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September 2014 | Read this issue and more at www.healthandwellnessmagazine.net |
More Than
Words:
Regaining
Communication Skills
After a Brain Injury
By Fiona Young-Brown
When a loved one is recovering from a traumatic brain injury,
the number of doctors and medical
specialists involved in helping them
on the road to wellness can be overwhelming, and one person you may
not be expecting is a speech therapist (technically a speech-language
pathologist or SLP). But in speaking
to Cardinal Hill’s Jennifer Noffsinger,
one realizes she does much more than
aid with speech.
Cardinal Hill is a Lexington-based
hospital offering rehabilitation services to both inpatients and outpatients.
Noffsinger is one of the many professionals on staff who work with those
recovering from brain injuries. She
outlines several key components of
her role when dealing with patients:
• Communication / comprehension – This goes beyond
speech (although regaining that
ability is certainly part of rehabilitation). If a patient is unable to
speak, can they comprehend basic
questions and communicate their
needs? This may be through gestures, charts, eye movement, etc.
• Orientation – Is the patient
aware of where they are? Who
they are? In many patients,
Noffsinger sees retention of longterm memories but loss of short-
term memory, and so she works
with them to regain those skills.
• Swallowing – Loss of the ability
to swallow may hinder the ability to eat safely. Furthermore, if a
patient has been on a ventilator,
they may need therapy afterwards.
• Reasoning skills – problem
solving. Noffsinger says, “A lot of
times a patient may be very agitated and so we have to work with
the nurses to make they are safe
and won’t injure themselves. They
don’t realize that, for example,
their left side doesn’t work.”
For each patient, Noffsinger works
as part of a team with an occupational therapist (OT) and a physical
therapist (PT). Together, this trio
combines their skills to ensure that
the patient can relearn the physical
and mental skills needed to go about
daily life. But their duties go beyond
the day to day skills education, as
they become emotional support for
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both the patient and their families.
Noffsinger notes that it is difficult to
work with a patient on their recovery
until they are able to accept what has
happened to them. At the same time,
recovery is unpredictable, sometimes
with two steps forward, and one
step back. This can be discouraging
for both patient and family. Equally
difficult for the family can be the
disorientation period, where a patient
may not know them. Samantha
Richardson, Cardinal Hill’s Marketing
Coordinator mentions that, after suffering a severe brain injury, a patient
may undergo a complete personality transformation, and that such a
transformation may be temporary
or it may be permanent. “It can be
hard for people to see their family
member who might be cursing, or
ignoring them,” says Noffsinger. “I
have to explain to them that this is
very normal.” During this time, she
helps the family to become part of the
therapy. She also notes that at times,
they are key during the communication process. A patient may be trying
to communicate something but only
when she asks the family, can she
learn the special significance of a key
object or place.
The public has gained more awareness of brain injury and recovery,
in large part thanks to the media
coverage of veterans from the Gulf
Wars. Before that, Noffsinger says
that many family’s only concept of
brain injury was “what they saw in
movies where the patient wakes up
after twenty years, walks home, and
everything’s fine.” At the same time,
there have been a number of significant technological improvements in
the past decade or so, all of which
help Noffsinger and her patients to
communicate better. These include
better assistive technologies, text to
speech devices, and even apps