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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.
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.
Recovering from a concussion differs for every person. Some return to their normal life days after their injury, while others suffer physical and mental effects months or years after the incident.
Fortunately, 80% of concussed patients recover in 10 days, on average. In this case, the recovery period only has two stages: an acute phase (the period wherein concussion symptoms manifest) and a recovery phase (a period of healing where patients experience a gradual decrease in symptoms).
The recovery takes longer for patients whose symptoms persist and increase in severity. This blog covers the six stages of concussion recovery for patients with long-term symptoms.
A concussion is a form of traumatic brain injury (TBI) that occurs when a strong force hits the head or upper body and causes the head and brain to move forward and backward rapidly. Such an event disrupts the brain’s normal function and affects the patient’s memory, consciousness, speech, muscle coordination, balance, and memory.
People who get a concussion experience immediate side effects and symptoms like dizziness, nausea, confusion, a headache, double or blurry vision, ringing in the ears, and vomiting. Other short-term symptoms are memory loss, balance problems, loss of smell or taste, and trouble sleeping. Patients should seek medical care if they experience these symptoms after getting into an accident, falling, or bumping their heads against a hard surface.
Concussion symptoms may not appear severe, but two or more at once are debilitating. Worse, patients may experience post-concussion syndrome wherein mild TBI symptoms continue to show long after the incident.
Post-concussion syndrome often develops during the stages of concussion recovery. It occurs when neurovascular coupling (NVC), or the process of neurons receiving oxygen and nourishment from blood vessels, gets interrupted.
When you get a concussion, the site of the injury gets inflamed, and the tiny structures around the neurons that help establish NVC temporarily break. Neurons don’t get enough oxygen and cannot power the brain to send signals as quickly as usual. As a result, people with post-concussion syndrome have trouble retaining new memory or keeping up with a rapid-fire conversation because their neural pathways aren’t functioning correctly.
Post-concussion syndrome can go on for weeks, months, or even years. It is a tough situation because the symptoms can significantly affect your everyday life. Moreover, there is no particular treatment; specialists can only treat the symptoms and help patients manage them.
Concussions are challenging because you don’t receive a prescription to restore your body’s physical condition before the injury. Doctors will only tell you to rest, avoid physical activities, and allow your brain and neurological functions to recover from the trauma.
You should know that recovering from TBI can take a long time. The recovery period can also vary per patient. Some go through the stages of concussion recovery within a year; for others, it takes years.
With that in mind, people who suffered a concussion typically experience these six stages:
Doctors call the next 24 to 72 hours after a concussion the acute phase. They will strongly advise resting and cutting back on all activities. This means calling in a sick day at work or school and refraining from doing any housework. Patients should also refrain from drinking alcohol and taking any medication, including painkillers, without getting clearance from their doctor.
People who’ve sustained minor concussions may start feeling better hours after the incident. Some will even feel well enough to get back to their regular activities. Still, they must take things slowly and not jump into physically strenuous activities like lifting heavy objects, playing sports, exercising, or doing manual labor for at least three days.
Contrary to popular belief, sleeping won’t do further damage in a concussion. In fact, sleep is necessary for the brain to heal. Shaking awake a person suspected of having a concussion every hour is counterproductive to their healing. Doctors will recommend rest and sleep unless they have good reason to say otherwise (i.e., the patient needs further treatment requiring them to be conscious).
That being said, patients should always have a companion within the first 48 hours who’ll help observe for symptoms and call the doctors if the patient’s condition turns bad quickly.
Patients with active lifestyles or who are used to working will find it challenging to do nothing during the resting period. At some point, they will feel like they’re back to normal and can already go back to work, drive around and do errands, resume physical activities, continue their travel plans, etc. That would be good news, but to be safe, patients should still check in with their doctor and get an all-clear.
Why is a follow-up check necessary? Because sometimes the symptoms don’t appear until days or weeks after the incident. Moreover, there is a risk of developing post-concussion syndrome. Symptoms persisting months after the injury is a red flag for that.
Once diagnosed with post-concussion syndrome, the patient will have more frequent visits with their doctors as the latter will do their best to address the symptoms.
The hardest part about having post-concussion syndrome is there is no single cure for it. Patients may experience similar symptoms, but the duration, severity, and how they respond to treatment differ. So it will be frustrating, but expect doctors to recommend even more rest. What they want more than anything is to prevent any incident that might aggravate the patient’s symptoms.
This is a difficult period for most patients as post-concussion syndrome can affect one’s lifestyle. It might even affect your work life because it will prevent you from engaging in physically strenuous activities. It might also impair your focus and decision-making abilities. In this stage, it is crucial to have a support system of loving family and friends who can lend a hand with your housework, help you prepare meals, take care of your shopping and errands, and offer financial assistance if necessary.
