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2007 Concurrent Sessions
Download PDF file of PCBIC 2007 Friday Program
Download PDF file of PCBIC 2007 Saturday Program
Friday, February 16, 2007
Start time 8:30am
End Time 10am
Session: Welcome & Opening Plenary
From Little Acorns Mighty Oaks Do Grow ~ Peter Eames, MD
Pathways to Community ~ Al Condeluci, PhD
Start time 10:30am
End Time 2:30pm
Session Keynote Concurrent
Learning after TBI: Challenges and Solutions for Students
Presenter
Roberta DePompei, PhD, CCC-SP/A - The University of Akron - Akron, OH
Description
This session will provide information about behaviours after ABI relating to classroom learning and community participation. Emphasis is on explaining the neuropsychological basis for language and learning; describing the cognitive-communicative problems that affect classroom learning, behaviour, applying these behaviours to the curriculum; and using this understanding to maximize the student's performance through the use of appropriate assessment and teaching strategies. some of the objectives for these two concurrent sessions include: identifying the relationship between neuropsychological brain functioning and learning; describing the cognitive, communicative, and behavioural characteristics of youngsters with brain injury, explaining how those behaviours impact on the student's learning and ability to meet expectations of the education curriculum and the application of procedures to assess and treat students returning to school and community.
Target Audience
Family Members
Service Providers
Medical
Lawyers
Educators, Counsellors
Concurrent Sessions A
Start time 10:30am
End Time 12 noon
Session A2
ABI Services in BC - What does the future hold?
Presenter(s)
Judith Armstrong, - Vancouver Island Health - Victoria, BC
Jerry Stanger, MHA - Fraser Health - Coquitlam, BC
Jana Pirsel - Northern Health - Prince George, BC
Elizabeth Baron - Vancouver Coastal Health - Vancouver, BC
Deborah Preston - Interior Health - Kelowna, BC
Objective
To overview the current state and future planning for BC Health Authority ABI services.
Abstract
BC Health Authorities play a pivotal role in the development and delivery of ABI services. This presentation will include a representative from each health authority who will discuss the future of ABI services in their region. Presenters will discuss current services available, identify needs/gaps in service, and outline strategic goals. As time allows, each health authority will review the process undertaken to determine incidents/prevalence of ABI, community consultation processes, gap analysis, or other planning activities used in the development of strategic priorities.
Participants will have an opportunity to ask each health authority representative questions about current services and strategic goals for ABI services in their home community. Participants will gain an understanding of the constraints associated with developing ABI services. Also, participants will learn about the future development of ABI services in their region and how to participate in this process. We anticipate a panel like format with brief presentations followed by an interactive discussion with participants. An appropriate moderator will be selected.
Target Audience
Survivors
Family Members
Service Providers
Health Authority Staff and Management
Session A3
When Sensory Auditory Overload Leads to Mild TBI-Like Symptoms
Presenter(s)
Clint Landrock, B Eng - NeuroKinetics - Vancouver,BC
Philippe Souvestre, MD - NeuroKinetics - Vancouver,BC
Objective
To identifying contributing factors that lead to TBI symptoms.
Abstract
Commonly observed in the field of occupational and military medicine, unprotected auditory exposure to major noise blasts or severe sustained high noise intensity (auditory sensory trauma) have been definitely acknowledged as causing conditions similar to those seen after traumatic brain injury (TBI). Such conditions can also be seen in other settings. For instance, Jane, an 80 year old retired nurse, came for a consultation after having experienced a significant, accidental auditory blast in one ear 5 years before. Since this accident, and after having tried everything offered without success, she was still complaining of a number of different symptoms which include the following: hyperacousis, hypersensitivity to noise and vibration, tinnitus, hearing loss, frontal occipital pressure, balance/dizziness issues, neck pain, loss of concentration, and fatigue. All of these symptoms are commonly described in classic cardinal parameters of a post-traumatic condition diagnosed in Traumatology and Rehabilitation Medicine as Postural Deficiency Syndrome, which can have impact on physical, cognitive, intellectual and emotional areas. A specialized neurophysiological sensory-motor assessment confirmed, along with her history, that her symptoms could very likely have resulted from the extreme sensory auditory overload.
Central Neurophysiological Adaptive Mechanisms Explain Types of Symptoms Sensory overloads to the sensory-motor/sensory-cognitive controls in the brain can cause specific reactions in related neural network "circuits" (dysfunctional, which means that it imitates damage but are not); these results in producing a range of symptoms comparable to a TBI condition. Effective and stable therapeutic correction is possible and only obtained by using appropriate neurophysiological stimulations addressing these sensory-motor controls. Given treatment in this context, Jane has responded favourably, gaining significant stable relief across her symptoms and no longer taking pain medication.
Conclusion
Trauma symptomatology is traditionally understood as resulting from physical injury to the brain. Sensory types of overload such as Auditory can also cause mild TBI-like symptoms and should be given due consideration. This scientific addition certainly allows for earlier detection of symptom cause, improved therapeutic protocols, and therefore can result in greater successes with plateaued patients.
Target Audience
Survivors
Family Members
Service Providers
Medical
Lawyers
Session A4
Healing the Self- Emotional Recovery and Psychological Growth After Acquired Brain Injury
Presenter(s)
Valerie Reynolds, ABI Survivor/Group Co- Facilitator - Victoria, BC
Carol Morrison, Wife of ABI Survivor - Victoria, BC
Corinne Tweter, LPN - Neurosciences Victoria General Hospital - Victoria, BC
J. Ellen Connell, MA - Counsellor - Victoria, BC
Shannon Buchan, ABI Survivor - Victoria, BC
Objective
Participants will gain an appreciation for the loss of "the self" experienced by ABI survivors and caregivers of persons living with ABI. This interactive panel presentation will provide the participants with the opportunity to hear a variety of perspectives regarding this loss of self and the struggle to recover and rebuild a meaningful, satisfying and sustainable sense of self. Participants will be introduced to a model of emotional recovery and psychological growth that empowers ABI survivors and caregivers/family members to understand and engage fully in their own healing and growth. Participants will gain an understanding of how this model is used in the therapeutic group context to support, foster and facilitate adjustment, emotional recovery and psychological growth following ABI.
