Post on 01-Apr-2015
transcript
The Journey is the Destination
David J. Scarisbrick, Ph.D.Director of Neuropsychology
Progressive Health of Pennsylvania
Brain Injury: The Family’s JourneyBrain Injury Alliance of New Jersey
October 18, 2014
General “Guiding Principles”
You MUST plan for both the short-game and the long-
game.
General “Guiding Principles”
It is a LONG-GAME
General “Guiding Principles”
ALL Plans are subject to change.
General “Guiding Principles”
TTT- Things Take Time
General “Guiding Principles”
The labels “Mild-Moderate-Severe” are related to the effects of the initial insult
and not necessarily mapped onto the long-term sequelae.
General “Guiding Principles”
The neurological system is a dynamic NOT static
system
General “Guiding Principles”
One must be wary of inadvertently creating
problems (iatrogenic). Some individuals will begin to steal or lie to get their
perceived “needs” met.
General “Guiding Principles”
Individuals may “Grow Into” a deficit
General “Guiding Principles”
Be aware of “control” issues and always try to respect
and give as much control as possible.
General “Guiding Principles”
“Windows of Opportunity” open and close at various and unpredictable times
during one’s life
General “Guiding Principles”
Whose GOALS are they anyway?
General “Guiding Principles”
Topic of Hope
Acute Stages: Family and therapist are viewed as sources of hope. They are helping me do something
Long-term Stages: Family and therapist are viewed as trying to “stop me” from doing something.
General “Guiding Principles”
This ain’t for sissies
General Overview of the Brain and Organization
Brain and Spinal Cord are continuous
“Lower” areas of the brain (e.g. brain tem) serve more basic
automatic functions
General Overview of the Brain and Organization
Evolution is not wasteful. Newer brain regions are added onto existing ones
“Newer” regions often control “lower” areas through inhibition
“Higher” functions may be lateralized to a greater extant to one side of the brain (e.g. language, emotions, facial processing)
Long-term Cognitive and Emotional Problem
Awareness
“We don’t see things are they are, we see them as we are.”
Anais Nin
Long-term Cognitive and Emotional Problem
Anger-Episodic Dyscontrol-Frustration
Long-term Cognitive and Emotional Problem
Depression- Disorders of Mood
Long-term Cognitive and Emotional Problem
Disinhibition-Impulsivity
Long-term Cognitive and Emotional Problem
Memory
Long-term Cognitive and Emotional Problem
Initiation (Motivation)
Long-term Cognitive and Emotional Problem
Aging and Health
General ConclusionsGive control when possibleBe Specific in your feedbackCheck for mutual understandingDisengage when anger arisesRe-engage when anger subsidesBe positive and find humor when possibleLook for “Windows of Openness”Try and set goals that are meaningful to
allLook for positives to reinforce
Questions?