Living with TBI Coup-

Contrecoup

Injury

Lyle VanDeventer

Manager

Persons with Disabilities

and Brain Injury

Programs 217-558-4142

lyle.vandeventer@illinois.gov

Session Goals

• Overview of brain injury

• Effect on the survivor

• Effect on the family

• State Resources

• Home Service Programs

What can happen to me after

I have had a brain injury?

- - -

My story…a typical story…

Brain Injury 101 5

Brain injury can cause a

variety of neurologically-based

impairments in these domains:

• Physical

• Cognitive

• Behavioral

Physical Functioning

Physical Limitations

Associated with Brain Injury • Seizure disorders

• Loss of motor control and coordination

• Muscle atrophy, loss of strength

• Spasticity

• Sensory loss (touch, taste, smell, vision, etc)

• Fatigue or headaches

• Incontinence of bowel and/or bladder

• Loss of appetite

Brain Injury 101

Cognitive Functioning

Cognitive Limitations

• Problems with concentration/attention, inability to

maintain focus on tasks, distractibility

• Memory loss, learning difficulty, PTA retrograde

amnesia

• Difficulty with organization, planning and preparing for

future activities

• Limitations in problem-solving, decision-making and

anticipating the consequences of your actions

• Disorders of communication, inability to understand

spoken/written language, receptive and expressive

Psychosocial Functioning

Psychosocial Limitations Linked

to Brain Injury • Inappropriate behavior & lack of awareness

• Impulsivity, irritability

• Depression, other mood disorders

• Pre-morbid conditions probably present

• Egocentrism

• Sexual disinhibition

• Emotional lability

• Perseverance

12/10/2012 Brain Injury 101 12

Recovery/Outcomes

• There is no easy way to predict outcomes after brain injury

• Nor is there a hard and fast rule about recovery

• Recovery is not usually quick, nor is it exact

• There is no cure for brain injury

• Sometimes there is only minimal recovery, or none at all

• Sometimes there is a great degree of recovery in a relatively short time!

12/10/2012

A. Lincoln was brain injured at 14...

…and was thought

to have had ataxia

(impaired

coordination)

Don’t Forget the Family!

• There may be a devastating impact on

the family when a member experiences

a brain injury.

• Family education, and maybe

counseling should be considered.

• Not only might there be a financial

drain, there is likely to be an emotional

strain on the family as well.

Family as Ally

• The family is likely to be the greatest

support for a loved one with brain injury

• The family may also sabotage rehab

efforts

• Similar to Elizabeth Kübler-Ross’

“stages of grief” (in “On Death and

Dying”), families are likely to move

through stages of adjustment after TBI

Stages of Adjustment

• Denial

• Anger

• Bargaining

• Depression

• Acceptance

• Stages may overlap, not even occur, or

sometimes get ‘stuck’…

Time to Move On…

• Ok, I accept the fact that my loved one

has been changed by this accident,

where do I go now?

• Health care and rehab systems are not

usually designed to address the needs

of families.

• What about geriatric service providers?

Illinois

Department of

Human Services

Programs for Persons

with Brain Injury

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Illinois Department of Human Services

DHS can help you and your family meet your basic needs.

We offer a range of services to help you become healthy and self-

sufficient.

See our "for Customers" section for details.

•Cash, Food, Child Care, Housing

•Health & Medical,

Pregnancy & Parenting

•Developmental Disability, Disability & Rehabilitation

•Mental Health, Addiction

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If you are - or want to be - a DHS partner, provider, contractor, or vendor, you can find the information and resources you need under "for Providers."

•Payments, Licensure

•Contracts, Grants, RFPs

•Forms, Software, Training

•More for Providers...

Learn about our mission, organization, and programs in "about DHS."

•DHS Divisions, Organization

•News Archive

•Initiatives, Calendar

•More about DHS...

