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Brain Injury Association of New Jersey Returning to Work After a Brain Injury The Brain Injury Association of New Jersey is a statewide membership organization dedicated to providing education, outreach, prevention, advocacy, and support services to all persons affected by brain injury and to the general public.

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Acquired Brain Injury is an injury to the brain that has occurred after birth Definitions

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 Too little oxygen or blood flow in the brain (examples: heart attack, stroke, carbon monoxide poisoning, near suffocation)  Infections of the brain  Toxic exposure (examples: substance abuse, ingestion of lead, sniffing glue)  Traumatic Brain Injury Causes of Acquired Brain Injury

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Traumatic Brain Injury is a blow to the brain caused by an external physical force Definitions

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Brain Injury Dangers Percentage of Average Annual Traumatic Brain Injury-Related Emergency Department Visits, Hospitalizations, and Deaths, by External Cause, United States, 1995-2001

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Injury and Disability Prevalence Rates 500,000 with Cerebral Palsy 2 million Americans with Epilepsy 3 million with Stroke disabilities 4 million with Alzheimer’s Disease 5 million with persistent mental illness 7.3 million Americans with mental retardation National organizations’ web sites, 4/2000 400,000 w/ Spinal Cord Injuries 5.3 million with TBI disability

Brain Injury in New Jersey: 

Brain Injury in New Jersey Approximately 8,000 adults and children each year are hospitalized or die as a result of a traumatic brain injury. More than 20,000 people are treated each year in doctor offices or emergency rooms for TBI.* * Conservatively extrapolated from national data

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25% of brain injuries are severe enough to require medical and rehabilitation care following injury

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People with more severe brain injuries have significant problems returning to work

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Mild Brain Injury 75% of all brain injuries are mild

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 A mild brain injury is also known as a 'concussion'  Brief (less than 15 minutes) or NO loss of consciousness  A dazed, vacant stare right after the injury  A normal neurological exam Mild Brain Injury

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 Delayed response to questions or commands  Disorientation and foggy memory  Headaches, dizziness or nausea Slurred speech Ringing in ears/blurred vision Mild Brain Injury Symptoms

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2/3 of people with mild brain injury return to work with few or no problems

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1/3 of people with mild brain injury will quit or get fired from their job after injury

Example 1: 

Example 1 Nurse following mild brain injury

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Thinking Changes Memory problems Poor concentration Easily distracted Difficulty making simple decisions Problems with organization Possible Changes after a Mild Brain Injury

Example 2: 

Example 2 Auto mechanic following mild brain injury

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Possible Changes after a Mild Brain Injury Personality and Behavioral Changes Lack of motivation Sad and/or depressed Anxiety Irritability

Example 3: 

Example 3 Construction worker following mild brain injury

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Physical Changes Possible Changes after a Mild Brain Injury Headaches Dizziness Balance problems Fatigue and/or weakness Sleep disturbance

Finding work after a brain injury: 

Finding work after a brain injury People with brain injuries are going to One Stop Centers when looking for work

Finding work after a brain injury: 

Finding work after a brain injury Brain injuries are often invisible

Clues to a hidden disability: 

Clues to a hidden disability Form to complete is not filled out 'I left my glasses at home' 'Can you write that down for me' Reaction to perfume, etc. Sketchy work or education history Difficulty answering questions Distractible

What do you do when a client has…: 

What do you do when a client has… Difficulty paying attention Difficulty answering questions Difficulty making decisions Lack of follow through Forgotten appointments Difficulty controlling emotions

Issue: Difficulty paying attention – appears uninterested: 

Issue: Difficulty paying attention – appears uninterested Move to quiet area with less distractions Shorten length of session Provide information in writing Ask client to repeat information Ask – 'You appear distracted. Is there some way I can help?'

Issue: Difficulty answering questions: 

Issue: Difficulty answering questions Simplify questions – ask one thing at a time Change from open-ended to close-ended questions Provide choices Provide information in writing Slow down your rate of speech Take time to listen

Issue: Difficulty following through: 

Issue: Difficulty following through Establish time frames for completing tasks Encourage the use of a notebook or calendar to set specific deadlines Break down tasks into simple steps Develop a structured routine for the job search Offer praise for accomplishments

Issue: Difficulty making decisions: 

Issue: Difficulty making decisions Encourage the person to 'stop and think' Help identify options Write down options Discuss advantages/disadvantages of each option Role play to prepare for various situations

Issue: Forgetting appointments: 

Issue: Forgetting appointments Make sure client has an appointment book Make sure client writes down appointments Have client repeat information verbally Have client call family member/friend to remind him of appointment Counselor calls on morning of appointment to remind client

Issue: Difficulty controlling emotions: 

Issue: Difficulty controlling emotions Expect the unexpected Remain a model of calm assurance Take the person to a quiet area and give time to calm down Provide feedback in a gentle supportive manner Redirect behavior to a different topic or activity Use humor in a positive, supportive manner

Training and Resources for One Stop Center Staff: 

Training and Resources for One Stop Center Staff Brain Injury Information andamp; Resource Guide for every One Stop Center Bimonthly e-newsletter Consultation

Brain Injury Association of New Jersey: 

Brain Injury Association of New Jersey Information and Resources Support Groups Family Support Services Mentoring Education and Advocacy

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