“Energy Pie” & Neurofatigue Strategies

Throughout my education process as an occupational therapy student I have been aware of the term neurofatigue. Neurofatigue, as it was described in our readings in a quick brush, is when the brain/mind becomes tired from overuse, just as the body endures physical fatigue from overuse.

 

From my own personal experience, after a long day when I have a lot on my mind, not slept the night before, have been forced to focus for prolong periods of time, this will leave me feeling in a “Fog” or like a “Zombie.”  I am more prone to forget things, and have less control over my emotions. The effects of neurofatigue are much more complex than a tired brain/mind, especially if an individual has experienced a brain injury.

 

“Energy Pie”

 

Dee Cassidy introduced me to the visual conceptual model of the “Energy Pie.”   The “Energy Pie” is comprised of four components: (1) Physical Energy; (2) Cognitive Energy; (3) Emotional Energy; and (4) Reserve Energy.   Reserve Energy provides key support to the three other areas of our “Energy Pie” once they begin to deplete from mental exertion.

 

After an individual has experienced a brain injury the Reserve Energy portion of the “Energy Pie” is significantly smaller, thus depending on the demands of the task, will require more strain and pull more energy from any given area of their Pie.

 

 

Neurofatigue Strategies: The Four P’s

 

Occupational therapists look at strategies to manage neurofatigue and ways to assist a person increase function in their home, community and social environment when the “Energy Pie” is being depleted.  The Four P’s (1) Prioritize; (2) Plan; (3) Pace; and (4) Position can be helpful strategies to manage neurofatigue.

 

Prioritize

Use a Daily Planner; a daily planner can be a calendar on the wall, on a phone, monthly planner, etc. When we get confused it causes us to get frustrated, thus decreasing our neuro-energy leading to neurofatigue; Decide what is most important; For example: Going to a doctor’s appointment would take priority over dusting the living room.

 

Plan

Plan Activities First to Avoid Extra Trips; Gather supplies and equipment you need before task; Example: Before you begin to garden, gather all your garden supplies; Plan Alternative Heavy and Light Tasks; When physical energy is lowered, this will lead to neurofatigue; Example: Plan your tasks so your aren’t trying to do too much all at once; Plan Good Night’s Rest; Sleep will replenish our energy; Example: Limit electronics in bedroom; Have a routine for relaxing before sleep; Use Family, Friends or Caregivers When Needed For Assistance; It’s better to ask for help than to suffer from neurofatigue; Asking for help is not a sign of weakness.

 

Pace

Maintain a slow steady pace. Never rush; the faster we rush, the quicker our energy will decrease and will lead to confusion and fatigue; Rest often. Rest before you feel tired; Used Pursed Lipped Breathing; Breath through your nose and then out through your mouth. Think of it like smelling the flowers and blowing out the candles on a cake.

 

Position

Avoid Excessive Bending; too much bending and reaching can cause fatigue and shortness of breath. When we are out of breath this effects are focus on the task at hand and leads to frustration; Use adaptive equipment to help avoid bending, this will make the task easier and lead to increased energy; Maintain Upright Position; maintaining an upright position when sitting and standing. This will increase oxygen that will increase our focus during a task; Sit When You Can – Sitting increases energy during task performance.

 

 

I would like to thank Dee Cassidy for helping my education process and introducing a new concept that I can share with others as I proceed with my education. She was so kind by taking the time to teach me about the concept of the “Energy Pie” as well as allowing me to be part of her “Energy Pie” presentation and give the OT perspective and share some intervention strategies that can assist with neurofatigue.

 

Guest blog author: Brady Handlon, written March 2, 2018, as a Level II OT fieldwork student at O’Connor Occupational Therapy Services, PLLC, while attending Eastern Michigan University to obtain a combined Bachelor of Science and Master of Occupational Therapy degree. His graduate research study “The Study of a Novel Occupation: The Culture of Table-Top Roleplay Gaming” was disseminated as a poster presentation at Eastern Michigan University’s Graduate Research Conference as well as the Lyla M. Spelbring Endowed Leadership and Conference in 2017.

 

For more information http://www.oconnorot.com/

 

 

 

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What does “March Madness” have to do with Brain Injury Awareness Month?

P bball

Friends who know me know that I’m a fan of high school and college basketball and I love March Madness.  Although I don’t take governmental holidays as days off, I have been known to take a day off to watch college basketball.  I recall the excitement when I was a student at Eastern Michigan University in 1991 and our EMU Huron’s advanced to the Sweet Sixteen!  Living in Ypsilanti at EMU and working at a clinic at U of M – I have great memories of the Fab Five and UM Final Four.

 

Twenty plus years of working, living, and playing in the Lansing area, and seasons of taking my son to MSU basketball certainly have me committed to MSU Spartans!  For me it’s a great year when Notre Dame is in “the dance”!  And who doesn’t love a Cinderella team that gets in the brackets, or a top seeded team defeated in the first round, as it comes down to one game at a time, 40 minutes at a time.

 

 

“March Madness” is Brain Injury Awareness Month

 

March is recognized as National Brain Injury Awareness Month as a campaign to increase awareness of incidence, and resources for support.

