alaska brain injury network, inc
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Grace Snider Resource Navigator Program Director 907-274-2824 toll free: 888-574-2824 [email protected]. Alaska Brain Injury Network, Inc. ABIN Mission: Educate, plan, coordinate, and advocate on behalf of survivors of TBI and their families. Track needs of Alaskans - PowerPoint PPT PresentationTRANSCRIPT
Grace SniderResource Navigator Program Director
907-274-2824toll free: 888-574-2824
Alaska Brain Injury Network, Inc. Track needs of
Alaskans TBI survivors/family
members are the experts.
Make recommendations to Department of Health and Social Services and the Alaska Mental Health Trust
Bring brain injury services close to home
Prevention First!
Information and Referral
Online Resource Directory and Library Materials
Online Discussion Group
Library Advocacy Network of consumers,
professionals, policy makers, and advocates to make systems change!
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ABIN Mission: Educate, plan, coordinate, and advocate on behalf of survivors of TBI and
their families
Special thank you to:
Alaska Native Tribal Health Consortium Injury Prevention
Program
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Traumatic Brain Injury in Alaska:Who, How and Where
Alaska Native Tribal Health Consortium
Injury Prevention Program
What is a Traumatic Brain Injury?
CDC describes it as:
“…caused by a bump, blow, or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.”
How do you get a TBI?
Many different kinds of events, some that are almost everyday events, can cause a
TBI:
Hitting your head when you fall or trip
Crashing your bike, snow machine or ATV
Being in a motor vehicle crash
Injure your head during sports
Being near an explosion
How does a TBI affect you?
If you or someone else gets a TBI, it can cause temporary or permanent changes in:
Thinking (remembering and reasoning)
Physical abilities (walking, coordination)
Sensation (touch, taste, smell)
Language (understanding, communication)
Emotion (depression, aggression, anxiety)
Increased Risk of TBI
Who?
The Gender GapNon-fatal TBI Hospitalizations in Alaska 2004-2008
Age DifferencesNon-fatal TBI Hospitalizations in Alaska 2004-2008
Age groups and Activities
Different age groups have different activities that result in the highest numbers of TBI:
Ages (years) Activities with the most TBI 0-9 Falls
10-19 Motor vehicle, ATV/Snowmachine
20-39 Motor vehicle, Assault
40+ Falls, Motor vehicle
Increased Risk of TBI
Where?
Region of Patient ResidenceNon-fatal TBI Hospitalizations in Alaska 2004-2008*
All U.S. Rate**: 93
All Alaska Rate*: 92
Alaska Native Rate*: 174
* Crude rates, reported as TBI per 100,000 people
** All U.S. rate for 2002-2006, per CDC.
Specific places of occurrence Non-fatal TBI Hospitalizations in Alaska 2004-2008
Highway
Home
Public Place
Industrial Place
Recreation Sports
Residential Institution
Other
Increased Risk of TBI
Is Alcohol a Risk Factor?
Yes
Alcohol Association by Age Non-fatal TBI Hospitalizations in Alaska 2004-2008
Alcohol by Activity Non-fatal TBI Hospitalizations in Alaska, 2004-2008
Cases associatedACTIVITY with alcohol
Assault 3 out of every 4
Suicide attempt and Snow machine 1 out of every 2
Pedestrian and All-terrain vehicle 2 out of every 5
Motor vehicle traffic 1 out of every 3
All other 1 out of every 5
Alcohol by Activity Non-fatal TBI Hospitalizations in Alaska2004-2008
Percent of cases ACTIVITY Total Cases associated with alcohol
Assault 37572%
Snow machine 12149%
Suicide attempt 27 48%
Pedestrian 108 41%
All-terrain vehicle 240 39%
Motor vehicle traffic 644 32%
Bicycle 132 23%
Falls 1034 18%
All other 408 18%
Increased Risk of TBI
How severe?
Time in Hospital
For TBI hospitalizations from 2004-2008, the length of time patients spent in the hospital:
Average:5.6 days (compared to 3.9 for
non-TBI injuries)
Maximum: 305 days (10 months)
Patient destination at dischargeNon-fatal TBI Hospitalizations in Alaska
2004-2008
2082
521
162
83
71 44 29 97Home,No Assistance
Acute Care Hospital
Inpatient Rehabilitation
Skilled Nursing
Home,Rehab Outpatient
Home,Health Care
Left against medical advice (AMA)
Other or unknown
Patient’s General Condition on Discharge
Condition Frequency %
Good, Return to Previous Level of Function861 28
Temporary Disability, Expected to Return 1111 36to Previous Level of Function
Moderate Disability with Self Care 133 4
Severe Disability, Dependent 155 5
Persistent Vegetative State 4 .1
Unknown 825 27
Risks of TBI
How much $$?