Abstract
It has been said that "personhood is the one component that most significantly changes following acquired brain injury, and since the core of the person shapes the life of the self this is the story to tell." (Robert Vooght PhD) This interactive panel presentation will explore the loss of self as experienced by two ABI survivors and two women caring for husbands living with ABI. Through telling their stories these "direct" and "indirect" survivors will clarify the magnitude of the emotional, psychological and spiritual losses which frequently accompany ABI. These losses while felt keenly by direct and indirect survivors are often unrecognized or undervalued by professionals and those outside the family unit. The direct and indirect survivors will then outline some of the challenges they have faced in their own journey of recovery.
Ellen Connell will present a model for understanding and navigating the complex journey that is emotional recovery and psychological growth following ABI. This Trauma Recovery and Growth Model, which Ms. Connell co - developed (with J. Lynne Mann R. Psych.), is specifically designed for use in a guided mutual aid therapeutic group with direct and indirect survivors of ABI. Ms. Connell has been facilitating these groups since 1987 and is currently training survivors and caregivers as co - facilitators for these groups. The importance of providing both professional and peer support in the therapeutic group setting will be emphasized.
All of the other panel members have participated in these therapeutic groups and will describe ways in which the Trauma Recovery and Growth Model and participation in the groups has impacted their journey of recovery and growth. Panel members will present some of the basic recovery concepts which are central to the Trauma Recovery and Growth Model to illustrate how the model makes seemingly abstract concepts quite concrete and accessible. Using the Trauma Recovery and Growth Group as part of a comprehensive and cost effective approach to rehabilitation and recovery following ABI will be discussed. There will be ample time for questions during and after the presentation.
Target Audience
Survivors
Family Members
Service Providers
Medical
Lawyers
Session A5
Managing Problems With Thinking and Behavior in the Home: Strategies for Caregivers
Presenter(s)
Angelle Sander, PhD - The Institute for Rehabilitation and Research, Baylor College of Medicine - Houston, TX
Description
This presentation will focus on describing the most typical cognitive and behavioural difficulties resulting from traumatic brain injury (TBI) and proposing some simple strategies that caregivers can implement in the home to compensate for these problems. Problems discussed will include reduced awareness, attention and memory problems, reduced social communication abilities, decreased initiation, and difficulty inhibiting behaviour.
Target Audience
Survivors
Family Members
Service Providers
Concurrent Sessions B
Start time 1:30pm
End Time 2:30pm
Session B2
Left Behind: The ABI communities fight for a role in welfare reform
Presenter(s)
Michael F. Seiferling - PEARL Manor - Regina, SK
Joel Brownridge, RTC - PEARL Manor - Regina, SK
Objective
Participants will gain a better understanding of how to successfully lobby government and policy makers to accommodate for the needs of the brain injured population on provincial welfare programs.
Abstract
Since the mid 90's there have been dramatic shifts in funding arrangements between the provincial and federal governments. In Saskatchewan, this has produced a number of income security programs that neglect the needs of many ABI survivors. For example, current policy assumes that all ABI survivors will return to full-time employment. Currently, the government has acknowledged it mistakes and is willing to look at reforming the system as a whole. This presentation will focus on what the ABI community has been doing to lobby the government towards creating policy which provides for the needs of ABI survivors. This includes a review of the challenges we face on both a short term and long term basis. Some of the issues encountered include: how to provide a quality of life for long term recipients of income security, and finding a place for ABI in the disability community. Examples of the successful lobbying efforts will also be presented. These include gaining substantial increases to basic living and shelter allowances, as well as working with government to educate front line workers about the needs of ABI survivors. Using various community organization modules as a framework for action, participants will gain a better understanding of how to successfully lobby government and policy makers to accommodate for the needs of the brain injured population on provincial welfare programs.
Target Audience
Survivors
Family Members
Service Providers
Community Activists/ Policy Makers
Session B3
Peer Trainers: Survivors Helping Survivors on the Job
Presenter(s)
Dean Powers, MA - Vocational Solutions Inc. - Vancouver, BC
Charles Ottewell - Ottewell & Associates - Burnaby, BC
Objective
Participants will learn through seminar and two case studies how peer trainers can be utilized in conjunction with vocational rehabilitation services.
Abstract
Persons with ABI returning to the work world or into community settings may face difficulties with memory, work habituation and communication. This presentation explores utilizing peer trainers as coaches/mentors to address both "on and off the job issues" as part of the vocational rehabilitation service. Peer trainers are valuable to more recent survivors in sharing their experiences and journey during recovery. As part of the vocational rehabilitation team, peer trainers provide mentorship to clients through individual contact predominantly when the client is off the job and isolated. This is important in assisting with work or a vocational stabilization. This presentation reviews two case studies where a peer trainer and the vocational rehabilitation consultant work together to provide vocational and personal support leading to work stability and an increase in quality of life for survivors moving into employment venues.
Target Audience
Survivors
Family Members
Service Providers
Medical
Lawyers
Session B4
Integrated Intervention for ABI and Substance Abuse: Findings form the SUBI Bridging Project
Presenter
Carolyn Lemsky, PhD - Community Head Injury Resource Services of Toronto - Toronto, ON
Objective
- Provide a brief review of the literature pertaining to Substance Use and ABI.
- Report on a collaborative interverention project.
- Provide an overview of the program materials designed to facilitate collaboration between ABI and Substance Abuse Providers.
Abstract
The link between brain injury and substance abuse is now well recognized. Recent research indicates that more than half of persons presenting for rehabilitation after brain injury report a pre-injury history of substance abuse. As many as half of these patients return to problematic substance use within two years of sustaining their injury. But that seems to be the tip of the ice berg. Our own data indicate that nearly one quarter of persons presenting for treatment at the Centre for Addictions and Mental Health in Toronto report a history of head injury with loss of consciousness. Unfortunately, there are few practical resources that facilitate appropriate treatment partnerships and cross- training of professionals.
