My name is Dr. Bryan Weinstein. I am a board-certified psychiatrist specializing in the pharmacological and rehabilitative treatment of people with traumatic brain injuries. I see over 100 brain-injured patients every week and am privy to the tragic details and consequences of their injuries.
After an injury, my patients tell me that the world looks different to them – and sees them differently too. Allow me to employ a mental exercise to share their perspective with you:
Imagine that you wake up one morning to discover that you are in a foreign country. Everyone – including your friends and family – speaks a different language. Their language is as incomprehensible to you as yours is to them. Beyond learning the language, you now have to become culturally competent in your new home country.
Now imagine that you just enjoyed a dinner with friends and had one too many drinks. You stumble into an Uber and are chauffeured home. You wake up in the morning and realize that not only did you fail to sober up – you never will. You will continue to be disoriented, dizzy, off-balance; impulsivity and dis-inhibition will define your behavior; your affect will alternate between inappropriately jovial and incongruously aggressive. Absent your normal inhibitions, you say and do things with no insight into your own behavior (Let alone the ability to regulate that behavior!).
Take a moment to mentally fuse both scenarios. Now picture this state lasting for a minimum of two years. Or even the rest of your life. Your loved ones may attempt to care for you, but it isn’t long before your behavior alienates both family and friends. Maybe even your children. You can no more hold a job than you could wish yourself better. You find yourself isolated, inconsolable and without immediate access to your usual emotions, memories and coping skills.
This may sound like a nightmare, but the reality is that there is a very real possibility of a head injury turning into a lifelong disability.
Every day, we casually enter a nearly 5,000 pound vehicle and drive between 40 and 80 miles per hour while talking on the phone, texting, adjusting the radio or simply pondering the events of the day. We share the road with thousands of other drivers caught in these same moments of distraction. On some roads, oncoming traffic is separated by a single yellow line – when a vehicle strays across it, tragedy ensues.
You may think the potential for a crash is low, but how often have you heard the phrase, “I never thought it could happen to me?” I hear it dozens of times each week. As long as you drive a motor vehicle, you and your loved ones stand a chance of becoming victims.
You don’t have to suffer a catastrophic accident to acquire a brain injury. Experiencing rapid deceleration can cause your brain to slam into the front and back of your skull – this is called a contrecoup event and is one of the most common injuries resulting from an auto accident. Even minor injuries can damage billions of neurons and effect large parts of your brain.
A bruise to your brain can have devastating implications. Unlike most physical injuries, a trauma to the brain is invisible – which makes it extremely unlikely that you will be afforded any sympathy for the behaviors we discussed earlier. Instead, you will be held responsible for your behavior. You will become a victim of your brain’s inability to function properly. You may become a pariah, a social outcast unable to relate and unable to have other people relate to you. Soon, you enter into a world of pervasive loneliness.
That’s more, the brain does not heal in a predictable fashion. Symptoms may vanish within six months or last a lifetime. The severity of a brain injury bears no correlation to the length of recovery time. Even a minor fender bender with no visible physical injury can result in behavioral and cognitive deficits that have profound social and occupational consequences.
As a medical student, I was taught that the best moral compass for compassionate patient care was to treat patients as I would members of my own family. It’s no easy feat for any of us to understand what a person is feeling after a traumatic brain injury. However, it is incumbent upon all of us – whether a medical provider or loved one – to at least make the attempt. When we’re able to step into the shoes of a survivor, some things certainly do become clear. People with brain injuries want:
Note: This content was updated in February 2017. Some of the apps from the original post are still listed; however, we’ve found many more that can be extremely helpful…
We know what you’re thinking: don’t people with a traumatic brain injury have enough to relearn without training in new smart phone technology? Our answer: Yes and no. Yes, absolutely, which is why the apps we recommend are meant to complement existing therapies and programming. No, because the more frequently the mind is exercised, the greater the possibility of neuroplasticity rewiring the brain to be more functional in the future.
Technology today is working harder than ever to improve our lives. There are literally hundreds of apps for people with brain injuries and similar problems. We have selected these apps because they build on the day-to-day needs of an individual living with a TBI. We focused our research on these areas:
Specifically, these apps help clients work on the following: short-term memory loss, communication/socialization problems, anxiety, behavioral and organization issues.
Free with $1.99 Upgrade Available (iOS)
(Android Counterpart: Lists Alarmed!)
Alarmed augments short-term memory while the user is rebuilding his or her own. A productivity app for the masses, people with traumatic brain injuries can use Alarmed to create multiple reminders with unique, memorable tones for each task. Reminders can be customized with a “To Do” list and send multiple email reminders/updates. This app also comes with a timer to assist in programming.
Cozi Family Organizer
Free (iOS & Android)
Families can stay in sync on multiple platforms using this app that combines a shared calendar, shopping and “To Do” lists. With everyone on the same page, organizational skills are enhanced and frustration diminished.
Free (iOS & Android)
EverNote helps improve memory, organizational skills and even creativity by syncing ideas on multiple devices. The user can take notes, capture photos, create “To Do” lists and record voice reminders. The searchability function can be a tremendous boon for those with short-term memory loss.