Hospitalization costs
Hospitalization costs for TBI in all Alaska averages $29,000 per injury, compared to the $20,000 average for all injury hospitalizations
Estimated total per year: $16.7 million
Highest hospitalization cost for TBI: $1,010,000
Medivac costsThese costs vary dramatically depending on the contract with the Medivac company.
These are cost ranges Alaska companies provided for actual trips taken:
Juneau to Seattle: $17,000 to $37,000
Anchorage to Seattle: $27,000 to $56,000
Nome to Seattle: $37,000 to $75,000
Anchorage to Richmond, VA: $63,000 to $124,000
Prevention
What is being done?
Snowmachine, ATV, and
Motorcycle Safety
Child Motor Vehicle Safety
Gun Safes
Reducing harm from guns
Date: Resident: Assessment by:
This Home Safety Survey is designed to look for hazards in and around the house so they can be fixed before they cause problems. Home safety problems could lead to unintentional injuries from falls, burns, or poisoning. Falls can be a major problem for an elder. Falling can result in serious injury or loss of independence. This survey can be done by a CHA/P, CHR, or a family member.
YES NO
Home Entrance
Steps and walkways in good repair; no broken edges or boards or other hazard
Secure ramp installed if resident uses a wheelchair or finds stairs difficult
Exterior stairs and landing are slippery when wet
Area on roof for ice/snow to accumulate and slide onto landing, stairs, or ramp
Secure, sturdy railing on both sides that is easy to grasp with both hands
Lights that light up a wide area of the yard and walkway
Lock that does not need a key to open from inside (unless wandering is an issue)
Mat, carpeting or textured floor in entryway to prevent slipping when wet
Seat available for putting on and removing ice grippers or cleats
Living Areas
Doorways wide enough to use a walker, a wheelchair, or if carrying a load
Open pathways with no small furniture, clutter, or "stuff"
Throw rugs or mats
Thresholds between rooms/floor textures are smooth with visible color contrast
Electric phone cords running under rugs or carpeting or across open areas
Frayed electric cords
Electric outlets and switches overloaded (warm to the touch)
Lights can be turned on without walking across a dark room
Home Safety Survey
Ice cleats
Home modification
Raising awareness
Bike Safety
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Pedestrian Safety
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ANTHC Traumatic Brain Injury Contacts
Jaylene Wheeler, Injury Prevention Coordinator(907) 729-3799 [email protected]
Hillary Strayer, Senior Injury Prevention Specialist (907) 729-3513 [email protected]
Website: http://www.anthc.org/chs/wp/injprev/
Once an injury occurs…Ideal system of care vs. Alaska’s
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Prevention
RESEARCH
trauma Pre -
Hospital,
Emergency
Medical
Services
Emergency
DepartmentAcute
Care
Inpatient
Rehabilitation
COMMUNITY
Out Patient Rehab
Education
Family Support Services
Housing
Vocational
Training/Employment
Long Term Services and
Supports
Physicians
CASE MANAGEMENT/
SERVICE COORDINATION
Prevention
RESEARCH
Pre -
Hospital,
Emergency
Medical
Services
Emergency
Department
Acute care
Post AcuteCare
Inpatient
Rehabilitation
COMMUNITY
Out Patient Rehab
Education-Training
-Resource Navigator
Family Support Services
Housing
Vocational
Training/Employment
Long Term Services and
Supports
Physicians
CASE MANAGEMENT/
SERVICE COORDINATION
TraumaAlaskans suffer TBI 28% more than the lower
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Screening
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Locating needed services…
Information and ReferralCare Coordination (Case Management)Acute and Post-acute RehabEducation and Related SupportsVocational Training and RehabilitationLong-Term Community Supports
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Alaska Brain Injury Network’s Resource Navigation Program
Available to ANYONE in the State looking for resources for brain injury.
Helping people find… Information about brain injuries Services to help them recover Help brainstorming solutions Someone to listen and understand.
