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Heads up on Brain Injury assessments

Heads up on Brain Injury assessments. Jackie Burt BA Hons. CQSW Social worker, Case manager. What is so special about brain injury?. Why are cases complicated? What are the pitfalls and possibilities for assessment?. Brain injury can happen to anyone.

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Heads up on Brain Injury assessments

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  1. Heads up on Brain Injury assessments Jackie Burt BA Hons. CQSW Social worker, Case manager

  2. What is so special about brain injury? Why are cases complicated? What are the pitfalls and possibilities for assessment?

  3. Brain injury can happen to anyone Traumatic [TBI] or Acquired Brain Injury [ABI] can affect one specific area But very often the whole brain is affected with diffuse damage across all areas

  4. The brain

  5. Areas of the Brain Explained

  6. Causes and Case Studies RTA - [ TBI] Don - motorbike accident, working man, husband, father. Rob- 20 years , out clubbing , hit by fire engine. Both suffered frontal and cerebellar damage D was able to claim compensation R was not

  7. Falls Dee , existing MH problems , jumped from a bridge . Scott , fell from bridge on a night out . Both suffered physical and cognitive damage . D’s pre-existing problems led to added stress for carers. Conflict for social work over who is responsible for after care .

  8. Anoxia Mike – carbon monoxide poisoning Brian – heart attack , Global brain damage, diffuse difficulties . Memory badly affected. Families of both struggle to cope. M > compensation B > not applicable

  9. Haemorrhage /Stroke Gary – 23 years – haemorrhage. Jim – 25 years -stroke following IV drug use Both left with communication difficulties G > no speech and unable to read . J > pre existing drug dependency. Both > anger , frustration Both received inappropriate support following SSD assessment .

  10. Assault Steve , beaten with baseball bat by drug gang Pete - beaten by gang, mistaken identity Both > major frontal lobe damage , reduced insight . No physical damage . Both > very vulnerable and at risk . Pete had help to apply for Criminal Injuries Compensation

  11. ABI in childhood N – RTA aged 3 L -- Swallowed adult medication aged 3 Children's brains have plasticity and can develop different neural pathways but often at the expense of other skills But often long term problems exist which may not be obviously associated . [ see research on prison population etc]

  12. What’s the damage? And how does this affect assessment? Cognitive changes . Poor memory Poor concentration Slower information processing. Difficulty with writing , reading . Impaired understanding / ability to think logically. Fatigue

  13. Personality /Emotional changes The frontal lobes are the gatekeeper of the brain . Damage --- Lack of forethought / consequences . Altered behaviour ,irritability, anxiety Lack of self restraint , disinhibition , inappropriate comments/ actions / humour Impulsive behaviour .

  14. Reduced insight Unrealistic ideas of their own abilities and difficulties. Reduced understanding of the needs of others. “ Damage to the frontal lobes is similar to how an 11 year old might function.ie OK until there is a need to problem solve and live within boundaries”

  15. Assessments - Common mistakes Not reading notes and reports prior to assessment. Relying on account of person with ABI[ client] Not appreciating extent of impairment ,especially if client lacks insight. Pretending to understand when communication is affected Assuming that when someone can’t speak that they can’t understand.

  16. Common mistakes cont. Expecting to achieve full assessment in one or even two meetings [ many people with ABI can only concentrate for 10 – 20 minutes] Assuming that reasoning will bring about changes in behaviour. Expecting that 6 week programme of generic enabling will effect change . Someone with a brain injury may not be able to manage Direct Payments or to retain support staff.

  17. Help ? Check any notes [ not always easy with electronic recording] Involve family/ significant others if appropriate . Recognise that assessments could be more time consuming Brain injury is NOT the same as a learning disability

  18. Many people with ABI have Case Managers , work with them to assess. Many pw ABI will have lawyers / legal support. These people have a wealth of knowledge and can assist with finances at all stages of Brain Injury . Consider encouraging clients/families to seek legal advice . [CICA]

  19. Pressures The current climate brings added pressures to Social Services departments . Many authorities now prefer generic working instead of specialist . ABI can bring with it particular difficulties for the pw ABI and those around them . Many of these no longer meet the remit for help from SSD.

  20. HELP ! • But there are people who can help and advise and support . • Eg -Headway [ see website ] – excellent advice for professionals , see also their list of law firms • BISWG see website • UKABIF , see website • INSWABI see www.tbistafftraining.info

  21. Brain Injury Rehab Trust And of course BIRT who have developed BINIa tool to assist with what is arguably the most important first step on the road to maximising potential for people with ABI. A GOOD ASSESSMENT !!

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