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Brain Injury

The consequences for sustaining brain injury of any magnitude can have a life changing effect on the individual and the family. Whether the person is an adult or a child their life changes drastically. There are various types of brain injuries; the one that is in detail in this paper is Traumatic Brain Injury (TBI) of any degree. The obstacles a person has to overcome to become rehabilitated are numerous, tedious, and frustrating. The expenses that a person or family have to pay for rehabilitation are tremendous, and many cannot afford the treatments.

Brain Injury
Whether an adult or a child, suffers from brain injury of any degree, they have to overcome numerous obstacles in order to achieve rehabilitation. Each case differs greatly depending on the severity of the injury and the personís physiology. A person suffering from TBI (Traumatic Brain Injury) may never fully recover from the damage that has occurred. The cost to complete rehabilitation may seem unlikely to most families. One would think that when a child suffers from brain injury it is more distressing, this is not true, and an adult suffering from brain injury can be just as devastating. In both cases, the individualís family experiences the consequences of the injury. In order to understand what TBI is and how it differs from other brain injuries one would have to know the cause and the results of the injury sustained.
An estimated 5.3 million Americans (a little more than 2% of the U.S. population) currently lives with disabilities resulting from brain injury (. There are numerous types of brain injury: 1) TBI (Traumatic Brain Injury) results from damage to brain tissue caused by an external force. Leading causes of TBI are motor vehicles accidents, acts of violence, falls, sports and recreational injuries, lightening strikes, electric strikes, and blows to the head. 2) Acquired Brain Injury (ABI) results from damage to the brain caused by strokes, tumors, hypoxia, toxins, degenerative diseases, near drowning and/or other conditions not necessarily, caused by external forces. 3) Concussion results from a quick blow to the head by an external force. Every 21 seconds, one person in the U.S. sustains a brain injury (NIH 9-10). That is an amazing number, which means that over 4,000 people in the U.S. sustain a brain injury per day.
TBI has numerous complications and is not limited to a certain amount of symptoms. This makes it hard for doctors to say well what you see is what you have to deal with. TBI affects an individual neurologically, which hinders many day-to-day human functions. A person may not be as likely to show all of the symptoms at once. TBI patients are vulnerable to movement disorders, seizures, headaches, visual deficits, sleep disorders, and various no neurological problems.
The process of rehabilitation is taxing on the individual suffering from TBI and the patientís family. Many types of adult rehabilitation are used. 1) Restorative training focuses on improving a specific cognitive function, 2) compensatory training focuses on adapting to the presence of a cognitive deficit, 3) single strategy focuses on a computer assisted cognitive training, 4) integrated or interdisciplinary approach. Other elements used in rehabilitation are such thing as compensatory devices (memory books or electronic paging devices). Psychotherapy treats a person for depression and low self-esteem. Psychotherapy creates a support system for the emotional or psychological problems the person may be experiencing. Medications in addition to psychotherapy treat behavioral problems.
Children are often rehabilitated within a school setting by being placed in a special education class. This will allow them the chance to learn cognitive skills that will help them later in life. The effects of TBI on a child may not be even noticed until his/her is older. Like adults, children experience complications with the interaction of a ďnormalĒ peer. Unfortunately, there have not been enough studies to isolate what aspects of this rehabilitation are most effective.
With doctor, bills and the everyday cost of living a family may suffer financial difficulties. In comparison to other medical conditions, Brain Injury has one of the highest incident rates and cost rates.
Table 1
Estimated annual costs for all conditions includes medical costs and indirect costs associated with death and loss of income #

