According to the Centers for Disease Control and Prevention, an estimated 5.3 million Americans currently live with a disability as a result of brain injury, which translates to an estimated 100,000 Minnesotans. Despite this startling statistic, brain injury is largely a silent public health epidemic. Falls and motor vehicle crashes are the leading causes of brain injury in Minnesota.
Clinically, brain injury is classified in two groups: traumatic brain injury and acquired brain injury. A traumatic brain injury occurs when an outside force impacts the head hard enough to cause the brain to bounce against the skull and directly damage the brain. An acquired brain injury is an injury that occurs after birth and is not hereditary, congenital or degenerative. Common causes of acquired brain injury include strokes, aneurysms and diseases such as encephalitis.
Brain injury may cause some of the following changes:
Physical: movement or coordination problems, seizures, disruption in basic bodily functions like breathing or body temperature
Cognitive: inability to concentrate, issues with memory, difficulty processing information, language and communication problems
Emotional: lack of emotional control or self-awareness, impulsivity, anxiety and depression
No Two Alike
Each brain injury is unique and depending on where the brain is injured, the person can be left with a range of mild to long-term physical, cognitive and/or emotional challenges. Several factors determine the extent of the challenges, including the damaged area of the brain, the length of time, if in a coma, the personality and learning style before the injury, the emotional reaction to the injury, and the social supports.
Brain injury is frequently referred to as a silent epidemic because of the invisible nature of the impact. Symptoms not readily apparent, such as loss of memory or initiative, often lead others to misunderstand the injured person’s actions and abilities. The person with the injury may be grappling with newly acquired difficulties, which often lead to frustration and confusion. Some individuals develop their own compensations or strategies while others may require assistance and accommodation.
Cognitive and Memory Accommodations
Simple tasks can suddenly become insurmountable hurdles for many people with brain injury. Short-term memory loss, inability to problem-solve, difficulty processing information, poor judgment, trouble initiating activities and even reading difficulty may vary in severity, frequency and circumstance.
The question is how to keep track of and follow through on non-routine tasks. Carrying a simple pocket notebook with a “to do” list and a pencil may be sufficient as a reminder tool. A Franklin organizer is more comprehensive, with a calendar, contact lists, note pages and important information all together. Many technology lovers have found Personal Digital Assistants (PDAs) and electronic organizers to be crucial to success. The Zire is the leading PDA in ease of operation and comprehension for brain injury users, as demonstrated through research at the University of Colorado.
Taking medication in a timely fashion helps manage some cognitive issues, and becomes a safety issue when seizures and other disorders are occurring. There are medication reminders from the simple to the complex. A watch with alarms can be set to medication times or the CompuMed works where a medication is in a locked container then dropped to a dispenser cup with an alarm. If the person does not pick up the medication, it continues to alarm until either the medication is taken or a security company calls a medical professional or family member to respond.
Many devices have voice output options that are beneficial to those who no longer can read. These devices, which will speak information to the user, include talking watches, talking calendars, books on tape, computer software, electronic reminders, medication identifiers, talking blood pressure cuffs, and talking scales are among the many devices.
Visual tracking and orientation may become difficult after a brain injury. Visual training by watching lights appear and vanish on an eye board is a therapeutic method often prescribed by a doctor or occupational therapist to help in regaining spatial skills. Accommodations include using a magnifier, large print books, color coding, voice output, a writing guide, texture for feel or alerting devices. Uncluttering the work area is also a simple option.
If the person with the brain injury has balance, coordination, and/or motor skill difficulties, medical professionals may recommend mobility aids including a quad cane, scooter, rails, rolling walker with seat, wheelchair, or nonskid supportive shoes.
Persons who’ve sustained a stroke, which is a type of acquired brain injury, often use one-handed tools for daily needs to enhance independence at home and work. Dynamic-Living.com sells a wide variety of products to help people with such symptoms: kitchen gadgets, telephones, bathroom aides, rails and holders.
For people with brain injury, coping and adjustment are lifelong processes. Assistive technology is one avenue of rehabilitation proving beneficial to this group. Using and adjusting to new technologies takes extra time and support initially, but the rewards of increased independence and feeling of control make the effort worthwhile.
Jen Mundl is the assistive technology specialist at the Courage Center.
Nissa French is the Public Awareness Director for the Brain Injury Association of Minnesota.