1. Dr. Marie Goss. NORTH SOUTH BRAIN INJURY CONFERENCE SEPT 2006
BRAIN INJURY SUPPORT SERVICE South and East Belfast Health and Social Services Trust
Dr. Marie Goss.
NORTH SOUTH BRAIN INJURY CONFERENCE SEPT 2006

2. BRAIN INJURY SUPPORT SERVICE
MAINE NEUROBEHAVIOURAL UNIT
MOURNE DAY SUPPORT UNIT
COMMUNITY BRAIN INJURY SERVICE

3. CORE ISSUES IN SERVICE PROVISION
UNIQUE SERVICES IN N.I. CONTEXT
WORK WITH PEOPLE WITH COMPLEX NEEDS
FOCUS IS ON PROVISION OF A THERAPEUTIC APPROACH
MINIMISING RISK, DEVELOPING SKILLS, COMPENSATING FOR DISABILITY THROUGH CHANGES WITHN THE CLIENT AND THE ENVIRONMENT, MAXIMISING QUALITY OF LIFE

4. Challenging Behaviours can be
short lived in early recovery
ongoing/interfere with rehabilitation
long term - limit/prevent community reintegration - cause major challenges to those providing care and support

5. CAN PREVENT SUCCESSFUL COMMUNITY REINTEGRATION POST BRAIN INJURY
IMPACT OF SOCIAL AND EMOTIONAL AND BEHAVIOURAL PROBLEMS ARISING POST BRAIN INJURY
CAN PREVENT SUCCESSFUL COMMUNITY REINTEGRATION POST BRAIN INJURY
CAN PREVENT ACCESS TO SERVICES
eg REHABILITATION, VOCATIONAL TRAINING, DAY CARE, SUPPORTED HOUSING, RESPITE.
CONTRIBUTE TO FAMILY/CARER STRESS
ADVERSLY AFFECT FAMILY COPING AND ADAPTATION

7. Maine neurobehavioural unit
Post acute rehabilitation
slow stream rehabilitation
long term care
day care
respite care
crisis intervention

8. MAINE NEUROBEHAVIOURAL UNIT ADMISSION CRITERIA
Male , years, ABI.
Requires specialist inpatient assessment .
Difficult to manage in other settings due to challenging behaviour.
Risk to self or others.
Requires a rehab programme focussing on social, emotional and behavioural functioning.
Does not require secure provision.

9. MAINE NEUROBEHAVIOURAL UNIT SOURCE OF REFERRALS
Neurosurgery
Acute hospital settings
Neurorehabilitation settings
Mental Health services
Acute Psychiatric units
Residential facilities
Home
Social services

10. Post Acute Rehabilitation Risk Management
MAINE
NEURO
BEHAVIOURAL
UNIT
FOCUS OF INTERVENTION
GOALS
Post Acute Rehabilitation
Risk Management
Skills Development
Discharge to Neuro
Rehabilitation
in-patient or community setting
Slow Stream Rehabilitation
Behavioural Management
Discharge to home/ supported living.
Care in a less restrictive setting.
Long Term Care
Skills Maintenance
Minimise risk.
Maximise and maintain optimal levels of functioning.
Maximise quality of life.
Care in a specialist care setting.

11. Multidisciplinary team
Nursing
Nursing assistants
Occupational therapy
Social work
Clinical neuropsychology
Medical (Neuropsychiatry, G.P)
[Physiotherapy, Speech and Language therapy]
[Artscare, artist,musician,dance]

12. MOURNE DAY PROJECT TARGET GROUP
Adults who present with significant social dysfunction after brain injury
Those who require highly individualised treatment/rehabilitation and care plans to enable and maintain community participation and reintegration.
Those whose needs cannot be met in mainstream settings, due to risks associated with behaviour and who require a high staff /client ratio.

13. MOURNE DAY SUPPORT UNIT referral criteria
Male or female, 18 – 65 years,ABI.
Resident within the community
Requires specialist assessment
Requires a rehabilitation programme in a specialist setting focussing on social emotional and behavioural functioning
Requires specialist support to maintain functioning and enable community participation
Difficult to manage in other settings due to challenging behaviour
Requires a high level of staff support and supervision

14. MOURNE DAY PROJECT SOURCE OF REFERRALS
Community brain injury teams / EHSSB
Social services
Mental health services
G.P.s
Regional Acquired Brain Injury Unit

15. etc MOURNE DAY PROJECT ASSESSMENT OUTCOME GOALS Risk Community ADL
FOCUS OF INTERVENTION
OUTCOME
GOALS
ASSESSMENT
Risk
Community ADL
Physical
Mental state
Cognitive skills
etc
To contribute to the development of a comprehensive treatment /care /support plan
REHABILITATION
Risk Management
Skills training
Behavioural
treatment
To facilitate community reintegration
SUPPORT /RESPITE
Skills Maintenance
Engagment in meaningful activity
Enable social participation
Minimise risk.
Maintain optimal levels of functioning.
Maximise quality of life.
Reduce caregiver stress.
maintain community living.

16. MOURNE DAY PROJECT STAFFING
Unit Manager
Senior Day care Worker
Day Care Workers
Administrative Staff
Neuropsychologist
Psychology Assistants
Occupational Therapist

17. MAINE NEUROBEHAVIOURAL UNIT & MOURNE DAY PROJECT
ASSESSMENT eg.Cognitive,behavioural, ADL social skills, communication, risk assessment
REHABILIATATION / TREATMENT
DEVELOPMENT OF NEW SKILLS
MAINTENANCE OF EXISTING SKILLS
SUPPORT TO ENABLE SOCIAL PARTICIPATION
CRISIS INTERVENTION
RESPITE CARE

18. ASSESSMENT Level of ADL functioning Behaviour Cognition
Social functioning
Emotional functioning
Mental State
RISK
NEEDS
( future support )

19. Difficulties resulting from :
FORMULATION
Difficulties resulting from :
physical impairment
sensory impairment
medical condition
cognitive capacity
eg.attention, understanding, judgement
mental disorder
eg perception, ideation,moodstate
psychological reaction

20. INTERVENTION Skilled Staff observation and assessment skills
communication & interpersonal skills
prompting, feedback
Structured Day
Activities/routines
Environmental
Management
level of stimulation
cues

21. INTERVENTION Risk management
Skills training, e.g., planning skills, social skills
Therapies
Occupational therapy
Speech and Language therapy
Physiotherapy
Treatments pharmacology behavioural therapy CBT