This workshop will present the findings from SUBI Bridging Project (Substance Use and Brain Injury) an Ontario Ministry of Health Transition Fund project completed in partnership between Community Head Injury Resource Services of Toronto, The Centre for Addictions and Mental Health and the Toronto ABI Network. Following a brief review of relevant literature, materials developed for use by the project partners will be reviewed. Project materials include a prevention pamphlet, a psycho-educational program for inpatient rehabilitation, a cross training provider manual and a client workbook. Application of Harm Reduction principles, Motivational Interviewing techniques, and Relapse Prevention and 12-step programs will be discussed. Findings from our implementation pilot will be reviewed, highlighting case management issues and the successes and challenges associated with the partnership relationships established through the project.
Target Audience
Service Providers
Medical
Research
Session B5
Home, School and Community -- Where It's At For Comprehensive Assessments
Presenter(s)
Jane Gillett, MDFRCP - GBF Associates - Toronto, ON
Ann Bedard, MS,OT - GBF Associates - Toronto, ON
Objective
Participants will gain an appreciation of the importance of context in the completion of medical legal and comprehensive medical/ rehabilitation planning assessments.
Abstract
Multi-disciplinary assessments of children and adolescents are often pivotal in determining both compensation and long term medical and rehabilitative care following an acquired brain injury. The applicability of the evaluations to the child or youth's ability to function in his or her own environment and the long-term "real world" impact of the injury are essential in order to ensure that the individual receives the services and support that he or she needs. We believe that the most effective way to achieve the most accurate assessments of function is to evaluate children and adolescents in the situations in which they carry out their lives: at home, school and in their communities.
This presentation will review the general assessment approaches that we as a pediatric neurologist and an occupational therapist use to complete our comprehensive evaluations in the community. We will use case examples to illustrate both the methodology used and the effectiveness of this approach in three challenging situations: one where the impact of the injury and the child's long term needs had been overlooked due to family trauma and the passage of time, one where a pre-existing diagnosis had obscured the acknowledgement of the traumatic brain injury, and a third where a lack of funding and the presence of behavioural challenges were barriers to the provision of the extensive therapies required. In each situation, the use of a contextual assessment approach ensured an accurate and complete picture of the individual's strengths, challenges and needs, and resulted in a better outcome
Target Audience
Family Members
Service Providers
Lawyers
Insurance Companies
Concurrent Session C
Start time 3pm
End Time 4pm
Session C1
Years later...
Presenter(s)
Robyn Littleford, M Ed - VSB/GF Strong Rehab Centre - Vancouver, BC
Julia Zarudzka, M Ed - Private Educational Consultant - Vancouver, BC
Objective
Inherent in a student's education should be a goal of maturing with a sense of meaning/purpose and with a positive sense of self-esteem. The presentation will offer insights into several individual's perception of the process down this path. Participants will celebrate the many and varied accomplishments of numerous students with ABI and acknowledge the many definitions of success.
Abstract
As professionals working in the field of rehab, our contact with children and teens with brain injury extends past high school graduation. Julia and Robyn have had the opportunity and privilege to follow numerous students through their educational journeys post-ABI. All of our students have had to make significant adjustments to how they learn, their course of study and their post-secondary pursuits. It is with pleasure that Julia and Robyn celebrate the accomplishments of a number of students whose successes range from completing school with a School Leaving Certificate to University Graduation. At the same time, a brief overview of how the school system has accommodated students with ABI over the past 20 years will be presented.
Target Audience
Survivors
Family Members
Service Providers
Educators
Lawyers
Session C2
Foundations For New Direction In Brain Injury: The Calgary Health Region Experience
Presenter(s)
Aruna Mitra, M Ed - Calgary Health Region - Calgary, AB
Objective
1) Share outcomes of Calgary Health Region Brain Injury Strategy;
2) Provide a conceptual framework for service delivery structure which is inclusive, accessible and flexible;
3) Describe new regional roles of BI Manager and BI Coordinator to facilitate program development and promote a seamless model of care; and
4) Describe initiatives for Regional BI client database, concussion early education and management, community based rehabilitation, day support and linkages with primary care.
Abstract
Provision of a comprehensive, evidence based system aimed at addressing the needs of the brain injured population throughout the continuum has eluded health care providers for decades. As new technologies and treatment approaches evolve to effectively manage the very acute stage of traumatic and acquired brain injury resulting in increasing survival rates makes development of such a system an imperative. In 2004-05, the Calgary Health Region actively embarked on building such a system by conducting a major review of the issues and gaps in its system and implementation of a mechanism to orchestrate connections between the different sectors. The vision is to have a service delivery system for the Region which is inclusive, accessible and flexible. In order that survivors are enabled to live to live to their fullest capacity, they may require ongoing consistent services, or bursts of intense services.
This presentation will share the conceptual framework based three key influences: the WHO International Classification of Function (ICF), the Chronic Disease Management (CDM) model and the "Just Right Challenge" (Csikszentmihalya, 1975, Kaplan, 1988). The service delivery framework spans the continuum from prevention, acute management, rehabilitation, community care and supportive living for all age groups. Discussion will include the administrative and human resource structure and roles created to successfully implement the model- including implementation of a regional database to support the evidence based approach. Specific implementation challenges and successes will be shared.
Target Audience
Service Providers
Session C3
Striving for Participation: Providing a Continuum of Employment Opportunities
Presenter(s)
Stacey Martin, BA - CHIRS - Toronto, ON
Vesna Latkovic, Hon BA - CHIRS - Toronto, ON
Objective
Tools to develop a continuum of Employment Opportunities; Strategies to increase participant independence and satisfaction in a vocational context; Strategies for working with Community Partners
Abstract
How can we address a variety of abilities and needs in a single employment program? What do you do when the funds for job-coaching have run out, but the desire to work and the need for job-coaching remain?
This presentation will provide an overview of CHIRS continuum of employment programs designed to provide employment experience and sustainable, community-based supported employment specifically for persons with moderate to severe behavioural and cognitive disabilities resulting from acquired brain injury.
Special focus will be given to our entry level employment opportunity CardSharks+. This innovative program format provides a range of tasks from errorless card production for persons with severe to profound impairment to, work-station set-up and data entry for persons who are employment bound. In a recreational setting, participants are encouraged to practice team work, social skills and a professional attitude toward project completion. Participants often advance to a graduated work crew model developed in cooperation with three large employers, IKEA, Canadian Tire, Sheridan Nurseries. The model enables teams of clients to work in competitive settings as a collective with ongoing support from a job coach. We will illustrate how clients deemed "permanently unemployable" have become paid employees with opportunities for advancement.