DHS Office Locator

Type:

County:

Please use the DHS Office Locator

DHS Help Line •1-800-843-6154

•1-800-447-6404 TTY

Quick Links

News

•Governor Recognizes DHS efforts in promoting Mental Health

•(10/22/2007)

•Southern Illinois Businesses Honored for Employing People with

Disabilities

• (10/17/2007)

•State and private employers work together to mentor people with

disabilities to help them go to work and earn more.

•Gov. Blagojevich Launches New Statewide Helpline for Victims of

Domestic Violence

• (10/9/2007)

•Domestic Violence Helpline, 1-877-TO-END-DV to coordinate services

for domestic violence victims across Illinois.

•Illinois Receives $13.9 Million to Expand Drug Treatment and

Recovery Options

• (10/2/2007)

•Access to Recovery Grant to Increase Client Choice in Substance Abuse

Treatment Programs and Recovery Support Services

•Illinois Information Technology Accessibility Act

• (9/26/2007)

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State Features

•Illinois AMBER Alert

•National Center for Missing and Exploited Children

•Illinois Skills Match

•Illinois State Board of Elections: Registration Information and Forms

•Illinois Small Business Advisor

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•Accessibility

•Contact DHS

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Skip to: Content | News

Illinoi

s

Depart

ment

of

Huma

n

Servic

es

Carol

L.

Adam

s,

Ph.D.,

Secret

ary

Search:

Menu

•for Customers

•Alcoholism & Addiction

•Cash

•Child Care

•Developmental Disabilities

•Disability & Rehabilitation

•Food

•Health & Medical

•Housing

•Mental Health

•Pregnancy & Parenting

•Violence & Abuse

•Youth Services

•Customer Service

•for Providers

•Becoming a Provider

•Contracts

•Forms

•FAQs

•Grants

•Licensure & Certification

•Payments

•RFPs

•Rules

•Software

•Training

•Provider Information by Division

•about DHS

•Calendar

•Contact DHS

•Divisions

•Initiatives

•News & Publications

•Organization

•Resource Library

Illinois Department of Human Services

DHS can help you and your family meet your basic needs.

We offer a range of services to help you become healthy and self-

sufficient.

See our "for Customers" section for details.

•Cash, Food, Child Care, Housing

•Health & Medical,

Pregnancy & Parenting

•Developmental Disability, Disability & Rehabilitation

•Mental Health, Addiction

•More for Customers...

If you are - or want to be - a DHS partner, provider, contractor, or vendor, you can find the information and resources you need under "for Providers."

•Payments, Licensure

•Contracts, Grants, RFPs

•Forms, Software, Training

•More for Providers...

Learn about our mission, organization, and programs in "about DHS."

•DHS Divisions, Organization

•News Archive

•Initiatives, Calendar

•More about DHS...

DHS Office Locator

Type:

County:

Please use the DHS Office Locator

DHS Help Line •1-800-843-6154

•1-800-447-6404 TTY

Quick Links

News

•Governor Recognizes DHS efforts in promoting Mental Health

•(10/22/2007)

•Southern Illinois Businesses Honored for Employing People with

Disabilities

• (10/17/2007)

•State and private employers work together to mentor people with

disabilities to help them go to work and earn more.

•Gov. Blagojevich Launches New Statewide Helpline for Victims of

Domestic Violence

• (10/9/2007)

•Domestic Violence Helpline, 1-877-TO-END-DV to coordinate services

for domestic violence victims across Illinois.

•Illinois Receives $13.9 Million to Expand Drug Treatment and

Recovery Options

• (10/2/2007)

•Access to Recovery Grant to Increase Client Choice in Substance Abuse

Treatment Programs and Recovery Support Services

•Illinois Information Technology Accessibility Act

• (9/26/2007)

Prev

| Current | Next

Features

•

State Features

•Illinois AMBER Alert

•National Center for Missing and Exploited Children

•Illinois Skills Match

•Illinois State Board of Elections: Registration Information and Forms

•Illinois Small Business Advisor

Footer

•Copyright © 2007 DHS

•State of Illinois

•Accessibility

•Contact DHS

•Report Abuse/Neglect

DHS GroupWise Login

DHS can help persons with brain injury

and their family meet their basic needs.

