We each tend to be our own harshest critic. There is nothing that someone can say that would be meaner or nastier than what we say to ourselves. This is a natural part of being human; everyone does this. When our lives are going well, a little self-criticism does not impact our mood greatly. However, after a brain injury, when life is much more stressful, brain injury survivors may engage in more and harsher self-criticism than before. This can lead to low mood, anxiety, anger, depression, and in severe cases, thoughts of self-harm. Self-criticism can also lower motivation and overall success in brain injury rehabilitation.
Self-criticism tends to be more frequent after a brain injury as survivors are often struggling with everyday tasks that used to be easy. Tasks such as remembering a grocery list, putting on a pair of socks, or walking down a hallway may be difficult. As neurons in the brain take more time to heal than skin or bone, the rehabilitation process is often longer than the healing processes that survivors are accustomed to. It is not uncommon for survivors to make statements such as “I should be better already! I am failing in my recovery!”
Moreover, survivors often blame themselves for their injuries. In some cases, it is accurate that the survivors are the causes of their injuries (e.g., a drunk driving accident caused by the survivor) but excessive time spent on blaming themselves is often counter-productive.
There are a few actions that can be taken to manage self-criticism:
Remember, be kind to yourself in your rehabilitation.
A non-traumatic brain injury (nTBI) refers to brain damage caused by factors other than external trauma. These causes can include exposure to certain toxins, complications of an infection, or a symptom of a medical condition. A stroke is usually the most common cause of an nTBI, and understanding the signs and symptoms is necessary for implementing prevention measures and assessing treatment options.
A brain injury can have life-altering consequences for patients, impacting their physical well-being, cognitive functions, and emotional state. The implications of these injuries can significantly affect a person’s ability to perform daily tasks, maintain relationships, pursue their careers, or enjoy their hobbies.
Coping with these new circumstances is a challenging and ongoing process. However, understanding the nature of the injury and its underlying cause can help patients acquire the best treatment to provide the best outcome.
An nTBI is a complex medical condition that can significantly alter brain function and impact everyday functioning. It is caused by factors not involving external physical force to the head. These causes can include an illness, oxygen deprivation, aneurysms, metabolic disorders, or cardiac arrest, among many others.
It’s essential to differentiate nTBI from traumatic brain injury (TBI) as both types of brain damage are distinct in their etiologies (causation) and clinical presentations (treatment). While nTBIs arise internally, TBIs result from external forces impacting the head, leading to physical damage to the brain tissue. These can be events like a blow to the head, sports injury, or impact from a vehicular accident.
Implementing the proper diagnostic techniques is crucial in accurately diagnosing nTBI and developing appropriate treatment strategies for the injury. Comprehensive medical assessments of the condition can include taking detailed patient histories, neurological examinations, and advanced imaging techniques, such as magnetic resonance imaging (MRI) and computerized tomography (CT) scans.
By applying the appropriate diagnostic procedure, healthcare professionals can provide a timely and precise diagnosis of the injury and its underlying cause. This enables them to implement targeted interventions and rehabilitative measures that enhance patient outcomes and improve their overall quality of life.
A non-traumatic brain injury can be characterized by a range of symptoms that can be difficult to detect. This is due to the fact that most of these symptoms are attributable to other conditions, while the possibility of a brain injury is almost never considered.
These symptoms need careful attention to provide a timely diagnosis for effective injury management. Several symptoms can be categorized as physical, emotional, cognitive, and perceptual symptoms:
Physical symptoms include:
Emotional symptoms include:
Cognitive symptoms include:
Perceptual symptoms result from a portion of the brain being affected by the injury, which alters the patient’s senses and changes how they perceive stimuli.
These include:
Diagnosing an nTBI can be challenging as these symptoms might overlap with other neurological or psychological conditions. In many cases, the possibility of a non-traumatic brain injury may be considered late due to the absence of visible external injuries.
Nevertheless, seeking medical attention is still imperative if individuals experience any or a combination of the symptoms listed above to increase the likelihood of early intervention.
nTBIs can result from a wide range of internal factors that impair the brain’s functioning. One of the most common causes of an nTBI is a stroke, which occurs when blood flow to the brain is disrupted, resulting in tissue damage and neurological impairments. Brain tumors can also lead to functional disturbances as a result of exerted pressure on the surrounding tissue, which can impair brain function.
Other causes of an nTBI include:
The risk factors for nTBI can vary based on individual circumstances and underlying health conditions. Identifying these risk factors associated with nTBI is vital for early recognition and appropriate management. Some of these risk factors include:
Treatment for nTBIs will depend on several factors and must be tailored to the specific individual to produce the best outcome. These treatment methods can include addressing specific brain issues, treating the underlying cause, and providing supportive care, rehabilitation, and education:
Based on a patient’s condition and medical history, a physician may prescribe certain medications to treat the underlying condition causing nTBI or the symptoms that appear.
Some common types of medications used in nTBI management include:
Rehabilitation aims to improve a patient’s functional abilities, restore independence, and enhance their overall quality of life. The type of treatment they receive is tailored to the individual’s specific needs and can encompass different disciplines. Some of the most common types of rehabilitation therapies used include:
Supportive care refers to the comprehensive and compassionate approaches taken to meet the diverse needs of nTBI patients, especially those with chronic or progressive conditions. It does not directly target the underlying cause of the injury. However, it is still a critical aspect of its treatment and management.
Supportive care is given to enhance the patient’s overall well-being, comfort, and quality of life. These can be in the form of providing daily living assistance, emotional support, symptom management, palliative care, or end-of-life care.
In cases where an infection was the cause of the injury, metabolic disorder, or any other medical condition, targeted treatments can be provided to treat the underlying issue first. Addressing the main contributing factor is essential to slow down or halt the progression of the injury.
Adopting a healthy lifestyle can be beneficial in managing symptoms of an nTBI. Practices like maintaining a balanced diet and engaging in regular exercise are beneficial for managing chronic conditions like hypertension and diabetes, which contribute to an nTBI.
Moody Neurorehabilitation recognizes the importance of providing exceptional medical care and unwavering emotional support and guidance to nTBI patients during this challenging journey. We are committed to providing personalized care that aligns with patients’ challenges and goals.
Since 1982, Moody Neurorehabilitation has been at the forefront of brain injury treatment and patient care. Working with a multidisciplinary team of experts, we develop a comprehensive treatment plan that addresses each patient’s unique needs and improves their quality of life.
If you or a loved one has suffered a non-traumatic brain injury, contact us today to arrange a consultation with our experts.
Moody Neurorehabilitation Institute (Moody Neuro) provides personalized care to treat the unique challenges of brain injury with the singular purpose of achieving the best possible outcome for patients and their families.
For humans, few afflictions are as complex and concerning as traumatic brain injuries (TBIs). A TBI is defined by the Centers for Disease Control and Prevention (CDC) as a disruption in normal brain function due to an external force with symptoms manifesting at varying degrees of severity. No matter the cause or outcome, the consequences of a TBI present a broad spectrum of challenges for those affected.