Participants will gain an understanding of the employment model and information about how to get started. Topics covered will include: obtaining funding grants to develop crews, pairing clients at different functioning levels with complimentary abilities, negotiating independent positions for successful crew members up front, nurturing an attentive employer - agency relationship, establishing on-site mentoring relationships with employers and outcome evaluation. Techniques to foster the growth of individual workers including the use of group and individual shift feedback forms and goal setting will also be presented. Using video-taped interviews, we will explore client and employer outcomes such as the changes in attitudes, identity and self-esteem that occur when people can do real work for a real wage.
Target Audience
Survivors
Family Members
Service Providers
Lawyers
Session C4
From Hospital to Home: A Family's Story
Presenter(s)
Mike Rossiter - Rossiter Graphic Design - Richmond, BC
Geoff Sing, MA - Macdonald House - Victoria, BC
Objective
The objectives of this presentation are: 1. to demonstrate the role of family as advocates and caregivers; 2. to explore a supportive continuum of care from hospital to community; and 3. to examine the 5 most important things to families in the continuum of care.
Abstract
This presentation uses the story of Blake Rossiter as a backdrop to demonstrate the supportive continuum of care that is required to ensure survivors of complete community integration.
Blake Rossiter's story offers inspiration and hope to survivors and family members. Following a car crash over ten years ago, doctors prepared Blake's family that it was unlikely he would survive and if he did it would be in a vegetative state. Nonetheless, Blake offered his family signs that he would recover. His parents used these gifts of hope to fuel their energy to advocate for rehab services. It was through their persistence and determination that Blake received every possible service available to him, which later enabled him to move from hospital to rehab to a community-based residential facility. Blake struggled in the years following and finally reached a crisis-point requiring intervention. Resuming their role as advocates, Blake's family built a circle of support in the community, which brought him from a psychotic/confrontational state to where he is now living independently and once again, participating as a member of his community.
Presented by a member of Blake's family and a survivor/service provider, this session demonstrates the benefits of building a circle of support for rehab services to span the continuum of care and to ensure an individual's reintegration into their community.
Target Audience
Survivors
Family Members
Service Providers
Session C5
Post Injury to Podium- a perspective in Sports for people with Disabilities
Presenter(s)
Terrie Moore, BPE - SportAbility BC - Surrey, BC
Todd Phillips - Canadian CP Sports Association - Surrey, BC
Abstract
Many people with disabilities and service providers are not aware of the opportunities to participate in organized sport for people with disabilities. From the local club to the Paralympics, the opportunities include soccer, athletics, boccia, sledge hockey, cycling and many other exciting sports. Athletes who meet the eligibility criteria can participate in local clubs and provincial competitions. They can aspire to be on the national team and travel to the Paralympics.
Target Audience
Survivors
Family Members
Service Providers
Medical
Concurrent Sessions D
Start time 4:15pm
End Time 5:15pm
Session D1
Improving Outcomes of Paedatric Brain Injury Through Education and Awareness
Presenter(s)
Sheila Bennett, EdD - Brock University - St. Catharines, ON
John Kumpf, BA - ON Brain Injury Association - St Catharines, ON
Objective
This project is aimed at providing an alternative perspective from which to view/interpret "behaviours" by: (a) increasing insight and awareness of ABI presentations in the paediatric population that are confusable with other, perhaps more familiar, ones such as conduct or mental health presentations; (b) outlining academic, social and behavioural concerns within the mental health context; (c) providing appropriate and effective strategies for classroom use to facilitate improved outcomes by promoting a problem-solving approach; and (d) disseminating this information with a support framework to ensure understanding, use and continuous support for child and youth care workers, rehabilitation workers, educators (teachers, education assistants) and thus, ultimately, children living with ABI.
Abstract
Acquired brain injury (ABI) accounts for 30% of all paediatric injuries and is the leading cause of death and disability for children and adolescents (Patrick et al, 2002). The prevalence of school age individuals in Canada who have sustained a brain injury and survived is approximately 108,000 (e.g. Kraus, 1995). Common to ABI are frontal lobe injuries and the disruption of related neurochemical systems (Anderson et al, 2000; Ownsworth & Oei, 1998) along with their associated presentations such as disinhibition, emotional labiality, anger dyscontrol, and impaired social judgement or, conversely, limited initiation, reduced emotional reactivity, inattentiveness, and limited self-monitoring - all of which can impair one's social effectiveness and integration/acceptance. Even so, most will return to their communities, requiring adaptations and modifications for successful re-entry.
Since they present with cognitive and externalizing behaviour problems (Greenspan & Mackenzie, 2000), these children are often viewed as a behavioural problem, primarily as a function of psychosocial issues. As a result, inappropriate interventions may be introduced, while the brain injury remains undetected and unmanaged. It is important that children with ABI are identified by teachers, family members and health care workers so as effective interventions shown to expedite recovery and improve functional outcomes are applied. Addressing children's behavioural and mental health issues post injury within the context of other factors, such as academic ability, pre-existing status and family context (Donders & Strom, 2000; Stancin et al, 2002) is critical in facilitating optimal adjustment to one's social environment.
Target Audience
Family Members
Education Professionals, Support/Health Care Workers
Session D2
Igniting the Imagination
Presenter(s)
Lynda Batist-Friedman, OT - Lynda Batist-Friedman &Associates - Toronto, ON
Objective
Participants will appreciate the value of active listening and engaging the client's dreams.
Abstract
Today there are many new insights into the connection between mind and body. Researchers from various neuroscientific fields are positing theories about this relationship, which continues to further our understanding of the influence of the brain, in combination with maturational and environmental factors (i.e. including trauma to the brain) on a person's functions. This paper will discuss theories of mind, as proposed by Antonio Damasio, ("…we should "not minimize the value of satisfying human curiosity, least of all curiosity about humanity itself"), Elkhonon Goldberg and George P. Prigitano , who encourages a broader, less restrictive exploration of the nature of self-awareness as it relates to the brain-injured patient . This presentation will further address and elaborate on Lev Vygotsky's theory of Zone of Proximal Development, to support the belief that brain -injured clients can be encouraged to operate at their optimal level of function, provided they are respected for their abilities to imagine and create the reality of self following a brain injury. A young client will share, by way of DVD presentation, the importance of perseverance, dreams, and collaboration between client and therapist, to his achievement of success. This presentation's goal is to reinforce the importance both of the therapeutic relationship, and the broadest support for facilitation of client's dream-achievement.
