1. Traumatic Brain Injury & Post Traumatic Stress Disorder Homeless Veterans Reintegration Program Washington D.C. August - 2008

2. Traumatic Brain Injury An estimate up to 30% of OIF/OEF suffer mild, moderate and severe brain trauma 60% of bomb blast victims have TBI Many mild injuries are remedied within 90 days Approximately 2,000 have been treated Many avoid screening or do not fully disclose 80% of TBI also have PTSD An estimate up to 30% of OIF/OEF suffer mild, moderate and severe brain trauma 60% of bomb blast victims have TBI Many mild injuries are remedied within 90 days Approximately 2,000 have been treated Many avoid screening or do not fully disclose 80% of TBI also have PTSD

3. TRAUMATIC BRAIN INJURY Number one cause of disabilities, if strokes and dementia are included Not one description of TBI – each one is different IED’s create blasts of 800 to 2,000 mph Recovery can take days, weeks, years and may be incomplete

4. Common Symptoms Alertness and Concentration can be Impaired Self Awareness can be Distorted Inaccurate Perceptions Memory and Learning Reasoning and Planning Problem Solving Speech and Language Motor Control Emotions

5. Working with Individuals with TBI Encourage use of notebook Gently remind the person of correct details of past and present events Confirm accurate information with other people Arrange for consistency in routine tasks Limit changes in daily routine Provide detailed explanations of even the most basic changes Realize that fatigue is a huge factor

6. What to Do Start the process back to work slowly Have them do volunteer work a few hours a day Connect with their peers at work Maybe start with a part time job that is low stress and somewhat routine Utilize strategies like work-hardening, and supported employment Work closely with their supervisor while they get back into their previous job, if possible

7. Post Traumatic Stress Disorder Many do not seek help – do not want to be seen as “weak” May feel great guilt – just for surviving Do not recognize own symptoms for a long time Often a major event will bring PTSD to surface

8. Possible Symptoms Sleep problems Restlessness Overly watchful or hyper vigilant Social withdrawal Headaches or changes in personality Anger outbursts, out of character Changes in alcohol use Risk taking behaviors Thoughts of death

9. PTSD – What to do Follow your health professional’s advice; take medication, continue with therapy Take care of themselves Don’t self medicate Break the cycle Talk to someone Consider a support group

10. PTSD – How you can help Ask what jobs they would consider Avoid highly stressful jobs Monitor them closely on the job Make sure they are following the recommended guidelines from their therapist Have them keep a log of what seems to trigger their emotions and then ask what they think causes problems at work or what they are experiencing on the job now.