 

In his essay Michael Gillespie in “Examined Life” writes about the month of March, and the “madness” of college basketball playoffs.  I note a parallel to Brain Injury Awareness Month.

 

“What is it about March? The giddiness of spring when nature breaks forth in all its fecundity. Festivals like St. Patrick’s Day, Carnival, Mardi Gras, but also Caesar dead at the base of Pompey’s statue, the Crucifixion, as well as the death of Egypt’s firstborn before the exodus of the Israelites. Death in the midst of rebirth and renewal. The month itself was named by the Romans after Mars, their god of war, because it marked the time when they finished planting their crops and could go back to fighting their enemies. March as a time of incipient growth but also as a time to kill and die. Madness indeed.”  http://thepointmag.com/2011/examined-life/march-madness#sthash.XS3cyHS6.dpuf

 

 

Mr. Gillespie uses that as introduction on a narrative of the excitement and frenzy of NCAA basketball.  As I read, and re-read Gillespie’s essay, I can relate the competition, challenges, and the victories of basketball, to the competition, challenges, and the victories of those surviving with traumatic brain injury.

 

 

“In the midst of rebirth and renewal.”

 

I’ve had the honor to support those Survivors of brain injury in their rebirth and renewal. In twenty-plus of occupational therapy practice, the majority of it serving individuals and families in rehabilitation after a brain injury, I’ve observed some common characteristics of those who seem to cope and adapt more easily or more successfully. Although the list that follows started as a few bullet points, and morphed to loosely look like the 12 Steps of Alcoholics Anonymous, there is NOT a sequence to these as “steps” to move through as a hierarchy. Rather I have recognized these all as important building blocks in the foundation of rehabilitation and resumption of roles.

 

Acknowledge diagnosis of the brain injury. In viewing brain injury as a disease process know that there are complicating factors, just as there are to disease processes such as diabetes, or heart disease. An athlete with an ankle injury doesn’t minimize how important the ankle is to smooth movement, jumping, pivoting, or speed.

 

Recognize that successful rehabilitation requires a strong foundation that includes proper rest, sleep, nutrition, physical exercise, and taking medications as prescribed. Athletes in March Madness do not compete, without establishing and maintaining a healthy foundation.

 

Take inventory of your strengths. Successful rehabilitation builds on strengths. Celebrate progress and accomplishments large and small. What are the “Most Valuable Players” of your strengths?

 

Be aware of your deficits ~ to be able to work on solutions. However do not dwell on errors – it increases anxiety, which can lead to more mistakes. The basketball player who misses a shot, or block or rebound, cannot dwell on it or as the game moves on. A “foul” alone does not result in a loss.

 

 

“…named by the Romans after Mars, their god of war, because it marked the time when they finished planting their crops and could go back to fighting their enemies.”

 

For Survivors of brain injury fighting the enemy as visualized by mythology, or by the opposing team in NCAA basketball, are symbolism in fighting and defeating the deficits of a brain injury, and building personal strengths.

 

Nurture relationships that mean the most to you. Be patient with those closest to you. Supportive family and close friends are indicators for a positive prognosis for recovery. Team. Teamwork. Those who do not work together will not win.

 

Commit to “Single Tasking.” “Multi-tasking” is over-rated, and can be largely ineffective, and distracting from accomplishing anything. Know what role, what Position you play, and stay focused.

 

Create structure. Recurring time for appointments and tasks (in the day, week, and month) creates predictability of routine to improve recall, and reduce stress / anxiety related to memory. Teams know each other and know where each other are on the court, have plays, and execute those plays effectively. Create intentional “plays” with structure to support your success.

 

Create quietness. Take a break from thoughts in your head or mental-to-do-lists through physical exercise, quiet rest, meditation, prayer, worship, deep breathing, yoga, etc. Take a Time-Out to re-group, to strategize, and then move on.

 

 

“March as a time of incipient growth but also as a time to kill and die. Madness indeed.”

 

For Survivors of brain injury, the “time to kill and die” fighting the opposing team, again is about a strong foundation to dominate and defeat the deficits of a brain injury, building strengths, for a structure that supports the survivor and family.

 

Disclosure of brain injury is a personal decision. Having a simple, “go-to” phrase that you have rehearsed for how to disclose your injury can reduce anxiety when it does come up. How you choose to discuss or disclose brain injury is a personal decision. Some coaches have a policy to not talk about player injuries, others discuss them openly. Plan your talking points.

 

Accept help from others. Prioritize what is important to complete yourself, and what you can accept help with. There is no weakness, no failure in accepting help from others. We all depend on help from each other to succeed. No ONE player and no ONE coach will win a game in NCAA March Madness. They will win as a Team.

 

Set goals for the future – but commit to one day at time. One game at a time. 40 minutes at a time. One shot clock at a time.

 

Accept that life has changed since the brain injury – and may be considerably different than before the injury. Life goes on, and can be meaningful, successful, and prosperous. Win or lose a game, you go on.

 

The excitement of March Madness is the opportunity to advance and the risk of “one and done.”

 

 

 

For more information http://www.oconnorot.com/

 

 

“What are you doing for others?”

