Families and TBI Flashcards
caregiver
Caregiver is typically defined as an unpaid individual who provides care services to those who cannot adequately care for themselves
caregiver burden
Studies show caregivers of individuals with TBI experience chronically high levels of distress when compared to caregivers of other populations
Stress can result from neurobehavioral and mood disturbances associated with the injury, the overall demands of caring for the individual, lack of appropriate social supports, limited access to important resources and services, and changes within the family structure
caregiver burden in acute phase
Care burden can start in the acute phase of injury when family members emotionally deal with the catastrophe while taking on responsibilities formerly managed by the injured person
caregiver burden in rehab phase
Rehab phase stressors include lack of familiarity with rehab protocol and language, how to measure progress, uncertainty of their role and looming pressure for their role as care giver
caregiver burden in post rehab phase
Post discharge stressors include social isolation, care giver depression, anxiety and distress
Other factors include survivor disability, survivor unemployment, and survivor substance misuse
addressing caregiver burden in tx
Helping families develop realistic expectations for recovery
Assisting families in developing hopeful or progress focused attitude
Encouraging them to rely on other family members
Family systems theoretical framework for caregiver burden
Grounded in the notion that the whole is greater than the sum
Encourages practitioners to think of interactions which occur between family members thoughts, beliefs and actions; they influence decisions and behaviors
Families have shared beliefs and ways of communicating that affect the way they understand rehab goals and outcomes
Assumes families have strength and capacity to solve problems
Family centered services theoretical framework for caregiver burden
Similar to FST, it is about mutual respect, information sharing, participation and collaborative partnerships between the survivor and their family
FCS emphasizes that the survivor, family and provider are partners in health care; care should be comprehensive and tailored to the person with the injury and their family’s strengths, needs, priorities and values
Cognitive Behavioral Family Theory
like CBT
CBT helps the individual become aware of inaccurate or negative thinking; the person can view challenging situations more clearly and respond to them in a more effective way
Activating event - DO NOT have control
Belief - DO have control (focus here)
Consequence - DO have control (focus here)
Resilience theory
Based on notion no matter how catastrophic the event, there are always individuals and families who rise above the expected negative outcomes - they “beat the odds”
Encompasses skill set not personality traits so it can be taught
Skill sets include:
Belief systems defined by making meaning out of adversity, maintaining a positive outlook and having an inherent spirituality
Family organization includes the capacity to change, an integral and supportive connection between family members and willingness to use social resources
Effective communication strategies and willingness to take a collaborative approach to problem solving
Challenges for being parent of adult with TBI
Parents must return to their early life role of authority; difficult for both parents and child
Over long term, parents become social outlet for their adult child as peers pull away
Significant degree of stress across lifespan
As parents age, face difficulty of providing care. May consider institutionalization. It offers options to reduce care giving burden
Rehab focus: listen to caregiver concerns, provide comprehensive training for in-home care, identify respite and facilitate opportunities for peer support for the individual
Challenges for siblings
Siblings struggle to cope with the changes in their brother or sister; may feel resentment around attention which has shifted to the injured sibling
Siblings’ needs are at times overlooked; they experience distress, increased sibling conflict, role changes and increased responsibilities or feelings of loss related to family
Rehab focus: they require support, information, guidance and ability to participate in family decisions.
Parents should be encouraged to maintain normalcy in routines and activities, and devote special time to non-injured child
consideration for military families
Military culture, particularly on base, may lead to confusion after a family member has a brain injury
Confusion may be related to the civilian systems of care
Injury may cause family feeling disconnected and untrusting or hesitant to access community resources and support
Military families have pre-injury stressors even before the rehab process (i.e., relocation, deployment, functioning during the absence of their loved one and reintegration of the family member)
National Guard and Reserves maintain non-military occupations; may be unfamiliar with military supports
Rehab professionals should be aware of military family stressors, possible poly-traumatic injuries, PTSD, and military systems of care
Brain Injury Family Intervention
Common model is the Brain Injury Family Intervention (BIFI); created to assist families in meeting the complex needs of a family member with TBI. Also has manual for adolescents (BIFI-A)
BIFI is manualized with fact sheets, guides and readings broken into 90 to 120 minute sessions
BIFI
What’s normal after brain injury
implemented by NON Professional and back up from the professional