Productive Habits and Daily Goals Tracker
Free with In-App Purchases (iOS)
(Android Counterpart: Habitizer)
This app helps users develop positive habits in their lives by keeping them organized, tracking their progress and maintaining motivation. It allows users to set the habits they want to develop and receive reminders when tasks are to be completed. Users can color code these based on the priority or category of the habit. This app can also allow a therapist or caregiver to set priority levels for each task.
Free with In-App Purchases (iOS)
(Android Counterpart: Luminosity)
Brain HQ tailors a training program for each persons’ unique mind. Therapeutic exercises are personalized based on performance and can help improve cognitive skills. Exercises are designed to improve attention, memory, people skills and navigation.
Brainscape - Smart Flashcards
Free to $9.99 with In-App Purchases (iOS & Android)
Pick a subject from geography to vocabulary-building and Brainscape has a set of smart digital flashcards. What makes these flashcards so smart? Besides being color-coded to aid recall, users are asked to indicate prior knowledge of the answers. Questions the user did not understand or answer correctly are repeated more frequently than those answered correctly.
Free for 30 Days (iOS & Android)
Constant Therapy is a speech therapy app for individuals who are looking to increase their cognitive abilities. This app is scientifically proven to improve speech, memory, cognition and comprehension skills. While this app can’t take the place of therapy, it is a great way to augment existing treatment by completing progressively challenging tasks right from your very own phone.
Spaced Retrieval TherAppy
(Android Counterpart: Spaced Retrieval)
Spaced Retrieval is a scientifically-proven way of improving recall of names, facts, the routines of several people and more. People with brain injuries can rehearse memory skills by recalling an answer over expanding intervals of time (1, 2, 4 or 8 minutes) that helps to cement the information in their memories. Please note: this app is not intended for use without therapy.
$1.99 (iOS & Android)
For non-verbal clients, this app utilizes two large, color-coded buttons, green for “Yes” and red for “No”. When either button is pressed, the app vocalizes the client’s decision. This is a wonderful tool to help those with a brain injury or speech problem communicate without a struggle.
Free (iOS &Android)
Audible is for individuals who love a good book but are having difficulty reading, retaining information or who simply enjoy closing their eyes and having a good book read to them. With Audible, users do not have to give up their literary passions, they just have to listen. This app is also compatible with Amazon, so books can be downloaded right from your account.
Clear Record Premium
Price ranges from $.99 to $1.99 (iOS) depending on upgrades
(Android Counterpart: AndRecord)
This audio recording app allows the user to record conversations in practically any environment and play it back at the speed and volume of their choosing. Unlike many other voice-recording apps, Clear Record Premium filters out ambient sound to ensure pitch and clear voices.
Free (iOS & Android)
Speak and this app will recognize the users voice and transcribe what they say into text messages, emails and even update social media. Dragon Dictation is a perfect mass media communication tool for anyone with a physical limitation.
Type ‘n Talk
(Android Counterpart: Type and Speak)
This app is incredibly useful for non-verbal individuals and other individuals who have difficulty with speech due to physical limitations. Type ‘n Talk allows the user to type what they need to say and their verbalized audio will play through whatever device is being used. This app also allows the user to copy text from websites and messages and provides a variety of languages.
Pocket Verbal Ability
Free (iOS & Android)
Users can increase their vocabulary with this user-friendly vocabulary app. Pocket Verbal Ability asks questions that will help prepare for job interviews, exams, and day-to-day life.
(Android Counterpart: Talkingtiles)
This app includes the most common topics in the functional social skills system for people with brain injuries to model for appropriateness. Topics include the following: meeting/greeting people, taking responsibility, being polite, joining others in groups, apologizing/excusing self, following directions and handling criticism. Users watch a brief video of a person performing the correct behavior for the social situation and can then pattern their own behavior accordingly.
Free (iOS & Android)
For anyone who could use a time out to relax, Breathe2Relax has been proven to help mood stabilization and control anger and anxiety. Users should simply indicate their level of stress and follow the audio instructions to breathe their way back to serenity. Essentially, this app provides on-site audio diaphragmatic breathing exercises.
Free (iOS & Android)
WeFeel is a mental health app that users can use to track their emotions and monitor how they change over time. This app can help manage emotions by allowing the user to visualize their anger, fear, stress, etc and then offer coping strategies. With a subscription, a counselor, therapist or caregiver will be able to monitor the users recorded emotions in real time from their own smart phone.
In Case of Emergency
$1.99 (iOS & Android)
This app allows people to store their medical information in a single location that is convenient for medical personnel in the event of any urgent situation. This app can also use to locate the nearest hospital.
All apps labeled iOS can be found at the Amazon.com: Apps & Games. Apps for Android can be found at either Google Play or the Amazon App Store for Android.
Since this is by no means an exhaustive list, we are always working to improve and add to it. We would love to hear from individuals with a traumatic brain injury and their physicians and caregivers about which apps they use.