Target Audience
Survivors
Family Members
Service Providers
Lawyers
Session D3
The Lawyer's Role in Rehabilitation: Is there one?
Presenter(s)
David Doig, LLB - David H. Doig & Associates, Barristers & Solicitors - Vancouver, BC
Objective
This controversial talk will focus on the interaction between the legal and the rehabilitation/medical community. Strong views are held on both sides of this issue. This presentation will raise a number of controversial points that are usually the subject of a heated debate within the medical/rehabilitation/legal community. This presentation will allow conference delegates to understand some of the more complex issues relating to the interaction between law and medicine. Audience participation will be welcomed. Participants will take away from the talk a much greater understanding of the role of lawyers in the rehabilitation field. Hopefully this will foster a greater understanding and cooperation while at the same time enlightening participants as to the differing points of view related to the lawyer's role in rehabilitation.
Abstract
Should the patient's lawyer simply focus on legal issues and not become involved in rehabilitation or should the lawyer take an activist role in supporting the client's rehabilitation?
Some lawyers and medical professionals are of the view that a lawyer should not be involved in the rehabilitation process, but rather should simply focus on advancing the tort claim to maximize the amount of financial recovery possible. Some members of the rehabilitation team may see the lawyer's questions in a team meeting as interfering or threatening. Finally, many lawyers lack the detailed medical knowledge to participate meaningfully in the rehabilitation process.
Some lawyers and medical professionals hold a different view. They believe that the lawyer plays a crucial role in the rehabilitation process. It is the lawyer's responsibility to ensure that the patient receives full and fair lifetime compensation. Some lawyers believe the way to accomplish this is to rely upon expert witnesses retained specifically to give a medical opinion for legal purposes only. Much less emphasis is placed upon the treating team from the point of view of providing expert opinions for the purposes of litigation. One of the problems with this approach is that litigation tends to turn into a battle of experts. Both plaintiff and defence counsel retain their "usual" stable of expert witnesses to provide differing opinions. We now have a gun-slinging match which may require a judicial ruling to determine which set of expert opinions should be accepted. In some instances, the plaintiff's version is accepted and the plaintiff is compensated accordingly. On other occasions the defence experts prevail and the patient may be under compensated.
On the other hand, an experienced plaintiff's counsel who becomes involved in the rehabilitation process will spend the time talking to the treating experts in order to understand the patient's condition and continuing problems. Using these treating practitioners to provide expert opinions on diagnosis, treatment and prognosis has several advantages over the expert who sees the patient on one occasion and provides a report. What could be more convincing to a Court than the evidence of treating practitioners who have used their skill and experience over the past years to treat and rehabilitate the patient?
What the treating professional may lack in the form of a polished courtroom presentation, they gain in terms of credibility that comes from being a treating practitioner.
The issue of whether there is a role for lawyers in rehabilitation and if so what should that role be has been a contentious topic for many years. Unfortunately the opportunities to discuss or debate this issue usually only occur on a one to one basis. It is hoped through this presentation and discussion that all the participants will enhance their professional practice through a greater understanding of the issues relating to the role of lawyers in rehabilitation. Materials will be provided.
Target Audience
Survivors
Family Members
Service Providers
Medical
Lawyers
Medical/Rehabilitation Professionals
Session D4
Caregivers Exclusive: Exploring the Grief Journey of a Caregiver
Presenter(s)
Janelle Breese Biagioni, - Soulwriter.com - Victoria, BC
Objective
This presentation will: 1. Recognize and understand the layers of loss that caregivers experience following a loved one's catastrophic injury; 2. Explore the potential responses of grief that caregivers may experience; and 3. Demonstrate strategies to assist caregivers in the grieving process.
Abstract
This presentation explores the profound grief that grips caregivers following the catastrophic injury of a loved one. Their "layers of loss" are often overlooked and require a multi-faceted approach to help them move beyond their grief and to heal.
It brings to the forefront that traditional modes of grieving (i.e. funeral) are not available to the families and individuals who are coping with the devastating and life-altering outcome of catastrophic injury. They often describe their experience as 'death-like,' yet there is no 'invitation' for them to mourn their loss. Individuals and families coping with multiple losses that have resulted from one event, or occurred in quick succession, are plummeted into immense sorrow. They cannot grieve their losses en masse - each loss brings its own grief and demands its own time. Presented by a family member, this presentation offers caregivers a compelling testimony blended with practical, yet revolutionary guidance to empower them through their journey of grief.
Elements of this presentation include the following:
- Definitions of Extraordinary Bereavement, Grieving and Mourning
- Overview of models of grief (what works/what doesn't)
- Exploring the primary and secondary losses experienced by caregivers
- Exploring the special needs of grieving caregivers
- Practical ways to assist the caregiver in coping with grief
Target Audience
Family Members
Caregivers
Session D5
Education and Enforcement Initiative: 'Doing' it Right' Injury Prevention Campaign
Presenter(s)
Brenda MacDougald, MSW - Prince George Brain Injured Group Soc. - Prince George, BC
Objective
This session will provide a detailed account of the 2006 'Doing' it Right' Injury Prevention Campaign, with a focus on the 'Education and Enforcement' component. The take home Injury Prevention Campaign Toolkit will provide participants with the means to replicate similar enforcement initiatives within their home communities.
Abstract
As prevention is the only cure for brain injury, the 'Doin' it Right' campaign was created by the Prince George Brain Injured Group Society to educate community members with the 'Ride Safe', 'Think Safe' and 'Play Safe' philosophy. The target population for this campaign was families in the Prince George area who were rewarded for 'Doin' it Right' and provided with education and/or formal warning tickets for non-compliance with the laws. There was an emphasis on teaching people the correct way to fit a helmet and promotion of the usage of appropriate safety gear. Vulnerable road users were educated about the rules of the road and the legal consequences of non-compliance.
