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March is Brain Injury Awareness Month: CDC Launches "Help Seniors Live Better, Longer: Prevent Brain Injury" Initiative

March 6, 2008. The Centers for Disease Control (CDC) launched its national “Help Seniors Live Better, Longer:  Prevent Brain Injury” initiative in recognition of March as “Brain Injury Awareness Month.” The initiative is designed to raise awareness about preventing, recognizing, and responding to fall-related traumatic brain injury (TBI) in older adults. “Help Seniors Live Better, Longer: Prevent Brain Injury” reaches out to children and caregivers of adults 75 and older with messages to help them understand ways to prevent falls, the leading cause of TBI among older adults, learn the symptoms of TBI in older adults, and how to respond to a TBI should one occur.
TBI is a special health concern for older adults. People ages 75 and older have the highest rates of TBI-related hospitalizations and death. In addition, they recover more slowly and die more often from these injuries than do younger people. 

Nationally

• More than one-third of the adults 65 years and older in the United States fall each year.
• Twenty to 30 percent of people in this age group who fall suffer moderate to severe injuries such as bruises, hip fractures, or head traumas. These injuries can make it hard to move around and limit independent living. They can also increase the risk of early death.
• Falls are the most common cause of TBI.  In 2000, TBI occurred in 46% of fatal falls among older adults.
• Among older adults, falls are the leading cause of injury deaths. They are also the most common cause of nonfatal injuries and hospital admissions for trauma.
• Approximately 85% of deaths caused by falls in 2004 were among people age 75 years and older.
• People 75 years and older who fall are 4 to 5 times more likely than younger people to be hospitalized in a long-term care facility for a year or longer.
  

In Virginia

• Between 2001-2005, Virginians 65 and older had higher rates of TBI hospitalizations than any other age group. Eighty percent of the injuries among those 65 and older were attributed to falls.
• Virginians aged 65 and older experienced a higher number of TBI related deaths than any other age group. Over half (51%) of these deaths were the result of a fall.
• The Virginia Department of Health, Division of Injury and Violence Prevention examined five years of Traumatic Brain Injury hospitalization and death data.  This data review tells us that fall-related TBI among older adults is a serious public health problem that can rob older adults of their independence or cause death. The Virginia Injury Update: Traumatic Brain Injury 2001-2005  gives a clear picture of the problem and includes case studies and prevention tips.  A companion piece, the Traumatic Brain Injury Fact Sheet, was developed and includes some highlights of the report.  Both documents are available for viewing or download at www.vahealth.org/civp.

During the month of March 2008 and in support of the initiative, the Virginia Department of Health, Division of Injury and Violence Prevention (DIVP), and the Brain Injury Association of Virginia will be raising awareness about fall & traumatic brain injury prevention using radio and transit advertisement.  The DIVP has partnered with 2-1-1 VIRGINIA and SeniorNavigator (www.seniornavigator.org) to respond to requests for additional information and resources. 

To learn more about the CDC initiative or to view or order the FREE materials developed for the campaign, visit www.cdc.gov/BrainInjuryInSeniors. You can also contact Tia Clark at tiaclark@aed.org or 202-884-8855 or Kelly Sarmiento at Ksarmiento@cdc.gov or 770-488-1384.

For more information about DIVP’s fall & TBI prevention media awareness campaign, visit DIVP’s website www.vahealth.org/civp.  The website also contains additional links and resources. 

For traumatic brain injury information, resources and support visit the Brain Injury Association of Virginia's website, www.biav.net, or call them at 1-800-334-8443.

Brain Injury and Spinal Cord Injury Services Unit

The Brain Injury and Spinal Cord Injury Services Unit (BI/SCIS), located within the Community Based Services Division in the Richmond Central Office, provides support, guidance, and technical assistance to DRS field staff and agency administration regarding the rehabilitation of persons with acquired neurotrauma. BI/SCIS program staff often serve as the initial point of contact for DRS staff and external customers who need resource or referral information about brain injury and spinal cord injury in general, as well as information about specific agency services for persons with neurotrauma. Program staff work closely with DRS field staff to resolve customer concerns regarding agency services for persons with brain injury and spinal cord injuries.

