BRAIN INJURY SUPPORT SERVICE South and East Belfast Health and Social Services Trust
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Transcript of BRAIN INJURY SUPPORT SERVICE South and East Belfast Health and Social Services Trust
BRAIN INJURY SUPPORT BRAIN INJURY SUPPORT SERVICESERVICE
South and East Belfast Health and South and East Belfast Health and Social Services TrustSocial Services Trust
BRAIN INJURY SUPPORT BRAIN INJURY SUPPORT SERVICESERVICE
South and East Belfast Health and South and East Belfast Health and Social Services TrustSocial Services Trust
Dr. Marie Goss. NORTH SOUTH BRAIN INJURY CONFERENCE SEPT 2006
Dr. Marie Goss. NORTH SOUTH BRAIN INJURY CONFERENCE SEPT 2006
BRAIN INJURY SUPPORTBRAIN INJURY SUPPORT SERVICESERVICE
• MAINE NEUROBEHAVIOURAL UNIT
• MOURNE DAY SUPPORT UNIT
• COMMUNITY BRAIN INJURY SERVICE
CORE ISSUES IN SERVICE PROVISIONCORE 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
short lived in early recovery ongoing/interfere with rehabilitation long term
- limit/prevent community reintegration
- cause major challenges to those providing care and support
short lived in early recovery ongoing/interfere with rehabilitation long term
- limit/prevent community reintegration
- cause major challenges to those providing care and support
Challenging Behaviours can be
Challenging Behaviours can be
IMPACT OF SOCIAL AND EMOTIONAL AND IMPACT OF SOCIAL AND EMOTIONAL AND BEHAVIOURAL PROBLEMS ARISING POST BRAIN BEHAVIOURAL PROBLEMS ARISING POST BRAIN
INJURYINJURY
• 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
Maine neurobehavioural unit
Maine neurobehavioural unit
Post acute rehabilitation
slow stream rehabilitation
long term care
day care respite care crisis intervention
Post acute rehabilitation
slow stream rehabilitation
long term care
day care respite care crisis intervention
MAINE NEUROBEHAVIOURAL UNITMAINE NEUROBEHAVIOURAL UNIT ADMISSION CRITERIA
• Male , 17 - 65 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.
MAINE NEUROBEHAVIOURAL UNITMAINE NEUROBEHAVIOURAL UNIT SOURCE OF REFERRALS
• Neurosurgery• Acute hospital settings• Neurorehabilitation settings• Mental Health services• Acute Psychiatric units• Residential facilities• Home• Social services
MAINE MAINE
NEURONEURO
BEHAVIOURALBEHAVIOURAL
UNITUNIT
FOCUS OF FOCUS OF INTERVENTIONINTERVENTION
GOALSGOALS
Post Acute Post Acute RehabilitationRehabilitation
Risk Management
Skills Development
Discharge to NeuroRehabilitation in-patient or community setting
Slow Stream Slow Stream RehabilitationRehabilitation
Risk ManagementSkills DevelopmentBehavioural Management
Discharge to home/supported living.Care in a less restrictive setting.
Long Term CareLong Term Care Risk Management
Skills Maintenance
Minimise risk.Maximise and maintain optimal levels of functioning.Maximise quality of life.Care in a specialist care setting.
Multidisciplinary teamMultidisciplinary team
• Nursing• Nursing assistants• Occupational therapy• Social work• Clinical neuropsychology• Medical (Neuropsychiatry, G.P)
• [Physiotherapy, Speech and Language therapy]• [Artscare, artist,musician,dance]
MOURNE DAY PROJECT TARGET GROUPMOURNE 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.
MOURNE DAY SUPPORT UNITMOURNE DAY SUPPORT UNITreferral 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
MOURNE DAY PROJECTMOURNE DAY PROJECT SOURCE OF REFERRALS
• Community brain injury teams / EHSSB
• Social services
• Mental health services
• G.P.s
• Regional Acquired Brain Injury Unit
MOURNE DAY MOURNE DAY PROJECT PROJECT
FOCUS OF FOCUS OF INTERVENTIONINTERVENTION
OUTCOMEOUTCOMEGOALSGOALS
ASSESSMENTASSESSMENT RiskCommunity ADLPhysicalMental stateCognitive skills
etc
To contribute to the development of a comprehensive treatment /care /support plan
REHABILITATIONREHABILITATION Risk ManagementSkills trainingBehaviouraltreatment
To facilitate community reintegration
SUPPORT SUPPORT /RESPITE/RESPITE
Risk Management
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.
MOURNE DAY PROJECTMOURNE DAY PROJECT STAFFING
– Unit Manager– Senior Day care Worker– Day Care Workers– Administrative Staff– Neuropsychologist– Psychology Assistants– Occupational Therapist
– Unit Manager– Senior Day care Worker– Day Care Workers– Administrative Staff– Neuropsychologist– Psychology Assistants– Occupational Therapist
MAINE NEUROBEHAVIOURAL MAINE NEUROBEHAVIOURAL UNIT & MOURNE DAY UNIT & MOURNE DAY
PROJECTPROJECT
• 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
ASSESSMENTASSESSMENT
• Level of ADL functioning• Behaviour• Cognition• Social functioning• Emotional functioning• Mental State• RISK• NEEDS ( future support )
FORMULATIONFORMULATION
Difficulties resulting from :• physical impairment• sensory impairment• medical condition• cognitive capacity eg.attention, understanding,
judgement• mental disorder eg perception, ideation,moodstate• psychological reaction
INTERVENTIONINTERVENTION
Skilled Staff• observation and
assessment skills• communication
& interpersonal skills
• prompting, feedback
Structured Day• Activities/routines
Environmental
Management• level of stimulation• cues
INTERVENTIONINTERVENTION
• Risk management
• Skills training, e.g., planning skills, social skills
• Therapies
Occupational therapy
Speech and Language therapy
Physiotherapy
• Treatments pharmacology behavioural therapy CBT