Below, we explore the common causes of TBIs and then shed light on the crucial stages of recovery. While each individual’s journey is unique, understanding the typical stages of recuperation provides vital insights into holistic rehabilitation. Whether you are a survivor, caregiver, or a curious reader seeking to grasp the intricacies of the human brain’s capacity to heal, below we offer invaluable knowledge and hope for a healthier tomorrow.
The human brain is remarkably resilient. However, its vulnerability becomes evident when subjected to external forces of sufficient magnitude. TBIs can be caused by a variety of incidents, altering lives instantly and leaving a trail of physical and emotional challenges.
The most common causes of traumatic brain injuries include:
The path toward healing and restoration after a TBI unfolds through several stages. In this subsection, we explore the ten traumatic brain injury recovery stages that characterize the course to full recovery. Delving into the physical, cognitive, and emotional aspects of healing, we highlight the milestones that survivors, caregivers, and healthcare professionals may encounter throughout this journey.
The first and most critical phase in the TBI recovery stages is the medical care immediately following the incident. During this crucial period, the primary focus is stabilizing the patient, preventing further damage, and addressing life-threatening conditions. Medical professionals conduct thorough evaluations and may employ various interventions to alleviate pressure on the brain. The goal is to ensure the injured individual’s survival and lay the foundation for subsequent stages of recovery.
As the patient’s condition stabilizes, early rehabilitation commences. This stage involves a comprehensive assessment of the individual’s physical, cognitive, and communicative abilities. Rehabilitation specialists, such as physical, occupational, and speech-language therapists, design personalized treatment plans to improve the patient’s overall quality of life. Intensive therapy during this phase sets the tone for the rehabilitation journey and aims to maximize the potential for recovery.
Brain injury recovery often brings forth a range of physical symptoms that require careful management. These may include headaches, dizziness, balance issues, muscle weakness, and sensitivity to light or noise. Specialized therapies, medications, and lifestyle adjustments are implemented to address physical afflictions and improve the individual’s well-being.
Cognitive challenges are common after a traumatic brain injury, impacting memory, attention, problem-solving, and executive functions. During this stage, cognitive rehabilitation becomes a primary focus. Neuropsychologists and therapists work collaboratively to create rehabilitation programs tailored to the individual’s specific problems. These plans aim to enhance cognitive abilities, promote mental clarity, and facilitate a smoother reintegration into daily activities.
The emotional toll of a TBI on the survivor and their support system cannot be overlooked. Therefore, emotional and psychological support is paramount during this stage. Professionals, such as psychologists or counselors, provide guidance and coping strategies to address frustration, anxiety, depression, and emotional instability. Family members and caregivers are also educated in providing a supportive and nurturing environment to foster emotional healing.
After progressing through previous stages of medical care, rehabilitation, and cognitive improvement, individuals are ready to embrace the challenges of resuming their routines and responsibilities. This stage focuses on helping survivors regain their independence, adapt to lasting changes, and reintegrate into their homes, workplaces, schools or communities. During this phase, occupational and recreational therapists play a pivotal role, assisting individuals in developing strategies to manage daily activities effectively.
The unwavering support of family and friends is a cornerstone of brain injury recovery. As survivors progress through rehabilitation and reintegration, the role of family and social support becomes increasingly vital. Education and counseling are invaluable, helping them understand the ongoing effects of TBIs and providing tools to cope with potential changes in their relationship dynamics. Support groups and community resources also offer a network of understanding peers, fostering a sense of camaraderie and shared experiences that can ease the emotional burden.
Survivors may require ongoing medical, rehabilitative, and psychological support as they progress. This stage emphasizes the importance of regular follow-ups with healthcare professionals to monitor progress, address emerging challenges, and adjust treatment plans as needed. Coordination among healthcare providers, therapists, and caregivers ensures solid support throughout the recovery journey.
Amidst the challenges and hard work, it is essential to celebrate the progress and achievements made during the process. Whether reaching a physical milestone, achieving cognitive improvements, or overcoming emotional hurdles, each triumph signifies the survivor’s resilience and determination. Celebrating these victories boosts the survivor’s morale and reinforces the support and appreciation from the entire support network.
The final phase of the traumatic brain injury recovery stages marks a transformative moment because this is when survivors embrace life beyond the recovery process. Having navigated through the various phases of medical care, rehabilitation, emotional support, and reintegration, individuals emerge with a newfound perspective on life’s fragility. While some survivors may return to a life resembling their pre-injury state, others may need to adapt to new circumstances and redefine their goals. This period emphasizes embracing change, setting new goals, and cultivating a positive outlook.
The trajectory of TBI recuperation is an intricate interplay of various factors that significantly influence the progression and outcomes of each phase. The following are the elements that impact the 10 stages of brain injury recovery:
It’s important to remember that each brain injury case is unique, and the factors presented above may vary from person to person. Still, understanding the elements that affect the traumatic brain injury recovery stages helps patients, caregivers, and healthcare professionals navigate the complexities of healing. This, in turn, gives them a more informed and compassionate approach to support the journey toward rebuilding lives after a TBI.
Each recovery phase serves as a building block toward regaining function and independence. The road to TBI rehabilitation may be filled with obstacles but is also imbued with hope and possibility. Every step forward, no matter how small, represents a triumph of human resilience and the tireless pursuit of progress.
Are you or a loved one on the path to recovery after a TBI? Moody Neurorehabilitation is here to support you every step of the way. With personalized treatment plans tailored to the patient’s unique needs, our experienced staff brings extensive knowledge and expertise to ensure a comprehensive and practical recovery journey.
Let us guide you toward total healing and independence. Contact us today to learn more about our specialized services.
https://www.cdc.gov/traumaticbraininjury/index.html
https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury-tbi
https://www.cdc.gov/traumaticbraininjury/moderate-severe/recovery.html
https://www.flintrehab.com/traumatic-brain-injury-recovery-stages/
https://www.philbrook-law.com/blog/what-are-the-stages-of-a-traumatic-brain-injury-recovery/
https://hms.harvard.edu/news/recovery-may-take-time
https://msktc.org/tbi/factsheets/understanding-tbi-part-3-recovery-process
https://www.spinalcord.com/blog/5-emotional-mental-stages-to-recovery-traumatic-brain-injury
Moody Neurorehabilitation Institute (Moody Neuro) provides personalized care to treat the unique challenges of brain injury with the singular purpose of achieving the best possible outcome for patients and their families.
When you hit your head, fall or get tackled to the ground, your brain can bounce and move against the skull’s bony structure. This results in a concussion or a mild traumatic brain injury (TBI) and brings symptoms of varying severity.
Some events that cause concussions include falls, car accidents and physical assaults, but athletes involved in contact sports are also vulnerable to TBIs. In fact, at least 1.6 million sports-related concussions are estimated each year in the United States.
Mild concussions may cause short-term symptoms that typically resolve within a week or two, but some patients experience symptoms that linger longer, even with time and rest.
Moreover, athletes engaged in contact sports like soccer, rugby, ice hockey and boxing are at risk of repetitive concussions and their long-term consequences. At what point do multiple TBIs become problematic? How many concussions are too many? Let’s dig deeper into these fundamental topics on concussions in the following sections.
