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Accommodation Outcomes and Transitions Following Community-Based Intervention for Individuals with Acquired Brain Injury

  • Sue Sloan (a1), Libby Callaway (a2), Dianne Winkler (a3), Kirsten McKinley (a1) and Carlo Ziino (a1)...
Abstract

Objectives: To explore living situation, support and participation outcomes of people with severe acquired brain injury (ABI) residing in either home-like or disability-specific accommodation settings, who were provided with 3 years of occupational therapy intervention based on the Community Approach to Participation (CAP).

To examine transitions for a subgroup whose accommodation and support model changed during this 3-year period and identify factors critical to this change.

Method: Forty-three participants who had sustained severe to extremely severe ABI, and were an average of 6.73 years post-injury, were provided with CAP intervention over a 3-year period. Living situation and support model, participation levels and accommodation transition data were collected at four time points.

Results: Participants were living in a range of home-like and disability-specific accommodation settings at baseline. The disability-specific accommodation group had mainly noncompensable injuries and required a significantly higher level of daily support at all four time points. They also received higher total hours of support, which averaged 170.83 hours per week at baseline and did not change significantly over the 3 years. In contrast, 86% of the participants residing in home-like settings had compensable injuries and received an average of 91.46 hours of support per week at baseline. This reduced to 70.97 hours per week over the 3-year intervention period, a change that was statistically significant.

Conclusion: It is possible to achieve accommodation transitions to more independent, home-like situations many years post-injury and regardless of injury severity. Home-like settings provide scope to adjust support along a continuum to reflect gains in independence, community integration and role participation that the fixed models and hours of support in disability-specific accommodation do not. Over time, these gains can flow into a significant reduction in hours of support.

