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Mirror Images May Assist the Brain During Rehab
The Heart and Stroke Foundation reports from this year’s World Stroke Congress that using a mirror during therapy may support the brain’s efforts to recover from stroke.
Japanese research shows that a mirror placed between the legs of patients during rehab exercise helped increase the speed of leg-lifting activity up to 12%. They suggest that the mirror image may “trick” the mind in some way, helping to support physical recovery. (Story)
Brain Interface Making Speech Recovery Possible
Erik Ramsey suffered a brain stem stroke nine years ago, leaving him almost totally paralyzed. But thanks to an implanted electrode, some software and a collaboration, Erik is learning to talk again. The software interprets signals from Erik’s brain to his vocal tract as he attempts to make sounds, translating his thoughts into sounds. He can hear his voice in real time, providing him feedback on his pronunciation, helping him to hone his speaking skills. According to an article in New Scientist, over the course of just a few weeks he improved his speech accuracy from 45% to 80%.
The “brain interface” is collaboration between a Georgia company, Neural Signals and a research team at Boston University. It currently works best with vowel sounds, and improvements are needed to better articulate consonants as they require more coordination of the body’s vocal system.
Early and Frequent Mobility Keeps Depression at Bay for Stoke Patients
Post stroke depression is a major concern to patient and family, but it also is associated with less participation in therapy and a poorer rate of recovery.
Dr. Toby B. Cumming at the National Stoke Research Institute in Australia tested the impact of early mobilization on stroke patients. On average their study group was up and mobilizing within 18 hours after the stroke (the standard care group wasn’t mobile until after 30 hours). The early results of Dr. Cumming’s study shows that increased physical activity in the days immediately after a stroke has a positive effect on patient’s general mood, leading to more effective rehabilitation and recovery. (Reuter’s story)
Understanding “Spreading Depression” in Brain Neurology Key to TBI Treatment
Researchers at the University of Cincinnati are leading a $2 million research project, focusing on a brain injury phenomenon called “spreading depression.” Spreading depressions are electrical failures in the brain’s neural network activity that spread beyond the initial injury site to other parts of the brain. As many as 60% of brain injury patients experience this phenomenon.
Researchers are trying to determine over how long a period spreading depression continues after injury. This is key information for early brain injury treatment because as these electrical disruptions spread, they cause increased tissue death or damage due to of the loss of blood and oxygen to those affected areas. Understanding spreading depression will help in developing early TBI treatment.
The research is being funded by the U.S. Department of Defense as a large number of Iraq and Afghanistan war veterans are being afflicted by brain injury. (Story) The DOD has also recently awarded a $60 million grant to the University of California, San Diego to study TBI and its relation to post-traumatic stress disorder.
TBI Sufferers Show Significantly Lower Empathy
The Brain Blogger points to a recent study in the Journal of International Neuropsychological Society that shows that 61% of sufferers of traumatic brain injury exhibit low scores on the Balanced Emotional Empathy Scale (BEES), meaning they had less ability to empathize with others. The study seems to indicate that the low scores were not influenced by the severity of the brain damage, suggesting that even mild TBI can have lasting effects and that TBI interrupts general social cognition.
It’s interesting to note that almost simultaneously the University of Michigan has found in a recent study there that nearly one out of five delinquent youths suffer from some level of TBI. The question comes to mind, could a decreased level of empathy in TBI patients be related to the increased delinquency among youth who have some form of TBI?
Inside our warm, home-like (yet highly specialized rehabilitation) Fresno CareMeridian facility, we’re proudly caring for some of our country’s veterans.
About one year ago, the Veteran’s Administration contacted us to assist them in caring for some of their most medically complex veteran patients. We of course welcomed this opportunity to serve with open arms. Plus, it made such perfect sense.
The VA approached us because CareMeridian has in place the knowledge
and high quality medical care programs for the very specialized care
that their brain injury, spinal cord injury, tracheotomy, and
ventilator-dependant patients require.
The VA is treating more than 200,000 patients from the wars in Afghanistan and Iraq alone. Many of these are brain-injured – a class of injury about which the VA is admittedly struggling to become more knowledgeable. CareMeridian has a long history of exactly the type of specialized, long-term care such catastrophically injured patients require.
