Individuals With Traumatic Brain Injury and Their Significant Others' Perceptions of Information Given About the Nature and Possible Consequences of Brain Injury: Analysis of a National Survey.

PURPOSE OF THE STUDY: An online survey was developed to assess how well individuals with brain injuries and family/friends of those with traumatic brain injury (TBI) (significant others) felt they were informed about the nature and consequences of brain injury. PARTICIPANTS: A total of 117 significant others completed the survey. They were primarily female (84.6%), white (94.9%), and well educated (81.2%). A total of 149 individuals with brain injuries completed the survey and again were primarily female (63.8%), white (88.2%), and well educated (82.9%). RESULTS: More than half of the significant other respondents indicated that they were not provided enough information about TBI (53.5%). Up to 53.8% of the respondents with TBI felt that they were not provided enough information, with 43% reporting dissatisfaction with services. Female survivors and those with mild brain injuries were significantly more likely to feel that they were not provided sufficient rehabilitation or information. Increased satisfaction with services was correlated with decreased time since injury (r = -0.165, p = .049). Qualitative analysis revealed key themes about prognostic information and the adequacy of discharge planning and resources. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Given that more than half of all surveyed indicated that they were not well-informed about brain injury and its possible effects, it is evident that case managers and their teams need to be aware of and invested in their efforts to educate both individuals with brain injuries and their significant others (family and friends) about both the nature and consequences of brain injury. Specific recommendations for practice are included.

Mortality of elderly individuals with TBI in the first 5 years following injury.

INTRODUCTION: Although there has been a decline in the incidence of TBI in the general population, the rate of TBI in older adults has increased. Increased age has been long recognized as a predictor of worse outcomes after TBI. Despite the growing number of TBI in the elderly, our understanding of the long-term consequences of TBI is quite limited. METHODS: Chart review; individuals 55 years and older, who completed inpatient acute rehabilitation during the period 2003-2009 and who died one to four years after injury, were compared to matched patients who did not die. RESULTS: There were a significantly higher proportion of deceased subjects with a diagnosis of Abnormality of Gait (53%), respiratory medications at admission (32%) and discharge (17%). Deceased participants were more likely to be prescribed diabetes medication at discharge (35%) while controls were more likely to be prescribed cholesterol-lowering medications (27%) at admission. Deceased patients were discharged with significantly more medications, CONCLUSIONS: The results suggest the need for medical and lifestyle interventions for selected elderly TBI patients. The factors related to death following TBI in the elderly are in need of more research.