bring (medical timeline, notebook, tape recorder, etc.) -Communicate with medical team prior to appointment -Attend together • How feedback will be provided after appointments -Who calls who after appointment (you, client, medical provider) -Establish systems for processing & fine tuning systems

  16. Questions/Feedback

  17. References: • www.biama.org • www.biausa.org • www.ABIstafftraining.info • www.nursing.advanceweb.com • www.ntooc.org • Donald T. Stuss and Robert T. Knight. Principles of Frontal Lobe Function (Oxford University Press, 2002).

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