December 29, 2006, 1:56 pm

Geriatric Brain Injury Care: The Gaping Hole in Care

Lately, I’ve been receiving a large number of calls from individuals hoping to find care for their aging parent who has recently sustained a TBI. Usually, they’re looking for a place that caters to specific issues that senior citizens face, and I’m usually the one that breaks the news to them: there aren’t many places that understand the needs of elderly TBI patients.

In many cases, elderly TBI patients are often resigned to skilled nursing centers that don’t offer any of the brain-building therapies that are crucial to neurological rehabilitation.

So what’s a person to do? My advice is to do a thorough assessment of the patient’s needs. If the patient requires more physical therapy, look for a center that has a bustling PT program and lots of community-oriented therapies. If the issues are more cognitive in nature, consider a facility that has a healthy blend of occupational, vocational, and speech therapies. Make sure you ask important questions critical to aging patients: Is there a hospital nearby? What kinds of specialists will look after my mother or father? Do any of the physicians have experience working among geriatric populations?

In a pinch, pick up some rehabilitation basics, like the kind offered through the Brain Injury Recovery Kit. No matter what people tell you, keep in mind that brain injuries, even if they occur in the golden years, are treatable.

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December 21, 2006, 9:18 am

So much depends on a traumatic brain injury.

Think that the term “brain injury” doesn’t carry a stigma? Think again. Recently, Senator Johnson of South Dakota has been making the headlines for a “stroke-like” event that has left him with some level of cognitive impairment. It’s creating some serious political fallout, of course, but I think it’s interesting to have a look at how the media is portraying this.

When I searched for “Senator Johnson” and “Stroke” through Google’s news service, I found 921 articles. Although a stroke is an injury to the brain, when I googled “Senator Johnson” and “brain injury,” I received ZERO returns. When I searched for “senator” and “brain injury,” I received 10 articles, not all of them dealing with Johnson.

While the Iraq war is helping to create awareness about TBI, the media needs to be clued in to the fact that brains get injured here on the home front as well.

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December 11, 2006, 1:40 pm

Numbers from the Iraq War

Last night I spoke to Gerry Grant, who served as a neurotrauma surgeon in Iraq. I was telling him about the trouble I’d been having digging up numbers on the Iraq War, and he commented that it was no surprise to him. I’ll leave readers to decide the context, but Grant also raised a good point about medical costs.

A few weeks ago, 60 minutes aired a special on wartime medicine, and one physician commented that a soldier had gone through a million dollars worth of treatment in little more than a week’s time. It’s a likely figure, but it’s hard to actually prove. What would it cost to pay for ten surgeons to give you emergency service simultaneously? What would it cost to load an entire intensive care unit onto a massive cargo plane? What would it cost to build a computerized system capable of fashioning a new skull for you? Because the dollars in military care are aggregated, it’s difficult to come up with a solid number.

Same thing goes with body counts. Click here to read a good article on that complexity.

The real costs, I’m afraid, are going to be on the backs of the survivors themselves and the communities that attempt to support them. With healthcare premiums ballooning and average care of TBI patients exceeding 5 million dollars over the course of a lifetime, we only commit a grave disservice to our soldiers if we continue to ignore the issue.

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December 4, 2006, 10:03 am

TBI Can Occur Before Direct Contact

Researchers at Sandia UNM laboratories used complex tomography scans to reveal the brain injury can occur before the head comes into contact with an object. The pressure from the motion alone can cause diffuse injuries throughout the brain:

“In discussions between Taylor and Ford, it became apparent that different types of cell damage might occur depending on the type of stress to which the cells are exposed. “Isotropic stress,” commonly called pressure stress, imposes density changes that can damage a cell’s internal structure. “Shearing stress” acts as a tearing mechanism that damages the cell wall and membranes, giving rise to apoptosis, or cell death. Both are likely at play in most incidents leading to TBI.”

To read the entire report, click here.

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