NeuroRehabilitation An InterdllCiplirlllry Journal

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NeuroRehabilitation 7 (1996) 95-117

Quality of life: an aspect of life care planning and long-term care Robert D. Voogt Roben Voogt & Associates, Inc., Rehabilitation Consultants, 3524 Canal St., New Orleans, LA 70119, USA

Abstract Traumatic brain injury (TBI) has a devastating effect on all aspects of a person's life, which negatively impacts the individual's quality of life. Indeed, the individual is not the same person following TBI. However, through systematic life care planning and appropriate long-term care, this negative impact can be mitigated.

Keywords: Life care planning; Long-term care; Psycho-social issues; Executive functions

1. Introduction

Traumatic brain lDJUry (TBI) permanently changes the lives of millions of individuals in the United States annually. Hospital discharge diagnoses indicate that the annual incidence of TBI is approximately 200 per 100000 in the United States, and that TBI causes significant disability in 30-40 persons per 100000. However, the exact prevalence of TBI is difficult to estimate because the severity and duration of disability among persons with TBI have not been accurately assessed [1]. The most frequent site of damage as a result of head injury is the frontal lobes of the brain. Even 'mild' head injury, defined as head injury which occurs without loss of consciousness, may result in damage to the orbital frontal cortex, resulting in potentially catastrophic consequences on psy-

chosocial competency, ability to maintain employment and execution of activities of daily living. More subtle yet devastating effects of frontal lobe injury include disturbances in attention, synthetic reasoning and planning, initiation, spontaneity, verbal and constructional fluency, spatial orientation, behavioral restraint, social affect and global features of personality [2,3]. One of the most important tasks performed by the rehabilitation team is in determining what an individual with TBI will need for the remainder of his or her life. This specialization is called life care planning, and it is best performed by a qualified, experienced rehabilitation specialist who has knowledge of medical conditions, pathophysiology and current treatment procedures for persons with TBI of all ages; medical and therapeutic disciplines and their limitations; adaptive equipment; psychosocial development and

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Quality of life: an aspect of life care planning and long-term care.

Traumatic brain injury (TBI) has a devastating effect on all aspects of a person's life, which negatively impacts the individual's quality of life. In...
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