Brain Waves: UAB Traumatic Brain Injury Model System Newsletter Volume 17 | Number 1 | Page 2

LIFE AFTER TBI • Cut down or cut out caffeine and Caregiving after Traumatic Brain Injury - Staying Healthy • • If you are a caregiver for a family member who has a traumatic brain injury (TBI), you face many unique challenges. This is part 1 of 2 articles that can help you better manage those challenges. This article aims to help you find a balance between taking care of yourself while caring for your loved one. Part 2 will be in the next issue of Brain Waves and focus on the challenges of caring for a partner/spouse. What can I expect after Rehab? The first challenge is to establish a new “normal.” You and your loved one learned a lot during rehab, but what works in rehab does not always work at home. It takes time to learn what works best for you at home and adjust to a daily routine. It may also take additional work to motivate your loved one to continue performing rehabilitation exercises at home or an outpatient basis. What can I expect early after injury? Life is often chaotic and very stressful during the early period after injury. For a parent, spouse or other close family member, there is worry and concern for the condition and recovery of your loved one. There is often stress over juggling work, family life, money issues, and many other things that are disrupted after injury. At the same time, you are learning about the many issues of TBI and how to provide care. Taking time to educate yourself will help set you up for success. • Visit the TBI Model Systems Knowledge Translation Center for more information about TBI. Why is it important to manage my personal health? Here are only a few of the many reasons it is important. • Provide the best care for your loved one. You cannot expect to properly care for your loved one if you do not properly care for yourself. • Keep your relationship healthy. Long-Term caregiving for a loved one can put a strain on any relationship. Staying healthy helps you better manage stressors. • You are worth it! Simply put, your health is just as important as your loved one’s health. • It is important to remember that you are not only a caregiver. Your role is also as a spouse, parent, child, or other loved one. How do I manage my personal health? This can also be a challenge. Here are 3 key steps. 1. Adopt a Healthy Lifestyle A healthy lifestyle includes a balance of things you can do to feel better emotionally and physically. This helps reduce stress and increase your ability to cope with problem issues. A few simple acts can be a great foundation for self-health. • Get plenty of sleep. • Eat regular, healthy meals and snacks. • Exercise and participate in regular physical activities. • Seek out social support to share ideas, resources and coping skills. • Take quiet time for yourself to listen to soothing music, soak in a warm bath or shower, read an interesting book or magazine or go to the park or some other place quiet. • Maintain your sense of humor. • Enjoy hobbies or crafts. Get Involved In UAB Research! Brave Initiative The University of Alabama in Birmingham (UAB) aims to improve the motor deficit of veterans who have sustained a traumatic brain injury. Potential participants must: • be at least 19 years old and 3 months post TBI; • have movement problems or weakness of the • • arms, but the ability to make at least some limited movements with the more affected hand; have no excessive pain; and be able to undergo MRI If you believe you meet the criteria above and would like to participate in this study, Go to the website, call 205- 934-9768, or email for more information. 2 uab.edu/tbi • products with nicotine. Do not rely on food, alcohol or drugs to reduce stress. Spend quality time with friends and family. Keep things organized. 2. Do not ignore signs of stress or depression Stress is a physical, chemical, and emotional factor that causes tension in your body or mind. Most everyone has some type of stress in their life. Stress is common because it is almost impossible to escape the realities of life. Stress can quickly become a problem for people who ignore warning signs that stress is getting out of control. Continued stress puts people at higher risk for serious health problems including illness, addiction, and depression. Here are some signs and symptoms of stress that your stress might be getting out of control. • The way you feel – you might feel more anxious, scared, irritable, or moody. • The way you think – you