Due to the apparent gap in current research regarding small wheels and the usage of appropriate protective gear, data was intermittently collected among vulnerable road users at various locations throughout the city during the summer months. This data will guide future injury prevention campaigns across the city and promote further study in the use of appropriate protective gear among vulnerable road users.
This collaborative venture was a fun and interactive way to promote safety awareness and created the opportunity for positive and unique working partnerships with a variety of community businesses and agencies including the RCMP.
Target Audience
Survivors
Family Members
Service Providers
Research
Child and Youth Educators
Saturday, February 17, 2007
Start time 8:30am
End Time 10am
Session Morning Plenary
The Long Road Back ~ Dave Irwin
Concurrent Session E
Start time 10:30am
End Time 12noon
Session E1
The Healthy Brain Program
Presenter(s)
Stephen Kiraly, FRCPC - VCHA - Coastal Area - Squamish, BC
Patricia Stoop, BScOT - VCHA - Coastal Area - Squamish, BC
Objective
Participants will learn what brain health means and what the Healthy Brain Program can do for it. Participants will learn why brain health is more important than ever. Participants will learn about the Eight Pillars and how they contribute to brain health and longevity.
Abstract
This presentation provides an outline and overview of the Healthy Brain Program (HBP). The mission of the program is to increase awareness of the brain as a vital organ. It is meant to urge individuals to pursue healthy, successful living and aging. Some topics covered include the importance of brain health, obstacles to brain health, the bad news about brain deterioration and the good news about the staying power of the brain. The brain is our best health care system. We eagerly focus on the brain's ability to make new connections and generate new cells. We will show how the Eight Pillars of Brain Health and Longevity actually protects the brain, contribute to new connections and neurogenesis. This promotes life-long rehabilitation.
The Eight Pillars of Brain Health and Longevity are: Nutrition, Exercise, Sleep, Hormone Management, Stress Management, Treatment of Disease, Mental Activity and Physical Activity. This fresh, prevention-based outlook fosters a positive attitude and empowerment regarding brain health issues and rehabilitation.
The Healthy Brain Program uses evidence based knowledge and was developed by professionals dedicated to the field of clinical medicine and neuropsychiatry. Brain health information has been analyzed and filtered to purge information that is misleading and potentially dangerous. We are currently using the HBP in our Community Brain Injury Program and mental health programs in the Coastal Area of VCHA. We will provide a brief outline with respect to how we have implemented it in the Squamish Community Brain Injury Program.
Target Audience
Survivors
Family Members
Service Providers
Medical
Lawyers
Session E2
Twenty The View from Twenty-Plus Years In The Trenches: A Panel Presentation By Some Of Us Who Have “Been There, Been Doing That” For A Long, Long Time
Presenter(s)
Wendy Duke, MSc - Columbia Speech & Language Services Inc. - Vancouver, BC
Carmen Dennis - ICBC, Vancouver, BC
George Hahn, MD - Vancouver, BC
Robyn Littleford, M Ed - GF Strong Rehab Centre - School Program Dept. Head - Vancouver, BC
Linda Hirsekorn, BSR OT - Community Therapists Inc. - Vancouver, BC
John Macdonald, PhD - GF Strong Rehab Centre - Vancouver, BC
Joseph Murphy, Q C - Murphy Battista, Lawyers - Vancouver, BC
John Simpson - Retired Case Manager - Abbotsford, BC
Loretto Stitilis - Mission, BC
Objective
Participants will gain an appreciation of the rich history of the brain injury community in British Columbia and of the Pacific Coast Brain Injury Conference. Participants will also learn the presenters’ perspectives on what has changed for the better, what has changed for the worse, and what has stayed the same since the first PCBIC of 1987. Challenges and ideas for the future will be explored.
Abstract
Once upon a time, a small group of people envisioned and organized a conference that would provide a home-grown forum for all stakeholders in British Columbia’s diverse and growing brain injury community. In October, 1987, their dream was realized in the form of the first annual Pacific Coast Brain Injury Conference. Each of the panellists presenting in this session were active in both the brain injury community at that time and also in that first PCBIC. Moreover, each of our panellists remains active in both today. Our panellists hail from a variety of backgrounds; each provides an invaluable perspective on the twenty years of challenges, changes, successes and failures in the brain injury community in our province. Each has ideas, born of years of practical experience, about future directions.
In this presentation, each of the panellists will share a few minutes of their perspective on what has changed for the better, what has changed for the worse, and what problems remain unchanged since that first Pacific Coast Brain Injury Conference in October 1987 as well as ideas for the future of the brain injury community in BC. Approximately one third of the session will be available for discussion, comments and questions.
Target Audience
Survivors
Family Members
Service Providers
Medical
Research
Lawyers
Feepayers
Session E3
Brain Injury 30 Years Later: Where Do We Go From Here?
Presenter(s)
Brian Webster, LLB - Webster & Associates - Richmond, BC
Daniel Corrin, LLB - Webster & Associates - Richmond, BC
Objective
To identify goals and ideal models for the future of traumatic brain injury survivors and their families.
Abstract
"Those who do not learn from the mistakes of history are doomed to repeat them." - George Santayana, philosopher, from Reason in Common Sense. Advances in emergency care, medical diagnoses and treatment since the 1970's have been nothing short of revolutionary. Yet, the lot of traumatic brain injury survivors and families has changed little. Society has begun to deal with the improving rate of survival, but long term outcome is still dependant on good families and good luck. Our systems of rehabilitation and care have not advanced significantly, neither has our legal system. This presentation, founded upon more than 30 years of legal experience in this area of practice involving cases in British Columbia, US, the UK, China, will propose specific targets and steps to reach them to better the lives of those who suffer these devastating injuries. These proposals are a specific call for change to the medical, rehabilitation, insurance, and legal systems.
Target Audience
Survivors
Family Members
Service Providers
Medical
Research
Lawyers
Session E4
Drinking and Drugging with a Brain Injury: How Does This Affect Me? The Etiology of Addiction
Presenter(s)
Jan McNeill, MA - GF Strong Rehab- Vancouver, BC
Objective
Participants will gain an understanding of how addiction develops; Participants will develop an understanding of how drugs and alcohol affect the brain injured patient; Participants will learn tools to educate and support clients who are using and are brain injured; and Participants will learn what resources there are in their local community and on the internet to support these individuals to get support.
