(Cont’d)
7. The most effective rehabilitation following head injury occurs in familiar settings.
Since head injured individuals frequently have difficulty learning new information and generalizing new skills from one environment to another, the most effective rehabilitation programs occur in the home setting where old learning is maximized. When injured individuals are transported to another city or state, much of what they learn cannot be applied when they return home: the familiar cues which facilitated recall in the treatment setting disappear and the new behavior cannot be elicited. Therefore, whenever possible, rehabilitation should occur in the home and community rather than a hospital setting.
8. Unconditional positive regard is unfair to the head injured individual.
Head injured individuals have enough problems without increasing their burden by accepting any and all behavior. If family members tolerate behavior which drives others away, the injured individual becomes increasingly isolated from human contact and the burden on the caregiver becomes immense. The real world never offers unconditional positive regard and an individual who expects it will be sorely disappointed. One of the most constructive things you can do for head injured individuals is to provide accurate and realistic feedback on their behavior and its consequences.
9. Brain tissue may not re-grow, but we have only begun to explore the ability of the brain and body to find creative ways to accomplish essential tasks.
Clinical practice and research are just beginning to explore the plasticity of the human brain and the results are overturning long cherished beliefs about human potential. In my practice, for example, I have used hypnotherapeutic relaxation strategies to decrease severe ataxia and a variety of cognitive strategies to increase function in paretic extremities. In a more traditional vein, I have found that computers can be extremely powerful tools in rehabilitation.
Unfortunately, the computer is a highly sophisticated tool which can do more damage than good. It is critical that programs be selected to meet the needs of the particular individual and that the material is presented at the appropriate level. I am deeply saddened when I discover a head injured person who hates computers because they were presented at an inappropriate time or used inappropriate material.
One Head Injury is Enough!
Individuals who sustain a head injury are 3 to 8 times more likely to sustain additional head injuries. Some of these added insults occur because of the cognitive and behavioral deficits following the original injury: the impulsive person who has poor judgment may repeatedly place himself in dangerous situations and then be unable to cope. Adequate supervision reduces the risk but does not eliminate the possibility of additional injury. What can be prevented, however, is the additional risk presented by:
Exposure to toxic materials. Anyone who has sustained a head injury should avoid environments which have high concentrations of fumes or toxic substances. This includes paint and solvent fumes, chemicals, non-prescription drugs and alcohol.
Exposure to megavitamin therapy. Many vitamins and minerals are toxic in dosages above MDR and may interact in unknown ways with prescription medications or be metabolized differently by a damaged brain. A balanced diet may be one of the few pleasures left to a head injured individual and should meet nutritional needs without supplementation.
Conclusion
I hope this information has been useful to you and that you will begin to think about rehabilitation in terms of cognition and behavior rather than medical and physical problems. People who have sustained head injuries have a great deal to offer to family, friends, and society if they are given a chance.
Reprinted by permission of Judith Falconer, Ph.D., 8343 Currant Way, Parker, CO 80134 www.brain-train.com
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