If you are an athlete or a parent of an athlete, you may have heard of the three-strike rule. This was developed 60 years ago and essentially said that an athlete who has suffered three concussions in a season will have to sit out for the rest of that season. However, this rule is not based on scientific data.
Rather than the number, more relevant factors to consider when an athlete should stop or return to the game include the severity and recentness of the last concussion. Suffering three TBIs in a single year differs from suffering the same number of concussions over three years.
An individual’s response to brain injuries also influences how many concussions are too many for that person. For example, those predisposed to certain problems can experience worsened dizziness or balance issues after a single head injury.
As every person is different, there’s no definite number of how many head injuries a person can sustain before permanent damage occurs. After all, some experience long-term complications after a single concussion, while others seem fine after multiple injuries. Still, the more traumas you’ve had, the greater the chances of permanent damage.
It’s also worth stressing that how many concussions you can have isn’t the best question to ask, as it encourages an unhealthy understanding of how TBIs can cause damage. Following the three-concussion rule or setting a specific limit can discourage athletes from reporting symptoms so that they can continue playing.
As individuals experience head injuries differently, discussing your vulnerability and injury history is a better approach. The timing between the injuries matters as athletes who continue to play with a healing concussion can develop worse symptoms, double their recovery time and suffer more significant impairment. There’s also the risk of suffering second impact syndrome, which happens when an already-damaged brain swells up rapidly after getting hit again.
This is a rare but potentially fatal phenomenon in individuals sustaining a TBI while recovering from a recent concussion. Also known as repetitive head injury syndrome, this is when the brain dramatically swells after a second concussion before symptoms from an earlier injury have resolved.
Second-impact syndromes are often fatal, and the few who survive usually become severely disabled.
Athletes and non-athletes who suffered a blow to the head may experience physical, emotional and psychological symptoms. They may experience a headache, nausea or vomiting, double vision, confusion, fatigue or sensitivity to light, among many others. Other symptoms include losing consciousness or not recalling getting injured. Some also report feeling sluggish or hazy.
Meanwhile, persistent symptoms post-concussion include but are not limited to irritability, loss of concentration and memory, sleep disturbances, smell and taste dysfunction and anxiety.
The recovery time for a single concussion is typically short. Symptoms usually disappear within ten days, but they can also last up to three months in some cases. Fortunately, once they are resolved and the brain has healed, there are usually no further complications.
However, it’s a different story when there are multiple concussions involved. The brain needs time to recover from an injury, so permanent damage can happen when it is overwhelmed by several injuries.
After too much trauma, blood flow and oxygenation in the brain are negatively impacted. This makes it hard for the brain cells to do their job, consequently hampering an individual’s ability to think, concentrate and even move. Ultimately, repetitive brain injuries can lead to chronic traumatic encephalopathy, a progressive degenerative disease.
Repeat injuries while recovering from a recent concussion can cause life-changing consequences. However, it’s important to note that it can also occur with less force, as the brain is at an increased risk while still healing.
In boxing, attacking the head and face of the opponent is part of the game. While amateur boxers wear protective gear, the nature of the sport makes concussions and even severe brain injuries common among fighters.
A 1997 study examined boxers who played 12 or more professional bouts and, therefore, had higher exposure to head contact and compared their neurocognitive performance with those who played less than 12 professional bouts. The authors reported that the first group had lower cognitive function than the latter.
A high-resolution MRI study of 100 professional boxers in 2009 also showed a significant correlation between their years in the sport and diffuse axonal injury. It is a type of traumatic brain injury that occurs when axons in the brain become torn as the brain rapidly moves and rotates inside the skull. This movement typically results in the shearing of nerve fibers and usually leads to a coma.
Considering all these, it’s best to move beyond asking how many concussions are too many for an individual. Whether in a boxing ring or field, it’s best to sit out if you’re at risk for a repeat injury until you’ve healed. The brain is vulnerable after a trauma, and successive injuries will only increase the chances of permanent deficits.
Just like, “How many concussions can you have?” it’s difficult to give a definite answer for when it’s best for an individual to return to a sport. Return-to-play guidelines vary by the severity of the head injury.
With that said, the Centers for Disease Control and Prevention recommends a graduated return-to-play protocol for players who suffer concussion symptoms like confusion or loss of consciousness. Following these six gradual steps is a great starting point, but working closely with your physician is still paramount. Athletes who continue to play sports after concussions risk repeat injuries, more serious complications and a longer recovery time.
Most sports-related concussion symptoms resolve on their own within two weeks. Athletes can also return to their sports practices if they have the approval and supervision of their healthcare provider.
However, in cases where multiple or severe concussions resulted in mobility issues, speech and language impairment, or emotional and behavioral struggles, undergoing rehab is recommended. Rehabilitation programs can take many forms, including physical, occupational, speech and language therapy, as well as counseling and community integration. These are designed to help patients recover from the effects of their injury.
Ultimately, a proactive approach is the key to a speedy and successful recovery. Simply mitigating the symptoms with medication may increase your comfort, but it doesn’t address the underlying issue.
At Moody Neurorehabilitation, we’re all about empowering patients to gain independence and return to the activities they love. With our world-class facilities, experienced staff and passion for improving the lives of our patients, we provide highly personalized care for adolescents and adults with acquired brain injury.
We serve several locations across Texas and are available to begin the admissions process for you. Upon admission, a comprehensive evaluation will be done to develop a rehabilitation regimen tailored to your cognitive and emotional status. Please don’t hesitate to contact us to schedule a tour or refer a patient.
Sources:
Moody Neurorehabilitation Institute (Moody Neuro) provides personalized care to treat the unique challenges of brain injury with the singular purpose of achieving the best possible outcome for patients and their families.
The holidays are about spending time with those closest to you. However, when you’re recovering from a traumatic brain injury (TBI), the holidays can be a little more challenging.
In fact, when you have a TBI, holidays can easily feel overwhelming. You may not have the energy to spend the whole day celebrating. And the worst part is that all you want to do is spend time with friends and family.
Moreover, you want to show up and be present with those you love without causing them or yourself worry. But overextending yourself and your time can leave you feeling exhausted and mentally drained.
Here are some great tips to help you get through the celebrations while still prioritizing your health. After all, you don’t want your TBI to prevent you from participating in family traditions!
Note: It’s important to listen to your body and rest when rest is needed. If you’re a survivor’s friend or family member, please remember these considerations as the holidays approach.
[Related: Noticing the Positive]
It’s OK to go at your own pace.
With or without a TBI, holidays and the accompanying celebrations can quickly become hectic. It may be tempting to try and match everyone else’s pace. But doing too much can make you irritable and put a cloud over a day that’s supposed to be full of family, love and fun.
Pushing yourself too far will lead you to wipe out early and leave you feeling worse the following day. Additionally, try to avoid doing too much cooking, decorating or participating in other activities you might traditionally undertake.
Most importantly, focus on enjoying the day in your own way. Do what feels right for your current energy level and mood.
If that includes taking a nap after dinner, then that’s fine!