Condition Incidence Deaths Cost
Brain Injury 2 million 100,000 $25 billion
Stroke 2.6 million 145,000 $25 billion
Spinal Cord Injury 10,000 unknown $8 billion
Cancer 1.1 million 510,000 $104 billion
AIDS 50,000 26,000 $15 billion
The cost of TBI care in the United States is estimated to be $48.3 billion annually. Hospitalization accounts for $31.7 billion (Lewin, 1992).
TBIs have numerous influences on a person whether it is cognitive, physical or/and emotionally. A study done by the NIH (National Institutes of Health) illustrates the cognitive consequences of a person that has sustained a TBI:
Cognitive consequences of TBI have most persistent problems include memory impairment and difficulties in attention and concentration. Deficits in language use and visual perception are common. Frontal lobe functions, such as executive skills of problem solving, abstract reasoning, insight, judgment, planning information processing, and organization. Common behavioral deficits include decreased ability to initiate responses, verbal and physical aggression, agitation, learning difficulties, shallow self-awareness, altered sexual functions, impulsivity, and social disinheriting. Mood disorders, personality changes, altered emotional control, depression, and anxiety are also prevalent after TBI. (P.8)
A person with TBI is at higher risk to fail in everyday relationships or tasks. According to the National Institute of Head Injury, Social consequences of mild, moderate and severe TBI suffer from an increase risk of suicide, divorce, chronic unemployment, economic strain, and substance abuse (p.8).
Children suffering from TBI suffer similar difficulties as that of an adult, but may be able to recover at a further extent. The plasticity (the brainís ability to change its structure and functions) of a childís brain is far more than that of an adult. If a child that is at the age of two can shift language processing from one hemisphere of the brain to the other (Coon, 78). While an adult has established their patterns or norms and it is hard for an adult to be able to change. As where the child who suffers from TBI later in life will not know the difference. The NIH study concluded that children with TBI suffer from interactions of physical, cognitive, and behavioral sequel interfere with the task of new learning. (NIH p.8) When a family member suffers from TBI, it is extremely hard for the family as a unit. Many TBI patients suffer an increased rate of suicide, divorce, chronic unemployment, economic strain, and substance abuse. An adult with TBI may attempt to live life as they did before and only find it to be difficult to do so.
For example, Bob is married and has two beautiful children. His job is as an insurance salesman. His job demands that he have great memorization skills, organizational skills, people skills, and attention to detail. Bob gets into a car crash and sustains a TBI from hitting his left frontal and temporal lobes on the diver window. After Bob leaves the hospital he will have to take, see a psychologist, an occupational therapist, a physical therapist, and a support group for people who have a TBI. When Bob goes home he notices that he is having a hard time relating to his family the way he use to. His children will ask him if he could help them with their homework and he becomes frustrated easily. His wife asks if he could please bring in the laundry from down stairs and forgets the conversation when his wife asks why it was not done. After a few months of treatments, Bobís psychologist says that he may attempt to go back to work. Bob enters the office and looks at his desk. Everything seems foreign to him, he does not remember what the entire form means, and how he is, suppose to fill them out. A coworker approaches him and says hello. Bob has no recollection of who the person is. As the day progresses it only becomes more frustrating and Bob is snapping at everyone. Two weeks later Bob receives a pink slip from his job. This causes financial strain on his family. His children donít interact with him as much, and his wife makes small talk. A year later, Bob is divorced and still not working. This is a worse case example for a person who suffers from a TBI, but is likely to happen.
From personal knowledge, a parent that suffers from brain injury changes the dynamics of a family, even to the extent that the person can become a complete stranger. It was during the school year of 95-96 when the accident occurred. My stepfather had sustained injury to the left temporal and frontal lobe of his brain. He had to go through about two years of tests, and different types of therapy to rehabilitate him. At the end of his rehabilitation, he was very concrete with his thoughts and was often childlike. Everyday tasks that he had completed before the accident seemed to frustrate him. He would obsess about things to the point that he seemed to be a man gone crazy. Honestly, the man was no longer the caring, gray area, witty person he use to be; he had become a complete stranger. The relationship between him and my mother ended in divorce.
This purpose of this paper is was to educate the reader about the hardship of a personís life that suffers from TBI. Brain injury has an enormous impact on a person whether a child or adult if very difficult. The individual but the family does not only felt the difficulty as well. The rehabilitation process of a brain injury patient will seem endless, and the patient may not fully recover in the end. A person has to learn to create a new life, which may seem very frustrating and causing depression.

References Rehabilitation of Persons with Traumatic Brain Injury. NIH Consensus Statement Online 1998 Oct 26-28; 16(1): 1-41 Retrieved on 1/25/2002. Available: Head Injury Hotline: Types of Brain Injury Online Oct 1998 1-7 Retrieved on 2/21/2002. Available: Head Injury Hotline: Costs of Brain Injury Online Oct 1998 1-2 Retrieved on 2/21/2002. Available: Coon, Dennis (2001). Introduction to Psychology: Gateways to Mind and Behavior. California: Wadsworth/Thomson Learning. Lewin-ICF (1992). The Cost of Disorders of the Brain. Washington, DC: The National Foundation of the Brain.

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