The best way to manage long-term concussion symptoms is to undergo brain injury rehab and therapy. While rest is necessary for the brain to heal, it is also crucial that patients do cognitive exercises to recover.
Studies show that participating in cognitive games like puzzles and word games after a concussion increases heart rate variability – a sign that the parasympathetic nervous system (PNS) is activated.
One consequence of concussion is that it drives a person’s sympathetic nervous system (SNS), which stimulates the “fight or flight” response, into hyperdrive after the injury. PNS and SNS work harmoniously and activate at different times of the day depending on the circumstances (i.e., PNS is active during rest time while SNS is during high-tension moments at work or when driving during rush hour). A concussion disrupts their rhythm. Moreover, many patients seem to experience hyperactive SNS after their injury.
Engaging in cognitive tasks will trigger the PNS into action and engage the parts of the brain that facilitate decision-making and critical thinking.
How long before you can start doing physical therapy? Some researchers say patients can begin 48 hours after their injury. It should be gradual, starting with light activities like walking and slowly increasing the intensity or duration until the patient can perform them without experiencing any symptoms. If a headache forms and quickly intensifies, or other symptoms like severe nausea and dizziness occur, that’s a clear sign of stopping the activity. The patient must scale back and give themselves more time before scaling up again.
The goal is to ease the brain and body into moving again without aggravating the TBI. Hence, it might be long before a patient can comfortably run, play sports, and do other physically demanding activities again. Moreover, symptoms sometimes appear hours after an activity.
Patients must also constantly communicate with their doctors and therapists at this stage of concussion recovery. They should:
Depending on the symptoms and their frequency and severity, patients might receive other forms of therapy like interval training and neurofeedback therapy. They may also have to consult a psychologist and neuro optometrist. Some see improvements with yoga, changing their diets, and continuously doing cognitive exercises.
The final stage of recovery is transitioning to life before the injury. The brain can heal itself even years after a TBI, but the road to recovery will be difficult for some. A proper diagnosis and holistic therapy will be crucial to recovery and ensuring the patient’s quality of life won’t deteriorate drastically.
TBI Patients need highly specialized treatment and care that address their unique needs. For some, it takes a team of specialists, therapists, and trustworthy caregivers to help achieve a breakthrough and recover sufficiently, if not entirely, from TBI.
Moody Neurorehabilitation can provide more information about TBI, the recovery process, and what it entails for patients and their families. We are a leading rehabilitation institute specializing in brain injury treatment and patient care since 1982. We use techniques, strategies, and therapies from all over the world and provide the best care possible for brain injury patients and survivors.
Moody Neurorehabilitation can help you or someone you love overcome the challenges of long-term concussion symptoms and power through recovery. Contact us to learn more about our programs, services, and facilities.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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:
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.
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:
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.
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.
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.
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!
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Following a traumatic brain injury (TBI), sleep disorders are a common problem. Even in mild cases of TBI, the quality and quantity of an individual’s sleep can suffer.
Studies estimate that around 30% to 70% of TBI patients have sleeping disorders. Furthermore, regular sleep is a crucial part of our health. A lack of sleep may lead to various health problems — cardiovascular disease, strokes, depression, and anxiety are all possible.
So how can we help our loved ones find good rest again?
Identifying possible sleeping disorders is the first step.
Our brains play a crucial role in how our bodies sleep. The brain regulates essential sleep hormones, like melatonin. So, any trauma to the brain can cause a significant change in normal sleeping patterns. What’s more, any sleeping issues can quickly snowball into more severe health issues, affecting both mental and physical health.
Additionally, TBI patients can develop mental health problems like depression, anxiety, and more. Depression can make falling and staying asleep hard. Or, it can cause you to sleep for longer than you should. While your body needs rest to recover, too much sleep can indicate more serious issues.
Furthermore, because headaches often occur after TBI, pain can make falling asleep difficult. And, sometimes, even adding or changing medications will affect how we sleep. If you believe your medication is preventing or drastically increasing your sleep, talk to your doctor. It may just be a matter of adjusting the time of the day you take each dose.
If you’re looking for the best recovery programs for your loved one, reach out to Moody Neuro. We specialize in helping TBI patients and their families to recover and reclaim their lives. Our mission is to help each patient through their recovery.
When you experience a TBI, some of the following sleep disorders may develop.
It’s important to acknowledge changes to your sleep patterns as they occur. Keeping a sleep journal or making notes on your phone may help. There are also endless apps you can use that are designed to track sleep patterns.
Insomnia can make falling asleep and staying asleep tough. Additionally, you might wake up earlier than usual and feel restless.