If you have poor muscle control in your arms, you shouldn’t be lighting menorah candles for Chanukah. Similarly, if you have balance issues, you shouldn’t climb onto the roof to put up Christmas lights.
However, with this in mind, you’ll always have some identifiable strengths.
For example, although a person in a wheelchair may be unable to put up all the decorations on the Christmas tree, they may be able to put some on the lower branches. Additionally, a survivor may be unable to be fully responsible for cooking a turkey, but maybe they could cut some vegetables for a salad or help set the table.
If you and your family members look closely enough, there’s almost always something you can do or help with. Even taking on a small task will boost your pride and self-esteem.
Injury or no injury, working together on holiday celebrations brings family members together. You have a joyful opportunity to bond.
[Related: Emergency Preparedness Guide for Post-Brain Injury Patients]
Some families traditionally go from house to house for multiple holiday celebrations throughout the day. However, you might become fatigued easily, and holiday parties tend to be long and active.
For many survivors, attending several celebrations on the same day may be very difficult. You might benefit from spending less time at each celebration.
Try to keep things simple and easy but still fun. Doing this has the added benefit of cutting out excess details or over-the-top traditions. Instead, you can focus on sharing the day with your family.
While last-minute shopping is sometimes necessary, TBI survivors should consider light scheduling closer to the holidays.
Space out everything you want to do, like cleaning or shopping. That way, you don’t feel rushed and have plenty of time to do things at your own speed. It’s also wise to give yourself a day of rest before any celebration.
Furthermore, try to figure out how long the trip will take if you’re traveling. An app like Google Maps can be helpful.
What’s more, there are plenty of options to get from point A to point B without being behind the wheel yourself! Look into rideshare apps, public transportation or bus schedules for long-distance trips. You can even sleep through the commute if you need a bit more rest.
However, it’s also a good idea to ask a relative to drive if you feel uncomfortable taking public transportation. And if you need support at any point, don’t hesitate to reach out to your network.
[Related: What Do Post-Traumatic Brain Injury and Sleep Disorders Have to Do With One Another?]
Many survivors struggle with the tradition of giving gifts during holidays like Christmas and Chanukah. You might be dealing with strained finances in the aftermath of your TBI, and that can make gift-buying for the holidays stressful.
If you’re a friend or family member of someone recovering from a TBI, simply reassuring them that you’re not worried about receiving a gift or are perfectly fine with getting a small gift can ease their concerns.
Alternatively, you could always create a handmade gift or card (with a family member’s help if needed).
Or families might switch to a gift exchange. For a gift exchange, everyone buys just one gift, puts it in a bag (no names marked) and then randomly chooses one of the bagged gifts. It’s fun, special and much less stressful.
In addition, families and friends might limit the cost of the gifts everyone buys. That makes gift-giving easier and helps everyone — you included — feel less financial pressure.
Plus, it’s wise to put little (if any) emphasis on the role money plays in the holidays. When you’re not worried about impressing others with pricey presents, everyone can focus on the meaning behind the holidays.
Setting boundaries is important for your mental health during the holidays. Whether that means politely changing the conversation with a family member who wants to know more than you’re comfortable sharing or stepping away from the hubbub for a moment, you sometimes must set boundaries.
Regardless, setting boundaries is a healthy way of maintaining quality relationships with those close to you.
And frankly, it might be a little difficult at first to set boundaries with a family member or move past worrying that you’ll hurt someone’s feelings. Push past those emotions! Setting boundaries actually has the opposite effect.
When you set boundaries, family members understand that you’re doing what’s best for you. They should know that with a TBI, holidays can require parameters in your social life. And this allows you to be at your best when you’re with them.
[Related: 10 Supportive Traumatic Brain Injury Resources for Parents]
Survivors and their loved ones need to address several issues in terms of where they hold celebrations. But this consideration applies to both survivors and their friends and family members. If you’re a survivor’s friend or family, ask yourself these questions:
Some TBI survivors’ families find it’s easier to host holiday celebrations at their own homes rather than travel to others’ homes. They’ve already adapted their own homes to survivors’ needs.
Survivors and their families should also consider the physical layout of rooms where celebrations will take place. For example, rearranging tables and chairs so survivors can navigate rooms more easily is a good idea.
You should also make sure toys and gifts aren’t left on the floor — they’re trip hazards. Cords from lights or decorations can be trip hazards as well, so place them so they’re not dangerous when survivors move around.
Additionally, consider practical matters regarding holiday meals. Here are just a few questions to ask yourself as a TBI survivor’s friend or family member:
Small changes in room and furniture layouts can make a huge difference! Striving for safety and accessibility helps survivors enjoy celebrations and feel included.
If you’re a TBI survivor, your family may want to consider how loud they allow holiday celebrations to be.
Some survivors find that they’re more sensitive to noise than they were before their injury, and loud noises can lead to agitation, anxiety and/or anger. If this is the case with you, then you might want to attend smaller celebrations or spend time in quiet rooms during big, boisterous parties.
Noise can also be a relevant issue when considering attending religious services. It may be better for you to go at less busy times or find a smaller house of worship with fewer people present.
[Related: Which TBI Care Plan Is Right for You?]
When you’re a TBI survivor, fatigue can be a constant struggle — and this certainly extends to holiday celebrations. Holiday parties and celebrations often run for many hours, and you may become tired easily.
Sometimes, changing how long you’ll attend the celebration can increase your likelihood of going! Three hours of fun participation is better than five hours of exhaustion.
People drink alcohol on several holidays. For example, a champagne toast is often at the center of New Year’s Eve celebrations. Eggnog with liquor is standard at many Christmas parties.
However, alcohol can be highly problematic for TBI survivors. If you’re a TBI survivor, speak with your doctor before you drink. It’s much better than taking a risk.
When you have a TBI, holidays should be joyful as well as accessible. And they can be exactly that with a little effort from you, your family and your friends.
At Moody Neuro, we specialize in personalized rehabilitation programs for TBI survivors. We also offer help and resources to caregivers and family members. From residential care to outpatient therapy services, you can find the support you need.
Contact us today to learn more.
Moody Neurorehabilitation Institute (Moody Neuro) provides personalized care to treat the unique challenges of brain injury with the singular purpose of achieving the best possible outcome for patients and their families.
According to the Centers for Disease Control (CDC), almost 800,000 people have strokes every year in the U.S. Someone suffers from a stroke in the U.S. every 40 seconds, and stroke fatalities occur every 3.5 minutes.
These are unsettling numbers, and the risks don’t end with the stroke itself. In addition to needing aftercare, stroke survivors face the possibility of a second stroke. Every year, about 185,000 strokes happen in people who have had prior strokes.
So, what’s the best way to prevent a second stroke?
To begin with, people who have suffered a stroke should receive treatment, change their lifestyles and follow preventive practices.
With age, human arteries become hard and narrow, which can lead to blockages. Unhealthy lifestyles and preexisting medical conditions can affect artery health, increasing the risk of stroke. In addition, sedentary lifestyles and poor eating habits are often leading factors in stroke victims.
