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Brain Injury Association NSW(BIA NSW)PresentationRachel Merton – CEOBev Taylor – Training andDevelopment ManagerABI and Ho...
Outline BIA NSW What is Acquired Brain Injury (ABI) A few statistics Living life after an ABI How can BIA NSW assist ...
Who is BIA NSW?The Brain Injury Association of NSW (BIA NSW) the peak body in NSW for people affected byacquired brain in...
What do we do? Support for people with an ABI, their families andcarers: Information and referral service (1800 number)...
What do we do? Building knowledge and networks Training (general and tailored) Facilitating networks – interagency and ...
What do we do?We shine the spotlight on ABI tomake visible the invisible disability!
 BIA NSW What is Acquired Brain Injury (ABI) A few statistics Living life after an ABI How can BIA NSW assist you? D...
Definition of ABI An injury to the brain after birth. The effects may be either temporary orpermanent. May cause partia...
Types of Acquired Brain Injury Traumatic Brain Injury (TBI) Non-traumatic Brain Injury
What is TBI? TBI (Traumatic Brain Injury) is one type of ABI TBI is caused by violent physical force to the head (eg:MVA...
How does ABI happen?AcquiredBrainInjuryTraumaBrainTumourToxinsHypoxiaDegen.DiseasesInfectionStrokeMVAFallsAssaultsSportPed...
 BIA NSW What is Acquired Brain Injury (ABI) A few statistics Living life after an ABI How can BIA NSW assist you? D...
 BIA NSW What is Acquired Brain Injury (ABI) A few statistics Living life after an ABI How can BIA NSW assist you? D...
Prevalence:How many people have an ABI? 1 in 45 Australians (432,700 people) have ABI withactivity limitations or partici...
Incidence:No. of TBIs per yearSource: AIHW 2007 Bulletin 5521,800 hospital stays69% malesPeaks: Males 15-24 years (MVAs, s...
Disadvantaged CommunitiesRates of ABI are higher in socially disadvantaged populations: ATSI:– prevalence estimates are t...
Involvement with policePeople with an ABI have: a higher number of contacts with police than people withoutan ABI a high...
 BIA NSW What is Acquired Brain Injury (ABI) A few statistics Living life after an ABI How can BIA NSW assist you? D...
 The location of the brain damage The severity of the injury The length of time since injury The extent a person has b...
Changes after ABI Physical problems Sensory problems Cognitive (thinking) problems Emotional problems Problems with s...
May lead to ... Changes to important relationships - people commonlylose key relationships and have trouble making new on...
Some challenges to services Lack of motivation Memory problems (eg not attending appointments;retaining information) Be...
Practical Techniques Emotional support– Speak clearly, calmly, reassuringly, in an adult voice– Avoid arguments and confr...
Practical Techniques - cont’d Reduce confusion– Allow processing time– Reduce background noise and distractions– Keep con...
ABI: ‘The Hidden Disability’ Causes problems with a person’s basic ability tothink and make decisions Not as easy to dis...
 BIA NSW What is Acquired Brain Injury (ABI) How is ABI different from … A few statistics Living life after an ABI H...
Brainstorm?
How can BIA NSW help you? Information and Referral service Training and professional development; mentoring Resources a...
BIA NSWPhone: (02) 9868 5261Toll free: 1800 820 840www.biansw.org.auYou can also find us on Facebook!Remember to ‘Bang on ...
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Bia NSW Acquired brain Injury and homelessness presentation 2013

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Presented at the recent Brain Injury Forum, hosted by the Mercy Foundation and the Haymarket Foundation.

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  • A TBI is one type of acquired brain injury and occurs when an external force traumatically injures the brain. Injury can be caused by a direct impact to the head (fall, assault, road trauma, surgery) or by acceleration alone – eg: acceleration and deceleration from high speed MVAs.  As our brain sits in a gel like fluid called cerebro-spinal fluid, encased in a sac of dura mater, the ‘violent force to the head’ or acceleration forces, can cause the brain, which has the consistency of chocolate pudding, to bounce around inside the hard skull hitting the walls of the skull and possibly sheering across the sharp, boney ridges at the base and front of the skull. Depending on the forces involved and/or the nature of direct impact, the brain may bleed, tear, be penetrated, stretched, bruised and swollen. The brain may also rotate on the brain stem. Millions of neurons that communicate with each other and make up ‘who we are’, may be displaced and damaged, possibly affecting one or more areas of the brain.