“Life’s most persistent and urgent question is, “What are you doing for others?””

Martin Luther King, Jr.

 

I recently used my annual yearend blog that reflects on O’Connor OT’s “favorite things” of the year, to reflect on the importance, the value, and the impact of grass roots volunteerism the community where we live.

As I prepare to attend Monday’s Martin Luther King Jr. Day’s Luncheon in Lansing, with the continuous crass and racist words and actions from the sitting U.S. President, I again reflect what should be a call to action. Community service is perhaps more important now than ever, especially in 2017, that has been particularly politically and socially divisive, that I reflect on both the challenges and the opportunities to impact where we live.

 

 “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.”

Margaret Mead

 

I am grateful for, and impressed and motivated by the humble individuals and collective groups who generously volunteer their personal time to improve the quality of life in our communities, and indeed are changing the world.

AARP Michigan. “Volunteers are our greatest gift here at AARP.  We couldn’t do many of the things that we do without them.  I am so appreciative that they share their time, their talents and their expertise with us. By doing so they help share important information on topics such as Fraud, how to remain in your home as you age and the better form of walking to reduce impact on joints (these are just a few among the many presentation topics we have).  Our volunteers play an important role in helping make the community a better place for all.” Karen Kafantaris, AARP Michigan, Associate State Director.

Allen Neighborhood Center, Lansing, MI. “Every year over 400 neighbors volunteer at Allen Neighborhood Center. These volunteers donate approximately 10,000 hours!  Allen Neighborhood Center relies on volunteers – with our volunteers and interns we are able to operate a year round farmers market, programs for both seniors and youth, a garden house, food access programs, and health and other basic needs enrollment services.  The hours that our volunteers donate equal nearly five full-time equivalent employees, nearly doubling our “staff.”” – Denise Paquette, Allen Neighborhood Center, Health & Housing Outreach Director.

Brain Injury Association of Michigan. “BIAMI serves people in the brain injury community across the whole state of Michigan.  Whether is a one-on-one phone call with a lonely survivor or running the world’s largest conference, we are busy year round trying to improve the lives of those affected by brain injury.   Every year we look back in amazement at what we have accomplished.  Our calendars are full with advocacy, awareness, educational and fundraising events.  But with a staff of only 10 people, there is no way we could do what we do without a little help from our friends!  Over 300 volunteers contributed approximately 4000 hours of volunteer involvement and we are forever grateful for each and every one of them.  It is especially gratifying to see the effect of someone with a brain injury who volunteers; not only does it help the volunteer build confidence in themselves and find their value once again; but it challenges others to consider what they can be capable of as well!”  – Kathie Sell, Information and Resources, Brain Injury Association of Michigan

Community Building Services (No Roof Left Behind), Mason, MI. Jared Browers and the team at Community Building Services supported the community by becoming a certified installer for the “No Roof Left Behind” program providing a free roof for a local homeowner. Nominations were narrowed down by volunteers and the finalist chosen by on-line votes based on need.  The program is not just about rewarding people with roofs, as you see in the nomination written by a neighbor of the home selected I am nominating an outstanding woman, an extraordinary mom, and a woman who gives more than she receives. I recently lost my son unexpectedly, and Tina came to the rescue. This mom of many decided to use her funds to purchase lots of food, toiletries, and paper products to help my family in our time of need. She consistently gave her time, and herself, to help my family and my children. Not only has she done this for me, she has always gone above and beyond to volunteer and help whenever necessary.”

Mason High School’s National Honor Society, Mason, MI. National Honor Society students provide community service to a variety of charitable organizations and programs throughout the Capital region, to support an overall goal to improve their community. I am impressed by the service that my son and his peer students at Mason High School provide to our community now, and I am and encouraged that they are establishing habits of service for a lifetime.  Last school year we had 2,400 reported hours by 68 Mason High School students.”  – Brittany Catalano, Mason High School.

 

“All that you can take with you is that which you’ve given away.”  

Peter Bailey, It’s A Wonderful Life

 

I am proud of my to continue to volunteer my time to two particular organizations, AARP and the Brain Injury Association of Michigan, as a means to honor of the patients and families that I serve, and because I believe that as an OT, there is a calling to be active in the community for activities and movements that benefit the greater good.

Join us.

 

For information on more opportunities to volunteer, contact the writer Michael O’Connor by email Michael@oconnorot.com  or phone 517-881-1302.

The following are links for more information on the organizations above:

https://secure.aarp.org/applications/VMISLocator/searchChapterLocations.action

 

http://allenneighborhoodcenter.org/volunteer-2

 

https://www.biami.org/

 

https://www.communitybuildingservices.com/no-roof-left-behind

 

http://www.mhsnews.com/service-opportunities

 

 

Michael Patrick O’Connor, OTRL, CAPS, CBIST, has worked in the field of rehabilitation since 1988 and completed a Bachelor of Science degree in Occupational Therapy with a minor in Gerontology from Eastern Michigan University in 1994. Michael is an Occupational Therapist and Executive Director of O’Connor Occupational Therapy Services, PLLC in Lansing, Michigan. He can be reached at michael@oconnorot.com http://www.oconnorot.com

 

“Our Favorite Things” 6th Annual Year in Review; 2017 Edition.