These are a few other important risk factors for vascular diseases:
Avoid these risk factors to help protect yourself from becoming a stroke victim.
Ischemic strokes, the most common type of stroke, make up 85% of all strokes. A lack of oxygen or poor blood flow to the brain causes ischemic strokes. If not treated properly, ischemic stroke patients can be at risk for another stroke.
Hemorrhagic strokes make up the other 15% of strokes. Hemorrhagic strokes occur when there is bleeding around the brain. Main causes and risk factors for this type of stroke include high blood pressure and abnormal blood vessels in the brain.
Also known as a mini-stroke, a transient ischemic attack (TIA) is similar to an ischemic stroke. However, a TIA’s symptoms last a shorter period. These attacks are often warning signs for a more serious ischemic or hemorrhagic stroke.
The American Heart Association/American Stroke Association (AHA/ASA) guideline for stroke prevention addresses diagnoses, treatments and secondary stroke prevention.
Review some of the AHA/ASA guide’s key takeaways below:
Strokes affect people differently, so it is important to pick a rehabilitation facility that focuses on your physical, social and emotional goals. Due to the high risk of secondary stroke, a rehabilitation facility should also have individuals who will address your risk factors as you are returning to the community. Choosing the best brain injury rehabilitation is critical. Moody Neurorehabilitation Institute has 40 years of experience and specializes in brain injury rehabilitation, which is needed after suffering a stroke.
For more information, see what the CDC says about stroke prevention.
Since 1982, Moody Neurorehabilitation Institute has served Galveston, Texas, and neighboring Gulf Coast communities. With 40 years of experience, we provide quality treatment for a variety of brain injuries, such as strokes and support secondary stroke prevention guidelines. We offer effective home evaluations, in-house training and unique home exercise programs.
For effective treatment, one must understand the fundamentals of the brain. Explore our comprehensive resources to learn more about the body’s most intricate organ — the brain.
Let the Moody Neurorehabilitation Institute team answer your questions about brain injuries, rehabilitation and other treatments:
Moody Neurorehabilitation programs assist stroke patients in their recovery so they can maintain their independence. We consider cognitive, behavioral and physical limitations while tailoring personalized treatment plans for every patient’s unique needs.
We offer outpatient programs and residential services, as well as short- and long-term care. In 2019, our patient satisfaction survey revealed that 90% of our patients found our quality of therapy outstanding.
Furthermore, Moody Neurorehabilitation Institute provides long-term support to care for patients who are unable to return to an independent lifestyle.
Learn the latest information regarding Moody Neurorehabilitation’s Program Evaluation Data.
Moody Neurorehabilitation Institute incorporates technology and traditional therapy practices to help stroke patients recover quickly and effectively. Based on physician recommendations, we create a rehabilitation program for the patient’s individual recovery needs.
Our hours are flexible, and we work with patients’ physical capabilities using innovative robotics and technological simulations for optimal outcomes. At Moody Neurorehabilitation Institute, we’re dedicated to supporting families and assisting them throughout the recovery journey.
For people suffering from strokes, we’re here to help guide patients and their families through the difficult road to recovery. Our experience and personalized care make us the premier choice for neurorehabilitation.
Contact Moody Neurorehabilitation Institute to learn about our programs and quality services, or call us at (409) 762-6661 today for more information.
Moody Neurorehabilitation Institute (Moody Neuro) provides personalized care to treat the unique challenges of brain injury with the singular purpose of achieving the best possible outcome for patients and their families.
Depression and low mood are common symptoms after a brain injury. Some of this may be due to neurochemical changes in the brain after an injury. However, much of it is due to the feelings of loss, stress, and frustration following a brain injury. The brain injury experience can often disrupt routine. Instead, it takes brain injury survivors into the very different world of rehabilitation and recovery. Survivors may experience profound emotional struggles due to issues. They may experience loss of skills, frustrations doing everyday tasks or stressful thoughts about an uncertain future. The brain injury experience may feel very negative, even as the survivor takes tangible positive steps forward in their rehabilitation journey. Noticing the positive can feel difficult.
One of the complicating factors in the rehabilitation journey is that our brains naturally demonstrate a “negativity bias”. Negativity bias refers to the brain’s tendency to pay more attention and remember negative events better than positive events. Most people, even without an injury, display some level of a negativity bias. For instance, you likely remember the last time someone insulted you more quickly than the last time you received a compliment.
Most of our lives tend to have far more positive events than negative events, so the negativity bias does not take over our whole thought process. However, the brain injury experience often increases the number of negative events and decreases the number of positive events in a survivor’s experience.
Also, the positive events are different from what they would have been prior to the brain injury. The events are now often minimized or ignored. For many survivors, their brains’ natural tendency for a negativity bias, coupled with the difficulties of the brain injury experience, lead to depression and low mood.
With all of this in mind, it is clear that extra effort must be taken to notice the daily positive events during the rehabilitation and recovery process. This must be done consciously and deliberately, to override the brain’s natural negativity bias.
One activity that can help is to write a list of activities and experiences that were good or successful at the end of each day. The items on the list do not necessarily have to be things that were huge breakthroughs. They should simply include anything that was positive.
For instance, a list could be:
Although it may be tempting to simply think of some positive events at the end of each day, it is generally best to write the list down. A written list of the positive events allows the survivor to review not only the current positive events but also be reminded of past positive events.
If a survivor cannot generate at least 3 items on their own, they should ask for help from families, friends, and rehabilitation professionals. Daily focus and writing down of positive events help overcome the negativity bias, improving overall mood and life satisfaction. It also helps train the survivor and family. They can now recognize the new, different positive events of daily life after an injury.
Remember that every positive event, no matter how large or small, is important!
Learn about how Moody Neuro can help with neuropsychology and counseling, speech and language disorders, physical therapy, outpatient rehabilitation assistance, community integration programs, and occupational therapy.
Questions? Contact us today, we’re happy to help in any way we can.
Image Attribution: Positive Mindset by Nick Youngson, CC BY-SA 3.0, Alpha Stock Images
Early June brings hurricane season to Texas, and with that comes a fresh reminder of the need to plan for emergencies. People often don’t realize the full extent of consideration that new challenges require following a brain injury. They particularly may not understand new challenges regarding emergency situations, such as sheltering and evacuation.
In this blog, we’ll tell you some useful and effective ways to approach those new challenges when planning for an emergency with a brain injury survivor. We’ll cover how to address transportation issues, medical and health concerns, and cognitive and emotional difficulties in the wake of a traumatic brain injury.
[Related: Taking Care of Yourself While Caring for a Loved One]
After a brain injury, many possible issues may arise concerning transportation preparedness during an emergency. We’ve listed some of those issues below.
Is the brain injury survivor able to drive independently to safety?
If the survivor hasn’t been cleared to drive, it’s vital to identify a responsible person capable of transporting them to safety.
Can a friend or relative drive the survivor, or does the survivor need to be evacuated through a municipal program?
If they must use a municipal program, are they registered for the program?
Many states provide emergency evacuation services for the disabled and elderly. We recommend that all persons with disabilities register with their local 211 system or another similar emergency evacuation system, even if they already have an emergency plan in place.