DRS is actively involved in efforts to meet the needs of persons with acquired neurotrauma injuries (brain injury and spinal cord injury) most notably through Woodrow Wilson Rehabilitation Center's (WWRC) Brain Injury Services Program and WWRC Spinal Cord Injury Services; the Community Rehabilitation Case Management Services Program; the Brain Injury Direct Services (BIDS) Fund; Consumer-Directed Personal Assistance Services Program; and specialized inservice training in brain injury and spinal cord injury for DRS staff.

Additional agency activities include administration of the Commonwealth Neurotrauma Initiative (CNI) Trust Fund including staffing the CNI Advisory Board; management of a three-year (2006-09) federal TBI Act systems change grant, "Strengthening Our Statewide Infrastructure for Brain Injury Services (SOS:BIS)," and collaboration with consumers, state agencies, and community entities to improve services to people with brain injury and spinal cord injury.

Vocational Rehabilitation Program Services

• assessment/evaluation
• counseling/guidance
• job development/placement & supported employment
• vocational training

WWRC Spinal Cord Injury Services

• counseling/guidance
• driver evaluation/training
• independent living/community re-entry skills
• information clearinghouse and referral
• occupational/physical/recreational
• speech and language therapy 
• peer support
• rehabilitation engineering (wheelchair seating and assessment)
• SCI follow-up clinic (monthly)
• vocational evaluation/training

WWRC Brain Injury Services Program

• cognitive rehabilitation services
• community transition services
• driver evaluation/training
• independent living/community re-entry skills (dorms and cottage)
• counseling and guidance (including neuropsychological assessment)
• occupational/physical/recreational
• speech and language therapy
• rehabilitation engineering
• specialized case management services
• specialized vocational counseling

Administered by DRS

• Brain Injury Direct Services (BIDS) Fund.
• Consumer-Directed Personal Assistance Services (PAS) Program.
• Community Rehabilitation Case Management Services (CRCMS) Program.
• Community Support Services for People with Brain Injury (CSS/BI).
• Personal Assistance Services Program for People with Brain Injuries (PAS/BI).
• Supported Employment for Persons with Physical Disabilities (SEPD).

Community Support Services Training Program

DRS Brain Injury and Spinal Cord Injury Services conducts a Community Support Services Training Program in Richmond to provide a foundation of knowledge in the provision of community-based support services for people with acquired brain injuries (and other disabilities). One of the program's goals is to encourage providers to work with DRS customers with brain injury in community settings. Participants include current or potential service providers; state / private rehabilitation counselors and other professionals; and survivors and family members. Nationally recognized speakers provide information about the brain and brain injury; positive behavior support; development and implementation of individual service plans; cognitive strategies to enhance learning and behavior change; and the effect of medication on brain chemistry. Individuals interested in working as Community Support Services staff (i.e., independent living / life skills trainers; clubhouse staff; job coaches) would benefit from attending this program, as well as staff from organizations interested in applying for approval as DRS vendors of services. For more information, contact Patti Goodall at Patti.Goodall@drs.virginia.gov or 800-552-5019 (voice) or 800-464-9950 (TTY). An agenda and registration materials from the DEC 2005 program may be reviewed here.

Brain Injury State Action Plan in Virginia 2008-2012

The Virginia Brain Injury Council (VBIC), http://www.vadrs.org/vbic.asp, serves as the advisory body to a federal Traumatic Brain Injury (TBI) Act grant awarded to the Department of Rehabilitative Services (DRS), the lead agency in Virginia for the coordination of brain injury services.  A 1998-2000 federal “TBI Act Planning Grant” required DRS to develop an “action plan” to guide the development of brain injury services statewide.  DRS, in partnership with the Brain Injury Association of Virginia (BIAV) and Virginia Commonwealth University (VCU) Health Systems, developed the 2000-2005 Traumatic Brain Injury (TBI) State Action Plan.  DRS received additional funding through a TBI Act “Implementation Grant” and in Spring 2005 formed a Steering Committee to oversee the process of updating Virginia’s 2005 Action Plan, one of the goals of the grant. Representatives from the Virginia Brain Injury Council (VBIC), the Brain Injury Association of Virginia (BIAV), the Commonwealth Neurotrauma Initiative (CNI) Trust Fund Advisory Board, and the Virginia Alliance of Brain Injury Service Providers (VABISP) developed a work plan to carry out this important activity.  The Virginia Brain Injury Council endorsed the Steering Committee’s work plan.

