NSW Brain Injury Rehabilitation Forum May 2011

 

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Functional retraining in a client with agitated behaviour
after traumatic brain injury
JANE SIMPSON, Westmead Hospital, BIRS

 

Title: Functional retraining in a client with agitated behaviour after traumatic brain injury

Author: Jane Simpson and Or Joseph Gurka, Westmead Brain Injury Rehabilitation Service

Agitated behaviour is often observed during the early stages of recovery from traumatic brain injury and presents with both challenging cognitive and behavioural characteristics. The impact of agitation on a client's participation in life roles is significant and often leads to a high level of support to participate in everyday activities. This presentation is going to focus on a case study of a client experiencing an agitated stage of recovery during acute in-patient rehabilitation. A role based rehabilitation approach is an important framework governing practice in the in-patient team at the Westmead Brain Injury Unit. This approach assist's people after traumatic brain injury to develop their skills and abilities in life roles that are directly related their pre-injury roles. As occupational therapists, an important part of our role is focusing on developing skills and independence in self-maintainer role. Within this case study a priority intervention area was functional re-training in the self-care tasks of drinking and eating. The cognitive reasons for re-training in these areas during an agitated stage of recovery will be further explored. A learning theory frame of reference will be used to outline the stages of skill development over a three month period in self-care tasks and discuss the transition into additional self-maintainer tasks. This case study will outline how the different stages of learning can be used to understand the process of skill development in occupational performance. A longitudinal perspective is used to demonstrate how an 'in house' attendant care program was introduced to enable client participation in additional occupational roles at later stages of rehabilitation. In this context, the attendant care programme provided the necessary support to progress this client's participation in everyday routines and tasks to the maintenance stage of learning.