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How ABIN can help you?Information and Referral
Aka Resource Navigation!Online Discussion GroupWebsite
Resource DirectoryOnline Resource Library
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Resource #1: Alaskan Brain MattersOnline Discussion Group – Email Group
Group for survivors, caregivers, and providers to share information and offer support
Dialogues that make a differenceUrgent needs met immediately (case example)
Advocacy Works! Your voices make a difference
To join, email [email protected]
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Resource #2: WebsiteWebsite www.alaskabraininjury.net
Resource DirectoryFind community resources: physical therapists,
occupational therapists, speech therapists, vision therapy, biofeedback, counseling, assessment, independent living centers, accessibility, state agency programs, vocational rehab, and more.
Library of articlesFind educational materials for various topics.
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Head Injury Support Groups
Juneau: Margie Thomson/SAIL (907) 796-6465
Anchorage: Frank Box, Access Alaska (907) 263-1905
Fairbanks: Access Alaska (907) 479-7940
Mat-Su: Angie Boardman Access Alaska/Mat-Su Health Serv.(888)
574-2824
Homer: Cathy Stingley, Thoughtful Therapies (907) 235-
6226
Ketchikan: Pat Chapman (907) 617-5704
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Mentoring Similar Experiences
Share what resources and supports that have worked for them
Don’t feel so alone
A Friend
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Information about brain injuries
Trust Training Cooperative Acquired Traumatic Brain Injury Case Management
training https://www.ttclms.org/class_detail.php?z_classid=1
01877 Lash and Associates
www.lapublishing.com Tip cards, books, DVD’s
3rd Thursday Teleconference Training [email protected]
American Academy of Certified Brain Injury Specialists, www.aacbis.net
National Websites44
What is being done to improve the system of care in Alaska:
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Developing InitiativesInformation and Referral (ABIN, ADRC,
211)Case Management DHSS, Senior and
Disabilities Services (2009)State ATBI Program (2010)
TBI Program CoordinatorData collectionExpand Care Coordination
TBI Training-Intro to TBI course, Advance Management in Brain Disorders (2008)
ImPACT-concussion management, Alaska Neuro Associates
Public Awareness- Callan Chylook-Sifsof, television commercials, newspaper ads, posters.
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"An Act establishing a traumatic or acquired brain injury program and registry within the Department of Health and Social Services; and relating to medical assistance coverage for traumatic or acquired brain injury services."
SB 219 Introduced by Senator Lesil McGuire, family member of a TBI survivor, January 19, 2010, added “acquired” brain injury - ATBI
The Alaska Acquired and TraumaticBrain Injury ProgramSB 219 – ATBI Program
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State responsibilities under SB 219Assessment of the scope, availability and effectiveness of current ATBI services
Supervision, coordination and expansion of ATBI services
Development of standards for prevention and treatment of ATBI
The Alaska Acquired and TraumaticBrain Injury ProgramSB 219 – ATBI Program
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State responsibilities under SB 219Development and maintenance of an ATBI Registry to track the status and outcomes for people served by the ATBI Program
The addition of targeted case management as a Medicaid service for people with ATBI, which will require SDS to develop standards and regulations for delivery of this service ($1.2 million fiscal note)
The Alaska Acquired and TraumaticBrain Injury ProgramSB 219 – ATBI Program
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What works for you?
Case by Case basisDifficult to know what will work for
someone until you get to know them.Find colleagues to brainstorm with.Get comfortable with ambiguity. (from Dr. Jeffrey
Barth)
Recognize and embrace the complexity of TBI and treat it as a challenge to your scientific and clinical skills. (from Dr. Jeffrey Barth)
Feel free to contact me. Jennifer at [email protected]
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Troubleshooting brain injury…
• Understanding the symptoms • Brainstorming solutions
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Four areas of effectsPhysical LinguisticCognitiveEmotions and Behaviors
What you might see after TBI
HeadachesFatigueSleeping in classSeems tuned outPhysical weaknessSeizuresClumsiness
What you might see:physical effects
Difficulty finding the right wordCocktail party languageReceptive or expressive language
What you might see:language/linguistics
What you might see:cognitive effects
Irritability, angry outbursts, impulsivityAggressive acting outPassive behaviorSocial immaturitySexually inappropriate behaviorDepressionFrustrationDisinhibitionSelf monitoringInterpreting social cues
What you might see:emotions and behaviors
Shorter day
Frequent breaks
Person driven solutions
Build in success
What can we do?
Shorten tasks/assignments
Be flexible with expectations
What can we do?
Follow routine
Daily schedule/picture schedule
What can we do?
Minimize distractions
Give choices
Limit changes
Predictability
What can we do?
Use cues!VisualTools
PlannerComputerWatch/alarmTimers
THANK YOU FOR YOUR TIME
What can we do?