Acute Head Injury: Practical management in rehabilitation by Ruth Garner

By Ruth Garner

It is either a excitement and a privilege to be invited to give a contribution a foreword to this ebook, which merits - and desires - to be learn through almost every person who's fascinated with the therapy and subse­ quent welfare of the sufferers of critical accidents of the mind. a few neighbors, family members and workmates may be helped by means of analyzing a few elements of it, yet, if the booklet has the influence it merits to have on therapists, nurses, medical professionals, and others operating in either hospitals and the group, those laymen may be certainly proficient and assisted by means of a number of contributors of the inevitably huge healing workforce. The advancements in tools of resuscitation that experience taken position over the last forty years or so have abolished the formerly fatalistic readiness to simply accept week or in coma after a head harm was once almost a sentence to demise from pneumonia. After it had turn into attainable to avoid wasting lives it steadily grew to become transparent that survival of the sufferer was once no longer inevitably by way of restoration of the mind and that the cost of luck, in saving lives, used to be a popula­ tion of cerebral cripples that used to be expanding on the cost of one thousand or extra a yr in the course of the state. even if this determine has remained in regards to the comparable for greater than two decades, there was an exceptional development within the quantity of curiosity, the traditional of care and the standard of effects which are being achieved.

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Physical considerations To mitigate physical disorders, a good sitting pos1t1on should be achieved, according to patients' needs and set objectives, as well as appropriate placing of the bowl, and towel and so on. The amount of support given in sitting will be determined by the patient's need for it. The therapist should be in a position to give the support and encouragement needed, giving the patient sufficient security to perform difficult tasks. Movements which will lead to increase in tone in affected muscles, or reinforce incorrect patterns of movement should not be encouraged.

The therapist needs to keep pace with the constantly changing needs and abilities of the patient and to adapt the amount of prompting given to help orientation. The patient must learn to use his/her initiative and reasoning ability in picking up clues to orientation. THERAPEUTIC APPLICATION OF EVERYDAY ACTIVITIES The head-injured patient's dependence on others for personal care is not related only to the level of consciousness, but also to the limitations in physical and cognitive abilities. Because patients have such diverse needs, the combinations of which are often unique, it is impossible to give other than general guidance in this section.

All treatments should be planned to bring the affected side into action, whether for holding or supporting or for more complicated functions. 38 CONTINENCE Perceptual considerations Independence in dressing is dependent on such perceptual abilities as intact form constancy, figure/ground, spatial awareness, as well as absence of apraxias or agnosias. Careful records of the patient's performance during dressing should be kept and analysed in relation to the results of tests of perception. The presence of sensory impairment and communication disturbances (both expressive and receptive) should be considered, as these may affect the patient's performance and may be misinterpreted as perceptual dysfunction.

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