Sarah Downing, Roby Miller, Michael Milligan, Amanda Muise, … · 2014-11-20 · Authentic...
Transcript of Sarah Downing, Roby Miller, Michael Milligan, Amanda Muise, … · 2014-11-20 · Authentic...
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Sarah Downing, Roby Miller, Michael Milligan,
Amanda Muise, Amee Le, Dr. Carolyn Lemsky
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Life Worth Living What makes a life worth living?
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Life Worth Living (The PERMA Model)
Positive Emotion Engagement Positive
Relationships Meaning
Accomplishment/
Achievement
Peace,
Pleasure, Inspiration, Curiosity,
Hope, Love
Career, Hobbies
& Activities
Family, Friends, Neighbors, Colleagues
Family Time, Random Acts of
Kindness, Volunteering
Mastering a Skill, Achieving Goals,
Winning Competitive Events
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Case Study – Al Adventure
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The Injury Age 30
GCS 3/15, Coma >21 days
Open Brain Injury (multiple skull fractures and areas of bleeding)
Multiple orthopedic injuries
Transverse T7-9 fractures, multiple rib fractures and wrist fractures
Pneumothorax
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Challenges Presented by Injury Profound memory impairment
Spasticity and ataxia affecting gait and speech
Moderate to severe impairments of fine motor control bilaterally
Cognitive slowing
Executive impairments
Limited awareness of his disabilities
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Case Study – Al Adventure
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Unable to Remember What is it like to be unable to remember?
Your last conversation with someone…
Where and how you met…
How or why you have a bad feeling about a situation…
Why and how your role changed…
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Challenges at the Start
Unaware of what he was and wasn’t doing for himself
Refusing supports and new activities
Socially withdrawn
Depressed mood, angry
Irritability related to uncertainty, feeling pushed, direct offers of support, corrections
Magnified negative events and experiences
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Case Study – Al Adventure
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Different Memory Systems Declarative Memory
Knowing What
Semantic
(Facts, Meanings, Knowledge of the World)
Episodic
(Experiences & Events)
Procedural Memory
Knowing How
Skills & Habits
Conditioned Responses
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Main Goal of Intervention Make up for impaired declarative memory using
procedural memory
Errorless Learning
Represents a set of teaching procedures designed to reduce incorrect responding as the individual gains mastery over the task
Avoid aversions
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Memory Link Memory Link is an errorless learning approach used to
teach an individual with memory problems to use an electronic personal device
Baycrest’s program focuses on individuals with memory problems and few other or mild cognitive impairments (e.g. people who have had strokes)
CHIRS adapted this program to apply to people with more global brain injuries
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Affect
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Intervention
Novel Journal Entries
Reliving Experiences as Mood Support
Increased Exposure
Participation in New Social Activities
Daily Orientation to Calendar
Building Positive Routine
Memory Link & cTech Training
+ Affect
Acceptance Increases
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Skiing
Family Involved
Talking & Watching
Skiing
Ski Gear
Skiing Events in Calendar
Accepting Refusals
Skiing, Success, &
FUN
Journaling
Pictures
Parties & Sailing
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Case Study – Al Adventure
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Outcomes
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Ethical Considerations Family involved in making decisions
Refusals are always accepted
Support is tailored to client interests
Avoid development of an aversion and/or refusal
Develop + affect towards meaningful activities
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Outcome
Happiness, Laughter,
Enjoyment, Peace
Managing Schedule, New
Skills & Activities
FaceTime Family, Roommates,
CHIRS Community
Helping Out, Recreation &
Leisure, Employment
Health/Fitness,
Tackling New Adventures
Intervention
Errorless Learning
Memory Link & cTech Training
Identity Mapping Behavioural Activation
Antecedent Management
Injury
Anger & Frustration
Loses Career, Increased Support
Loss of Partner/
Family Caregivers
Medical/
Rehabilitation
Unaware of Strengths & Skills
Life Worth Living
Positive Emotion
Engagement Positive
Relationships Meaning
Achievement/
Accomplishment
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It Works!
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Question Period Questions?
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References Bier, N.. Vanier. M., Meulemans, T. (2002). Errorless Learning: A Method to Help Amnesic Patients
Learn New Information. Journal of Cognitive Rehabilitation, 12-18
I. -L. Boman, K. Tham, A. Granqvist, A. Bartfai, H. Hemmingsson Using electronic aids to daily living after acquired brain injury: A study of the learning process and the usability. Disability and Rehabilitation: Assistive Technology 2007 2:1 , 23-33
Kapur, N., Glisky, E., & Wilson, B. (n.d.). Technological Memory Aids For People With Memory Deficits. Neuropsychological Rehabilitation, 41-60.
Kessels, R.P.C. de Hann, E.H.F, (2003) Implicit Learning I Memory Rehabilitation: A Meta-Analysis on Errorless Learning and Vanishing Cues Methods. Journal of Clinical and Experimental Neuropsychology, Vol. 25, No. 6, 805-814
Lannin, N., Carr, B., Allaous, J., Mackenzie, B., Falcon, A., & Tate, R. (2014). A randomized controlled trial of the effectiveness of handheld computers for improving everyday memory functioning in patients with memory impairments after acquired brain injury. Clinical rehabilitation, 0269215513512216.
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References Savage, K. R., & Svoboda, E. (2012). Long-term benefits of the Memory-Link programme in a case of
amnesia. Clinical rehabilitation, 0269215512464230.
Seligman, M. E. (2002). Authentic happiness: Using the new positive psychology to realize your potential for lasting fulfillment. Simon and Schuster.
Seligman, M. E. (2002). Positive psychology, positive prevention, and positive therapy. Handbook of positive psychology, 2, 3-12.
Snyder, C. R. (2010). Positive psychology: The scientific and practical explorations of human strengths. Sage Publications.
Svoboda, E., Richards, B., Yao, C., & Leach, L. (2014). Long-term maintenance of smartphone and PDA use in individuals with moderate to severe memory impairment. Neuropsychological rehabilitation, (ahead-of-print), 1-21.
Ylvisaker, Mark; Jacobs, Harvey E.; Feeney, Timothy. (2002) Positive Supports for People Who Experience Behavioral and Cognitive Disability After Brain Injury: A Review. Journal of Head Trauma Rehabilitation: January/February, Volume 18 - Issue 1 - p 7–32
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Thank You!