Hypersomnia will leave you feeling tired throughout the day. This drowsiness makes focusing harder than usual. It can also make driving dangerous if you’re falling asleep behind the wheel.
Having a delayed sleep phase means that your internal sleep clock is off. You might not be able to fall asleep at your regular bedtime. Eventually, the delayed sleep phase makes having a consistent sleep schedule difficult.
Parasomnia is a sleeping disorder that includes several types of disruptive sleeping behavior. For example, teeth grinding, sleepwalking, and night terrors are all kinds of parasomnia.
Having a TBI can make managing sleeping disorders difficult. But, certain lifestyle changes can help symptoms.
However, contact your healthcare provider if you have trouble sleeping for longer than a few weeks or feel like your symptoms are getting worse.
First, try going to bed at night and waking up in the morning at the same time every day. A regular sleep schedule is one of the best ways to help get your body used to a sleep routine. Although this can take some time to work, a little patience goes a long way!
Additionally, if you take long naps during the day, try to cut the length to only 20 minutes a day. Lengthy naps can disrupt a regular sleep schedule and make it harder for you to fall asleep.
Furthermore, regular exercise, a healthy diet, and avoiding caffeine and alcohol can help sleep disorder symptoms.
Each patient receives highly personalized care at our facilities. Our goal is to make the recovery process as supportive and successful as possible for both families and patients.
Get in touch with us today to learn more about the outpatient, inpatient, and other therapeutic services we offer to those with TBI. Together, we can tackle any challenges that lie ahead. Contact us today to learn more.
Finding helpful resources for your TBI recovery isn’t always straightforward. If you’re also providing care to your child after a TBI, searching for help can add to the already stressful season.
It should be easier to find the resources you need to help get through this period. After all, you want to provide your child with the best care and support possible.
Here are the 10 most supportive traumatic brain injury resources for parents.
Looking for personalized TBI therapy services? Moody Neurorehabilitation is here to help. We offer outpatient and residential care and can help families find accommodations during the process. Contact us to learn more.
The Brain Injury Association offers many helpful resources on traumatic brain injury. From educational guides to support groups, you can find help on their website.
Moreover, they offer a list of state rehabilitation programs.
The Office of Acquired Brain Injury (OABI) helps TBI patients and caregivers learn more about TBI. Furthermore, the organization raises awareness about brain injuries and how to prevent them.
Additionally, you can find information on local support groups.
The Comprehensive Rehabilitation Services (CRS) Program helps eligible TBI patients with the rehabilitative process and their recovery goals. They also assist patients with finding support services and may even pay for them.
The Centers for Disease Control and Prevention (CDC) offers more than updates on the pandemic. They also offer the latest studies on traumatic brain injury.
Additionally, they have a special Heads Up page where parents can find support as they help their children recover from TBI.
Your Texas Benefits is a resource that simplifies finding financial aid for healthcare, food costs, and support services. After answering basic questions, you’ll be able to see which benefits you can receive. Or if you’re looking for support services, you can sign up for updates about available options.
The Coalition for Barrier Free Living, INC. offers services and programs that help those with disabilities. Their goal is to promote equal opportunity for those with traumatic brain injuries.
The organization teaches those in recovery how to live independently, find peer support, and learn practical skills. Workshops cover money management, public transportation, and more. Community integration is the focus of this group.
The Texas Workforce Commission helps people with disabilities find meaningful employment. They do this through free, vocational rehabilitation programs for both adults and youth.
For example, the group helps teach job skills and connects those in recovery with employers.
The Texas Department of Public Safety (TDPS) helps people with TBI sign up to take their driving tests.
The ability to drive is a privilege and freedom teenagers look forward to. Adolescents with a TBI aren’t doomed to always be driven by mom and dad.
Another resource to keep in mind is 211 Texas, a Texas Health and Human Services Commission program. At their core, they provide information about local services. From food and housing to support groups and counseling, 211 Texas can help your family with basic needs.
Moody Neurorehabilitation has been leading the way in rehabilitation programs since 1982. In each of our four locations, we provide outpatient and residential care as well as a wide range of therapeutic services.
We want to give our loved ones the best care and support possible following a traumatic brain injury (TBI). Specialized care is often needed for a full recovery since the recovery process for TBI varies from one person to the next.
But numerous support programs are available and choosing the right one can be overwhelming. How do we know which TBI care plan is right for you and your loved one?
We want to make choosing a TBI care plan easier.
That way, you can focus on helping your loved one recover.
If you’re looking for rehabilitation services for a TBI patient, look no further than Moody Neurorehabilitation Institute. The services we offer focus on bringing patients and their families the support they need throughout each stage of the recovery process. Contact us to learn more about how we can help.