Since the NFL concussion scandal broke three years ago, public awareness of traumatic brain injury has increased exponentially. The long search for efficacious treatments is becoming public knowledge as TBI awareness reaches new audiences. From how kids play soccer and football to treating co-occurring disorders to new diagnosis methods and dietary considerations, 2016 has been an important year in the brain injury field.
Below is our list (including references) of 25 facts we’ve learned about traumatic brain injuries in the past year:
There are certainly other facts that have been introduced into the body of traumatic brain injury knowledge this year…feel free to share them below.
Traumatic brain injuries can happen to anyone, but when they affect an older individual, the effects can be life-altering. Caused by car accidents, violent injuries, falls, or blows to the head, traumatic brain injuries don’t always leave visible scars and could therefore go untreated for a period of time. However, they can cause memory loss, physical and cognitive changes, and mood and concentration, meaning behavior can drastically change as well.
It’s important to take very good care of yourself following a brain injury, and while there are obvious activities you should avoid, there may be some that you haven’t considered. Taking precautions and treating your body well will ensure that you cope with the injury effectively and learn to live with it day to day, which is necessary in some instances where the injury presents itself long-term.
Here are some of the best wellness tips for living with a traumatic brain injury.
It may seem like a small thing, but taking care of yourself will go a long way towards healing. That means getting enough sleep every night, eating well-balanced meals, and getting (gentle) exercise daily. Ask your doctor when you can expect to engage in physical activity before starting any fitness routines and make sure that when you’re ready, you start gradually rather than jumping in. Even if you feel energized, it’s not a good idea to go too fast following a brain injury. Do not engage in exercise that includes contact sports, as this can lead to further injury.
Because drugs and alcohol affect the brain in different ways, it’s best not to drink or consume any drugs other than your prescribed medication while you’re recovering. Even a glass of wine with dinner could be harmful to your healing. If you enjoy drinking socially, ask your doctor when you might be able to continue doing so. Be careful even with your prescribed medications and don’t take them more than instructed. Addiction is very legitimate threat to seniors, particularly for pain medications.
Ask for help
You might be eager to prove to everyone that you can take care of all the things you once did, especially if you had a long recovery in the hospital. However, it’s best to refrain from doing physically demanding chores, such as cleaning the house or gardening, or engaging in activities that require a lot of focus. These things can do more harm than good and can slow down the healing process.
Keep a journal
Some victims of traumatic brain injury report that they have trouble remembering things or focusing on more than one task. Do not try to multi-task; rather, engage in one thing at a time and go slowly if you need to. Keeping a journal, or even a small notebook on the kitchen counter or next to your favorite chair, will help your memory if you use it to write down to-do lists and phone numbers.
Remember to reach out to friends or family if you feel overwhelmed. You may think that asking for help makes you burdensome, but for the people who love you, it’s a simple thing to drop what they’re doing and give you assistance.
Thanks to ElderAction.org for writing this post. ElderAction.org is a website that Caroline James and her husband put together to help elderly caregivers like themselves do better in making our beloveds enjoy life.
Imagine that your work day has just ended. You leave the office feeling good. In your car, you roll down the windows and let the sun warm your face. The next thing you know, you wake up in a hospital bed…and a month has passed. The doctor at your bedside cautiously explains that you received a traumatic brain injury in an auto accident. You try to ask a question, but the words won’t come out of your mouth. After several attempts at communication, you’re exhausted and fade in a restless sleep. The months that follow are filled with what seems like every type of therapy in the book – you have to learn to speak, walk, eat and organize your thoughts all over again. Your life is upside down. You still feel the weight of your responsibilities. You want to work and support yourself (and your loved ones) again. Your desire for independence rules your thoughts, visions of life before your accident haunt your dreams.
Everyone agrees: life after a brain injury can be as traumatic as the injury itself. Many people choose to isolate themselves. Others do their best to pretend that nothing has changed, that they are still the same person post-accident. Still others seek out solution after solution until they find an accommodating neuro rehab program. In these ways and many others, the brain-injured people are expressing the one thing they all have in common: they want to be productive members of society again. And that means working.
So what sort of employment is available for someone with a brain injury? (Or for anyone else with a disability, for that matter?) The answer depends on the severity of the injury. Our goal at Life Skills Village is to help our clients reach their maximum level of functionality in every area of life – including the vocational. We offer several levels of vocational rehabilitation for our clients:
A sheltered workshop is a safe environment where, people with brain injuries can work without fear of losing their job for health or behavioral reasons. Clients are paid to perform simple tasks such as stuffing envelopes or washing clothes. Life Skills Village takes an altruistic approach to the Sheltered Workshop. Everything our clients do benefits the southeast Michigan community. Whether it’s collecting, washing and sorting clothes before we donate them to a veteran’s organization or assembling hygiene kits and distributing them to the homeless – we believe our clients should see the good they are capable of doing for others.
This may be the best employment option for someone with entrenched behavioral problems following the head injury.
Supported employment or, as we call it at Life Skills Village, the Work Re-Entry Program, is for people with brain injuries who have expressed employment as one of their highest priorities. Our therapists work with the client to prepare a resume, learn and rehearse interview skills, dress for success and will even attend the interview. We also work directly with the employer to coach them on ways to work with someone who has a head injury. Very often, a job coach accompanies the client to work. The coaches stay on as long as the client and employer feel that their presence is necessary.
