Often, Traumatic Brain Injury (TBI) is referred to as a silent epidemic because, for years, such injuries failed to receive proper diagnoses and, therefore, went untreated. To compound the situation, the medical profession frequently dismissed complaints of personality changes, memory loss, and decreased mental processing ability as completely unrelated occurrences. Thankfully, TBI recognition has changed significantly in recent years, and TBI patients now have access to a variety of helpful resources in the community (vocational rehabilitation, neuropsychological testing, brain injury specialized units, among others,) to address TBI-related impairment and handicaps. As life care planners, we often get consulted long after the date of the injury and when most of the obvious injuries have healed. A Life Care Planner should keep in mind that some of the cases we work on involve patients with an undiagnosed TBI.
The following are three very important concepts Life Care Planning professionals should keep in mind when authoring plans on the TBI population.
1. Difficulty of TBI patients obtaining gainful employment
A main focus of the rehabilitation aspect of a brain injury patient is the achievement of independent living, however, TBI patients face several hurdles in finding gainful employment. For younger individuals with limited or no work experience, the challenge can be acute and potentially drive them to frustration and despair. Persistent impairments like difficulty in reasoning, communication, problem-solving, memory, as well as difficulties in focusing on even simple tasks can further accentuate the challenge. In some instances, TBI can leave people with physical, behavioral and emotional problems further impacting their employability.
There is often even a social barrier in the workplace if co-workers and employers have concerns or fears about working with or employing individuals with TBI.
Social support groups and professional brain injury assistance programs, such as the Mary Lee Foundation in Austin can be life changing, since these organizations help train TBI patients to enter an appropriate work setting.
2. Increased risk of developing early dementia and early Parkinson’s Disease
Early dementia and early Parkinson’s Disease are among the most feared long-term consequences of TBI. Several studies have shown that individuals who experienced a TBI in the early or mid stages of their life have an enhanced risk of dementia in the later years of their life (DH Smith, VE Johnson, W Stewart – Nature Reviews Neurology, 2013). The risk factor can be as much as 4-fold depending on the severity of TBI. However, mild head injuries, which are also sometimes termed concussions, are not well documented, and retrospective studies may be impacted by recall bias. These mild TBIs can come into particular focus when the affected individual is an athlete (boxer or football player, for example) or a military person.
3. Dependence on social support in order to function on a daily basis
Depending on the severity of the brain injury, there is a likelihood the victim may become fully dependent on others in order to function. Even if the patient is independent for most ADLs (eating, bathing, dressing), he/she may not have the wherewithal to communicate effectively outside the household. In these scenarios where the functional impairment is not as obvious, the caregiver’s account of a day in the life of the patient can be key in assessing the degree of impairment. If the patient still has good introspection of his/her disability, he/she may develop symptoms of helplessness and depression, which compounds the problem. In these circumstances, social and emotional support are very important to the wellbeing of the patient.