Neuropsychology Topic 4

public stigma of dementia

society’s prejudiced attitudes towards people with dementia

internalised dementia stigma

patients own feelings of shame and inferiority

interpersonal needs of patients and caregivers

awareness of consequences, process of acceptance, dealing with consequences on daily life, personal time for caregivers

immediate social environment needs of patients and caregivers

role changes in relationships and families, understanding from families and friends

healthcare needs of patients and caregivers

understanding from professionals, information, peer support, support from family, acknolwedgement of individual differences and small improvements, case managers

societal needs of patients and caregivers

understansing from institutions, knowledge in society about brain injuries

Ownsworth et al 2011 personal and social processes of adjustment

sense making appraisals is influenced by diverse coping reactions, interactions with people in the health system, and reactions and support of personal support network

biopsychosocial framework of factors incfluencing outcomes for patients with brain injury

outcomes are influenced by pre-injury characteristics, neuropathology, psychological factors, and social environment

outcomes in the biopsychosocial framework

functional, emotional wellbeing, quality of life

pre-inury characteristics of the biopsychsocial framework

age, sex, ethnicity, occupation, physical and cognitive ability, psychological and social resources

neuropathology factors of the biopsychosocial framework

cause and mechanisms, severity, location, recurrence, treatment options, direct effects on functioning

psychological factors of the biopsychosocial framework

personal appraisals and reactions including personality, outlook, self-awareness, motivation, and goals

social environmental factors of the biopsychosocial framework

concurrent stressors, access to resources incluidng physical, financial, and social, and societal reactions to the diagnosis

typical themes of required support for caregivers

priorities that are mismatched with their needs for support and continuous, coordinated, and personalised support

subthemes of the mismatched priorities of caregivers

caregivers priorities support for the patient; caregivers needs are overlooked; caregivers percieved need for acceptance of support changes; caregivers have a lonely experience

cubthemes of the continuous, coordinated, and personalised support for caregivers

coordination of care and support services, value of palliative care, practical support which impacts caregiver wellbeing, and braim tumour specific psychological support

attitudinal barriers to psychological support seeking for caregivers

pre-existing beliefs about the validity of their accessing support; stigmatised mental health beliefs; perception that their role should be one of emotional stability and support and that psychological help is incongruent with this; the healthcare system reinforcing these barriers

neuroplasticity

the brains ability to reorganise its structure, function, and connections in response to positive or adverse life experiences

the brains potential for neuroplasticity occurs through

synaptogenesis and neurogenesis

synapotogenesis

new synapses being formed between neurons

neurogenesis

the creation of new neurons

functions with the greatest capacity for neuroplasticity

motor and sensory followed by language

functions with the least capacity for neuroplasticity

cognitive and behavioural

recovery implications of neuroplasticity

the greatest benefits of rehabilitation are soon after injury which capitalise on the window of optimal neuroplasticity

maintenance and further gain

participation in rehabilitation and meaningful activities are integral for ongoing recovery and prevention of further atrophy

compensation

the process through which deficits or losses in brain function and moderated

mechanisms for compensation

remediation, substitution, self-adjustment, exernal adjustment

remediation

investing more time and effort through repeated training and practice on a specific task

substitution

using previously developed skills or new skills to take over performance on absent, lost, or declining skills

self adjustment

adjusting goals and expectations of performance to match environmental demands to ones skill level

external adjustment

modifying and selecting environments and adjusting expectations of others

MAST individualised psychotherapy intervention

a 10 session telehealth intervention tailored to patient goals, concerns, and family needs

components of the MAST individualised psychotherapy

understanding and managing effects of brain tumours; coping skills and management of mood; support for future planning and decision making; support for family and their concerns; improving couple relationship functioning; legacy making projects

support strategies implemented by meeting centres

enhancing understanding and empowerment, improving emotional wellbeing, and building social opportunities

ways that meeting centres enhance understanding and empowerment

cognitive stimulation, physical fitness, optimising choice and control, and information and signposting

ways that meeting centres improve emotional wellbeing

relaxation and fun, building confidence, and opportunities to talk to others who understand

ways that meeting centres build social opportunities

opportunities to engage with others in a relaxed atmosphere, supporting others going through similar experiences, and effective help seeking