  • There is considerable uncertainty about the incidence and prevalence of ABI in Australia.The only measure we have available to measure prevalence of ABI is self-report. Based on the results of the 2003 ABS Survey of Disability, 1 in 45 Australians (432,700 people) have an ABI that limits or restricts their activity and social participation. Almost three-quarters of these people are under 65 years, and about 20,000 are under 15 years
  • Incidence of ABI is also impossible to measure accurately with current data collection practices, and the best proxy measure is to use hospital statistics – which we can do to a reasonable degree for Traumatic Brain Injury. This chart relates to hospital stays relating to TBI. In 2004–05 there were almost 21,800 hospital stays across Australia involving a diagnosis of TBI.Of these hospital stays:• males accounted for 69%, and in all age-groups, males were more likely to be hospitalised thanFemales • there was a strong peak in hospitalisation rates for males between the ages of 15 and24, and for both sexes beyond the age of 75 yearsFor non-traumatic brain injury, hospital stats are not reliable, as the diagnoses are not captured in a routine way due to the various ways of acquiring the injury. In many cases ABI is not diagnosed, so it is not recorded. Estimates place the incidence of non traumatic brain injury as at least 20,000 per year.We do know that about 48,000 people have a stroke in Australia each year, and about three quarters of strokes occur in people over 65 years. Due to the high proportion of non traumatic brain injury that is caused by stroke, we can say that the rate of non traumatic ABI increases with age, so if this chart were to reflect incidence of all ABI, it would have a very different shape (low in the younger years to a high in the 65+ years).
  • ABI rates are significantly higher in socially disadvantaged populations.These prevalence rates really are estimates. There has been very little research into the prevalence of ABI amongst ATSI populations. In addition, while data collection on ATSI disability has continued to improve, questions remain as to whether disability surveys are culturally relevant. ATSI communities may have a concept of disability that is dramatically different from non-ATSI communities, so a lot more work needs to be done in this area.However, the estimates we do have indicate rates of ABI up to three times that of non-ATSI communities. One study has shown that the rate of head injury due to assault among ATSI communities was 21 times higher than the equivalent rate for non-ATSI Australians (854 per 100,000 compared to 40.7 per 100,000 for the non-ATSI population)People with an ABI are also over-represented in the criminal justice system, with prevalence estimates ranging from 35% to one study finding that 82% of NSW prisoners reported having an ABI.
  • ABI rates are significantly higher in socially disadvantaged populations.These prevalence rates really are estimates. There has been very little research into the prevalence of ABI amongst ATSI populations. In addition, while data collection on ATSI disability has continued to improve, questions remain as to whether disability surveys are culturally relevant. ATSI communities may have a concept of disability that is dramatically different from non-ATSI communities, so a lot more work needs to be done in this area.However, the estimates we do have indicate rates of ABI up to three times that of non-ATSI communities. One study has shown that the rate of head injury due to assault among ATSI communities was 21 times higher than the equivalent rate for non-ATSI Australians (854 per 100,000 compared to 40.7 per 100,000 for the non-ATSI population)People with an ABI are also over-represented in the criminal justice system, with prevalence estimates ranging from 35% to one study finding that 82% of NSW prisoners reported having an ABI.
  • Transcript of "Bia NSW Acquired brain Injury and homelessness presentation 2013"

    1. 1. Brain Injury Association NSW(BIA NSW)PresentationRachel Merton – CEOBev Taylor – Training andDevelopment ManagerABI and HomelessnessApril 2013
    2. 2. Outline BIA NSW What is Acquired Brain Injury (ABI) A few statistics Living life after an ABI How can BIA NSW assist you? Questions
    3. 3. Who is BIA NSW?The Brain Injury Association of NSW (BIA NSW) the peak body in NSW for people affected byacquired brain injury (ABI) advocacy and support information and resources
    4. 4. What do we do? Support for people with an ABI, their families andcarers: Information and referral service (1800 number) Individual advocacy service Brokerage packages CarerLink mentoring program Systemic advocacy Representation to government and policy makers Submissions Media advocacy
    5. 5. What do we do? Building knowledge and networks Training (general and tailored) Facilitating networks – interagency and partnerships Raising awareness of ABI: Speakers Bureau: supporting people with ABI to sharetheir story – for education and awareness-raising Using the media Newsletters, fact-sheets, presentations
    6. 6. What do we do?We shine the spotlight on ABI tomake visible the invisible disability!