What kind of work can people with brain injuries perform? Depending on their level of function, people with a TBI can do anything, including but not limited to:
Employers have every incentive to participate in our Work Re-Entry Program, including limiting the cost of hiring a new employee and helping disabled people rejoin the community.
This is a relatively new concept that we’ve been developing at Life Skills Village. We define a micro-business as a business than can be operated by one or two people. For example, we recently launched “Good Brains Packaging,” which weighs, bags and labels coffee that is then purchased for distribution by marketing companies. We have another client who plans to launch a T-Shirt company that promotes a positive image of people with brain injuries. Most of these micro-businesses are housed in the “Nine-to-Five” room (we also refer to it as the “voc room” or the “microbusiness incubator) at Life Skills Village.
Competitive employment happens when a client is paid directly by the employer and no longer require a job coach. However, brain injuries are capricious and can cause debilitating symptoms even years later. That’s why Life Skills Village offers “The Academy.” This post-discharge support program means a client can return to our program to speak to a therapist for advice on overcoming a challenge on the job (or any other problem).
Life Skills Village offers a Sheltered Workshop, Supported Employment Program and Micro-Business Development programs to our clients. Just in case you aren’t within driving distance of Oak Park, Michigan – we have included several useful websites below that are designed to help people with disabilities work from home. You can find our current list below or periodically check for updates on our Resource Links page.
Job/Resume Assistance for disabled
ADA & IT Technical Assistance Program (ADATA) - Disability and Business Technical Assistance Centers
APSE: The Network on Employment
Formerly the Association for Persons in Supported Employment
Big Tent Jobs.com
Specialize in jobs for people with hidden and visible disabilities.
Customer Service and Transcription Jobs
Digital Marketing Jobs
Freedom to Work Web Site
Goodwill Industries International, Inc.
IT Career Guide
Job Accommodation Network (JAN)
Michigan Department of Licensing and Regulatory Affairs - Michigan Rehabilitation Services
Michigan Department of Career Development
Michigan Employment/Disability Resources
Michigan Rehab Services
Occupational Outlook Handbook – Bureau of Labor Statistics
The Riley Guide
Social Security Employment
Social Security program for people on disability who want to return to work without losing Medicare benefits.
Specializes in legitimate work from home opportunities
Traumatic Brain Injury Facts: Vocational Rehabilitation and Employment Services
VCU Rehabilitation Research and Training Center on Workplace Supports and Job Retention
When we hear the words “Tai Chi,” it's easy to envision an action-packed battle between strong, agile fighters. We may reflect on the history and intense training linked to the ancient martial art. Some may think back to the cheesy Kung Fu movies of the latter 20th century. A rare number of us, however, will associate Tai Chi with what it really is—a therapeutic and beneficial practice that promotes improved cognition as well as physical and psychological health.
Tai Chi is an ancient Chinese meditative practice that was originally developed to promote self-defense and inner peace. There are a few different styles of Tai Chi (the Chen style, Yang style, Wu style, Hao style, and a combination style) but the practice predominately focuses on slow, deliberate movements, breathing techniques and flowing motions. In recent years, Tai Chi has gained popularity due to numerous research studies touting its health benefits. Because it is a slow-paced and low impact form of exercise, Tai Chi is a great activity for beginners, older adults, people with health concerns...and, as we know at Life Skills Village, it's ideal for people with brain injuries.
Tai Chi for Traumatic Brain Injuries
A traumatic brain injury impacts an individual's brain as well as their body and the way it functions. Damage to the brain may result in a cast constellation of symptoms including a loss of balance, coordination and physical movement. Fortunately, Tai Chi helps with circulation, alignment, balance, coordination and muscle control. The slow speed and precision of each move allows individuals to practice their balance and coordination without overstraining their joints and muscles.
When someone receives a traumatic brain injury, they often experience major emotional changes such as mood swings, depression, anger and anxiety. A recent study of Tai Chi shows short-term benefits including “decreases in sadness, confusion, anger, tension, fear” and “increases in energy and happiness.” There is also evidence of improvements in mood and self-esteem. Beyond the physical and psychological benefits, Tai Chi also improves cognition by boosting memory and, according to one study, even increases brain volume. This is especially significant since brain injuries may lead to a loss of memory, learning, reasoning, processing speed, judgment and concentration.
Tai Chi at Life Skills Village
At Life Skills Village Center for Brain Injury Rehabilitation, we offer two daily sessions of Tai Chi for our traumatic brain injury clients. Our therapists challenge their memory and recall of each Tai Chi move. Examples include "Play Guitar" and "White Crane Spreads Wings and Flies"[See Attached Video]. During these sessions, the self-defense application of each move is discussed and nicknames are given to certain moves in order to help with recall. Through constant repetition and memory tactics like association, clients are able to work on their cognitive skills. At the same time, they experience the physical, psychological and therapeutic benefits of Tai Chi.
