Preparedness:

  • Identify locations of brain injury care and rehabilitation facilities, group homes or supported living facilities and the number of residents/patients that may need services in a crisis situation. The Office of Acquired Brain Injury has created a facility information form to assist in preparedness activities.
  • Collect and maintain copies of disaster preparedness plans of all brain injury facilities group home and supported living centers in your service area.
  • Locate brain injury support groups in your area and contact in advance for volunteer assistance in disaster situations.
  • Identify medical personnel in your area with specific brain injury expertise and have contact information available.
  • In planning for sheltering, designate a specific area for individuals with brain injuries and their family members or caretakers.
  • Ensure that space is available for durable equipment that may be necessary to support individuals with brain injuries.
  • Plan your brain injury-specific area in the calmest location in the facility possible. 
  • It is important that it be away from entrances and exits, food services or restrooms or other areas where long lines or large groups may form.
  • Inform staff and volunteers about necessary communication methods with brain-injured individuals. Call the Office of Acquired Brain Injury to schedule training or for assistance.
  • Incorporate space and communications skills in preparedness exercises.

Response:

  • Have brain injury professionals or knowledgeable personnel in charge of the designated area.
  • If brain injury facilities are evacuating, determine if they are implementing their plan or if emergency assistance is required. If so, determine needs such as transportation, oxygen, durable equipment, medications, level of care required and number of beds needed.
  • If individuals are evacuating, determine if shelter care is needed and level of care required.
  • Place neurologists and ancillary medical personnel, neuropsychologists, psychiatrists or counselors with brain injury know experience on standby and activate as needed.
  • The Office of Acquired Brain Injury may be able to assist in locating professionals in rural or frontier areas.
  • Place support groups on standby and activate as needed.

Communication Strategies for Use by Responders and Shelter Staff:

  • Successful interaction with brain-injured individuals depends upon their level of cognitive and emotional functioning.
  • Allow time for rest; fatigue is common.
  • To minimize sensory overload creating anxiety, anger or emotional outbursts, reserve a designated area, usually called “calming or quiet rooms” for known brain injury evacuees, as far away from disruption as possible.
  • Keep the environment simple and establish or maintain defined, regular schedules.
  • Speak slowly and clearly and keep instructions simple and concrete.
  • Fully explain circumstances or procedures. Short-term memory problems are common. Be prepared to repeat what you say, orally or in writing, several times.
  • Re-phrase the person’s comments to ensure they understand concepts and direction or tasks.
  • The ability to recognize and to comprehend verbal and non-verbal cues is often damaged or lost. The responder should explain to the person on what they believe they heard or saw. 
  • Redirect attention or move person to a quieter location if the person becomes emotional or if behavioral problems arise. Positively reinforce desired behaviors.
  • Do not “over-assist” or be patronizing with brain injury survivors.
  • Notify families as soon as possible, if not present.
  • Family members may become anxious. Make certain that families are included in changes of plan and in the care of their loved-one.
  • Patience and calm interaction with individuals are essential to ensuring successful outcomes during emergencies.

Communication Strategies for Use by Emergency Responders and Shelter Staff


 Communication

Maximizing success

Attention

  • Encourage participation.

 

  • Support existing skills and learning pace.
  • Speak slowly and clearly.

 

  • Fully explain tasks, circumstances or procedures.
  • Allow extra time to process information and respond.
  • Allow time for rest; fatigue is common.
  • Keep distractions to a minimum.
  • Keep instructions simple.
  • Focus on single, short-term goals.
  • Be prepared to repeat what you say, orally or in writing.
  • Do not “over-assist” or be patronizing.
  • Take time to make sure the individual understands you.
  • Adequate rest and low activity periods are essential to maintain focus.
  • Redirect attention or move person to a quieter location if the person is overwhelmed.
  • Reinforce positive behaviors.
  • Limit the amount of information presented at one time.

 

Memory Loss

Problem Solving

Impulsivity

  • Establish and maintain a consistent routine.
  • Use a journal/calendar.
  • Label items and develop checklists.
  • Use PDA’s, computers, tape recorders and other electronic tools.
  • Provide verbal or written cues.
  • Link new information with old information.
  • Constant review and repetition can lead to new memories.
  • Identify the problem.
  • Break the problem down into elements.
  • Identify possible solutions.
  • Identify potential consequence/outcomes.
  • Write down the problem and solutions.

 

  • Provide frequent non-judgmental verbal and non-verbal feedback.
  • Provide alternatives for inappropriate ideas and behavior.
  • If necessary divert attention or remove individual from environment.

 

For additional information or assistance please call the Office of Acquired Brain Injury at 512-487-3421.

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