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.