Abstract
Through the use of PowerPoint, case examples and handouts, participants will gain deeper understanding of how addiction develops, how drugs and alcohol affect the brain injured patient, and how to help support these individuals or themselves to use strategies in to reduce harm to themselves or others. Increase your knowledge of a variety of resources you can pass on to your clients/patients or use yourself and walk away with tools you can use tomorrow.
Participants will be presented with a model that they can use to understand the etiology of addiction (including other diagnoses) and establish hope for recovery. Learn how substances affect the brain and the pleasure pathway and how brain injuries impact this process. Increase your repertoire of tools to help facilitate dialogue with support workers or those who have brain injuries, such as how to use "Trigger Mountain" and a "Decisional Box".
Become familiar with a possibility therapy/solution-focused strengths- and evidence-based approach that has been found to work effectively and respectfully with this client population. Learn how important instilling hope, respecting client boundaries, and psychoeducation on healing and brain chemistry is to enhancing your client's recovery. Understand the role of harm reduction in working with this population and how it can help to increase commitment and motivation regarding reducing use of substances.
Learn how to find resources in your community and on the internet.
Target Audience
Survivors
Family Members
Service Providers
Students
Session E5
Kids on the Block Puppet Troupe In A Book To Remember, Exhibiting Friendship: Impact Of Brain Injury
Presenter(s)
Jonna Milledge - Kids on the Block, BC Coalition of People with Disabilities - Vancouver, BC
Tara Goerzen, - Kids on the Block, BC Coalition of People with Disabilities - Vancouver, BC
Elizabeth Milton, - Kids on the Block, BC Coalition of People with Disabilities - Vancouver, BC
Objective
Delegates will observe and gain a better understanding of the emotional and cognitive changes experienced by a child living with a brain injury, Delegates will understand why it's important to encourage children to talk about their feelings and ask questions, Delegates will look at some compensatory strategies used by a child living with a brain injury.
Abstract
The Kids on the Block Puppet Troupe presents: A Book to Remember, Exhibiting Friendship: A look at the impact of Brain Injury Introduction:
Kids on the Block puppet character Justin Campbell, who is 14, sustained a brain injury in a car accident. He was in hospital for a week and then in a rehabilitation facility. Since returning home, he has continued his various therapies as an outpatient. Justin has also returned to school and is learning compensatory strategies which enable him to do most of the things he enjoyed doing before the accident-like painting! Presentation:
Delegates meet Justin, his friend Melody James and her older brother Shaun in two scenes-A Book to Remember and Exhibiting Friendship. Melody represents children who are having difficulty understanding the impact of a brain injury on a friend. Shaun serves as Justin's peer mentor-he is patient, respectful, considerate and caring. Shaun listens to Justin's feelings and supports his interests.
After each scene delegates will have an opportunity to ask questions as well as participate in group activities.
Target Audience
Family Members
Service Providers
Early Childhood Educators, Students Enrolled in Early Childhood/Special Education Programs
Session E6
Unlocking the Myths: Keys To Success. Effective Behavioural Strategies for Children With ABI
Presenter(s)
Rebecca Swift-Weir, RN - Brain Injury Services Simcoe County - Barrie, ON
Catherine Dodds, B Ed - The Neurologic Rehabilitation Institute of Ontario - Etobicoke, ON
Objective
Participants will explore their own ideas of challenging behaviours and will build a strategy keychain to effectively work with children with acquired brain injury who exhibit those behaviours.
Abstract
One of the most distressing consequences of acquired brain injury is personality change and challenging behaviour. Family members of children and youth with ABI often report that they can cope with changes in their child's physical and cognitive needs, but it is the behavioural issues, which impact on the child's ability to learn and to complete daily routines, that they find the most difficult to understand.
Behaviours that emerge after a brain injury are unique to each child and are usually linked to cognitive issues. What is often labelled as "acting out" or "inappropriate behaviour" may actually be a result of loss of cognitive skills which have been affected by the injury, such as confusion about what is expected, difficulty understanding abstract language, lack of insight into limitations and memory impairment, to name a few. Children with ABI cannot benefit from consequence-based models of behavioural intervention when the injury impacts their ability to remember rules from day to day, nor when they are unable to anticipate the consequence of their behaviour.
This interactive workshop, designed for parents as well as professionals, will introduce participants to an approach to managing challenging behaviours in children with acquired brain injury that focuses on interventions which anticipate behaviour rather than react to behaviour.
Target Audience
Family Members
Service Providers
Concurrent Sessions F
Start time 1:30pm
End Time 2:30pm
Session F1
Team Terrific
Presenter(s)
Karen Waller, BGS - Comox Valley Head Injury Society/Executive Director - Courtenay, BC
Dean Holm - CVHIS/survivor - Courtenay, BC
Carrie Anne Beech - CVHIS/survivor - Courtenay, BC
Karae White, B Ed - Comox Valley Head Injury Society/Injury Prevention Coordinator - Courtenay,BC
Peggy Street, B Ed - CVHIS - Courtenay, BC
Helen Tomaszewski, - CVHIS/survivor - Courtenay, BC
Chris Tutin, - CVHIS/survivor - Courtenay, BC
Objective
1. To showcase the presentation, the survivors, and the staff of the TEAM TERRIFIC brain injury prevention program from the Comox Valley Head Injury Society
2. To present a tool for injury prevention organizations to generate income.
Abstract
The members of TEAM TERRIFIC will provide a:
Snapshot of the TEAM TERRIFIC program and proof of its success;
Description of the components;
A facilitated question and answer panel with survivor presenters; and
Review of options available for those wishing to develop their own injury prevention programs.
TEAM TERRIFIC is a dynamic interactive presentation focused on preventing brain injuries amongst high risk youth. Brain injury survivors tell their personal story of perseverance with every component of the presentation making this an unforgettable experience for the audience. The presentation illustrates how the brain works, what happens when it is injured. SMART RISK strategies are discussed to prevent injuries. A simulation exercise lets the audience temporarily experience what it feels like to have a brain injury. These components presented together are changing attitudes and behaviours in our community, as well as improving survivors' self confidence and public speaking skills.