Registering with an emergency evacuation system doesn’t mean the survivor has to use the services it offers. However, it provides a safety net in case an emergency plan doesn’t work. Additionally, 211 services are free, so there should be no issues regarding registration costs.
Deciding which vehicle will be best to use during an evacuation is an important step when preparing for an emergency. Consider whether you have a vehicle that can accommodate everyone who would evacuate, as well as the necessary equipment (wheelchairs, walkers, etc.).
If the brain injury survivor has a physical difficulty that may affect their ability to enter or exit a vehicle, it’s important that other people in the vehicle know the appropriate transfer process and can assist them.
[Related: What Do Traumatic Brain Injury and Sleep Disorders Have to Do With One Another?]
Preplan and locate rest stops that people with disabilities can access. If the brain injury survivor is incontinent, it’s important to find rest stops that have enough room for clothing changes and cleanup. Rest stops often simply put a grab bar in a regular-sized stall to comply with accessibility laws, but unfortunately such restrooms remain inaccessible from any practical perspective.
For those who take medication or frequently use assistive equipment, make sure you store that medication or equipment in an easily accessible location in the vehicle. You should definitely not store medication in an area of the vehicle prone to excessive heat because the medication may lose its potency.
The cardinal rule of evacuation is that the earlier you leave, the less potential you have for transportation problems.
In addition to transportation, it’s important to consider medical and health concerns for post-brain injury patients when preparing for an emergency. We’ve listed some of these concerns below.
When people must evacuate from areas affected by a natural disaster, evacuated cities immediately experience a population surge. This puts a remarkable strain on any local medical system, particularly pharmacies.
For example, let’s say a city has pharmacies normally prepared to have enough on-hand medication for a population of 50,000. Following an evacuation, the population may increase to 70,000 or more. Most pharmacies aren’t equipped to deal with this increase, and medication shortages inevitably occur.
Most government agencies recommend that people bring one to two weeks’ worth of medication with them when they evacuate. You may want to err on the side of caution and bring enough for two weeks to one month. You should use this same general rule when preparing a stock of disposable medical items, such as syringes, incontinence supplies and testing strips.
[Related: What Are the Top 10 Most Common Traumatic Brain Injury Symptoms?]
Most medications are sensitive to heat. Keeping medications in the trunk of a car or a similar location on a warm day can cause them to degrade. Furthermore, many medications (such as insulin) require refrigeration. When in a vehicle, consider storing such medications in an icebox with cold packs or a portable refrigeration device.
You should also keep medications in their original boxes or bottles and transport them in a container you can seal and reseal. Plastic bags with a zipper work great for this situation.
Don’t take medications and place them all into one container. This can be a nightmare to sort through later and can lead to crucial delays. It can even lead to dangerous errors in administering medication.
Additionally, you should protect medical devices and equipment from water and other environmental hazards.
If a medical device or piece of equipment operates on electricity, make sure to bring an emergency power source, such as extra batteries or a car adapter power cord.
Keep a list of all important medical information. This includes health history, medications (with dosages), doctors, allergies and immunizations. The Centers for Disease Control and Prevention has an excellent example of such a list available for download on its website. You can download another excellent example of this kind of checklist from the AARP website.
When you reach your new location, make sure you know where the nearest medical and health facilities are. Knowing where the closest pharmacies and hospitals are will help if a medical emergency occurs after evacuation.
[Related: 10 Supportive Traumatic Brain Injury Resources for Parents]
Following a brain injury, many survivors require a special diet, such as a diabetic diet. When purchasing food for evacuation, make sure to keep this diet in mind. For example, you may need to check boxed foods (crackers, cookies, etc.) for their sugar and sodium levels.
If a survivor has an item that helps communicate the difficulties they suffer, such as a medical bracelet or aphasia card, remember to bring that item. Left at home, it’s of no use.
Read on to learn about issues that can arise regarding the cognitive and emotional difficulties left after a traumatic brain injury.
Post-injury, brain injury survivors generally become far more susceptible to stress and agitation in their lives. Therefore, it’s often handy to have items that you can use to help them remain calm. Music played on a portable radio, phone or pair of headphones that the survivor finds relaxing is an example of such an item.
[Related: How Long Does It Take to Recover From a Traumatic Brain Injury?]
For survivors who have cognitive difficulties such as memory problems, the evacuation process can be very confusing. They may forget why they’re evacuating or where they’re going. Calmly repeating the evacuation plan and/or having the evacuation plan in writing can help reduce confusion.
If a survivor has issues with impulse control, they may be more likely to make hostile comments or rashly suggest an unwise action during the evacuation. At these times, loved ones should calmly remind them of the evacuation plan and that the loved one has the situation under control. If the loved one reacts with anger, emotions are likely to escalate.
Most people, even without a brain injury, find extensive car travel stressful. Keeping to a regular schedule of planned breaks during an evacuation often helps reduce that stress.
Because many brain injury survivors have already experienced significant loss due to their injury, an evacuation and worries about potential losses resulting from a disaster may trigger difficult memories. Some survivors may need extra emotional support at this time as memories of old losses and new concerns for fresh ones result in significant emotional struggles.
All people, especially those with brain injuries that affect cognitive skills, do best when operating under a stable schedule. Survivors and loved ones should try to create a daily schedule to reinforce stability in the evacuation environment.
[Related: When Should You Seek Medical Care for a Traumatic Brain Injury?]
The more you plan and review an evacuation plan, the less stress you’ll have when it’s time for a real evacuation. Regularly going through evacuation plans will make the process less stressful for a person with a brain injury, too.
Hopefully, this guide can help bring attention to the important issues that brain injury survivors and their loved ones need to consider regarding emergency preparedness post-injury.
Learn how Moody Neuro can help with neuropsychology and counseling, speech and language disorders, physical therapy, outpatient rehabilitation assistance, community integration programs and occupational therapy.
Featured image via Unsplash
Visual scanning skills are essential for processing information in our daily lives. However, some individuals might have issues with recognizing ocular stimuli for a variety of reasons. Luckily, several activities exist that are not only helpful for improving visual scanning skills, but are also easy and fun.
In this blog we will go over the definition of visual scanning, some of the causes of visual scanning issues, and three of our favorite visual scanning activities for adults.
[Related: What Are the Top 10 Most Common Traumatic Brain Injury Symptoms?]
Visual scanning refers to the ability for individuals to use ocular strategies to efficiently, quickly, and actively explore various relevant visual information. This type of visual stimuli can include faces, objects, scenery, and certain written information. Visual scanning is a crucial skill for daily life, and helps individuals process information and complete a number of different tasks.
Visual scanning is important not only to be able to process visual information, but for mobility as well. Poor visual scanning skills can prevent an individual from avoiding obstacles when moving through their environment, causing collision.
It can also help individuals with daily tasks such as finding missing items, organizing a table or cleaning a room, or locating a friend in the middle of a crowd.
Many brain injured patients have difficulty with their visual scanning skills. This can be due to many problems such as partial loss of vision, left neglect or visual-spatial deficits. Often, but not exclusively, these problems are associated with an injury to the right side of the brain.
