Positive Outcomes for Individuals with Severe Brain Injury

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1 Positive Outcomes for Individuals with Severe Brain Injury

2 Overview of Presentation Research History ARBI s unique and successful model Outcomes Case examples

3 Research Neuroplasticity: With a brain injury, functions performed by damaged areas are lost. Over time, with rehabilitation, uninjured parts of the brain can take over lost functions. Dr. Richard Dyck, University of Calgary Professor and Associate of Hotchkiss Brain Institute Principles of Experience-Dependent Neural Plasticity : (Kleim and Jones Journal of Speech, Language, and Hearing Research: Vol. 51. S , Feb. 2008) Use it or lose it Use it and improve it Task Specific Repetition Motivating, meaningful activities

4 Research Long-term Recovery Existing evidence indicates that severe brain injury survivors are capable of significant functional recovery years after injury. Rehabilitation may serve to further ameliorate disability and reduce long-term costs of care. Slow-to-recover severe traumatic brain injury: a review of outcomes and rehabilitation effectiveness Brain Injury: 2000, Vol. 14 No. 11 Dr. Shaun Gray, Director of Halvar Jonson Centre for Brain Injury, Ponoka, Alberta

5 ARBI s Co-Founders Alice Laine Audrey Morrice

6 Mel s Rehabilitation

7 Mel s Rehabilitation Meaningful, Task Specific Activities

8 In a Nurturing, Rich Environment Mel s Rehabilitation

9 Mel Today

10 ARBI Formed in 1978

11 ARBI Today ARBI is a critical asset to the organizations in Southern Alberta committed to improving the quality of life for those affected by neurological injury or disease. The care and commitment that ARBI demonstrates for those with severe brain injuries is an outstanding model for us all. Dr. Samuel Weiss, Director Hotchkiss Brain Institute

12 ARBI s Mission and Vision Mission ARBI is a community-based non-profit organization that strives to improve the lives of individuals with severe brain injury including stroke. We unite professionals, volunteers and caregivers throughout Alberta to provide personalized rehabilitation and community integration. Vision Creating a community where quality rehabilitation is accessible to all individuals with a severe brain injury including stroke, enabling them to live their best life possible.

13 Eligibility for Programs and Services Diagnosis Medical stability Rehab completed 16 to 75 years of age 24 hour care and/or supervision Behaviours Significantly compromised abilities

14 ARBI s Programs Only non-profit, community-based agency in Canada that provides intensive, long-term rehab for this population Three programs offered Fully accredited by Alberta Council of Disability Services

15 Our Team Physiotherapists, Occupational Therapists, Speech Language Pathologists and Recreation Therapists Rehabilitation Practitioners Neuropsychologist and Clinical Counsellor Volunteers Practicum Students

16 Rehabilitation Model COMMUNITY INTEGRATION PROGRAM ON-SITE Core rehab program 24 CLIENTS (A.M. TBI) (P.M. CVA) ACTIVE WAIT LIST POST DISCHARGE OUTREACH Calgary & Province wide 37 CLIENTS

17 On-site: Assessment to Program Implementation Assessment Client goals Personalized written program Demonstrated on DVD Chart developed Volunteers recruited Train the Trainer Intensive training and follow-up

18 On-Site Program Continued Program Coordinator s responsible for 8 clients and their team of volunteers/support workers Program Assistant provides direct client care Program Leader (PT) supervises program and supports team on daily basis 24 clients - Younger ABI: 5 am/wk Stroke: 3-5 pm/wk

19 On-Site Program Continued Reassessments: otbi - annual o Stroke 6 mo. Goals reviewed Team meeting No functional progress: transition planning Average Length of Stay: TBI: 4 yrs. Stroke: 3 yrs.

20 Volunteer Program KEY to success of program volunteers donated 8,000 hours 60+ volunteers weekly, 19 practicum placements Cost-savings of >$100,000/yr.

21 Outreach Program: Assessment to Program Implementation Modeled after On-site Program Assessment Written program Demonstrated on DVD Consistent person Place of residence or community setting 3-5x/wk.

22 Community Integration Assessment by RT Volunteer/leisure pursuits - Cesar volunteers once/wk. at SPCA caring for pets Group participation

23 CIP Group Programs Sensory Group: Psycho/social focus for clients who function at a lower response level

24 CIP Group Programs Not Too Serious Folk Group: Social and recreational activities for individuals with lower functional abilities

25 CIP Group Programs Music Therapy: Music therapist incorporates physical, vocal, cognitive and emotional aspects of therapy through music

26 CIP Groups Cont. Talking at your Leisure Group: Facilitated by RT and SLP Promotes development of communication and cognitive skills via recreational and social activities.