Patrick, a client at Life Skills Village, has come a long way since the accident that led to his traumatic brain injury. As a Tai Chi devotee, Pat has 26 out of 108 moves memorized (the average is 5-15 moves)! He even practices at home to improve his memory. To Pat, Tai Chi means more than working on his cognition and memory skills:
"It's really good physically—calms you down and works your muscles and balance and everything—and that's all really important. But for me it's more of a therapeutic form of relaxation. It's the one time out of my day where I can focus on something and not worry about things. It allows me to take a step back, take life a little slower and really be mindful of everything around me and of what I'm going through and the things I'm doing.”
Pat continues to practice Tai Chi regularly and encourages others to try the meditative practice.
Feel free to comment and share your own experiences regarding Tai Chi or any other therapeutic exercises.
Neuro trauma can completely disrupt the way a person feels, thinks and behaves. Whether it’s from a mild concussion, severe traumatic brain injury, stroke or aneurysm – neuro trauma causes a wide variety of deficits including long and short term memory loss, impulsivity, mood swings and many other social, cognitive and behavioral issues. Two of the most commonly recommended treatments also happen to be the most commonly mistaken for each other: Cognitive Behavioral Therapy (CBT) and Cognitive Rehabilitation Therapy (CRT). So, what’s the difference?
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy is effective for treating a variety of conditions such as mood, anxiety, personality, eating, addiction, dependence and psychotic disorders. Cognitive Behavioral Therapy replaces distorted or negative thoughts with more realistic ones to decrease emotional distress and self-defeating behavior. Simply put: if you change the way you think, you can change the way you feel and behave.
Drug addiction is commonly treated with Cognitive Behavioral Therapy. The therapist helps enable the patient to see how their thoughts, feelings and behavior patterns interact to trigger their urge to use drugs. From here, the therapist can determine the source of the patient’s problematic relationship with drugs. For example, feelings of depression may lead to self-destructive thoughts which, in turn, may result in the patient using drugs. The therapist targets negative feelings that start the cycle of abuse by helping the patient develop a positive self-worth. By altering thoughts like negative self-talk and self-isolation that can lead to drug-seeking behavior, Cognitive Behavioral Therapy helps end the negative feedback loop of addiction in a patient’s life. Even when therapy is complete, patients are advised to continue practicing CBT so they can maintain a positive outcome.
Cognitive Rehabilitation Therapy
Cognitive Rehabilitation Therapy is the process of mentally redeveloping the cognitive skills and function lost due to brain injury. These skills include intellectual performance, problem solving, attention deficits, memory and language difficulties. The key measure of CRT is the patient’s level of cognitive function. If the patient cannot relearn the lost skills, then the therapists teaches compensatory strategies. These strategies can literally be anything that helps the patient redevelop and maintain their independence. For example, a patient with short term memory problems could learn to set an alarm on his phone to remind him to take his medication.
Basic Cognitive Rehabilitation Therapy (CRT) included four components:
1) Assessment, education and awareness development of cognitive strengths and weaknesses, 2) skill development concentrating on resolving defined cognitive deficits, 3) compensatory strategy training and 4) functional activities that involve applying the first three components of CRT to everyday life.
At Life Skills Village, our therapists assess and treat patients’ cognitive skills by focusing BOTH on building upon the patient’s strengths while strategically shoring up their weaknesses. But what if a patient has a deficit that cannot be rebuilt? This is where the therapist’s list of compensatory strategies comes in – for every deficit, there is at least one compensatory strategy. A patient experiencing difficulties with short-term memory will have several strategies for them to try: there are many smart phone apps to help organize schedules and act as a reminder for events. Patients can develop the habit of taking notes in doctor’s appointments. They might keep a calendar on their refrigerator at home to know where they are scheduled to be on any particular day. Even maintaining a simple “thought” journal can aid patients in tracking their emotions in relation to daily events.
Although both Cognitive Behavioral Therapy and Cognitive Rehabilitation Therapy maintain a focus on cognition, they are distinct therapies designed to address specific cognitive concerns. Cognitive Behavioral Therapy is used to treat mental conditions such as anxiety or depression by focusing on an emotional or behavioral issue. The goal is to change a patient’s perception in order to decrease self-defeating behaviors, improve their mood and develop healthy thought patters. Cognitive Rehabilitation Therapy employs a broad range of cognition-based therapies to assist patients with cognitive deficits, such as memory, attention and executive function. The goal is to improve cognitive function and processes. Using these and a myriad of other therapies, Life Skills Village facilitates independence and a return to normal life for our clients after their injuries.
In the summer of 2011, Life Skills Village opened its doors with a mandate to revolutionize the neuro rehabilitation business. Our guiding principles emphasized helping people with brain injuries achieve a life of quality, purpose and fulfillment by regaining their independence. We began by treating them with dignity and providing opportunities to return to an independent lifestyle. Our transdisciplinary approach helped clients maintain focus on personal and social goals while guiding them successfully into the community. We adhered to evidence-based therapies and purposeful activities, so our clients could achieve positive functional outcomes. The Village environment allowed our clients to restore cognitive skills, self-regulate behaviors and improve overall independence in a supported, functional setting. Thanks to our talented clinical team, the many compassionate providers who partnered with us and our clients who worked so hard every day, we have more than a few success stories. On December 28th, we expect those success stories to multiply exponentially as Life Skills Village moves into a new, centrally-located and state-of-the-art 10,000 neuro rehab treatment center in Oak Park, Michigan.