DHS offers a range of services to help

persons with brain injury become healthy

and self-sufficient.

SearchdDw0NzUAllAllSearchdDw0NzUAllAll

• DHS website:

http://www.dhs.state.il.us/

Info about the programs offered by the

Department of

Human Services

Links to DRS

Web Referral

Program

Links

Rehab Services Programs • Client Assistance Program

Educational Services

• Vocational Rehabilitation

• Services for People Who Are Blind or Visually Impaired; and for People Who Are Deaf or are Hard of Hearing

• Hispanic/Latino Services

• Home Services Program

Home Services Program • Offers services to help persons with

severe disabilities to safely remain in

their homes and be as independent as

possible.

• HSP uses the ‘independent living

model’ in its approach to customer

service.

• Customers are offered choices so that

they can make their own decisions

about the care that they receive.

Basic HSP Services

• Personal Assistant (PA)

• Homemaker

• Maintenance Home Health

• Electronic Home Response

• Home Delivered Meals

• Adult Day Care

• Assistive Equipment

• Environmental Modification

• Respite Services

HSP

Brain Injury

Program

In the Beginning…

• Dateline July, 1999

• 1998 and before: Grassroots effort by

Connie Collins, Brain Injury Group, Peoria

• Need to address long-term support and

service needs of persons with brain injury

• Federal “prototype” Medicaid Waiver

available in 1990s

• Legislation by Rep. Leitch (Peoria) required

waiver implementation by July 1999

What is a Medicaid Waiver?

• “Home and Community-Based Medicaid Waivers” are programs that allow Medicaid recipients to either remain in their own homes or live in a community setting other than a hospital, nursing home or intermediate care facility for the developmentally disabled.

• These waivers only apply to persons who are Medicaid-eligible.

HSP Brain Injury Program

• The HSP Brain Injury program is a Medicaid

waiver program and is also an entitlement

program

• “Entitlement” means that persons who meet all

other requirements except Medicaid eligibility may

still be eligible

• However, everyone must apply for Medicaid

• A variety of services may be offered to persons

with acquired brain injuries so they can safely

remain in their homes.

• Habilitation and rehab services may also be

provided to help individuals regain lost function.

In order to qualify,

persons must be at

risk of placement in

a nursing home or a

similar institution.

With proper

supports…..

Individuals can

safely remain in

their own homes

at less cost than a

nursing home.

Eligibility

• In order to be eligible, there must be a

medical diagnosis of acquired brain

injury

• Must have impairments caused by the

brain injury

• Must meet remaining eligibility criteria

for HSP

• Must have at least one of the following

acquired brain injuries:

Acquired Brain Injury

Diagnoses

Traumatic Brain Injury (TBI)

Brain Infection (Encephalitis)

Lack of Oxygen (Anoxia/Hypoxia)

Stroke (Cerebral Vascular Accident)

Brain Bleeds (Aneurysm)

Electric Shock (TBI)

Brain Tumor (Malignant or Benign)

Poisoning (Toxic Encephalopathy)

Other

Requirements

• Must meet HSP asset limit

• Must be a U.S. citizen or legal alien

• Must live (or plan to live) in Illinois

• Service cost cannot exceed nursing home

cost

• Must apply for Medicaid (do not have to be

eligible though…)

To Apply,

Call DHS Toll-Free:

1-800-843-6154

1-800-447-6404 (TTY)

Also….

• By Phone: (Look for Department of

Human Services, Division of

Rehabilitation Services in phonebook

government pages)

• By internet…

DHS Office Finder

Online

Application

HSP Services are designed to increase

choices and independence for persons with

severe disabilities!