might forget things, think of yourself as a failure, or have trouble concentrating. • The way you act – you might cry easily or for no reason, act out of control, lose your appetite or start overeating, or abuse of drugs and/or alcohol. • Changes in your body – you might experience higher blood pressure, shaking, nervousness, headaches, more pain, change in weight, or sleep problems. Depression is a mood disorder that affects how you think, feel and act. The National Institute of Mental Health maintains you may be suffering from depression if you have some of these signs and symptoms most of the day, nearly every day, for at least two weeks. • Persistent sad, anxious, or “empty” mood • Feelings of hopelessness, or pessimism • Irritability • Feelings of guilt, worthlessness, or helplessness • Loss of interest or pleasure in hobbies and activities • Decreased energy or fatigue • Moving or talking more slowly • Feeling restless or having trouble sitting still • Difficulty concentrating, remembering, or making decisions • Difficulty sleeping, early-morning awakening, or oversleeping • Appetite and/or weight changes • Thoughts of death or suicide, or suicide attempts • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment 3. Get help when you need it Asking for help can be a challenge for some. However, asking for help is a sign of strength - not weakness. And asking for help does not mean you are failing as a person or a caregiver. It simply means you are taking care of yourself, too. • Support groups - Local and online support groups can be a great way to learn about resources and learn from others who have gone through similar experiences. • Respite - Caregiving is not a one- person job. You need time away for a healthy lifestyle. The best thing that you can do is have a list of people that you can call when you need someone. You might also have one or two people on your list who can be a backup care provider on short notice in case of sickness or crisis, or if you just need a break. • Your local Center for Independent Living (CIL) can provide information and referrals for respite or Personal Care Attendant services in your area. • Counseling - A psychologist, counselor, or social worker can provide you with resources and guidance on balancing caregiving and caring for yourself. UAB-TBIMS Research Spotlight Scale Up Project Evaluating Responsiveness to Home Exercise And Lifestyle Tele-Health (SUPER-HEALTH) This study evaluates the effects of an exercise program on improving pain, fatigue, physical activity, and physical function. The program is delivered through a tablet app in the convenience of the home using exercise videos. Criteria to Participate • Ages 18-64 • Mobility Impairment/Disability • WiFi Internet access in Home Participants receive a tablet and Fitbit to use during study and are eligible to keep all equipment at the completion of last study visit. Visit superhealthstudy.org, call (205) 403- 5509, or email [email protected]. The University of Alabama at Birmingham Traumatic Brain Injury Model System (UAB-TBIMS) is about mid-way through our current funding cycle (2017-2022). Below is a list of some of the most recent contributions to research by our UAB-TBIMS researchers and links to the research abstracts where available. • Employment stability in the first 5 years after moderate to severe traumatic brain injury. DiSanto, D., Kumar, R., Juengst, S.B., Hart, T. O’Neil- Pirozzi, T.M., Zasler, N., Novack, T.A., Dillahunt- Aspillaga, C., Graham, K.M., Cotner, B., Rabinowitz, A., Dikmen, S., Niemeier, J., Kesinger, M.R., Wagner, A.K. Archives of Physical Medicine and Rehabilitation, 2019, Mar:100(3), 412-421. • Longitudinal Effects of Medical Comorbidities on Functional Outcome and Life Satisfaction After • • Traumatic Brain Injury: An Individual Growth Curve Analysis of NIDILRR Traumatic Brain Injury Model System Data. Malec JF, Ketchum JM, Hammond FM, Corrigan JD, Dams-O’Connor K, Hart T, Novack T, Dahdah M, Whiteneck GG, Bogner J. J Head Trauma Rehabil. 2019, [Epub ahead of print] Sleep following traumatic brain injury (TBI): Experiences and influencing factors. Mumbower, R., Childs, G., Vance, D.E., Dreer, L.E., Novack, T.A., Heaton, K. Brain Injury [In Press] Neurocognitive status and return to work after moderate to severe traumatic brain injury. Hart, T., Ketchum, J.M., O’Neil-Pirozzi, T. M., Novack, T.A., Johnson-Greene, D., Dams-O’Connor, K. Rehabilitation Psychology. [ In Press]. UAB Traumatic Brain Injury Model System Information Network 3