The VA hospitals are top-notch in acute care. They also excel at all aspects of limb injuries, rehabilitation and prosthetics. This is because, until very recently, these have been a major source of injury for vets. The VA over the years has perfected their ability to provide these types of treatments. But today, with the impressive advances in immediate post-injury and acute care, soldiers are surviving injuries they may not have just a few years ago – and that can mean some soldiers require very specialized long-term care that the VA is now working hard to be able to provide on a broader basis.
In working with the VA on our partnership, it became clear that even though we provide this care in small, highly staffed (4-1 patient to care-giver ratio), 12-bed facilities for personalized care, CareMeridian was able to deliver these services at about ½ the cost that the VA could provide them.
All in all, this means better care for our vets – and for their families. Certainly our entire focus on caring for such specialized needs in an intimate environment - that allows for including the family in the care day-to-day - is a primary benefit. But, because families may also be faced with certain co-insurance payments, our cost-effective care means their co-payments are less as well. And by placing the appropriate patients within our skilled facilities, the VA in turn has more beds at their facilities to allow for better care for other veteran patients.
We’re proud to be supporting the VA in their efforts by currently providing two types of services for our vets. We’re caring for those that require round-the-clock skilled nursing, such as IV, tracheotomy, ventilator and other catastrophic injury therapies; as well as those needing neuro-behavioral therapies, community integration, and caregiver training.
CareMeridian stands ready to support our troops in our own, very unique way.
One of the foundations of our patient care for spinal cord injury - and of our philosophy at CareMeridian - is patient community integration. It differentiates our care from most other rehabilitation facilities and programs. We emphasize sustaining rehabilitation into the community setting – beyond the hallways of the rehab facility.
Unlike catastrophic illness such as brain injury, functionality and mobility are key to spinal cord injury recovery. Helping a patient to accomplish everyday tasks in their normal environment means they can achieve greater independence and enjoy daily living.
Traditional recovery often focuses almost completely on physical rehabilitation, which is of course a critical element of healing. However, community integration also addresses the equally important, if traditionally under emphasized, aspects of independence, friendships, family relationships and participation in activities.
Technically, community integration is defined as the resumption of appropriate social roles following a disability. So work, a social network, recreation, along with physical rehabilitation is what truly supports holistic healing and allows the individual to feel part of the larger community.
Knowing the importance of community integration, a part of our spinal cord rehabilitation includes teaching patients to navigate daily activities, such as shopping, going the gym or enjoying an outdoor activity. But because family becomes a critical source of social and recreational activity for an SCI patient, we also help families to assist patients and encourage them in interacting with their environment in ways appropriate to the individual and his or her injury.
Home is the central touch point of community. It is why CareMeridian’s facilities look, feel and function like a family home, yet are highly skilled environments for aggressive rehabilitation. Healing the whole person is always at the forefront of our programs, and we believe our commitment to community integration is a factor in the high degree of positive outcomes for our patients and eases the transition from rehab to home.
Life in our facilities follows the rhythms of every busy and growing family. It seems we’re always celebrating the seasons, honoring wedding anniversaries, and hailing birthdays. Sharing them makes them all the merrier:
Santiago Canyon Facility
On May 8th we celebrated Linda’s birthday. She is the beloved-by-all wife of resident Joe. For two years she has been a regular presence at the Santiago facility visiting with and participating in therapy with her husband. She always has comforting and encouraging words for Joe as well as with other families and residents. She is kind, loving, patient, helpful and in addition to all of that, she is a wonderful baker! She spoils all of us at the Santiago facility with delicious cakes and treats on a regular basis!
Oxnard Facility
On June 1, we celebrated the summer season with a beach outing! Here are a few photos we took along the way:
Cowen Heights Facility
Along with the Spring came family and friends to celebrate the season and join in on the performance of the Golden Celtic Dancers, who visited us for the 10th year!
And we had an extremely special visit from former patient, Amanda, who brought her new baby to visit us!
Sacramento
Our Easter egg hunting tradition is always fun. Patients, family, friends and staff all had a good time in our big backyard hunting for real eggs and chocolate, of course!
Patient Michael H celebrated a very special birthday - his 16th.
Las Vegas
Not something that happens everyday, but when it does it is quite the affair! We had a prom for resident Sherril M!
