September 28, 2005
Treating adolescents means caring for family, too
By Susan Christensen
Health and Research News Service
JACKSON, Miss.—Mary Anne Richardson of Clinton was in tears.
Her 16-year-old son Edward was being admitted to Methodist Rehabilitation Center in Jackson following a paralyzing spinal cord injury, and she was overwhelmed with thoughts of what lay ahead.
So it meant a lot when a Methodist employee noticed her anguish and said: “Somebody needs to take care of momma.”
“I thought that was so kind,” Richardson said. “I was very upset that day knowing all that was facing us. But everybody at Methodist was warm and caring and friendly and nice.”
While some might credit the concern to good old Southern hospitality, staff members say reaching out to a patient’s family is more than good manners. It’s also good medicine.
The more family support someone has, the better, says Methodist neuropsychologist Risa Nakase-Thompson.
Methodist researchers are currently studying how alliances between patients, family and staff affect the long-term outcome of brain injury patients. But fostering such bonds is hardly a practice confined to the research lab or to the brain injury domain.
Whether a patient is recovering from a spinal cord injury or adjusting to a prosthetic limb, family members play an important role—particularly when the injured party is an adolescent.
“Parents have to learn to advocate for their child, which is why education for the parent is so important,” Nakase-Thompson said.
In the best of worlds, parents and staff work as a team to help patients achieve therapy objectives. But staff admit it can be a tricky collaboration when parents’ first instinct is to protect their child.
Chris Wallace, director of Methodist Orthotics and Prosthetics in Flowood, said there are times when a parent’s “urge to comfort” can get in the way of therapy goals. “Sometimes they overcompensate for their child’s injury and the overcompensation results in a worsening of the condition, rather than an improvement.”
When that happens, it becomes the staff’s job to help them understand that a little discomfort now might mean big gains later. “It can be one of the sincerest forms of love to push a person,” Wallace said.
Of course, pushing can become a problem, too, especially when the issue concerns getting back to the classroom. “Sometimes parents don’t realize the reasons it’s important to delay a child’s return to school,” explained Joyce Leverenz, admissions coordinator for Methodist’s Quest program, a community reintegration program for brain injury survivors. “So we work with them to find a middle ground.”
Often the answer is a staggered return to schoolwork. Patients might do some school assignments in therapy or go back to just one class, instead of full-time coursework. “This helps us evaluate what their readiness is,” Leverenz said.
Once patients begin rehabilitation, families are kept apprised of a patient’s progress. But Nakase-Thompson said some parents—particularly those of brain injury survivors—have a difficult time adjusting to the reality of their child’s condition. “Parents are sensitive about hearing their child has an impairment, especially a cognitive one,” she said. “They want to hear that their children are going to be back in the classroom, fulfilling all their dreams and able to live a normal life.”
But the reality is that it’s impossible to predict if or when someone will recover from a brain injury. “We can’t make judgment calls early in a person’s recovery,” Nakase-Thompson said. “We try to instill a lot of hope and tell them that age is on their side. Younger people with brain injuries do heal faster and for a longer period of time.”
On the spinal cord floor, registered nurse and case manager Dianne W. Sanders said she tries to reassure parents by focusing on the positive. “I help them understand all the components that go into something as little as being able to put a forefinger on a tabletop. We mark each little thing as a milestone.”
When parents seem uneasy about a certain procedure—such as when a child is put in a standing position for the first time—Sanders said she sits with them so they can ask her questions.
Giving parents insight into the challenges their children face is a tack that’s also used by Methodist Orthotics and Prosthetics. Staff there attached rods and feet to the bottom of a pair of boots so family members can get a sense of what it’s like to walk with artificial legs.
Sanders said another strategy that seems to help parents is to put them in touch with other families facing the same hardships. “When parents interact with other parents and see other people have to go through this, too, they learn they can talk to others about it. And that increases their support.”