The new Village vastly expands therapeutic opportunities for clients. Like our first Village, this will literally be a “community within the community,” a supported environment built to be both rehabilitative and social. But that’s where the similarities end. The cumulative experience and creativity of our therapists, administrators and clients have added up to a singularly unique treatment center that provides an unrivaled array of therapies and services to a much larger client population. From creating an inviting space that promotes socialization to organizing a micro-business incubator for clients to offering extracurricular social programs and therapies – the new Life Skills Village Treatment Center for TBI is designed to accelerate and intensify neuro rehab and recovery.
So what can Life Skills Village clients expect in January?
The outpatient community reintegration day program will function much as before – utilizing behaviorally-based therapies augmented by opportunities for clients to achieve their individual goals, develop and expand their knowledge base, hone their living skills and practice their social skills. Didactic sessions will continue to emphasize therapy for the client’s whole life: the mind, the body, social relationships and life in the community.
Concentrating on community reintegration, vocational development, socialization and reducing counterproductive behaviors, the new Village functions both individually for clients and collectively as a supported community. For example, a client with vocational goals may focus on reducing behaviors that prevent community integration, acquiring computer skills in the Library, practice customer service skills in the Village Market, receive psychological counseling and attend didactic sessions with other clients. Another client, with different vocational goals, might focus on developing a microbusiness in “Nine-to-Five,” the Village micro-business incubator and, afterwards, savor a lunch prepared by other clients in the Village Bistro or catch a movie in the client-run theater.
People with brain injuries who are not members of our day program are encouraged to spend a complimentary guest day at the Village to gauge their interest in our intensive neuro rehab program. They may also participate in individual therapies or other activities.
The Village will be open and available for clients to use both for treatment as a community within the community environment that includes:
The new Village will be open from 9am to 5pm for clients to attend individual therapies, events and even spend the day for respite. The outpatient day program will stay at the usual 12:30 - 4:30pm time. To accommodate the longer hours while continuing to provide respite and “mobile” therapy to clients, we have hired several new clinicians.
Beyond the day program, clients can participate in numerous extracurricular activities intended to reinforce existing therapies or function independently. These activities include:
Ready to see the new Life Skills Village for yourself? Schedule a tour today!
By Dr. Bryan Weinstein and Drew Bufalini
Your doctor might have the bedside manner of McDreamy from Grey’s Anatomy, an office papered with Ivy League degrees, X-Ray eyes and hearing so sensitive he can detect blood pressure changes…but unless you’re a good patient, there isn’t much he can do for you. Why? Because it takes both a good doctor anda good patient to make the doctor/patient relationship function to your benefit. For example, suppose a doctor prescribes an anti-depressant. The patient takes it as required until he begins feeling better…and then stops. By the time of his next appointment, he’s wondering why he feels depressed again. The doctor did his part, but the patient did not.
Whether you’re going to your primary care doctor for a minor problem or are seeing numerous physicians for a chronic illness or injury (like a #TBI or #chronicpain), being a good patient can mean the difference between sickness and health; between recovery and relapse; between living a fulfilling life and suffering a sedentary, painful existence. Getting the most from your physicians means more work for you as a patient, but it’s the best way to achieve a positive outcome from your time with the doctor. Here are a few tips you can use to maximize this time:
1. Be on time. You know how much you hate waiting to see the doctor? He doesn’t want to wait for you either. Doctors generally have a good reason for being late – checking your medical history, spending extra time with another patient or doing some last minute research. A late patient has a cascade effect on the rest of the doctor’s schedule for the day – causing him to be late for the rest of his appointments that day.
2. Be prepared.
· Bring any pertinent medical records, identification, paperwork and insurance information with you to the appointment.
· If you have a long list of symptoms or a number of problems to discuss, organize your thoughts on paper before your appointment.
· Always bring a list of your medications that includes dosage and frequency.
3. Be honest. Even if you think your problem is embarrassing. If you’re dishonest, the physician won’t know how to treat your real problem. Communication is paramount in doctor/patient relationships – your doctor can only work with the knowledge you provide about yourself.
4. Be nice to the staff! Nurses, assistants, receptionists, schedulers – even billers – are all there to help you. Treat them with courtesy and respect.
5. Be informed. The internet is filled with medical education website for the lay person. For example, sites like healthgrades.com rate and provide extensive background information on most doctors. WebMD.com covers conditions ad nauseum. This is not to say that you should self-diagnose…merely that the more you know about your doctor and your potential condition, the more informed you’ll be in the long run.
6. Unplug. Don’t take calls or respond to text messages while you’re with the doctor.
7. Take notes. No one has a perfect memory. Shore yours up against forgetting by writing down all of your physician’s recommendations and instructions. Bring a trusted friend to your appointment to jot down every salient point your doctor makes.
