1. Traumatic Brain Injuries Dianne Kayala, M.S. National Resource Center for Participant-Directed Services Boston College

2. What is a traumatic brain injury (TBI)? A TBI is caused by a bump, blow or jolt to the head that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The severity of a TBI may range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury. The majority of TBIs that occur each year are concussions or other forms of mild TBI.

3. How many people have TBI? Of the 1.4 million who sustain a TBI each year in the United States:  50,000 die;  235,000 are hospitalized; and  1.1 million are treated and released from an emergency department. ( about 1/3 have permanent symptoms) Blast Injuries are the leading cause of TBI in soldiers Adults age 75 and older have the highest incidence of falls

4. Causes of TBI

5. Common Consequences of TBI Headaches or neck pain that do not go away; Difficulty remembering, concentrating, or making decisions; Slowness in thinking, speaking, acting, or reading; Getting lost or easily confused; Feeling tired all of the time, having no energy or motivation; Mood changes (feeling sad or angry for no reason); Changes in sleep patterns (sleeping a lot more or having a hard time sleeping); Light-headedness, dizziness, or loss of balance; Increased sensitivity to lights, sounds, or distractions; Blurred vision or eyes that tire easily; and Loss of sense of smell or taste.

6. TBI Considerations Many persons have symptoms without realizing they even had a brain injury  A referral for a neuropsychological evaluation may be warranted A TBI is not progressive, but those with TBIs have higher incidences of dementia as they age, as well as depression and substance abuse Oftentimes the greatest service need is to be assisted in setting up memory prompts and cuing systems in the home Even mild TBI can result in significant cognitive challenges

7. Consumer Direction and TBI The consumer should always be asked for his/her preferences Even with severe cognitive disability can successfully direct services with assistance of a representative With so many individual differences in need, consumer direction often allows optimal customization of worker training and skills for people with brain injuries

8. Key Resources Brain Injury Association of America  www.biausa.org – linkages with local affiliates and programs www.biausa.org Defense and Veterans Brain Injury Center  www.dvbic.org – resources for veterans and families www.dvbic.org National Association of Head Injury Administrators  www.nashia.org – linkages with state brain injury programs www.nashia.org