Copyright
Corresponding author
Address for correspondence: Sue Sloan, PO Box 2191, Kew, Victoria, 3101, Australia. E-mail: sue@osbornsloan.com.au
References
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Ashley M.J., Krych D.K., & Lehr R.P. (1990). Cost/benefit analysis for post-acute rehabilitation of the traumatically brain-injured patient. Journal of Insurance Medicine, 22 (2), 156161.
Australian Government (Producer). (n.d.). SAIF Overview. Retrieved from: http://saif.govspace.gov.au/
Chronister J., & Chan F. (2006). A stress process model of caregiving for individuals with traumatic brain injury. Rehabilitation Psychology, 51 (3), 190201.
Commonwealth of Australia (Producer). (2009a). National Disability Insurance Scheme. Retrieved from http://www.fahcsia.gov.au/sa/disability/progserv/govtint/Pages/ndis.aspx
Commonwealth of Australia. (2009b). Shut out: The experience of people with disabilities and their families in Australia. Canberra, ACT: Department of Families, Housing, Community Services and Indigenous Affairs. Retrieved from: http://www.fahcsia.gov.au/sa/disability/pubs/policy/community_consult/Pages/default.aspx
Dikmen S., Machamer L., & Temkin N. (1993). Psychosocial outcome in patients with moderate to severe head injury: 2-year follow-up. Brain Injury, 7 (2), 113124.
Disability Service Commission of Western Australia. (2008). Looking forward to community living: My own life, my own home, in communities where we all belong. West Perth, Australia. Retrieved from: http://www.disability.wa.gov.au/dscwr/_assets/main/instructional/documents/pdf/looking_forward_to_community_living.pdf
Dixon S., Walker M., & Salek S. (2006). Incorporating carer effects into economic evaluation. Pharmacoeconomics, 24 (1), 4553.
Douglas J.M., & Spellacy F.J. (2000). Correlates of depression in adults with severe traumatic brain injury and their carers. Brain Injury, 14 (1), 7188.
Eames P., Cotterill G., Kneale T.A., Storrar A.L., & Yeomans P. (1996). Outcome of intensive rehabilitation after severe brain injury: a long-term follow-up study. Brain Injury, 10, 631650.
Engberg A.W., & Teasdale G. (2004). Psychosocial outcome following traumatic brain injury in adults: a long term population-based follow-up. Brain Injury, 18 (6), 533545.
Feeney T.J., Ylvisaker M., Rosen B.H., & Greene P. (2001). Community supports for individuals with challenging behavior after brain injury: An analysis of the New York state behavioral resource project. Journal of Head Trauma Rehabilitation, 16 (1), 6175.
Geurtsen G.J., Martina J.D., Van Heugten C.M., & Geurts A.C.H. (2008). A prospective study to evaluate a new residential community reintegration programme for severe chronic brain injury: The brain integration programme. Brain Injury, 22 (7–8), 545554.
Hall K.M., Mann N., High W.M., Wright J., Kreutzer J., & Wood D. (1996). Functional measures after traumatic brain injury: Ceiling effects of FIM, FIM+FAM, DRS, and CIQ. Journal of Head Trauma Rehabilitation, 11 (5), 2739.
Hibbard M.R., Cantor J., Charatz H., Rosenthal R., Ashman T., Gundersen N., . . . Gartner A. (2002). Peer support in the community: Initial findings of a mentoring program for individuals with traumatic brain injury and their families. Journal of Head Trauma Rehabilitation, 17 (2), 112131.
Hough A. (2001). Physiotherapy in respiratory care. London: Chapman & Hall.
Kelly G., & Winkler D. (2007). Long-term accommodation and support for people with higher levels of challenging behaviour. Brain Impairment, 8 (3), 262275.
Kersel D.A., Marsh N.V., Havill J.H., & Sleigh J.W. (2001). Psychosocial functioning during the year following severe traumatic brain injury. Brain Injury, 15 (8), 683696.
Kielhofner G. (1985). A model of human occupation: theory and application (2nd ed.). Baltimore, MD: Williams & Wilkins.
Marsh N.V., Kersel D.A., Havill J.H., & Sleigh J.W. (1998). Caregiver burden at 6 months following severe traumatic brain injury. Brain Injury, 12 (3), 225238.
McCabe P., Lippert C., Weiser M., Hilditch M., Hartridge C., & Villamere J. (2007). Community reintegration following acquired brain injury. Brain Injury, 21 (2), 231257.
McColl M.A., Carlson P., Johnston J., Minnes P., Shue K., Davies D., & Karlovits T. (1998). The definition of community integration: perspectives of people with brain injuries. Brain Injury, 12 (1), 1530.
McMillan T.M., & Herbert C.M. (2004). Further recovery in a potential treatment withdrawal case 10 years after brain injury. Brain Injury, 18 (9), 935940.
O'Brien P., Pryor J., Harman A., Rivas M., & Nicholl B. (2010). Innovative models, housing design and home modification for people with acquired brain injury: A literature review and environmental scan. Sydney, Australia: University of Sydney, Centre for Disability Studies.
Oakley F., Kielhofner G., Barris R., & Reichler R. (1986). The Role Checklist: development and empirical assessment of reliability. Occupational Therapy Journal of Research, 6 (157–170), 157.
Pearson D.D.R. (2008). Accomodation for people with a disability. Melbourne, Australia: Victorian Goverment Printer.
Ponsford J., Olver J., Ponsford M., & Nelms R. (2003). Long-term adjustment of families following traumatic brain injury where comprehensive rehabilitation has been provided. Brain Injury, 17 (6), 453468.
Ponsford J.L., Olver J.H., & Curran C. (1995). A profile outcome: 2 years after traumatic brain injury. Brain Injury, 9 (1), 110.
Productivity Commission. (2011). Disability Care and Support Report no. 54. Canberra, Australia: Author. Retrieved from: http://www.pc.gov.au/__data/assets/pdf_file/0014/111272/disability-support-overview-booklet.pdf
