Community Reintegration: Doug Part Eight
One of the most important factors to recovery for a TBI survivors the community reintegration. Our philosophy is to ensure the best outcome after a TBI, the post morbid plan has to simulate the growth in behavior and maturity that we experience as children and young adults. The concept is easy to grasp in the context of speech pathology and physical therapy in the inpatient setting. Many severe TBI survivors have to relearn to both walk and talk, as if they were children again. When you apply that principle to long term improvement in the community, one must start from the realization that the frontal lobes are the slowest part of our brains to develop. Much of the neural networks that govern mood, executive functioning and maturity continue to develop well into our 20’s. If one is doubtful of that statement, think how you or your children behaved differently at 25 than at 18.
Thus, if key aspects of frontal lobe functioning are impacted by brain injury, then we must not only “go back to school” so to speak, we must also go through the social part of early adulthood. Too much of the modern approach to TBI diagnosis and treatment treats important neuro-behavioral deficits as permanent, unchangeable facts, which it will do our society no good to try to treat.
I believe TBI survivors can relearn to become adults, that while it may take more time, more patience than it did the first time, over a generation, severe neurobehavioral problems may be treated and disappear. The brain has great potential for plasticity. By plasticity I mean ability for a different part of the brain to take over the functions traditionally thought to be performed by a localized part of the brain. One theory I have with respect to frontal lobe deficits is that there is nothing unique about the cerebral cortex about that part of the brain as it relates to neurobehavior. I believe that the reason most adul- like functions are handled by the frontal lobes is because that is the largest unused part of the brain’s hard drive in those critical adolescent and young adult years when most maturity occurs.
While there aren’t hard scientific studies to prove many of my theories yet, the core purpose of TBI Voices is to show through subjective example that the “science of brain injury” can only fully evolve if the chorus of TBI Voices is heard.
As said in Part Seven, the two biggest opportunities to improve frontal lobe functioning is through vocational and community reintegration. Doug is someone who very much wants to reopen his social opportunities and participate on community reintegration.
Doug’s Success in Community Reintegration
As far as community reintegration, do you make friends on the computer?
I’ve made a few, a few friends on the computer.
Does the computer provide you with a social environment, community reintegration, social network of sorts?
It has now since I’ve joined Facebook a little, Facebook a little bit. Well I’ve seen some of my friends that, you know, that I haven’t seen since high school, what they’ve been up to.
Have you done any dating as part of your community reintegration?
No I haven’t.
Would you like to?
Yes I would. Well I’ve been on online a couple times, you know, I’ve been online. I’m on all the time and there’s just, I could never find, you know. I think the fact that I cannot drive, that I use a cane and I think because the fact they’re not the same religion but that’s, but I know the, probably the big one would have to be the same religion. Well because I’m Lutheran, and a lot of the people on there that I’ve seen, met, they’re not really Lutheran, and that’s just, I don’t know, there’s just something about that, you know, I just feel that they have to be, you know, Lutheran.
Mood is something very difficult to assess, without a collateral source such as a loved one, family member, co-worker. We did not have that opportunity with Doug, which shows how important community reintegration may be in his case. But from his own assessment, Doug doesn’t feel like mood is a big problem for him.
Do you have problems with depression?
Sometimes I do. The fact that I’m disabled, and the fact that I guess that other people are, you know, other people my age are married and like my brother’s married and I’m not. But I’m pretty easy to get out of it because I just, I’m, because I listen to 89Q Christian, Christian music, so I pretty much get out of that pretty easy.
Religion has helped Doug and that is part of the message he wants to leave people with:
To just take it one day at a time, and if you have, too, if you have religion to just pray to God to know that God is behind you he’ll get you through the tough times and he’ll let you, you know, and if you take it one day at a time, you should be able to make it.