[Related: Disorientation and the New Year]
The following are three visual scanning activities that are interesting and easily organized.
One way to practice scanning skills is by using hidden pictures puzzles. Many people are familiar with hidden picture puzzles from children’s magazines. They involve a larger picture having many smaller items hidden within it. The goal is to locate the smaller hidden items. “Highlights” magazine has a number of free hidden pictures puzzles that can be printed from their online website: Hidden Pictures.
Although this is a fun way to practice scanning skills, it can be quite difficult, and some individuals may need help from loved ones to work on these puzzles.
An easy (and free) way to practice visual scanning skills is through an adaptation of the game “I Spy.”
The adapted version of “I Spy” is a very simple game to play. To begin, you need at least two participants. Then, pick a location or room with lots of items to see, but which isn’t so familiar that everyone knows the location of the items by heart.
One person is the “spy” and has to choose an item that is visible to everyone. The spy then says, “I spy with my little eye (the item).” It is now the job of the other players to point to the item and show that they have found it.
When “I Spy” is used to practice scanning skills after a brain injury, it is important to vary the location and the items that are being “spied.” For instance, you may first want to choose an item on the right side and then an item on the left side. Varying locations forces a person to scan the entire visual field.
[Related: 10 Supportive Traumatic Brain Injury Resources for Parents]
If this game is being played with someone in a wheelchair or with other physical disabilities, make sure that each item can be seen from their visual perspective. For example, often items that are easy to see when standing are obstructed when sitting.
Also, make sure that the item is big enough to be clearly seen by all of the players. Sometimes a person with a brain injury loses some of their visual acuity due to the effects of the injury and may not be able to clearly see small items. If the person playing has left neglect, they will likely need extra help and direction to scan the left side of the visual field.
“I Spy” is one of the easiest, most portable visual scanning activities to practice active visual scanning and search techniques while still having fun.
One convenient and practical way to work on scanning is for the patient to practice with a telephone book or coupon circular.
The idea is pretty straightforward. The patient is tasked with locating various items found in the advertisements of the telephone book’s yellow pages or in a supermarket circular. You’ll want to pick items in a random order so as to prevent the individual from figuring out where each correct item is without really working on their visual scanning skills.
For example, if you are using restaurant ads in the yellow pages, you may first have the survivor find the hours of operation from an Arby’s ad in the top left corner, and then the address of a Taco Bell® advertised on the bottom left of the page. You can follow this up with the Domino’s® Pizza phone number down at the bottom right.
The supermarket circular can be used in the exact same manner.
As an example, you could ask the patient for:
[Related: How Long Does it Take to Recover From a Traumatic Brain Injury]
It’s important not to tell the patient where on the page each item is located, but allow them to naturally search on their own. This activity should use all parts of the page, including the center.
If they cannot find the material, loved one should prompt the individual to conduct a slow, organized search for the item in question. In the case of left neglect, a search should always begin on the left side. A slow up-down search rather than side-to-side works best.
If the patient is missing the right visual field in both eyes, the search should always begin on the right side. If they are missing the left visual field in both eyes, the search should always begin on the left. Missing both the right or both the left visual fields is known as homonymous hemianopsia.
To help this task go smoothly, you’ll want to keep in mind a few things. You will want to ensure that the information can be easily seen by the patient. Sometimes the writing in phone books and circulars may be quite small. In this case, the person may need to use reading glasses. Or, they might need only to work with the bigger items on the page.
When working with yellow pages, it is better to pick pages with lots of display ads rather than listings. We do not advise using the white pages. The writing is too small, placed very close together, and is always in obvious alphabetical order. Supermarket circulars are generally much better for this task since they will tend to list more items.
If the patient has left neglect, it may be helpful to highlight the left side of the page. Or, put a bright object (such as a strip of paper) on the left side. Additionally, some individuals benefit from the use of a line reader (such as a ruler). This helps with their ability to focus on one section of information at a time.
[Related: Choosing a Brain Injury Treatment Clinic]
Since 1982, Moody Neurorehabilitation Institute has been a pioneer in the field of post-acute brain injury treatment and rehabilitation.
Learn more about Moody Neuro’s brain injury treatment programs and services, and how we can help with neuropsychology and counseling, speech and language disorders, physical therapy, outpatient rehabilitation assistance, community integration programs, and occupational therapy.
Featured image via Unsplash
Moody Neurorehabilitation Institute (Moody Neuro) provides personalized care to treat the unique challenges of brain injury with the singular purpose of achieving the best possible outcome for patients and their families.
Injury to the brain’s right hemisphere can cause left neglect. The condition is also known as left side neglect, unilateral neglect or hemispatial neglect. It is one of the oddest symptoms of brain injury and can be one of the most troublesome.
“Left neglect” is a term describing a deficit in awareness that occurs following an injury to the brain’s right side. Because of the injury, the brain has difficulty paying attention to items falling into the left hemisphere.
[Related: 10 Things I Wish People Knew About Brain Injuries]
Left neglect or hemispatial neglect generally manifests most clearly in difficulties with visually noticing items on the left side. For example, survivors with left neglect may bump into door frames on their left side or miss eating food on the left side of plates. It often appears as if they’re blind to items on the left, but this isn’t a true vision issue — it’s an attention issue.
The brain isn’t attending to information generated from the person’s left side. The survivor can have perfect visual skills. However, the message their brain is providing is that the left side of their world essentially doesn’t exist, resulting in left visual neglect.
Left neglect doesn’t involve just visual components. It can also manifest as a lack of attention to sound or touch on the left side. For example, survivors may report they can’t hear as well from their left ear, despite audiological testing demonstrating perfect hearing.
Survivors may fail to notice left hands getting stuck in the wheels of their wheelchairs, and they may injure that hand. In severe cases, survivors may not recognize their own left limbs as being parts of their bodies. They may ask something like, “Whose arm is in my bed?”
Fine variations in damage suffered to slightly different parts of the right side of the brain lead to notably distinct manifestations of left neglect, which makes each survivor’s experiences differ.
[Related: Why Brain Injury Education Is Important]
Here are a few signs that rehabilitation professionals commonly see when diagnosing cases of left neglect or hemispatial neglect:
[Related: What Are the Top 10 Most Common Traumatic Brain Injury Symptoms?]
Left-sided neglect symptoms may result in considerable difficulties that can cause serious safety issues. For example, a survivor may not notice a boiling pot of water sitting on the stove on their left side and bump into the pot, causing serious burns from spilled boiling water.
Similarly, a survivor may not notice cars on their left and attempt to cross a busy street at a bad moment, which puts them at risk of being hit. It’s not uncommon for survivors with left neglect to have constant bruising on the left side of their bodies due to bumping into items.
To make the issue even more complex, many survivors with left neglect may have issues with impulse control or be very easily distracted. This substantially compounds the dangers and difficulties that survivors with left neglect have to deal with.
Some survivors may be missing vision on the left side — a condition known as a field cut (see below) that adds an actual visual problem on top of attentional issues. Even when survivors are completely aware of their left neglect, in the absence of treatment, difficulties and errors will persist.