Rivera P.A., Elliott T.R., Berry J.W., & Grant J.S. (2008). Problem-solving training for family caregivers of persons with traumatic brain injuries: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 89 (5), 931941.
Schofield P.W., Butler T.G., Hollis S.J., Smith N.E., Lee S.J., & Kelso W.M. (2006). Traumatic brain injury among Australian prisoners: rates, recurrence and sequelae. Brain Injury, 20 (5), 499506.
Simpson G., Secheny T., Lane-Brown A., Strettles B., Ferry K., & Phillips J. (2004). Post-acute rehabilitation for people with traumatic brain injury:Amodel description and evaluation of the Liverpool Hospital Transitional Living Program. Brain Impairment, 5 (1), 6780.
Sloan S., Callaway L., Winkler D., McKinley K., Ziino C., & Anson K. (2009a). Changes in care and support needs following community-based intervention for individuals with acquired brain injury. Brain Impairment, 10 (3), 295306.
Sloan S., Callaway L., Winkler D., McKinley K., Ziino C., & Anson K. (2009b). The community approach to participation: Outcomes following acquired brain injury intervention. Brain Impairment, 10 (3), 282294.
Sloan S., Winkler D., & Anson K. (2007). Long-term outcome following traumatic brain injury. Brain Impairment, 8 (3), 251261.
Sloan S., Winkler D., & Callaway L. (2004). Community integration following severe traumatic brain injury: Outcomes and best practice. Brain Impairment, 5 (1), 1229.
Soo C., Tate R., Hopman K., Forman M., Secheny T., & Aird V. (2007). Reliability of the Care and Needs Scare for assessing support needs after traumatic brain injury. Journal of Head Trauma Rehabilitation, 22 (5), 288295.
State Goverment of Victoria. (2006). Acquired brain injury — Slow to Recover Program. Retrieved from http://www.health.vic.gov.au/agedcare/publications/abi_slrpr.htm
Tate R.L. (2004). Assessing support needs for people with traumatic brain injury: The care and needs scale (CANS). Brain Injury, 18 (5), 445460.
Thomsen I.V. (1984). Late outcome of very severe blunt head trauma: A 10–15 year second follow-up. Journal of Neurology, Neurosurgery and Psychiatry, 47, 260268.
Turner B., Fleming J., Cornwell P., Worrall L., Ownsworth T., Haines T., . . . Chenoweth L. (2007). A qualitative study of the transition from hospital to home for individuals with acquired brain injury and their family caregivers. Brain Injury, 21 (11), 11191130.
Turner B.J., Fleming J.M., Ownsworth T.L., & Cornwell P.L. (2008). The transition from hospital to home for individuals with acquired brain injury: A literature review and research recommendations. Disability and Rehabilitation, 30 (16), 11531176.
UDS Data Management Service. (1990). Guide for use of the Uniform Data Set for Medical Rehabilitation including the Functional Independence Measure (3rd ed.). Buffalo, NY: State University of New York at Buffalo.
Wahl H., Fange A., Oswald F., Gitlin L.N., & Iwarsson S. (2009). The home environment and disability-related outcomes in aging individuals: What is the empirical evidence? The Gerontologist, 49 (3), 355367.
Whiteneck G.G., Gerhart K.A., & Cusick C.P. (2004). Identifying environmental factors that influence the outcomes of people with traumatic brain injury. Journal of Head Trauma Rehabilitation, 19 (3), 191204.
Willer B., & Corrigan J.D. (1994). Whatever it takes: A model for community-based services. Brain Injury, 8 (7), 647659.
Willer B., Ottenbacher K., & Coad M. (1994). The Community Integration Questionnaire: A comparative examination. American Journal of Physical Medicine and Rehabilitation, 73, 103111.
Willer B., Rosenthal M., Kreutzer J. S., Gordon W. A., & Rempel R. (1993). Assessment of community integration following rehabilitation for traumatic brain injury. Journal of Head Trauma Rehabilitation, 8 (2), 7587.
Winkler D., Farnworth L., & Sloan S. (2006). People under 60 living in aged care facilities in Victoria. Australian Health Review, 30 (1), 100108.
Winkler D., Farnworth L., Sloan S., Brown T., & Callaway L. (2010). Comparison of people with ABI living in two accommodation settings: Shared supported accommodation and residential aged care. Brain Impairment, 11 (3), 313325.
Winkler D., Sloan S., & Callaway L. (2007a). From a home to their home: Alternatives to young people living in nursing homes. Melbourne, Australia: Summer Foundation Ltd.
Winkler D., Sloan S., & Callaway L. (2007b). Younger people in residential aged care: Support needs, preferences and future directions. Melbourne, Australia: Summer Foundation Ltd. Retrieved from: http://www.summerfoundation.org.au/attachments/046_SF_A4_Brouchure_HR_SmallSize%20100px.pdf
Winstanley J., Simpson G., Tate R., & Myles B. (2006). Early indicators and contributors to psychological distress in relatives during rehabilitation following severe traumatic brain injury: Findings from the brain injury outcomes study. Journal of Head Trauma Rehabilitation, 21 (6), 453466.
Wood R.L., McCrea J.D., Wood L.M., & Merriman R.N. (1999). Clinical and cost effectiveness of post-acute neurobehavioural rehabilitation. Brain Injury, 13 (2), 6988.
World Health Organization. (2001). International classification of functioning, disability, and health (ICF). Geneva, Switzerland: Author.
Ylvisaker M., Feeney T., & Capo M. (2007). Long-term community supports for individuals with co-occurring disabilities after traumatic brain injury: Cost effectiveness and project-based intervention. Brain Impairment, 8 (3), 276292.
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Brain Impairment
  • ISSN: 1443-9646
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