During 2005, DRS hosted several Brain Injury Town Meetings across the state and invited survivors, family members, professionals, and other stakeholders to participate.  The Town Meeting process allowed facilitators to receive feedback on the development of "core" or foundational brain injury services; to identify and prioritize local service needs; and to share information on developing and enhancing services within a local community.  DRS partnered with the Brain Injury Association of Virginia (BIAV) http://www.biav.net and with the VCU Rehabilitation Research & Training Center to conduct the Town Meetings and prepare a report of their findings.  

In 2007 , DRS invited Susan Vaughn, Director of Public Policy for the National Association of State Head Injury Administrators (NASHIA) to provide an overview of other states’ actions plans and councils at its January 2007 meeting.  DRS also hired Ann Deaton, Ph.D., a neuropsychologist, to research, develop, and prepare a written draft of Virginia’s Brain Injury State Action Plan for 2008-2012. A preliminary draft and progress report on the Action Plan will be presented to the Council at its April 2007 meeting.

Information on Virginia’s 2005 State Traumatic Brain Injury Action Plan, the Town Meeting process, and a survey for gathering information on the development of the 2008-2012 Brain Injury State Action Plan are available below.  DRS invites stakeholders to submit comments by completing the survey below (due March 7, 2007) and mailing it to DRS Brain Injury & Spinal Cord Injury Services, 8004 Franklin Farms Drive, Richmond, VA 23229 or via e-mail to Patti.Gooall@drs.virginia.gov.  For assistance or to submit comments in any other format, contact Patti Goodall at Patti.Goodall@drs.virginia.gov; (804) 662-7615; (800) 552-5019 Toll Free; or (800) 464-9950 TTY.  We encourage all who are interested to participate in the process!

• 2007 Survey for Brain Injury State Action Plan
• Results of 2005 Town Meetings: Final Report (Word Document) (PDF Format)
• PowerPoint Presentation from the 2005 Town Meetings

For further information regarding the programs and services managed by the BI/SCIS Unit, please email Patti.Goodall@drs.virginia.gov or call (804) 662-7615 or (800) 552-5019.

Statistical Information

Virginia Department of Health
Center for Injury & Violence Prevention
http://www.vahealth.org/civp/datacivp.asp.

Traumatic Brain Injury in Virginia 1999-2003
http://www.vahealth.org/civp/TBIreport.pdf (PDF File).

Traumatic Brain Injury National Database Center
http://www.tbindc.org/

Centers for Disease Control and Prevention (CDC)
Traumatic Brain Injury: http://www.cdc.gov/node.do?id=0900f3ec8000dbdc&aspectId=A0400020
Spinal Cord Injury: http://www.cdc.gov/ncipc/factsheets/scifacts.htm

For additional information on brain injury and spinal cord injury:

Brain Injury Association of America (BIAA)
http://www.biausa.org

Brain Injury Association of Virginia (BIAV)
http://www.biav.net

National Resource Center for Traumatic Brain Injury
http://www.neuro.pmr.vcu.edu/

Virginia Commonwealth University Traumatic Brain Injury Model System
http://www.tbi.pmr.vcu.edu/

American Spinal Injury Association (ASIA)
www.asia-spinalinjury.org

National Spinal Cord Injury Association (NSCIA)
www.spinalcord.org 

Paralyzed Veterans of America (PVA)
www.pva.org

Spinal Cord Injury Information Network
www.spinalcord.uab.edu