I just attended the ABI Network Conference in Toronto. I’ve been a participant in this conference for years and each time it is convened I appreciate how the conference organizing committee hits the right themes. I spoke about problems in social role return and one of the questions related to what are realistic resources to achieve long term outcomes. Later in the day Dr. Robin Green spoke about the long term course of traumatic brain injury and pointed out that the problems are best conceptualized as a chronic disease and with data from her research addressed that progress plateaus and performance declines in the absence of stimulation and environmental enrichment. Just two weeks ago, I spoke with a grandmother who was the guardian of her 26-year old grand-daughter who has been in a nursing home for several years after her brain injury for which she received no rehabilitation. She calculated that if the state had spent up to $1000 a day for rehabilitation her grand-daughter could be living in the community with home health supports. Instead at 26 she was deteriorating in a nursing home. Clearly she spoke to what Dr. Green and I addressed in our talks.
The conference also featured a keynote by Dr. James Malec on post hospital assessment and planning and presentations by Caron Gan and Dr. Jeffrey Kreutzer on family issues and resilience. Jaisa Sulit a contributor to this blog spoke about Mindfulness, a theme which was also referenced by Dr. Green.
I left the conference thinking that the research and issues were focusing on the long term problems. Yet when one thinks about the barriers created by both insurance and public funding the resources for what is needed often does not provide for what people need to sustain independence. The problem that the concerned grandmother called me about was clearly the issue which needs to be faced. Its cheaper to treat brain injury early following the injury and sustain lifetime supports than to pay for a lifetime of nursing home placement.