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NeuroNotes is an informational web log that brings you the latest articles, news, events, and oddities relating to the brain and brain injury.
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Rolf B. Gainer, Ph.D., Diplomate ABDA, is the Chief Executive Office at Brookhaven Hospital and the Vice President of Rehabilitation Institutes of America. Dr. Gainer has been involved in the design and operation of treatment programs since 1977.
Penny Rott, MS, is a brain injury case manager for Neurologic Rehabilitation Institute at Brookhaven Hospital, providing resources and support for TBI victims and their families across the United States.
Aric Thorpe, MHR, is Brookhaven Hospital's Pastoral Liaison Representative. He conducts the quarterly Minister's Lifeline series and provides mental health information to pastors and clergy. |
Wednesday, May 07, 2008 3:13 PM
posted by Rolf B. Gainer, Ph.D.
Ingredients for the Perfect Storm
On a daily basis, through the newspapers and television, we hear and read stories about the problems faced by veterans returning from Iraq and Afghanistan with physical and psychological problems. At the APA conference this week the problem of 300,000 military members with PTSD was presented. Last week the number of drug overdoses, intentional and accidental, in wounded military personnel undergoing outpatient rehabilitation and other treatment was revealed. These soldiers are housed in transitional quarters on military bases, away from family, receiving limited services and case management. Many of these soldiers are disabled from traumatic brain injury and have other physical and psychological problems. Another story focused on the high number of suicides in military exceeding the number of war related deaths. The picture being painted for us is bleak and dangerous. Our soldiers need immediate help. The hidden psychological injuries must be identified and treated. The overt injuries and related disabilities cannot continue to be shuttled off into waiting lines and minimal treatment while task forces and committees are convened.
Disabilities from any cause affect every aspect of a person's life and treatment cannot be deferred. We need to move rapidly to bring the resources that are available in the civilian world to the members of our military who need help.
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Friday, May 02, 2008 12:50 PM
posted by Rolf B. Gainer, Ph.D.
Treatment Concerns for Returning Soldiers Continue
Returning soldiers with brain injuries and other disabilities, Post Traumatic Stress Disorder (PTSD) and mental health problems are at risk while they are in treatment at Walter Reed Army Medical Center and other military hospitals. At the Army hospitals serving our injured military personnel there have been 15 deaths of soldiers due to drug overdoses in recent months. The Army, through it's Surgeon General, Lt. General Eric Schoonmaker, is looking into the deaths as is a Congressional panel. It appears that many of the soldiers who have overdosed have been prescribed multiple medications with often limited communication between physicians and a lack of case management and coordination of care. In some cases, the soldiers had consumed alcohol which may have exacerbated the effects of the prescribed medications. There is also the unanswered issue of suicide which is known to be prevalent as a risk for traumatic brain injury and PTSD. The soldiers housed in Warrior Transition Units are a group at risk due to the low supervision and oversight of their care.
The problem underscores the need for integrated care and comprehensive case management. The Army must consider what services are needed by people with brain injuries, physical disabilities and mental health problems which affect their cognitive abilities and capacities to live independently. Currently the Army has banned alcohol in these Warrior Transition Units, but still has not provided the level of supervision that many of these individuals need to maintain safety and well being. Investigations and inquiries are important, but we do know the solution to the problem. Simply banning alcohol in a residence will not prevent soldiers from drinking there or in the community. The returning soldiers need program services and case management which are designed to meet their needs. We have those programs in the civilian world. Why wait for more overdoses and deaths?
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Thursday, May 01, 2008 4:13 PM
posted by Penny Rott, MS
VA Still Experiencing Problems Meeting the Needs of Veterans with Brain Injury
A recent story by Hope Yen, states that veteran’s needs post-TBI are still not being met. After a study of 52 VA TBI patients during a seven month post injury period in 2004, and the 2006 IG review which found problems 16 months post injury, the VA had promised to address the shortcomings. The article shares “10 of the 41 veterans who agreed to be interviewed said they weren't getting needed help for health care, vocational rehabilitation, family support or housing. At least four patients specifically cited trouble in getting primary or specialty eye care, while others reported gaps with family counseling for problems such as depression and anger”. Yen reports:
"This is very troubling," said Michael O'Rourke, assistant director for veterans health policy at Veterans of Foreign Wars. "The fact of the matter is from the very beginning VA and Defense went in with too little, too short (on resources), because they weren't expecting this to be a prolonged conflict of war. "I've seen a lot of effort to correct problems that exist. But constant vigilance is required," he said. "Veterans deserve to be treated for problems they may or may not know of." The report included a VA response in which the department acknowledged problems with case management but stated that with recent improvements it now had "systems in place to ensure that all veterans with TBI are being followed as their clinical needs require."
According to the article in an attempt to improve care the VA is proposing to call “570,000 recent combat veterans to make sure they know what services are available to them”. Click here to read the full article
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