Now that Ray has been at Neuro-Tampa for just over one month, the care team has been able to provide us with a clinical update. Since he is in the post-acute phase (post hospital) he is being evaluated using the Mayo-Portland Adaptability Inventory (MPAI). Using the MPAI form, Ray is assessed in many areas to rate his current ability. The goal is for Ray to eventually reach 0 – 2 in all or most areas. This is a proven indication that he would have the most success in going forward with an independent life once again. For those unaware of this rating scheme, please take the time to familiarize yourself with this using the links above. This will be the rating index used going forward.
From the evaluation report, Ray has been rated at mostly 4s and a few 3s in all areas. To rate this on the Rancho scale, he would be at a level VI. Chief among these items are his mobility, self-awareness, self-care, and decision making abilities. Ray’s participation has improved since his transfer to the new location but he still refuses many of his sessions and requires constant reminders and cues from staff before engaging in the therapy provided. The care team is working with Ray to come up with solutions to better gain his participation in the program. This process may take a month or two to figure out before gains can be seen. Given that Ray does not see himself as needing help, the team will have quite an obstacle to overcome.
Also indicated in the report is Ray’s difficulty with impulse control. This has been observed through several behavioral physical and verbal outbursts both during and outside of therapy sessions. Coordination between Neuro-Tampa and the VA continues in order to treat Ray for this problem. As mentioned in previous posts, this behavior is not uncommon to brain injury, but it does pose an issue to the recovery process if not properly controlled. The team has a good handle on the situation; this is just something everyone needs to consider when contacting Ray by phone or visiting in person. We do encourage all to show Ray their support how they can. Do not let his current behavior or situation prevent the support from happening. He will continue to heal with time and our support does matter!
Thank you for all the continued support.
Yesterday we received a very promising update from the care team on Ray’s progress. It has not even been a month since Ray’s transfer to Neuro-Tampa and we are already seeing great signs. The team has been able to gain his acceptance to participate in therapies and he has already had several speech, occupational, and physical therapy sessions. Ray’s mood has also been noticed to have improved since his arrival at the new location. New goals have been made for each therapy, among them to increase his participation to 100%. So far he has done well in ST and OT but needs improvements in PT. A constant obstacle for Ray remains his denial that he has injuries or needs help to get better.
Ray continues to remain strong and maintain his struggle back toward an independent life. He still requires assistance with basic ADLs to include 24×7 support. His therapy sessions are designed for him to better perform the basic daily activities with little to no assistance. This includes eating, personal hygiene, and dressing among others. Ray still has a ways to go before it would be safe for him to be on his own. The struggle in this is that Ray does not always acknowledge he can’t just go home or elsewhere to live on his own. The safety concerns and requirements for assisting Ray at this time are too great for this to be possible. With continued effort for those supporting Ray, we can work with him to understand his situation and make better use of the support being offered in order to make independent life more of a reality.
Consults to the VA have also been put through for a new swallow study (silent aspiration may still be present), neurology, psychiatry, and a change of his primary care physician. Neuro-Tampa can only do so much at their facility and must rely on the VA to provide the pieces not covered. With Ray in Tampa, he will have better access to the VA resources. Arrangements have been made with his VA case manager to expedite the consults to reduce the waiting time in receiving assistance. Case management at Neuro-Tampa has done a great job in ensuring Ray receives what is needed for his care. We should have more of a clinical update on Ray later this month from the VA.
Again for those that wish to contact Ray, his contact information is below. Over the past week there have been phone problems at his location, but we are told this will be fixed soon. All visitors should call in before scheduling a visit to ensure no conflicts in schedule.
Attn: Ray Brown
2411 Clement Road
Lutz, FL 33549
(813) 948-3325 x14
Thank you everyone for the support. It’s still a long road ahead but we are seeing some good things ahead. Stay tuned!
Ray during a ST session at Neuro-Tampa.