“Snowflakes that stay on my nose and eyelashes, Silver white winters that melt into springs, These are a few of my favorite things.    — Julie Andrews, The Sound of Music

 

Each December, in the spirit of Julie Andrews singing “My Favorite Things,” I compose a yearend blog that reflects on O’Connor OT’s “favorite things” of the year, to share some resources that make the world a little safer, a little more accessible, a little better regardless of our ability or disability.

As I began to draft this blog, I had a few notes that I had made to myself throughout the year of the usual suspects of gadgets and gizmos. But as I reviewed that list, I thought that my favorite things this year mean a little bit more.

 

“Then the Grinch thought of something he hadn’t before. What if Christmas, he thought, doesn’t come from a store? What if Christmas, perhaps, means a little bit more.” —  Dr. Seuss

I reflected on a marketing and community service lesson that I learned from my old friend Kate Snyder and my Piper and Gold buddies when we were startups together in the business incubator… In 2012 Kate, in lieu gifts to clients, made a donation to the Food Bank in honor of her clients. This set an example for me that I replicated in 2013 and I have proudly supported the Greater Lansing Food Bank as a gift in recognition to honor my stakeholders each year, as an important resource that serves a basic need to so many in our community.

 

“All that you can take with you is that which you’ve given away.”    — Peter Bailey, It’s A Wonderful Life

In identifying my favorite things, I reflected on the importance, the value, and the Butterfly Effect of grass roots volunteerism where we live, in our community, in our neighborhoods. Community service is perhaps more important now than ever; Especially in 2017, that has been particularly politically and socially divisive, that I reflect on both the challenges and the opportunities to impact where we live.

Barbara, our COTA, recently asked if I gave gifts to patients at this time of year. I replied that my donation of volunteering time and my support of sponsorships to our local and state Brain Injury Association of Michigan and volunteering for AARP were in effect my annual gifts to honor of the patients and families that I serve.   People have asked why I give of my time.   I do so because I believe that as an OT, there is a calling to participate in the community for activities and movements that benefit the greater good.  I also do so from a commitment to the role of OT in health & wellness and safety & prevention, as well as part of a commitment to OT role provide community-based intervention through service. These are both programs that I’ve continued to find to be good fit for my talents and time, and that are well aligned with me, and the mission and vision of O’Connor Occupational Therapy, PLLC.

 

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.”Margaret Mead

I am grateful for, and both impressed and motivated by my 2017 “Favorite Things;” the humble and generous individuals and collective groups who volunteer to improve the quality of life in our communities, and indeed are changing the world.

AARP Michigan. “Volunteers are our greatest gift here at AARP.  We couldn’t do many of the things that we do without them.  I am so appreciative that they share their time, their talents and their expertise with us. By doing so they help share important information on topics such as Fraud, how to remain in your home as you age and the better form of walking to reduce impact on joints (these are just a few among the many presentation topics we have).  Our volunteers play an important role in helping make the community a better place for all.” Karen Kafantaris, AARP Michigan, Associate State Director.

 Allen Neighborhood Center, Lansing, MI. “Every year over 400 neighbors volunteer at Allen Neighborhood Center. These volunteers donate approximately 10,000 hours!  Allen Neighborhood Center relies on volunteers – with our volunteers and interns we are able to operate a year round farmers market, programs for both seniors and youth, a garden house, food access programs, and health and other basic needs enrollment services.  The hours that our volunteers donate equal nearly five full-time equivalent employees, nearly doubling our “staff.”” – Denise Paquette, Allen Neighborhood Center, Health & Housing Outreach Director.

Brain Injury Association of Michigan. “BIAMI serves people in the brain injury community across the whole state of Michigan.  Whether is a one-on-one phone call with a lonely survivor or running the world’s largest conference, we are busy year round trying to improve the lives of those affected by brain injury.   Every year we look back in amazement at what we have accomplished.  Our calendars are full with advocacy, awareness, educational and fundraising events.  But with a staff of only 10 people, there is no way we could do what we do without a little help from our friends!  Over 300 volunteers contributed approximately 4000 hours of volunteer involvement and we are forever grateful for each and every one of them.  It is especially gratifying to see the effect of someone with a brain injury who volunteers; not only does it help the volunteer build confidence in themselves and find their value once again; but it challenges others to consider what they can be capable of as well!”  – Kathie Sell, Information and Resources, Brain Injury Association of Michigan

Community Building Services (No Roof Left Behind), Mason, MI. Jared Browers and the team at Community Building Services supported the community by becoming a certified installer for the “No Roof Left Behind” program providing a free roof for a local homeowner. Nominations were narrowed down by volunteers and the finalist chosen by on-line votes based on need.  The program is not just about rewarding people with roofs, as you see in the nomination written by a neighbor of the home selected I am nominating an outstanding woman, an extraordinary mom, and a woman who gives more than she receives. I recently lost my son unexpectedly, and Tina came to the rescue. This mom of many decided to use her funds to purchase lots of food, toiletries, and paper products to help my family in our time of need. She consistently gave her time, and herself, to help my family and my children. Not only has she done this for me, she has always gone above and beyond to volunteer and help whenever necessary.”