Fresno
Patients and staff are excited to celebrate moving into our remodeled Fresno facility. Here’s a peek:
La Habra Heights
CareMeridian La Habra has turned into a hub for grooving grandmas. Three of our staff members are all expectant first-time grandmothers this summer. The new arrivals will bring numbers to five grandmas and one great-grandma! We have certainly shattered the image of gray haired grannies in rocking chairs!
While our residents are working every day to recover from traumatic brain injury, serious spinal cord injury or other catastrophic illness, the joys and celebrations of life still accompany them and are a very integral part of their life and care here at CareMeridian.
We just must share a joyful update on “our little CJ.” She’s now at home with her family. We at CareMeridian had the great privilege of helping her get back there, where she belongs.
You see CJ was just 10 years old when she suffered a stroke. Such a very rare catastrophic injury in one so young.
CJ was in a coma, only very minimally responsive to any stimuli. Treating doctors at the hospital gave the family virtually no hope for CJ’s recovery.
CJ’s insurance case manager requested that Children’s’ Hospital Central California contact CareMeridian to evaluate CJ and make recommendations. CareMeridian staff evaluated her while she was in the hospital, and she was soon transferred to our San Martin facility for rehabilitation and home-like care.
During the 2 months CJ was with us we all worked hard; CJ, Mom, family and the entire San Martin team. With expert care, specialized therapies, dedicated staff and loving support, CJ went from almost no response and no ability to eat, walk or talk, to awareness, managing self care tasks and becoming mobile.
It was a happy day at Care Meridian when we saw CJ headed back to Children’s’ Hospital Central California Acute Rehabilitation Center. She still had work to do, but she was ready to continue her recovery outside the enveloping shelter of CareMeridian.
Today, her Mom told us she is growing and continuing to improve. She is now going to a specialized school and able to feed and dress herself and walk with the help of a brace.
CJ’s mom shared words we love to hear: that she knows the care she received here at CareMeridian was the best anywhere and she credits us with CJ’s recovery.
We couldn’t be prouder of “our little CJ.” And, no matter where she goes, she will always be a member of the CareMeridian family.
The hope and realities of TBI are getting more attention than ever before, unfortunately because so many of our soldiers are returning home with brain trauma. Some of their brain injuries are unseen - and even undiagnosed for long periods of time - and others bear the striking physical scars.
Doctors are declaring traumatic brain injury the signature wound of the Iraq war. TBI is getting this distinction partly because armor is vastly improving, helping troops to survive once-deadly explosions, but it cannot protect the brain against many of the very serious concussive injuries suffered inside the head from the force of the blasts. In some cases TBI is an “invisible wound.”
The television network ABC aired a special report recently both by and about reporter Bob Woodruff who suffered massive head injury last year while in Iraq covering the conflict. By all accounts Mr. Woodruff has made a miraculous recovery, although he admits his recovery is a continuous process. The report introduced those who may not be as familiar with TBI as we are here at Care Meridian to the journey it requires to recover, and to the inspiring hope for recovery expert care can provide.
The reality is the outlook for TBI is vastly influenced by both the immediate care and the on-going therapy sufferers receive. Sadly, ABC’s story also revealed not all our soldiers are yet getting the high-level extended care they need for optimal recovery. The Veterans Administration is struggling to cope, keep up and to provide better long-term TBI care.
Something we know intimately at Care Meridian is that traumatic brain injury recovery involves not only intense physical and neurological rehabilitation, but the emotional, psychological and spiritual aspects of a person as well. Secretary of Veterans Affairs, R. James Nicholson has said that TBI patients “need a combination of psychiatric, psychological and physical rehabilitation that can be difficult to coordinate in a traditional hospital.”
TBI can often be misunderstood and requires specialty and focused, expert care. The stories of our returning soldiers are as unique as the individual, and their recoveries will be as well. We at Care Meridian salute them.
There is a lot of information – some would say too much information – out on the Internet about traumatic brain injury, spinal cord injuries and other similar post-acute care challenges. Sorting through and making sense of it all is a Herculean task it itself.
You will find some great information on our site for families, medical professionals and payors. But if you are looking for other resources, here are some links we’d like to share. If you have other sites or sources you would like to share just let us know!
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