27 CIP Groups Cont. Leisure Skills Group: Leisure awareness, education/planning Facilitate independence and community re-integration

28 CIP Groups Cont. Horticulture Group: Clients take ownership for ARBI s outdoor garden from planning, planting (herbs, vegetables and, perennials) and harvesting the produce in the fall.

29 CIP Groups Cont. Wheelchair Curling Group: Four clients participate weekly in this fun, community based program.

30 CIP Groups Cont. Aquatics Group: Community pool provides an active, social and relaxing experience for participants

31 CIP Groups Cont. Stroke Group: Focused on developing leisure-related knowledge, attitudes and skills for stroke survivors Offers plenty of opportunity for practice in community settings

32 CIP Groups Cont. Sports Sampler: Provides clients the opportunity to sample several modified sports over the summer months

33 Funding Fundraising, events and restricted donations 48% United Way 18% GIK Prov. of AB 10% AB Seniors and Community Supports 23% Fee for Service 1%

34 Referrals % Health Care Professionals Families 92%

35 On-site TBI Demographics Average Age: Brain Injury: 33 Average Age Range: Brain Injury: Males: 25 Females: 8 At Admission At Discharge 13% 13% 13% 13% PCH Own Home LTC 27% Hospital 60% PCH Own Home LTC 61%

36 Traumatic Injury Origin % 7% 7% MVA Fall 13% 53% Sports Pellet Gun 13% Industrial Military

37 Changing Level of Disability Rappaport Disability Rating Scale at Admission to ARBI Date of admission

38 Our Outcomes

39 Outcomes At ARBI we help clients to regain quality of life and self-worth through: Increased physical mobility Increased and effective means of communication Increased ability to think clearly and make decisions Increased ability to contribute to their own health and well being through participation in stimulating, meaningful activities with family, friends and the community at large *** Individual outcomes vary depending on severity of injury

40 Outcome Measures Standardized Discipline Specific Assessments Outcome measures: Rappaport Disability Rating Scale Rancho Los Amigos Scale of Cognitive Functioning Chedoke McMaster Activity Inventory (Austoms, COPM) Satisfaction Survey

41 Rancho Los Amigos Score Admission to Discharge Rancho Los Amigos Scale (I-10) ADMISSION DISCHARGE

42 Rappaport Disability Rating Score Admission to Discharge Rappaport Disability Rating Scale (30-0) ADMISSION DISCHARGE

43 Chedoke-McMaster Activity Inventory - Admission to Discharge Chedoke McMaster Activity Inventory Score (0-100) ADMISSION DISCHARGE

44 Transitioning traumatic brain injury clients from Care Facility to Community Place of Residence on Admission to ARBI Place of Residence Currently 25% 12% 75% 88% Care Facility Home in Community

45 Community Participation Admission to Discharge Community Participation- Average Times per Week ADMISSION DISCHARGE

46 Community Participation Admission to Discharge Community Participation- Average Times per Week ADMISSION DISCHARGE

47 Our Report Card Progress Towards Goal Achievement, Summary Average Scores On-site Clients Satisfaction Survey 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Category: 84% My physical goals 72% My cognitive goals 76% 76% My communication goals My social interaction goals

48 What Our Clients Say - Satisfaction Survey

49 Impact ARBI has on Quality of life 1 Low Impact Significant Impact

50 New Initiatives CAMMRI - Comprehensive Assessment Measure for Minimally Responsive Individuals SaeboFlex Pilot Project Mirror Therapy Pilot Project

51 Grade 11 Honour roll Athlete Lots of friends Dave s Story

52 MVA 2005 Dave s life changed in an instant

53 Dave s Rehab at ARBI The best thing about ARBI is the people! They help me work to become more independent.

54 Dave Today

55 Carla s Story

56 Rehab at ARBI On-site program Carla s Goal: To walk without her walker

57 Carla Today The grand essentials of happiness are: something to do, something to love, and something to hope for. Allan K. Chalmers

58 Kylan - A Survivor s Story On ARBI s website:

59 THANK YOU! Contact Information ARBI: (403)

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