Insight Flashcards
How is rehab impacted by Lack of Awareness/Insight?
We can expect big time safety issues = need 24 hour supervision
They cannot get better if don’t know what’s wrong with them – they wont comply eg) use safety devices
Eg) they think they say a sentence fine but don’t really = you can record them & play it back so they can hear themselves
Rehab implications for this lack of insight = wont see the need for a goal & that you are being fussy because they think they are fine. Therefore potential for rehab outcome goes down
- Poor safety
- Poor compliance
- Poor engagement
- Poor feedback
Where and When is Anosognosia (Insight) an Issue?
Diagnosis:
- Stroke
- TBI
- Parkinson’s
- MS
Poor prognosis for rehabilitation
Improvements in first year are important
3 Layers of Self-Awareness/Insight?
INTELLECTUAL = the prerequisite =
You know you have a deficit because someone told you they do (even if they don’t believe it yet)
Recognizing they have a deficit is step 1
- ca achieve with table top activities
They need a LOT of support 24 hours
EMERGENT AWARENESS =
Understanding you have one in real time eg)you go to do an activity but you cannot do it on your own due to the deficit
Works best with functional activities
They will use compensatory strategies to complete the activity
ANTICIPATORY AWARENESS =
Based on what I know about myself that task will be hard for me because of my deficit
What they know will be a challenge based on what they know
Treatment for Self-Awareness?
Performance based treatment:
- Meaningful tasks, natural environments
- Anticipated performance & difficulties
- Evaluation of performance (videotape them)
- Give them feedback after completing tasks
- Planning for new situations: generalization
- Establish a goal