Target Audience
Survivors
Family Members
Service Providers
Medical
Session F2
NEW ~ Accepting What I Lost So I Can Understand What I Gained
Presenter
Sebastian Metz - Nanaimo, BC
Objective
To share my experience of a new life after acquiring a brain injury.
Target Audience
Survivors
Family Members
Session F3
Ethical Issues with Traumatic Brain Injury
Presenter(s)
Faith Hayman, LLB - Faith E. Hayman Law Corporation - Vancouver,BC
Objective
Participants will be introduced to ethical issues which often arise when a person suffers a brain injury and pursues a claim in relation to their injury. The session will explore how to go about making important decisions that reflect their values and beliefs; "what is my file"; and who makes decisions about my case?
Abstract
Ethical issues arise whenever decisions must be made which involve competing life values. In cases involving traumatic brain injuries, ethical issues can commonly arise in three different areas: (1) decision-making about resuscitation where the tension is between saving the person and concerns about the person's long-term quality of life; (2) tension between seeking recovery on one hand, and pursuing a personal injury claim (where the focus is on losses) on the other hand; and (3) tension in decision-making concerning the litigation process and the management of damages, between the value of promoting the independence of the individual with a TBI on one hand, and the value of ensuring that the funds will be put to good use on the other hand.
Ethical decision-making involves providing relevant information to the individual with a TBI and his/her family so that it is timely and understandable by them, recognizing their personal and cultural values about quality of life, the purpose of life, their religious commitment, their personal hopes, intuition and family considerations, and engaging them in the decision-making process in a meaningful and transparent way.
Target Audience
Survivors
Family Members
Service Providers
Medical
Lawyers
Session F4
ATTENTION PLEAZZE: Practical Applications!
Presenter(s)
Dorothy Hillmann, B ScPT - Thornhill, ON
Beverlee Melamed, B ScOT - Beverlee C. Melamed & Associates Inc. - Thornhill, ON
Objective
The purpose of this session is to follow-up on previous presentations on 'attention", looking at underlying factors. This will be accomplished by review and "hands on" approaches incorporating the practical ideas on the topic of "Improving Attention". For participants who have not attended a similar session previously, we will provide a brief overview and handouts.
Abstract
In this presentation we will review some of the some research that has been done in the areas of "Attention and Concentration", highlighting that lack of attention may be a significant factor contributing to poor outcome performance. We will present approaches we can use to build up "Attention" - what does this mean and are there more possibilities for treatment in this area? We will discuss the physiology and rationale underlying some issues effecting attention and concentration: fatigue, pain, poor sleep. Specific examples of strategies and concepts used will be discussed and shared as a group. Each participant will have a worksheet to follow, in assessing the possible strategies that they may wish to try or have tried, gaining a greater perspective and understanding on this most important topic. Increased awareness and self-monitoring techniques will be integrated in to the practical worksheet process.
Future treatment ideas will be initiated in the presentation and, hopefully expanded on by the participants.
Target Audience
Survivors
Family Members
Service Providers
Medical
Research
Lawyers
Session F5
The Road Not Chosen
Presenter(s)
Barb Butler, M Ed Admin. - Saskatchewan Brain Injury Association - Regina, SK
Larry Carlson, M Ed - Saskatchewan Brain Injury Association - Regina, SK
Objective
To share our personal stories as survivors of brain injury and to show how life can go on successfully in different directions.
Abstract
Barb Butler, current President of the Saskatchewan Brain Injury Association, and Larry Carlson, Past President, are both survivors of brain injury resulting from automobile collisions. Both began their careers as teachers, but were faced with decisions about the future. Is classroom teaching possible again? What options exist? Is volunteer work a possibility?
Barb shares her story of the road to recovery through coma and months of rehabilitation. Larry relates his experience of living with an undiagnosed brain injury, then corrective surgery, then a new life.
The stories relate to the roads travelled: literal roads where the injuries occurred, rehabilitative paths and finally the way to an altered, but exciting and fulfilling life.
"Life goes on. . . Life at a slower pace, life in a different direction. . . And I, now walking along that narrow path, begin to see the beauty. . . I am learning to move along the new road and in spite of the past, in spite of sorrow, in spite of myself, to enjoy it." Both Barb and Larry present their stories discussing the changes and identifying how they, with the support of family and friends, came to a successful new life after injury.
Target Audience
Survivors
Family Members
Service Providers
Medical
Session F6
Parental Psychological Health Following Onset of their Child's Acquired Brain Injury (ABI)
Presenter(s)
Kelly Benn, PhD - Queen's University - Kingston, ON
Objective
Review Research Findings; Discuss Clinical Implications; Discuss Recommendations for Service Provision.
Abstract
Parental psychological health was examined in the context of three models of stress and coping. A cross-sectional design was used in which parents of children with ABI (N=113) completed several questionnaires measuring stressors, resources, perceptions, and psychological health, and relevant demographic data.
The Double ABCX Model of Family Stress and Adaptation (McCubbin & Patterson, 1983), the Transactional Model of Stress and Coping (Lazarus, 1999) and the Multidimensional Model of Stress and Coping (Endler, 1988, 1993) were examined. Specifically, the variables relevant to parental psychological health were investigated, model fit was evaluated, and a model comparison was performed.
Parents in this study reported having readily available and accessible support systems, employed perception-focused coping strategies most often, described themselves as spiritual or religious, and were generally satisfied with their overall quality of life. The family environment described by the parents, and general health of the parents, were similar to the normative population. However, the majority of parents reported the presence of moderate to severe stress in a number of areas related to their child's ABI.
Findings indicated that the strongest contributing factors to parental psychological health were stressors and resources. A significant relationship was also found between the resource factor and the perceptions factor.
Of the three models examined, the Double ABCX Model of Family Stress and Adaptation was the best representation of parental psychological health following pediatric ABI. Theoretical and clinical implications of these findings, along with directions for future research will be discussed.
Target Audience
Family Members
Service Providers
Research
Start time 2:30pm
End Time 2:45pm
Refreshment Break
Start time 2:45pm
End Time 4pm
Session Closing Plenary & Remarks
Extreme Kindness Crew
View 2005 Concurrent Sessions |