Remember: The brain is unconsciously telling the survivor to ignore the left side, and the neglect is unintentional. Because the brain creates this false message, survivors feel like everything is normal and as if they’re attending to the left as well as they would have before their injury.
[Related: Tips for Improving Attention]
Multiple distinct symptoms of brain injury can present in remarkably similar ways.
For example, a brain-injured survivor’s failure to take medication could be due to a memory deficit that leads them to simply forget their medication, or the missed medication could be due to an attention deficit that causes them to be too distracted to take the medication.
The survivor missed taking the medication in each case, but they missed taking it for distinctly different reasons. A similar issue comes to light when looking at postinjury visual deficits. Did a survivor fail to notice information to their left due to left neglect or a field cut?
[Related: Visual and Verbal Memory]
Overall, a field cut is the simpler of the two conditions to understand. Similar to left neglect or hemispatial neglect, brain injury (often stroke) causes a field cut.
With a field cut, survivors have permanently lost the ability to perceive a portion of the field of vision. That area of the field formerly available has been “cut” away.
Because of their injury, the survivor is now in effect partially blind. In medical terms, this loss of vision is often called “hemianopsia.” A survivor with a field cut has had actual visual loss in their left visual field and thus misses seeing information on their left side.
In the case of a field cut, most survivors do reasonably well after becoming sufficiently aware of the condition. After enough practice, they’ll naturally turn and make extra effort to look for the information in their blind spots.
[Related: Different Parts, Different Speeds]
Although left neglect is certainly an issue of attention, it can’t be treated with stimulant medications like Ritalin, which rehabilitation professionals generally can rely on to improve more typical attention deficits.
Can left side neglect be reversed? Survivors can certainly get much better, although this takes dedication and time. Goals for left side neglect include retraining the brain to recognize the missing field of vision.
Survivors must engage in specific therapies and learn compensatory techniques to help make attentional deficits more manageable. Even with treatment, survivors must practice and carry over left neglect strategies into home life to avoid regressing in their performance.
Left neglect or hemispatial neglect can affect a survivor’s ability to engage in activities requiring both tabletop and environmental scanning. Rehabilitation professionals can observe left neglect effects on tabletop tasks when survivors miss words or numbers on the left side of a page.
Some examples of left neglect effects in terms of environmental scanning are survivors missing potholes on the left side of a street or a car parked on the left side of a parking lot. For such reasons, driving with left neglect is inadvisable.
For a survivor with left neglect, improvement requires awareness as well as daily scanning exercises and consistent visual aid use. Over time, survivors can improve. Below, we’ve listed a few common rehabilitation exercises for left side neglect.
[Related: What Is Post-Acute Brain Injury Rehabilitation?]
A number of methods can help survivors compensate for left neglect. One method is known as prism adaptation.
Under the care of rehabilitation professionals, patients engage in an activity while wearing strong prism glasses that pull visual items from the left into a more central attentional domain. This visual change forces them to compensate for the effects of the prism to accurately complete the activity.
After the activity, some patients with left neglect notice an aftereffect. The brain continues to pull visual items from the left to their attention, even without wearing the glasses.
[Related: What Is the Goal of Rehabilitation?]
Professionals also use limb activation therapy to aid survivors with left neglect.
The focus is to get survivors to actively use their left limbs in the space surrounding the body’s left side. This engages the brain’s spatial and motor maps for those domains. The method is very helpful to patients, but they often encounter substantial difficulties.
Unfortunately, this method has limitations. It’s common for survivors to also have difficulty moving anything on the left side of their bodies (such as targeted paralysis or semi-paralysis, one of the most common symptoms of stroke or brain injury). However, research has shown that even passive movement of the left side can help improve issues stemming from left neglect.
Honing scanning techniques is one of the most frequently used methods to treat patients with left neglect. Therapists teach patients methods by which to ensure they’ve scanned the entire visual field.
In scanning therapy, therapists often instruct patients to pretend as if the head is a lighthouse. They direct patients to turn their heads fully from one side to the other while scanning an environment, like how a lighthouse turns its light. Therapists generally teach patients that if they’re scanning the environment and haven’t seen their left shoulder, they probably haven’t scanned as far to the left as needed.
[Related: Visual Scanning Skills With I Spy]
When involved in tabletop activities, therapists teach patients to scan to their left hand or elbow. Patients can practice this type of scanning in several ways. Therapists may ask them to scan for and identify letters or lights on a board or to scan and find features in a parking lot.
Therapists often teach patients to highlight the left side of a page or place a bright bookmark to a page’s left side to institute a cue. This cue helps them recognize when they’ve scanned all the way to the left. If patients haven’t seen the highlighted area or bookmark, they know they haven’t made it as far to the left as they should.
[Related: Visual Scanning Using Menus]
Patients learn to always start their scanning from the left and then move slowly to the right. Patients with left neglect are less likely to miss items if they begin the scanning process on the left and proceed to the right than if they do the reverse.
Therapists may also place items to the left side of patients to force them to move, scan and use their left sides. They may place a glass of water to the left of a dinner plate or pass a pen to the left hand. All these seemingly small acts help improve scanning to the left. In addition, they help patients use the body’s left side in the left hemisphere of their space.
The goal is for robust scanning and increased use of the left side to become part of patients’ daily habits. Therapists may use other cues to help a patient better attend to the left.
For example, therapists may place bells on a patient’s left hand. They’ll hear the bells ring when their left hand falls from their wheelchair. This reminds them to pick up the hand.
[Related: Visual Scanning With Telephone Books and Circulars]
Therapists can easily teach scanning skills to a survivor’s family and friends, who can be of great help to them in extending these techniques beyond an environment dedicated to therapy.
Family and friends can also help by identifying situations in which the survivor may be unaware of left neglect-related difficulties. All involved can then apply this knowledge to identify how left neglect could affect future situations.
For example, a family member may help a survivor in an airport recognize they’ve knocked over a fellow traveler’s bag. They can then help the survivor prepare to enter the plane without bumping into the left aisle seats.
Reinforced over time, this aided behavior will greatly improve the survivor’s solo interactions with the world.
Unfortunately, sometimes a survivor may suffer from both left neglect and a field cut. This combination can make successful functioning especially difficult, but with dedication and determination, left neglect and field cut patients can reach almost any rehabilitation goal.
[Related: How Long Does It Take to Recover From a Traumatic Brain Injury?]
We hope this article clarifies issues about left neglect/hemispatial neglect and field cut. Please leave a comment below with any questions, thoughts or ideas!
Learn how Moody Neuro can help with neuropsychology and counseling, speech and language disorders, physical therapy, outpatient rehabilitation assistance, community integration programs, occupational therapy and brain injury treatment services.
Featured image via Pixabay
Moody Neurorehabilitation Institute (Moody Neuro) provides personalized care to treat the unique challenges of brain injury with the singular purpose of achieving the best possible outcome for patients and their families.
Our knowledgeable team is available to answer your questions and begin the admissions process.
409-762-6661
Monday – Friday
8:00 AM – 5:00 PM
