Brain Injury Program
Since our inception in 1986, Living Unlimited has been dedicated to serving those with brain injuries and related neurological challenges. Our earliest foundations were developed to assist those individuals with traumatic brain injuries transition from a rehab facility into their homes, communities and workplaces. Our extensive experience and work with the Hershey Medical Center/Geisinger Health Systems, our parent companies from 1986 until 2008, allowed Living Unlimited to formulate a cognitive behavioral approach while maintaining an awareness of the unique medical needs of those with brain injuries. Through our contract with the Department of Health, Living Unlimited is a provider for the Head Injury Waiver, which allows individuals with brain injuries to learn skills and abilities for increased inclusion and independence in all environments.
Living Unlimited recently contracted with Neuro Rehab Management and Neuro Community Care to provide services to veterans through the Wounded Warrior Program.
As with all services provided by Living Unlimited, those receiving brain injury services through the Head Injury Waiver are individualized based on each person's presenting skills and challenges. Services are provided in the person's home and community to ensure maximum participation and skill development. Possible services include but are not limited to improvement of executive thought and processing skills, development of coping strategies, development of compensatory strategies, improved physical functioning, development of work skills and improved community inclusion. Living Unlimited will develop service plans that address the challenges presented by the brain injury while also addressing those issues that may have existed prior to and contributed to the brain injury to further improve success.
The Principles of Trauma Informed Care are at the forefront of our programming as we ensure Safety, Trustworthiness/Transparency, Peer Support, Collaboration/Mutuality, Empowerment/Voice and Choice, Cultural, Historical and Gender Issues for all planning. Our team approach to services allows for consistency, collaboration and teaches advocacy skills to those receiving services. These are just some of the steps that we follow that helps the person on their road to recovery.
Head Injury Waiver Information - How to Start
In order to received brain Injury services, individuals must register with the Department of Health and be eligible for waiver services. This tip sheet is a good place to start:
Living Unlimited is dedicated to understanding the unique needs and components of traumatic brain injury. All staff who provide brain injury services must have a four year bachelors degree and participate in yearly brain injury training to ensure awareness of trends and treatment options. Currently Living Unlimited employs six Certified Brain Injury Specialists, which requires training, testing and yearly re-certification. All staff understand and employ services that are individually based and adhere to strength based practices. Staff are supervised by Regional Managers who guide each person through the service from start to finish.
It Really Works!
One of the individuals in our program sustained several traumatic brain injuries over a number of his early years, which significantly impacted his abilities to complete daily living tasks such as cleaning his home, cooking meals or proper budgeting skills. He would often begin a task and forget what he was doing or would take excessively long time periods to complete simple steps. His ability to self-start was most challenging and he would procrastinate on all tasks, creating frustration and depression related to not getting things done. Prior to services, he also struggled to follow through with multiple step directions, to maintain prolonged focus, and recall conversations or events without being reminded frequently by friends or family. The gentleman also struggled to use the computer in any capacity prior to service, which along with his other challenges, exasperated significant issues related to anxiety, depression, general emotional management and expressive and awareness skills.
Immediately following the injuries, this individual expressed significant difficulty as he would become angry, upset and anxious very easily. He noted that he tended to contain all of his emotions inside with no ability to express them in a healthy manner. Another challenge the individual faced was with initiating tasks, as well as having significant struggles maintaining mental stamina and focus. During his year of intensive services made possible through the Head Injury Program waiver, this individual developed, practiced and honed many of these skills and made great strides towards the completion of his goals.
One very positive experience as that this individual was very open to feedback, constructive critiques of his behaviors and implementing suggested strategies to achieve his goals. This allowed for steady movement toward goal achievement.
Over the course of services, the gentleman learned and utilized strategies such as repeating directions, writing directions down, asking for clarification on a confusing topic and used his resources to his advantage to initiate and problem solve. Additionally, the individual gained the ability to increase his mental stamina, memory recall and focus through cognitive reinforcing activities and by implementing breaks from time to time to avoid mental exhaustion. His awareness as to when breaks were needed greatly improved and he was able to develop overall awareness and confidence level.
Moreover, the individual gained adequate computer knowledge through cognitive strengthening exercises such as the ones offered on Lumosity.com. The staff worked with him on ways to utilize this system to the highest ability. By the end of services, the gentleman was able to complete household chores in a timely and organized fashion, often to the delight of his family as he became a large contributor to household management. He was able do accomplish this through strategies such as keeping note cards in strategic areas and creating daily schedules of tasks to be completed around his home. At times some reinforcement from the support staff was provided, however the individual executed and followed through with these new skills appropriately. In regards to meal preparation, the individual showed great improvements by first breaking down recipes, creating diagrams or searching for new ones on the internet to help him with initiation. By the end of services, he was making meals on his own.
Strategies used to support the individual with emotional management and self-awareness were using deep breaths and counting to ten. Other strategies the individual used were an anxiety scale to determine what level the individual was at and to increase his self-awareness and manage anxiety. A feeling pie was also implemented to give the individual a visual image of where his feelings were and what levels they were at for each particular session. In doing so, the gentleman received a good sense of what triggered his unpleasant emotions and gave him some tools to better manage those feelings. By the end of services, the individual stated that he felt he had made significant progress in many areas of his life and he did not think it would be possible to have done so after sustaining several traumatic brain injuries. In addition to making great strides in his home and community environments, this gentleman was able to transition all learned strategies with the support of OVR and Living Unlimited staff into a work environment. He remains employed and has mastered many skills that he did not know that he was able to complete.
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President - Living Unlimited
President - Living Unlimited