Four different kinds of care plans are available for TBI. Each one may have a slight overlap in the services they offer.
Residential care supports TBI patients with highly personalized care. While still respecting the patient’s comfort zone, residential care aims for progress over time.
Therapist recommendations guide residential care plans in offering support with all daily activities as well as rehabilitative treatment techniques.
Residential care also monitors a patient’s progress, so family members always know how their loved one is doing.
However, if your loved one can be supported at home, and you think they would recover better in a familiar space, you might want to consider outpatient care.
Outpatient care requires patients to meet the same admission checklist and practice the same therapeutic exercises as patients in residential care, but from the comfort of their own home. If a residential patient has made progress in their recovery, then they can transition to outpatient care.
But depending on your loved one’s condition, you might be providing more care and support than you are prepared for. Because recovery takes time, you may find yourself taking on multiple roles that you never have before. From nurse and coach to therapy-aide, becoming a primary care-giver for your loved one may take a lot of your attention. And while you’ll be learning a lot about how to help throughout recovery, taking on the added responsibilities can be overwhelming.
So it’s important to find a balance, and consider utilizing other care options like respite care that allow your loved one to get out of the house and experience something new. Or, consider a care plan like long-term support living.
Moody Neurorehabilitation Institute has outpatient care plans that fit your loved one’s needs. Connect with us today to learn more.
A TBI patient who needs support with things like cooking, taking medication, walking, or bathing may find the care they need with long-term support living.
Care is provided in a patient’s home, community-based settings, or care facilities.
If you are unable to help with the level of care your loved one needs, long-term support living may be the best TBI care plan.
Respite care is a short-term TBI care service that gives patients time away from their main caregivers. Respite care takes on a few different forms, and you can find options for short-term care in-home or out-of-home.
Agencies, volunteers, group homes, or even other family members can help provide this type of care.
You often plan respite care in advance, but if an emergency arises and you need immediate support for your loved one, respite care can help you.
Each physician at Moody Neurorehabilitation Institute has specialized training in brain injury rehabilitation.
All of our patients receive highly personalized care to set them up for success.
Because we believe family is so important for the recovery process, we offer family accommodations while your loved one is in the rehabilitation process.
Reach out to us today to learn about our patient intake process and take the first step toward finding the right TBI care plan for your loved one.
When a family member experiences a traumatic brain injury (TBI), it’s natural to want to know how long the recovery period will last.
However, this can be difficult to predict. In fact, depending on the severity of the injury, recovery time for a TBI may vary from a few weeks to six or more months.
Each person reacts differently to injury and illness. Thus, recovery time will vary between individuals. However, the length of recovery time for TBI depends on how long a patient is unconscious. The longer someone is unconscious, the longer the recovery time.
Learn more about the different types of TBI and the recovery time you can expect.
If you or a loved one is a TBI patient, connect with Moody Neurorehabilitation Institute to start the recovery process. Each of our patients receives patient-focused care from our experienced staff.
A mild case of TBI often has a fast recovery time. While a loss of consciousness is possible, it will likely be very brief. Oftentimes, there is a rapid recovery to normalcy within the first week of an injury. For most mild TBI patients, symptoms will last anywhere from a week to a month.
During the recovery time, patients may experience a wide range of symptoms:
Although other symptoms are possible, it’s likely that a mild TBI patient will experience at least one of these.
To recover, get plenty of rest. Pushing yourself too hard will worsen your symptoms.
A moderate TBI includes a loss of consciousness for up to 24 hours.
Severe TBI often involves a loss of consciousness for longer than 24 hours. Brain bleeding or swelling is also likely here.
Post-traumatic amnesia is longer in moderate to severe TBI. Moderate TBI patients can experience memory loss for anywhere from one to seven days.
Severe TBI patients, however, experience symptoms for longer than a week.
Recovery time for this type of TBI depends on the patient’s prior health, their access to healthcare and rehabilitation, and family support.
Moderate TBI patients may be more susceptible to long-term effects like mental health disorders. For example, many patients experience depression as a result of their injury.
While it’s hard to pinpoint the length of recovery for moderate and severe TBI, the range is typically from months to years. But the good news is that with the right support, lifestyle changes, and care, TBI patients can continue to show improvements to their health.
Providing TBI patients with the best possible rehabilitation services is a personal mission of Moody Neurorehabilitation Institute.
In 1982, Robert Moody founded the Moody Neurorehabilitation Institute after his son Russell experienced a traumatic brain injury. Robert’s dedication to the highest quality of care for TBI patients is the same dedication our staff brings to each one of our patients.
Contact us today to learn how we can help your loved one recover from TBI and regain their health.