Assistive Technology (A.T.) for Brain Injury

February 8, 2018

Christine Martin, MS, OTR/L, CBIS

Objectives

  • Identify common challenges with brain injury that may impact independent living
  • Identify at least 1 low tech and 1 high tech solution for common brain injury challenges
  • Identify available funding sources for AT devices

Brain Injury

“An acquired brain injury (ABI) is an injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma.”

Acquired Brain Injury= Traumatic or Non-Traumatic

“A traumatic brain injury (TBI) is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force.”

“A non-traumatic brain injury is an alteration in brain function or pathology caused by an internal force.”

Reference:

ABI vs. TBI

TBI causes

  • Falls
  • Assaults
  • Motor Vehicle Accidents
  • Sports/Recreation Injuries
  • Shaken Baby Syndrome
  • Gunshot Wounds
  • Workplace Injuries
  • Child Abuse
  • Domestic Violence
  • Military Actions (Blast Injury)

ABI causes

  • Stroke (Hemorrhage, Blood Clot)
  • Infectious Disease (Meningitis, Encephalitis)
  • Seizure
  • Electric Shock
  • Tumors
  • Toxic Exposure
  • Metabolic Disorders
  • Neurotoxic Poisoning (Carbon Monoxide, Lead Exposure)
  • Lack of Oxygen (Drowning, Choking, Hypoxic/Anoxic Injury)
  • Drug Overdose

Neurodegenerative Disease

Neurodegenerative disease = primarily impacts neurons in the brain

  • Alzheimer’s disease (AD) and other dementias
  • Parkinson’s disease (PD) and PD-related disorders
  • Huntington’s disease (HD)
  • Spinocerebellar ataxia (SCA)
  • Spinal muscular atrophy (SMA)

Brain Injury Recovery

  • Considerations:
  • Severity (mild, moderate, severe)
  • Location (brain stem vs. cortical)
  • Age
  • Loss of consciousness
  • Size
  • Time since initial injury
  • Type (TBI vs. ABI vs. Degenerative)

Common Challenges

  • Physical challenges
  • Cognitive challenges
  • Communication challenges
  • Behavioral/ Emotional challenges

Physical Challenges

  • Mobility
  • Hemiparesis
  • Sensory challenges (i.e.-touch, pain)
  • Tremors
  • Coordination
  • Balance
  • Strength
  • Endurance

Cognitive Challenges

  • Memory
  • Attention
  • Executive skills (problem solving, decision making)
  • Initiation
  • Self-awareness

Communication Challenges

  • Aphasia
  • Dysarthria
  • Dyspraxia of speech

Emotional/ Behavioral Challenges

  • Personality change
  • Wandering/ elopement
  • Agitation/ aggression

Sensory Disturbances

  • Can present themselves in many different ways …
  • Agitation
  • Withdrawal
  • Fidgeting / Restless

Low Tech vs. High Tech

  • Low Tech A.T. Devices=
  • No to low cost
  • Generally easily accessible
  • Generally easy to implement
  • High Test A.T. Devices=
  • More expensive
  • More features, usually more complex
  • More training and follow up required

Pros & Cons ofLow Tech A.T.

Pros

  • Easily accessible
  • Most cost less than $20.00
  • Simple to set up
  • Limited training required

Cons

  • Very simple, only do 1 thing
  • May have shorter “shelf life” need frequent replacement
  • Dependent on the client to use it properly

Pros & Cons ofHigh Tech A.T.

Pros

  • Several features
  • More intuitive and automatic
  • Smaller/ wearable
  • Involve the caregiver without direct support
  • Reduce caregiver burden

Cons

  • More expensive
  • More training needs

Assistive Technologies for People with Brain Injury

The next 24 slides show images of AT for people with Brain Injury. Please view the recorded webinar for more information.

Apps for Behavioral Challenges

  • Chillax
  • Relax Meditation: Mindfulness, Sleep Sounds, Noise
  • At Ease: Anxiety & Worry Relief
  • Buddhify
  • Calm
  • Meditation Helper

Funding

  • This is the key issue for the consumer & family!!
  • Professionals need to know about purchasing / funding options for AT
  • Funding decisions are based on need & eligibility
  • Learn about the eligibility & documentation requirements of funders
  • Do your homework…

Funding - 2

  • mPower Loan/Financing Program
  • Alpha One - IL grants & mPower Loans
  • Robbie Foundation

Funding- 3

Funding ---- MaineCare supports people living in the community: shifts funding to community based services away from more costly institutional care.

  • Waivers fund A.T. used in the community to increase safety & independence
  • Funding for home based remote monitoring
  • Support training on how to use AT
  • Homeward Bound Program -- people leave NFs to go back home

Maine Home and Community Based Waivers, AT Comparison Chart

By Kelley Smith, COTA/L, ATP (Revised Sept 2017)

Link:mainecite.org/wp-content/uploads/2017/09/ATWaiverComparisonChart-9-2017.pdf

Access to A.T.

Start with an A.T. assessment!

  • Device demonstrations and loans
  • Device loans- “try before you buy”
  • Explore available funding options

AT Providers

  • C.A.R.E.S. Inc.- AT demo & loan
  • mPower Loan Program – financial loans
  • Maine Center for Integrated Rehab - AT Services
  • Goodwill NNE - AT Services
  • Gallant Therapy Services - OT services
  • AT Practitioners (ATPs) - RESNA certified
  • Occupational Therapists
  • Speech Therapists
  • Physical Therapists
  • Manufacturers/vendors

AT Resources

  • Maine’s AT program - mainecite.org
  • Maine A.T. for Demo/Loan - at4maine.org/
  • Get AT Stuff - Online A.T. sales - getatstuff.com/
  • Spruwink ALLTECH – Demo/Loan and Reuse program - spurwinkalltech.org/
  • CARES. Inc. – Demo/Loan program -
  • American Foundation for the Blind-
  • Pass It On Center – list of AT Reuse programs -
  • Rest Assured – Vendor that provides remote monitoring - restassuredsystem.com
  • Smart Home Superstore – vendor selling monitoring equipment -

Thank you!!

Christine Martin -