8. Be compliant with medications and treatment recommendations. If you can’t afford your medications, tests or treatments - tell your doctor. There are often programs to help people in these situations. Check out: www.lifeskillsvillage.com/resource-links.html for numerous options.
9. Don’t rely on a pill to cure all ills. Quitting smoking, exercising, eating a balanced diet – these can all improve your overall health. When your doctor recommends a lifestyle change, follow instructions and there may be fewer pills in your future.
10. Don’t be afraid to ask questions. There is no such thing as a stupid question when it comes to your health. If possible, bring a list of your questions and concerns to the appointment.
11. Know your rights. You are not at the mercy of your physician. Every patient has rights that can be exercised as needed:
· You have the right to "fire" your physicians. If you do not like the way your physicians treat you, if you do not trust them, or if you do not believe they are providing you with the best possible care, you can leave and find a new doctor.
· You have the right to be told about alternative courses of treatment, even if your health insurance may not cover them or you may not be able to afford them
· You have the right to refuse consent for any procedure or treatment. If you refuse consent, you may be asked to read and sign a form indicating that refusal.
· You have the right to leave the hospital or care facility against medical advice. You will be likely have to sign a waiver form indicating that you are doing so on your own free will and against the recommendations of your medical providers.
· You have the right to be treated with dignity and respect in all matters related to your health.
Of course, you could always show up twenty minutes late sans shower and demand to be seen immediately; call the receptionist a few choice names you picked up online; lie to your doctor about your symptoms; demand medication for a self-diagnosed condition; and then threaten him with legal action if he doesn’t cure you immediately. See how far that gets you.
Whether you’re a physician or a patient, please add your own tips to this list by adding a comment.
Dr. Robert Lamberts of Augusta, Georgia from blog: Musings of a Distractible Mind
By Dr. Bryan Weinstein and Drew Bufalini
Approximately 96% of people who live with a disability have an illness that is not visually discernable (2002 US Census Bureau). They do not use wheelchairs, canes, oxygen or any obvious assistive devices. For all intents and purposes, they appear healthy. Yet, they are far from it.
Some examples of these invisible disabilities include: #traumatic brain injuries, #fibromyalgia, #Crohn’s disease, #bipolar disorder, #chronic pain, #PTSD, chronic sleep disorders and many other painful, inveterate illnesses.
These chronic diseases, syndromes and as-yet undiagnosed, life-changing afflictions wear a mask of normalcy that belies the truth. People living with invisible disabilities suffer more than severe health problems – they must also deal with disbelief and misunderstanding from loved ones and the general public. “They are forced to battle for respect and understanding while mourning their loss of ability and freedom; often while others accuse them of being lazy or malingering.” (InvisibleDisabilities.org)
Nevertheless, the invisibly disabled are quite real and facing the world against the odds. What can we learn from these people who face their challenges and challengers head-on in an effort to live a meaningful and fulfilling life?
1. Disability and happiness are not mutually exclusive.
Disability cannot steal happiness. Only a negative attitude can do that. Of course, there is a grieving period for the “healthy self” that has been lost. But once acceptance is achieved (through therapy, medication, prayer, meditation or other means), happiness again becomes possible. Anyone can learn to find the joy in life that transcends disability. Or, for that matter, any other problem.
2. Communication is courage.
Suffering in silence has its place, but maintaining healthy relationships with friends and loved ones means honesty. While illness is a very personal experience, the people who care about you want to help. Turning their help away may give the briefest feeling of self-righteous independence…but accepting it or even asking for help doesn't make you any less independent. Communication facilitates a connection and an understanding between you, those who care about you and the community at large. We should all have the courage to communicate honestly – both to keep our loved ones close and our consciences clear.
3. Kindness is a two way street.
While helping others can certainly provide a boost to the ego and even a “helper’s high,” the ability to accept help yourself is both a lesson in humility and an inside look at how others may feel when you help them. Using this knowledge to adapt your behavior when helping others is true sympathetic kindness. Share your positive feelings and kindness with others and, more often than not, it will be reciprocated when you need it most.
4. Know yourself.
Anyone with a disability knows their limits – whether they can only stand for ten minutes per hour, eat a specific diet or must stay close to a restroom – living within these limits without allowing them to becomelimiting is an art. Understanding yourself gives you the opportunity to fine tune your life and play to your strengths while cultivating new ones.
5. Learn to at least tolerate, if not accept, other people.
People with invisible disabilities face discrimination every day – from their doctors, insurance companies, families, employers and even strangers who feel compelled to label them “healthy” without any real knowledge. They are forced to tolerate this discrimination even while being judged. If the invisibly disabled can tolerate those who discriminate against them, it’s because they’ve learned to practice what civil rights leaders have espoused for years: everyone deserves tolerance. Even the ignorant. Extending this practice can only have positive results in your life.