Mason High School’s National Honor Society, Mason, MI. National Honor Society students provide community service to a variety of charitable organizations and programs throughout the Capital region, to support an overall goal to improve their community.  I am impressed by the service that my son and his peer students at Mason High School provide to our community now, and I am and encouraged that they are establishing habits of service for a lifetime. Today’s high school students have multiple demands to juggle; academics, athletics, music, clubs, jobs, and family, which makes their volunteerism all the more impressive. Last school year we had 2,400 reported hours by 68 Mason High School students.”  – Brittany Catalano, Mason High School.

 

My wish for you, as we close 2017 and turn the calendar to a New Year, is that the holiday season, and the increased light of our slow tilt-turn back toward the sun from the winter solstice, bring you hope and encouragement.  I wish you a peaceful, healthy and prosperous 2018.

For information on more opportunities to volunteer, contact the writer Michael O’Connor by email Michael@oconnorot.com  or phone 517-881-1302.

The following are links for more information on the organizations above:

 

https://secure.aarp.org/applications/VMISLocator/searchChapterLocations.action

http://allenneighborhoodcenter.org/volunteer-2

https://www.biami.org/

https://www.communitybuildingservices.com/no-roof-left-behind

http://www.mhsnews.com/service-opportunities

 

Michael Patrick O’Connor, OTRL, CAPS, CBIST, has worked in the field of rehabilitation since 1988 and completed a Bachelor of Science degree in Occupational Therapy with a minor in Gerontology from Eastern Michigan University in 1994. Michael is an Occupational Therapist and Executive Director of O’Connor Occupational Therapy Services, PLLC in Lansing, Michigan. He can be reached at michael@oconnorot.com http://www.oconnorot.com

 

Peace

 

 

March is Brain Injury Awareness Month

Maze template 10Jul16

Brain Injury Awareness

*March is Brain Injury Awareness Month*

*Brain Injury Awareness Day March 22, 2017*

*Theme for 2015-2017 campaign: Not Alone.*

“The Not Alone campaign provides a platform for educating the general public about the incidence of brain injury and the needs of people with brain injuries and their families. The campaign also lends itself to outreach within the brain injury community to de-stigmatize the injury, empower those who have survived, and promote the many types of support that are available.” (http://www.biausa.org)

#NotAloneinBrainInjury

Education is key! In order to spread awareness about brain injury, it is vital that people understand what brain injury entails.

What is Brain Injury?

The Brain Injury Association’s (BIA) Brain Injury Facts and Statistics Fact Sheet provides definitions, typical causes of brain injury, and some statistics:

Acquired Brain Injury (ABI): any injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma; typical causes include:

  • Electric Shock
  • Infectious Disease
  • Lightning Strike
  • Near Drowning
  • Oxygen Deprivation (Hypoxia / Anoxia)
  • Seizure Disorders
  • Stroke/Blood Clots
  • Substance Abuse
  • Toxic Exposure
  • Trauma
  • Tumor

 

“More than 3.5 million children and adults sustain an acquired brain injury (ABI) each year. The total incidence is unknown”

“More than 12 million Americans live with the impact of ABI”

 

Traumatic Brain Injury (TBI): a subset of ABI and is caused by trauma to the brain from an external force; typical causes include:

  • Falls
  • Struck by / Against
  • Motor Vehicle Accident
  • Assault
  • Child / Domestic Abuse
  • Gunshot Wounds
  • Sports Injuries / Concussions
  • Shaken Baby Injuries
  • Military Actions

 

“5.3 million Americans live with a long-term disability as a result of TBI”

“Males are more likely than females to sustain a TBI at any age”

“75% of traumatic brain injuries are classified as ‘mild’”

“Motor vehicle crashes and traffic-related incidences are the cause of 31.8% of TBI deaths”

(http://www.biausa.org)

 

Every person who experiences a brain injury will present in their own unique way. Below is a list of typical impacts that one may demonstrate, but it varies person to person based on factors such as: severity of the injury, cause of the injury, what part of the brain was affected by the injury, how long after the injury the person was diagnosed and treatment was started, as well as the person’s general health and age at the time of the injury.

General Impacts of Brain Injury:

Physical Impacts:

  • Difficulty Walking
  • Trouble with Balance
  • Falling
  • Clumsiness
  • Dizziness
  • Spasticity
  • Poor Coordination
  • Difficulty Grasping Objects
  • Headaches / Migraines
  • Nausea
  • Fatigue
  • Seizures
  • Vision- Double Vision, Low Vision or Blindness
  • Trouble with Speech

 

Cognitive Impacts:

  • Memory / Short-Term Memory Loss
  • Ability to Process Information
  • Concentration and Attention
  • Following Directions / Conversations
  • Problem Solving
  • Abstract Thinking
  • Organization
  • Planning
  • Judgment
  • Decision Making
  • Self-Monitoring
  • Initiating Tasks
  • Spatial Orientation

 

