Cost effective ways of facilitating home based rehabilitation and support

Abstract

BACKGROUND:The long term support of people with neurobehavioural disorders following a severe traumatic brain injury (TBI) can amount to a lifetime cost of several million dollars. Such costs are often obtained from personal injury compensation. However, those not eligible for such awards often depend on their families to provide support and care at no direct financial cost, but with indirect financial and human costs in terms of loss of productivity, and increased stress and health problems. OBJECTIVES: The aim of this paper is to examine the role of support workers in the long-term care of those with neurobehavioural deficits following severe TBI and to discuss the feasibility of meeting some aspects of their role with technological solutions. METHODS: This critical review uses observational and cost-analysis methodologies to establish the roles and costs associated with staff supporting people with neurobehavioural disorders resulting from severe TBI. RESULTS:The role of support workers is varied and includes prompting to initiate and guide simple or complex activities, promoting social behaviour and managing emotional reactions. Some of these roles can be fulfilled by existing technology. CONCLUSIONS: Cost effective care of those with long-term neurobehavioural disorders can be provided by a combination of human support and existing technology.

Efficacy of a Micro-Prompting Technology in Reducing Support Needed by People With Severe Acquired Brain Injury in Activities of Daily Living: A Randomized Control Trial

“…Deficits in performance of activities of daily living are related to performance on executive function tasks. 7 The predominant compensations for difficulties in activities of daily living are formal or informal caregivers 8 , and observations of caregiver behaviour reveals that they are often providing verbal scaffolding to augment cognitive performance, such as prompting, reminding, drawing attention to and structuring plans of action [9][10][11] . Thus the type of support provided by carers suggests that carers are primarily scaffolding executive and memory functions.…”

Cotidiano de cuidado de adolescentes com necessidades especiais de atenção à saúde

“…Figure 2 shows the heterogeneity of care required by a female adolescent and her access to different services and health professionals, reiterating the health care demands of CSHCN. A total of 26 medical diagnoses were identified, some adolescents had more than one diagnosis and asthma was highlighted (9). In addition, two female adolescents with Down's Syndrome and one with Turner's Syndrome stand out.…”

“…(1,2,4,5) The CSHCN group comprises children and adolescents between 0 and 18 years old who have or are at increased risk for the development of chronic conditions, behavioral or emotional limitations, mild or severe disability, and who need long-term health care. (1,(6)(7)(8)(9)(10) In Brazil, it is not possible to find official rates regarding the population of adolescents who are CSHCN. In the United States, there are approximately 14.6 million CSHCN, of which 43.2% are between 12 and 17 years old.…”

Evaluating the Use of Smart Home Technology by People With Brain Impairment: Protocol for a Single-Case Experimental Design

“…In Australia, new models of supported housing for people with disability are beginning to integrate smart home technologies, including home automation and support staff communication systems, into their base design [12,13]. The use of EAT in these ways is of particular interest to funders of long-term care and support for people with disability, with potential cost benefit associated with reduced dependence on others within the home to complete daily tasks [14]. In Australia, the National Disability Insurance Agency has identified assistive technology, including home automation, environmental control systems, and tablet or smartphone apps, as offering the potential to reduce the lifetime care costs of people with severe disability and reduce the liability to the National Disability Insurance Scheme [2].…”