6. Be grateful for every moment – both the good and the bad.
Make the good times count and be thankful for them. Learn from the bad moments and leverage them to make yourself stronger. Beyond helping you have a higher level of positive emotions, practicing gratitude can also lead to lower blood pressure and a stronger immune system. (http://greatergood.berkeley.edu/expandinggratitude)
7. Inspiration Is Everywhere. Find Yours.
Author Jack London was once quoted as saying, “You can’t wait for inspiration. You have to go after it with a club.” Disabilities – visible and invisible – can make getting out of bed to face the day a daunting challenge. Inspiration may lead to purpose, which can motivate you for the rest of your life. Whether you’re inspired by the sunrise, the smell of breakfast or your children - finding these “little” inspirations can make a significant difference in your life.
8. Enjoy the Mysteries In Life.
Appreciating what you do not understand can seem difficult at first. But do you need to know the moon’s gravity to appreciate its fullness in a cloudless midnight sky? “This is the greatest damn thing about the universe. That we can know so much, recognize so much, dissect, do everything, and we can’t grasp it.” - Henry Miller (http://www.brainpickings.org/2013/03/21/henry-miller-meaning-of-life/)
9. Life Is Short and Capricious. Live Without Regrets.
There is no time like the present to correct mistakes, tell someone how you feel, forgive a grudge, open yourself up to a new relationship, act on a long withheld, positive impulse and the million other things you may consider doing. No one wants to look back at their lives and feel they missed an opportunity that could have been life-changing. Take a chance.
10. Forgive and Forget.
Rationale: see above.
11. Develop a Support Network.
Support groups exist for just about every disability imaginable. They provide a judgement-free zone for people with similar disabilities to share a cathartic vent session and learn new techniques to help overcome various issues. Whether you’re a mom with a special needs child or a college kid with an unruly puppy – the internet has more than a few places to find people in similar situations to share their knowledge, experience and compassion with you. These can become connections that last for a lifetime.
12. Saying “No” to Others Is Only as Difficult as You Make It.
People with disabilities become people pleasers because they already feel they are disappointing their loved ones by having a disability. This tendency can cause them to lose focus on their own needs and suffer disproportionately as a result. Consequently, simply deciding on an invitation can turn into an agony of self-delusion, second-guessing and misery. Or it can be as simple as knowing yourself and RSVPing one way or the other.
13. Never Stop Fighting.
Whether it’s for a correct diagnosis, a good cause or simply to get through the day without giving in to your pain or symptoms – the fight makes us stronger and teaches us how to keep winning our daily battles. Sometimes no matter how much we put into it, we still lose. This is the time to take pride in the fact that you made the effort and know that you’ll live to fight another day.
14. Adapt or Suffer the Consequences.
Everyone has heard Albert Einstein’s definition of insanity: doing the same thing over and over again and expecting different results. As your life changes for better or worse, you have the opportunity to redefine yourself as a person who can build on experiences by adapting and forming new, game-changing habits and a happier life. The alternative is, simply put, suffering and insanity.
15. Sometimes Hope Is All You Need.
When it feels like the deck of life is stacked against you, remember that tomorrow is always another day. With any luck, a better one. Hope can also translate into effort when you make the decision to turn your hope into reality. Start by opening your mind to the possibilities.
16. Laughter May Not Always be the Best Medicine…But It Sure Helps!
Maintaining a sense of humor in the face of any adversity…regardless of how idiosyncratic your sense of humor. Here’s a bit of silly to get you started: “My insurance company refused to pay for my newborn son’s circumcision. Their rationale? “Unable to locate member.” (http://www.rd.com/jokes/funny/medical-care/insurance-policy-joke/)
Another often quoted gem of Einstein’s says that “When we stop learning, we start dying.” Therefore, we must recognize all that the world and its wild diversity of people, culture, philosophy, technology and even politics has something to teach every one of us – whether we have a disability, invisible disability or are as healthy as a thoroughbred on race day.
Please note: this list was culled to limit the length of the blog. We encourage readers to share their own life lessons with a comment.
About the Authors:
Dr. Bryan Weinstein, D.O.
Dr. Weinstein received both his undergraduate, and Osteopathic Medical Degree at Michigan State University. He attended the residency programs of Detroit Psychiatric Institute and Wayne State University and received a mini fellowship in electroconvulsive therapy at Duke University. Dr. Weinstein owns two private psychiatric clinics and Life Skills Village, a behaviorally-based neuro rehab treatment center. Full Bio: http://www.lifeskillsvillage.com/clinical-team-bios.html
Drew has lived with several invisible disabilities for going on ten years. Before returning to work after a health-enforced hiatus, Drew ran the chronic pain support group at Crittenton Hospital in Rochester, MI. After several years of effort, education, trial and error, Drew joined Life Skills Village as a volunteer to build up his endurance. Almost four years later, he works full-time at LSV as the Chief Marketing Officer.
Full Bio: http://www.lifeskillsvillage.com/marketing--admin-bios.html
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About the Doc
Dr. Bryan Weinstein is a practicing psychiatrist with certification from the American Board of Psychiatry and Neurology. He has practiced psychiatric pharmacology and psychotherapy since 1997. Dr. Weinstein is the CEO of Life Skills Village.