Behavioral / Emotional:

  • Irritability
  • Mood Swings
  • Egocentric Behaviors
  • Sadness
  • Low-Energy
  • Hostility
  • Depression
  • Anxiety
  • Impulsive Behavior
  • Agitation
  • Difficulty Understanding Behavioral Impact

(http://www.biami.org/bifacts)

 

Empowering Survivors. A most important piece of spreading awareness about brain injury comes directly from those who know brain injury best …The Survivors! In an effort to give a voice to those who desired to speak out and provide insight about living with brain injury, I developed an electronic survey through surveymonkey.com. This survey included three open-ended questions and was shared via Facebook in various groups that have a focus on brain injury awareness. A total of 41 people graciously provided responses to my questions, all of which will remain anonymous. Recorded below are the questions and a handful of responses.

What do you want the general public to know about surviving brain injury?

“It’s hard. Really hard losing the life you had. Always explaining why you can do somethings one day and not others. Having people not understand it.

“ALL head injuries are unique.”

“No two cases are the same.”

“Just because we look find on the outside and we tend to put on a brave face, on the inside we are normally screaming and fighting for some normalcy that we had prior to our TBI.”

“Everyday is a battle.”

“That I am still me.”

“I wish people understood how tired I get doing simple things.”

“It’s bad, really bad, but there is hope.”

“I’m genuinely tired though not just a lazy me.”

“It’s an invisible injury and to look at me sitting I look ‘normal’ but my life is unrecognizable!”

“Our deficits are real and hamper our lives.”

“What a survivor needs is compassion, support from family and friends.”

“Recovery takes time. Somethings recover, while other things do not.”

“It’s the hardest thing I’ve ever endured.”

“When people say ‘survive’ it sounds like they lost a lot, but I didn’t!

I learned to value life.”

What do you wish someone had told you / what do you wish you knew sooner about surviving brain injury?

“Things will probably never be the same but that’s OK. I was told so often you will get better soon. Every step is important.”

“I wish that my doctors and family members would have been more honest with me from the beginning that this kind of injury is so life changing instead of telling me that I was going to get back to work, and being my old self in no time!”

“It’s forever.”

“Accept the recovery process with a positive attitude.”

“Get involved in TBI survivor group(s) and research ways to increase brain function.”

“Survivors need people, not seclusion.”

“Everyday can be different.”

“Symptoms vary greatly.”

“Crying is normal. Sleeping is normal.”

“DON’T believe healthcare professionals (including occupational therapists) who portray recovery being ‘over’ after some period of time (6 mo, 1 year, etc.).”

“That it’s ok.”

“TBI recovery is possible. I work. I live alone. I know when to take my meds. I care for myself. It just didn’t happen right away – took like 15 years.”

How important is a support system in your life?  In what ways do you receive support / who is in your support system?

“My wife.”

“It is THE most important thing. Emotional, physical (for the first yr) and a hf.”

“It’s so important to have someone that is patient and tries to understand.”

“My husband, kids and parents are my support.”

“Very important, the most important is your loved ones excepting it and being supportive.”

“My support team is a local group that meets once a month and my family.”

“Very important. To handle anxiety, fear and depression, as well as physical disabilities.”

“My new church family is my support system.”

“I have a big support online.”

“My support system is my family and coworkers.”

“My family was amazing. I wouldn’t have made it if not for them.”

“I belong to several groups on FB.”

Support Systems. A support system as defined by the Merriam-Webster dictionary is a network of people who provide an individual with practical or emotional support. A major goal of brain injury awareness is to increase public knowledge of organizations and resources available for support, amongst survivors and those who are on the journey with them.

 

Brain Injury Association of America (BIAA): This national organization’s mission is to advance awareness, research, treatment, and education and to improve the quality of life for all people affected by brain injury.

Visit http://www.biausa.org/ for more information

Brain Injury Association of Michigan (BIAMI): State association that provides direct support, information, resources, education and advocacy for people living with brain injury, their friends and family, professionals who provide research, treatment and services, and the general public. Each state has their own association.

Visit http://www.biami.org for more information about BIAMI

Visit http://www.biausa.org/state-affiliates.htm to locate another state

Brain Injury Association-Capital Area Chapter (BIA-Lansing Chapter): One of the chapters in Michigan. This group meets on the 1st Wednesday of the Month at 7:00pm. A typical meeting consists of an educational presentation followed by a group support session where individuals can share their stories, meet people in their area, and have meaningful conversation.

Visit http://www.biami.org/sglist for more information about BIA-Capital Area or for a complete list of support groups located in Michigan

American Brain Foundation: This foundation aims to brain researchers and donors together. Patient education resources, information about events, and reading resources (magazines, eNewsletters) can be found here.

