The importance of a good assessment of invisible disabilities

La importancia de una buena valoración de las discapacidades invisibles. ¡lo que no se evalúa se queda sin tratar!

what is not evaluated is left untreated!

I want to dedicate a post to the importance of assessing invisible limitations: cognitive, emotional and behavioral after a sudden brain injury.

From first-hand experience, I know that what is not evaluated at the time remains untreated. And we all know that the sooner you start rehab after ACD, the better the results will be.

For more than 12 years I have emotionally accompanied many people after a stroke, a TBI or different brain pathologies that have resulted in a brain injury. And I have realized that some of these invisible limitations have remained unassessed, and therefore untreated, in a significant number of people. It is true that there is more and more attention towards these invisible disabilities by professionals and they are increasingly part of the assessments. But even so, I feel that my mission is to make them more and more known and that they can be part of the prisms with which a patient who is susceptible to brain injury is evaluated. So that the same thing doesn’t happen to other people.

Many times even more attention is paid to the recovery of mobility and the evaluation of other less visible limitations is done quickly or briefly. DCA specialists know that it is sometimes necessary to carry out an assessment of more than 60 minutes, if we want to study attentional limitations in depth and see if after a period of time there is excessive decline in performance. These types of evaluations are done in very few places. I was lucky enough to get to CEADAC where they do them. A partial evaluation can lead to incorrect diagnoses, and above all to a lack of timely treatments. That is why my mission is to be able to transmit this to professionals.

This message is important for the affected people and their families. Also for Neuropsychology professionals, clinical psychologists, general psychologists and health professionals from primary care.

In my book “Invisible Brain Damage” I give many examples from daily life of these more invisible limitations.

La importancia de una buena valoración de las discapacidades invisibles. ¡lo que no se evalúa se queda sin tratar!

It is very important to know that many times people with brain injury can suffer from Anosognosia (not aware of the limitations suffered). This will mean that they may not present these cognitive or emotional symptoms as a reason for consultation. Therefore, in order to make a correct assessment, it will be very important to anticipate the people affected with questions that evaluate these areas. It will then be necessary to ask about fatigue, apathy, lack of flexibility, organization and planning difficulties, impulsiveness, changes in emotional sensitivity or expressiveness, divided attention, communication problems, etc.

Although patients with ACD or their families do not present it as problems at first, we all have to look with new glasses that integrate the perspective of these symptoms, less noisy and familiar, but equally limiting. It also seems important to me to make them known, in case they appear over time. Some of these more invisible limitations come into play when one tries to recover their previous activities, after a period of rehabilitation.

A good assessment and the integration of the treatment of invisible limitations will greatly help to rebuild the identity of people after a sudden brain injury. If it is not done, people feel bad and are also treated worse, since they do not understand what is happening to them or receive treatment for it.

If we feel very tired, with many difficulties concentrating or any of the limitations to which I have referred and we do not feel that those around us understand it as a symptom, we also minimize it, we demand more of ourselves and sometimes we are even the first to believe that these symptoms are not real or that we are exaggerating them.

That is why it seems so important to me to have information about these more invisible disabilities. Because if we know them we can recognize them and seek a good assessment and treatment.



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