    7. 7.  BIA NSW What is Acquired Brain Injury (ABI) A few statistics Living life after an ABI How can BIA NSW assist you? Discussion
    8. 8. Definition of ABI An injury to the brain after birth. The effects may be either temporary orpermanent. May cause partial or total disability. ABI can happen to anybody at any time
    9. 9. Types of Acquired Brain Injury Traumatic Brain Injury (TBI) Non-traumatic Brain Injury
    10. 10. What is TBI? TBI (Traumatic Brain Injury) is one type of ABI TBI is caused by violent physical force to the head (eg:MVA’s, assaults, falls, sporting accidents oracceleration forces alone (eg: MVA) TBI may cause the brain to bleed, tear, bepenetrated, stretched, bruised or become swollen TBI can result in complete recovery, permanentdisability or death
    11. 11. How does ABI happen?AcquiredBrainInjuryTraumaBrainTumourToxinsHypoxiaDegen.DiseasesInfectionStrokeMVAFallsAssaultsSportPedestriansGrowths(malignant& benign)Surgery toremoveAlcoholDrugsChemicalsMedicationPetrolHeart AttackDrowningSuffocationSuicideChildbirthMedicalIschaemicblocked-arteryHaemorrhagic(bleed in thebrain)DementiaAlzheimer’sParkinson’sEncephalitisMeningitisDental abscessCold sores/herpes
    12. 12.  BIA NSW What is Acquired Brain Injury (ABI) A few statistics Living life after an ABI How can BIA NSW assist you? Discussion/brainstorm
    13. 13.  BIA NSW What is Acquired Brain Injury (ABI) A few statistics Living life after an ABI How can BIA NSW assist you? Discussion/brainstorm
    14. 14. Prevalence:How many people have an ABI? 1 in 45 Australians (432,700 people) have ABI withactivity limitations or participation restrictions due todisability. Almost three-quarters of these people are under 65 years About 20,000 are under 15 years Now: there are more survivors from MVAs – many areliving with severe injuries and limited access to supportSource: ABS Survey of Disability, Ageing and Carers 2003
    15. 15. Incidence:No. of TBIs per yearSource: AIHW 2007 Bulletin 5521,800 hospital stays69% malesPeaks: Males 15-24 years (MVAs, sport accidents); Both sexes: >75 years (falls)Hospitalisations for TBI, Australia, 2004-05
    16. 16. Disadvantaged CommunitiesRates of ABI are higher in socially disadvantaged populations: ATSI:– prevalence estimates are three times that of non-ATSIcommunities,– One study found head injury due to assault among ATSIcommunities was 21 times higher than for non-ATSIAustralians (854/100,000 cf 40.7/100,000 for the non-ATSIpopulation) People in the criminal justice system– Higher prevalence and incidence than general population– Estimated 60% of prisoners have ABI with one studyshowing up to 80%Sources: Jamieson et al, 2008; Schofield et al, 2006; Brain Injury Australia (July 2011) Out ofsight, out of mind: People with an acquired brain injury and the criminal justice system
    17. 17. Involvement with policePeople with an ABI have: a higher number of contacts with police than people withoutan ABI a higher proportion of convictions for minor offences thanoffenders without an ABI (Dowse et al). 40% of convictions inDowse’s cohort were for ‘theft and related offences’ or ‘roadtraffic and motor vehicle regulatory offences’. A further 12%were for public order offences.Sources:Dowse L et al (April 2011) People with mental health disorders and cognitive disabilities in thecriminal justice system: Impact of acquired brain injury (a study of 604 people within the CJSidentified as having an ABI)Brain Injury Australia (July 2011) Out of sight, out of mind: People with an acquired brain injury andthe criminal justice system
    18. 18.  BIA NSW What is Acquired Brain Injury (ABI) A few statistics Living life after an ABI How can BIA NSW assist you? Discussion/brainstorm
    19. 19.  The location of the brain damage The severity of the injury The length of time since injury The extent a person has been able to integrate backinto the community Access to rehabilitation The extent a person retains important/personalrelationships and friendshipsThe effects of ABIcan be complicated by:
    20. 20. Changes after ABI Physical problems Sensory problems Cognitive (thinking) problems Emotional problems Problems with social interaction Communication problems Overwhelming grief/sense of loss Before/Now comparisons Severe impact on families and friends
    21. 21. May lead to ... Changes to important relationships - people commonlylose key relationships and have trouble making new ones Social isolation, exploitation, neglect - access to servicesand support is unfair and inequitable Loss of employment, financial hardship, homelessness Loss of value status and respect in the community Mental health issues Drug and alcohol dependency Involvement with Criminal Justice System Need for long-term support
    22. 22. Some challenges to services Lack of motivation Memory problems (eg not attending appointments;retaining information) Behaviours of concern Communication difficulties Lack of natural / social supports High rate of comorbidity with other problems Mild ABI – significant for person but may not meeteligibility criteria
    23. 23. Practical Techniques Emotional support– Speak clearly, calmly, reassuringly, in an adult voice– Avoid arguments and confrontations– Use non-verbal expressions Memory Aids– Help clients with memory / reminder techniques– Write important things down– Use repetition– Use visual aids
    24. 24. Practical Techniques - cont’d Reduce confusion– Allow processing time– Reduce background noise and distractions– Keep concepts and instructions clear and concise– Realistic goal setting– Ask the person to repeat back to you what they understand Respect– Treat people with cognitive disabilities as adults– Adjust communication to match person’s understanding
    25. 25. ABI: ‘The Hidden Disability’ Causes problems with a person’s basic ability tothink and make decisions Not as easy to distinguish as other physicaldisabilities People with a brain injury may bemisunderstood, ignored and ‘judged’ by others(common labels: lazy, non-compliant, argumentative, ‘difficult’)
    26. 26.  BIA NSW What is Acquired Brain Injury (ABI) How is ABI different from … A few statistics Living life after an ABI How can BIA NSW assist you?
    27. 27. Brainstorm?
    28. 28. How can BIA NSW help you? Information and Referral service Training and professional development; mentoring Resources and handouts Brokerage Online information Membership and newsletters– For you– For people you work with Programs for people with an ABI and their families Interagencies, networking Other
    29. 29. BIA NSWPhone: (02) 9868 5261Toll free: 1800 820 840www.biansw.org.auYou can also find us on Facebook!Remember to ‘Bang on a Beanie’ duringBrain Injury Awareness Week12th to 20th August 2013
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