Visit https://www.americanbrainfoundation.org/ for more information

Blogs: Read first hand experiences from people who are brain injury survivors, or create a blog entry of your own to share your story and inspire others!

http://www.hopeafterbraininjury.org/blog/

http://www.trymunity.com/blog/

http://www.brainline.org/blogs/

http://www.healthline.com/health/best-traumatic-brain-injury-blogs

Facebook: Join a group / page on Facebook. Connect with others around the country who may have similarities with you! Post thoughts, ideas, photos, encouragement, progress, good reads, resources, etc. Search for these pages on Facebook’s search bar:

‘Brain Injury Awareness’

‘Brain Injury’

‘Traumatic Brain Injury Support’

‘Moving Forward After Brain Injury’

‘Brain Injury Survivors’ Worldwide’

‘Brain Injury Network’

‘Brain Injury Stories’

#NotAloneinBrainInjury

 

Melissa Byers is a student attending Eastern Michigan University to obtain a combined Bachelor of Science and Master of Occupational Therapy degree. She possesses an Associate’s Degree in Liberal Arts at Oakland Community College. Melissa’s experience includes working as a Certified Nursing Assistant and at a preschool as an assistant teacher. Melissa is a member of the American Occupational Therapy Association since 2015. Her graduate research study “Hippotherapy: The Lived Experience of the Practitioner” was disseminated as a poster presentation at Eastern Michigan University’s Graduate Research Conference as well as the Lyla M. Spelbring Endowed Leadership and Conference in 2016.

“Our Favorite Things” Our 5th Annual Year in Review; 2016 Edition.

“Raindrops on roses and whiskers on kittens Bright copper kettles and warm woolen mittens Brown paper packages tied up with strings These are a few of my favorite things.”

Julie Andrews, Sound of Music

 

One role of an occupational therapist is that of educator and sharing of resources. We’ve made a habit to compose a year-end post that reviews our “favorite things” of the year, to share some resources that make the world a little safer, a little more accessible, a little better regardless of our ability or disability.

…These are a few of my favorite things…

 

Water.  From the fall of 2015 into early 2016 state and national news began to cover the Flint Water Crisis. The disaster was man-made in every stretch of the word. So why would I count this as one of my favorite things? I do so to recognize some of positive public awareness that has resulted.  Increased recognition of importance of clean water supply for drinking, cooking, and bathing. Increased awareness of pollution, the chemicals that keep us safe, and aging infrastructure that needs to be updated. Increased awareness of the importance of neurological development especially in children aged birth to five years. People doing the RIGHT thing and people stepping up to help fellow man and fellow woman.

 

Impressive Williamston HANDL (Helping the Autistic and Neuro developmentally Disabled with Lockers). In March 2016 local news reported on Williamston students who are innovating to create practical application as an electronic device that helps people with autism or neurological impairments open their locker. Congratulations to the Williamston High School “InvenTeam’s” “Project HANDL.”

http://wkar.org/post/williamston-students-help-peers-disabilities-get-handl-lockers#stream/0

 

Nike’s self-tying Shoes. Also in March 2016 Nike promoted a new shoe in development that is self-tying.   Although some technological advances into simple tasks for general population may be viewed as unnecessary and contribute to laziness.  I view this type of technology as potential application for those in the rehab world, helping 1-handed shoe tying for people with limb loss by amputation or functional limb loss due to neurological injury.

http://venturebeat.com/2016/03/17/nike-unveils-its-first-official-self-tying-sneakers-just-like-in-that-movie/

 

Michigan Senate Bill 395. An AARP survey found that people whose homes don’t meet their needs often aren’t as active in their communities.  “Difficulty in getting around the home may make it difficult to prepare for getting out into the community.” People 50 and older who said that their homes would not meet their needs as they grew older were almost twice as likely to endorse feeling isolated. (Source: AARP, Fixing to Stay: A National Survey of Housing and Home Modification Issues, 2000).  This survey, coupled with my gerontology minor and my interest in helping well elderly, is a reason a significant portion of my volunteerism for the community is related to public education on home modifications for aging in place. This bill was introduced in 2015 but is one my favorite things of 2016 because in March of this year this SB 395 which provides tax credit for accessibility home mods for aging in place and or for disability made saw some activity in the Senate. Although the SB 395 has bi-partisan support, Governor Rick Snyder does not like tax credits, and the bill subsequently has sat in the Senate Committee on Tax Policy since March 23, 2016.

https://www.legislature.mi.gov/(S(qg3o34uwcfnuw5zc3ol15o5a))/mileg.aspx?page=Bills

 

 

Michigan State Police Winter Travel Advisory. Although our November was unseasonably mild, as I compose this blog on December 11, 2016 we are under a winter storm warning with significant accumulating snow locally and around the state. I am reminded of one my favorite tools that I use to plan (or cancel plans) for travel in winter.   Thank you to our friends at Michigan State Police this continues to be an excellent tool provided by our MSP and law enforcement and emergency personnel throughout the state.  Bookmark this site, for easy to use clickable map for current road conditions by regions throughout Michigan.

http://www.michtip.state.mi.us/rw/home.htm

 

 

 

 

Michael Patrick O’Connor, OTRL, CAPS, CBIST, has worked in the field of rehabilitation since 1988 and completed a Bachelor of Science degree in Occupational Therapy with a minor in Gerontology from Eastern Michigan University in 1994. Michael is an Occupational Therapist and Executive Director of O’Connor Occupational Therapy Services, PLLC in Lansing, Michigan. He can be reached at michael@oconnorot.com http://www.oconnorot.com

 

 

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“ABC’s” Strategies for Caregivers Managing Stress. November is National Family Caregivers Month

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Caregiving. Until you began caring for a spouse or aging parent you probably thought the role of caregiver applied to the role of a parent to a child.  The role of caregiving in relationship with a spouse or aging parent can vary from fairly incidental support for medication set up and assistance with medical appointment management, to 24 hour care for physical assistance with personal care due to progressive illness, or assistance for safety and behavior management due to dementia.

