Picking Our Brain with Shepherd Center

Each year, an estimated 2.4 million people in the United States sustain a traumatic brain injury (TBI), and another 795,000 people are diagnosed with an acquired brain injury (ABI) from non-traumatic causes, such as stroke.

Brain injury can have significant, long-term effects.

In fact, more than 5.3 million Americans are living with a lifelong disability because of TBI, and an estimated 1.1 million have a disability related to stroke.

With this large of an impact, many caregivers are seeking help from online educational resources.

To meet the needs of its brain and spinal cord injury rehabilitation patients and their families, Shepherd Center created an educational website found at MyShepherdConnection.org.

An in-depth section is devoted to brain injury-related topics, such as mood, behavior, memory, safety, nutrition, medication management and family dynamics. Instructional videos and other educational materials are also available on the website.

A number of other online resources also provide valuable information.

Here to discuss My Shepherd Connection and other resources is Susan Johnson, director of brain injury services at Shepherd Center.

Shepherd Center embraces a total approach to fitness and wellness that emphasizes physical and mental wellbeing.

Facilities include a weight room, indoor track, full-court gymnasium and swimming pool.

Through land and aquatic classes, personalized programs, massage, yoga and personal training, Shepherd Center attempts to improve its members’ fitness and quality of life.

The facility is completely accessible to allow people with physical disabilities to participate in all programs, as appropriate.

Professionally trained and certified staff members are available to ensure that all members receive the highest quality assistance.

Shepherd also introduces inpatients and day program patients to its fitness center, including aquatics, to give them the tools and knowledge to participate in their community fitness centers after discharge from the hospital.

Rebecca Washburn, M.S., is here to discuss how health and wellness before a person’s injury is important, but even more important following injury to maintain strength, endurance and prevent secondary complications.

Patients at Shepherd Center are at risk of infection for a few important reasons.

The risk goes up the longer a person is in a facility, and Shepherd’s average inpatient is in the hospital for more than six weeks.

Because Shepherd Center is a rehabilitation facility, patients are very mobile throughout the hospital, which sacrifices some infection protection afforded by having them stay put in their rooms.

Also, a high proportion of Shepherd patients use medical devices that add the risk of infection; these include certain kinds of IVs, tracheostomies and urinary catheters.

Listen in as Sarah Culberson, RN, discusses how Shepherd Center is working to decrease the risks of infection to patients.

Patients in the acute rehabilitation phase of recovery from a brain injury are at a high risk of falls, largely because of physical limitations and cognitive impairments.

But some prevention strategies implemented at Shepherd Center have proven successful in reducing fall rates significantly in this setting.

Falls among these patients can occur because patients experience weakness, confusion, impulsivity, impaired safety awareness, and poor judgment and reasoning.

They may also have uncontrollable spasms or movements that increase the risk of sliding out of a bed or a chair. Also, assisted falls may occur when a patient with limitations is learning new ways of moving and attempting to rebuild strength and endurance.

Strategies to prevent falls among these patients can be simple, but effective.

Shepherd Center uses bed alarms on all brain-injured patients, seatbelt alarms, one-on-one attendants and frequent rounding on patients.

Also, leadership engages staff members in maintaining a culture that recognizes the high risk of falls requires a high sense of urgency in responding to alarms, and that safety has to be more important than privacy for the brain-injured patient.

Shepherd Center Brain Injury Unit nursing manager Gail Greene, RN, is here to explain how Shepherd Center uses an interdisciplinary, collaborative approach to teaching and reinforcing the use of these strategies.

People with spinal cord injury and other conditions that limit movement are at great risk for pressure ulcer development.

Many risk factors predispose people with spinal cord injury to the development of these wounds; factors include impaired sensation, mobility, spasms and respiratory issues.

At Shepherd Center, nurse Cathy Koerner and her colleagues have implemented a comprehensive program to prevent these ulcers among patients while they are in the hospital and after they discharge.

Today, Cathy will share some pressure ulcer prevention strategies, which include scheduled turning and repositioning in beds and wheelchairs; management of bowel and bladder issues; proper support surfaces; and regular checks of the skin.

Every October, the U.S. Department of Labor’s Office of Disability Employment Policy celebrates National Disability Employment Awareness Month to recognize the workforce contributions of people with disabilities.

Those workers include people living with spinal cord or brain injury.

Returning to work after rehabilitation for these life-changing injuries is filled with challenges.

But with the guidance of vocational case managers and others, many have overcome the challenges and now make vital contributions to their employers and communities.

They have also become more financially independent and are living full, productive lives.

At Shepherd Center in Atlanta, vocational case manager Debbie Page counsels patients and employers on strategies to accommodate disabilities in the workplace.

She and her colleagues have witnessed many successful returns to work, and Debbie is sharing her insights today with Shepherd Center Radio listeners.

Congress has designated September as National Spinal Cord Injury (SCI) Awareness Month.

In addition to raising awareness and support for much-needed cure research, National SCI Awareness Month aims to further educate the public about how paralyzing accidents can be prevented.

There is no cure for spinal cord injury, nor is there an FDA-approved therapeutic or device that can restore function.

But researchers are working toward these goals, and more research dollars are needed to continue that work.

For now, people who sustain a spinal cord injury receive acute care in trauma hospitals and then typically undergo rehabilitation, which can help to restore some function and independence.

Early, comprehensive rehabilitation – such as what Shepherd Center provides – yields the best outcomes.

Anna Choo Elmers, M.D., is here to discuss how efforts are under way across the nation to prevent spinal cord injuries, especially those caused by distracted driving, falls and diving.

Patients who are in a reduced or minimally conscious state following a traumatic brain injury are often not ready to begin an active rehabilitation program.

But rehabilitation services are critical to optimize recovery until the patient emerges.

It is also vital to educate and train the patient’s family and/or caregivers about expectations and care.

For these patients, Shepherd Center’s specialized Disorders of Consciousness (DOC) Program provides pre-rehabilitation and education services.

Ford Vox, M.D., is here to discuss how research is under way at Shepherd Center and elsewhere with an eye toward new and innovative treatments for patients with a DOC.

Outpatient Services at Shepherd Center provides comprehensive medical treatment for people with spinal cord injury, brain injury, multiple sclerosis and chronic pain on an outpatient basis.

These programs provide individualized, integrative care and may even include family members.

Listen as Emily Cade, MS, CCM,CRC,CLCP,  director of Shepherd Center Outpatient Services, discusses the outpatient services available at Shepherd Center.

Shepherd Center is the lead clinical partner in the critical final stage of trials for a robotics-assisted walking device that could improve the lives of people with limited mobility caused by spinal cord or brain injury, stroke or multiple sclerosis.

Developer Parker Hannifin Corp. describes the exoskeleton device – called Indego® – as a “powered orthosis worn around the waist and legs that allows individuals with spinal cord injuries to stand and walk."

The device is being tested at Shepherd Center and a few other facilities across the nation in people with spinal cord and brain injury, multiple sclerosis and stroke.

Parker hopes to obtain FDA approval for the device in late 2015.

Casey Kandilakis, PT, DPT, NCS, is here to discuss the research and development of this robotics-assisted walking device.