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BRAIN INJURY SUPPORT SERVICE South and East Belfast Health and Social Services Trust

BRAIN INJURY SUPPORT SERVICE South and East Belfast Health and Social Services Trust. Dr. Marie Goss. NORTH SOUTH BRAIN INJURY CONFERENCE SEPT 2006. BRAIN INJURY SUPPORT SERVICE. MAINE NEUROBEHAVIOURAL UNIT MOURNE DAY SUPPORT UNIT COMMUNITY BRAIN INJURY SERVICE.

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BRAIN INJURY SUPPORT SERVICE South and East Belfast Health and Social Services Trust

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  1. BRAIN INJURY SUPPORT SERVICESouth and East Belfast Health and Social Services Trust Dr. Marie Goss. NORTH SOUTH BRAIN INJURY CONFERENCE SEPT 2006

  2. BRAIN INJURY SUPPORTSERVICE • MAINE NEUROBEHAVIOURAL UNIT • MOURNE DAY SUPPORT UNIT • COMMUNITY BRAIN INJURYSERVICE

  3. CORE ISSUES IN SERVICE PROVISION • UNIQUE SERVICES IN N.I. CONTEXT • WORK WITH PEOPLE WITH COMPLEX NEEDS • FOCUS IS ON PROVISION OF A THERAPEUTIC APPROACH MINIMISING RISK, DEVELOPING SKILLS, COMPENSATING FOR DISABILITY THROUGH CHANGES WITHN THE CLIENT AND THE ENVIRONMENT, MAXIMISING QUALITY OF LIFE

  4. Challenging Behaviours can be • short lived in early recovery • ongoing/interfere with rehabilitation • long term - limit/prevent community reintegration - cause major challenges to those providing care and support

  5. IMPACT OF SOCIAL AND EMOTIONAL AND BEHAVIOURAL PROBLEMS ARISING POST BRAIN INJURY • CAN PREVENT SUCCESSFUL COMMUNITY REINTEGRATION POST BRAIN INJURY • CAN PREVENT ACCESS TO SERVICES eg REHABILITATION, VOCATIONAL TRAINING, DAY CARE, SUPPORTED HOUSING, RESPITE. • CONTRIBUTE TO FAMILY/CARER STRESS • ADVERSLY AFFECT FAMILY COPING AND ADAPTATION

  6. Maine neurobehavioural unit • Post acute rehabilitation • slow stream rehabilitation • long term care • day care • respite care • crisis intervention

  7. MAINE NEUROBEHAVIOURAL UNIT ADMISSION CRITERIA • Male , 17 - 65 years, ABI. • Requires specialist inpatient assessment . • Difficult to manage in other settings due to challenging behaviour. • Risk to self or others. • Requires a rehab programme focussing on social, emotional and behavioural functioning. • Does not require secure provision.

  8. MAINE NEUROBEHAVIOURAL UNIT SOURCE OF REFERRALS • Neurosurgery • Acute hospital settings • Neurorehabilitation settings • Mental Health services • Acute Psychiatric units • Residential facilities • Home • Social services

  9. Multidisciplinary team • Nursing • Nursing assistants • Occupational therapy • Social work • Clinical neuropsychology • Medical (Neuropsychiatry, G.P) • [Physiotherapy, Speech and Language therapy] • [Artscare, artist,musician,dance]

  10. MOURNE DAY PROJECT TARGET GROUP • Adults who present with significant social dysfunction after brain injury • Those who require highly individualised treatment/rehabilitation and care plans to enable and maintain community participation and reintegration. • Those whose needs cannot be met in mainstream settings, due to risks associated with behaviour and who require a high staff /client ratio.

  11. MOURNE DAY SUPPORT UNITreferral criteria • Male or female, 18 – 65 years,ABI. • Resident within the community • Requires specialist assessment • Requires a rehabilitation programme in a specialist setting focussing on social emotional and behavioural functioning • Requires specialist support to maintain functioning and enable community participation • Difficult to manage in other settings due to challenging behaviour • Requires a high level of staff support and supervision

  12. MOURNE DAY PROJECTSOURCE OF REFERRALS • Community brain injury teams / EHSSB • Social services • Mental health services • G.P.s • Regional Acquired Brain Injury Unit

  13. MOURNE DAY PROJECT STAFFING • Unit Manager • Senior Day care Worker • Day Care Workers • Administrative Staff • Neuropsychologist • Psychology Assistants • Occupational Therapist

  14. MAINE NEUROBEHAVIOURAL UNIT & MOURNE DAY PROJECT • ASSESSMENT eg.Cognitive,behavioural, ADLsocial skills, communication, risk assessment • REHABILIATATION / TREATMENT • DEVELOPMENT OF NEW SKILLS • MAINTENANCE OF EXISTING SKILLS • SUPPORT TO ENABLE SOCIAL PARTICIPATION • CRISIS INTERVENTION • RESPITE CARE

  15. ASSESSMENT • Level of ADL functioning • Behaviour • Cognition • Social functioning • Emotional functioning • Mental State • RISK • NEEDS ( future support )

  16. FORMULATION • Difficulties resulting from : • physical impairment • sensory impairment • medical condition • cognitive capacity • eg.attention, understanding, judgement • mental disorder • eg perception, ideation,moodstate • psychological reaction

  17. Skilled Staff observation and assessment skills communication & interpersonal skills prompting, feedback Structured Day Activities/routines Environmental Management level of stimulation cues INTERVENTION

  18. Risk management Skills training, e.g.,planning skills, social skills Therapies Occupational therapy Speech and Language therapy Physiotherapy Treatmentspharmacology behavioural therapy CBT INTERVENTION

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