By 2030, 20% of the American population will be over 65 years of age. At present, families are the informal caregivers who provide over 90% of care for loved ones. In 2003 this “cost” $257 billion—an amount that is more than what the government spends on Medicaid.

http://www.aota.org/about-occupational-therapy/patients-clients/caregivers

 

AARP’s Public Policy Institute and National Alliance for Caregiving issued “2015 Report Caregiving in the U.S” which outlines the following prevalence of caregiving:

34.2 million Americans providing care for an adult age 50 or older.

Caregivers are caring for others with a long-term condition (59%), a physical condition (35%), memory problems (26%), or more than one ongoing problem or illness (37%).

Caring for a close relative, like a spouse (45%) or parent (44%) is more emotionally stressful for caregivers than caring for another relative (35%) or non-relative (18%).

One third of caregivers (32%) said a health care provider (physician, nurse, social worker) asked about what was needed to care for their recipient, however only half as many (16%) of caregivers said a health care provider has asked what they need to take care of themselves.

http://www.caregiving.org/wp-content/uploads/2015/05/2015_CaregivingintheUS_Final-Report-June-4_WEB.pdf

 

As an occupational therapist working with patients and their families, in supporting my Mom as caregiver through my Grandparent’s illnesses and deaths, and as a caregiver myself for my Father through his 10 year decline from dementia, I know from experience the important role family caregivers play in providing optimal quality of life, and I know well the stress on caregivers. The AARP “2015 Report Caregiving in the U.S” identified that the #1 area that caregiver’s seek more information is “managing stress” (48%).

 

Managing Stress

Managing Stress may be the most important thing a caregiver can do to ensure they are able to continue providing care. Many of us know at least anecdotally of someone who provided care for their loved one to the point of collapse of their own medical emergency, who then could not participate as a caregiver any longer. The AARP’s “2015 Report Caregiving in the U.S” identified the longer a caregiver has been providing care, the more likely she or he is to report their own health as “fair” or “poor.”  There is a correlation between providing more care per day to the caregiver’s compromised health.

One thing I have learned from the families of patients I serve, and from my experience helping my own Mom in her role as caregiver – is that caregivers, especially when under stress, need information in small increments and with some repetition over time to reinforce the availability of the information.   To that end, my “ABC’s” Strategies for Caregivers Managing Stress” is not a lengthy list for every letter in the alphabet, and rather a fairly simply 3 point list.

 

A. ALLOW.

Allow yourself to grieve.   Allow to feel the range of emotions that come with experiencing grief.  Acknowledge that life has changed and may never be “the same” again.

Acknowledgement doesn’t require Acceptance but it opens the door Allowing yourself to Accept help from others. Allow others to help.  Respite is NOT “for” the person receiving care. Respite IS “for” you the caregiver.
 

 B. BALANCE.

Balance the needs of the person you care for with your own needs. You need rest, sleep, nutrition, and exercise to recharge and to stay healthy to continue providing care. Know your limits and protect yourself to stay well.
 

 C. CONNECT.

Connect and Communicate with family, friends, church and other social groups. Due to perceived and experienced stigma of declining cognition and behavioral changes of dementia, coupled with stress and fatigue of caregiving, results in some caregivers isolating with the person they care for. Connect with your physician and Ask for resources.  Connect with local support groups and adult day programs. The formal education and the informal sharing of resources and ideas can be valuable, and at minimum reinforces that you are not alone.

 

 

“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.”  – Leo Buscaglia, author

 

 

 

Additional Resources.

 

AARP Caregiving Resources

http://www.aarp.org/home-family/caregiving/planning-and-resources/

 

 

Alzheimer’s Association Caregiver Center

http://www.alz.org/care/overview.asp

 

 

American Stroke Association – Family Caregivers

http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/ForFamilyCaregivers/For-Stroke-Family-Caregivers_UCM_308560_SubHomePage.jsp

 

 

American Occupational Therapy – Caregiving

http://www.aota.org/about-occupational-therapy/patients-clients/childrenandyouth/care.aspx

 

 

Medicare Caregiver Resource Kit

https://www.medicare.gov/campaigns/caregiver/caregiver-resource-kit.html

 

 

 

 

Michael Patrick O’Connor, OTRL, CAPS, CBIST, has worked in the field of rehabilitation since 1988 and completed a Bachelor of Science degree in Occupational Therapy with a minor in Gerontology from Eastern Michigan University in 1994. Michael is an Occupational Therapist and Executive Director of O’Connor Occupational Therapy Services, PLLC in Lansing, Michigan. He can be reached at michael@oconnorot.com http://www.oconnorot.com