What is Neuropsychology?
Neuropsychology is a branch of psychology that is concerned with the study of the relationship between the brain and behavior, often after some kind of physical damage to the brain has occurred. The use of psychological tests and assessment techniques are implemented to diagnose specific cognitive and behavioral deficits. It involves the rehabilitation of people who have suffered illness or injury to the brain, which has caused neurocognitive problems. In particular, neuropsychologists bring a psychological viewpoint to treatment, to understand how such illness and injury may affect and be affected by psychological factors.
There are many ailments and disorders that can affect the brain. These include strokes (Cerebrovascular Accidents), mild or traumatic brain injuries (MBI or TBI) due to falls, sports accidents, motor vehicle accidents etc., brain tumors, and other medical conditions such as Parkinson’s, Alzheimer’s, Vascular Dementia, and Multiple Sclerosis.
When a brain injury occurs, the functions of the neurons or sections of the brain can be affected, making it difficult to carry the messages that tell the brain what to do. This can change the way a person thinks, acts, feels, and moves the body. Brain injury can also change the complex internal functions of the body, such as regulating body temperature; blood pressure; bowel and bladder control. These changes can be temporary or permanent. They may cause impairment or a complete inability to perform a function.
Spinal Cord Injury
Spinal Cord Injury (SCI) is damage to the spinal cord that results in a loss of function such as mobility or feeling. Frequent causes of damage are trauma (car accident, gunshot, falls, etc.) or disease (polio, spina bifida, Friedreich’s Ataxia, etc.). The spinal cord does not have to be completely severed in order for a loss of functioning to occur. In fact, in most people with SCI, the spinal cord is intact, but the damage to it results in loss of functioning. SCI is very different from back injuries such as ruptured disks, spinal stenosis or pinched nerves.
The effects of SCI depend on the type of injury and the level of the injury. SCI can be divided into two types of injury: Complete and Incomplete.
A complete injury means that there is no function below the level of the injury; no sensation and no voluntary movement. Both sides of the body are equally affected.
An incomplete injury means that there is some functioning below the primary level of the injury. A person with an incomplete injury may be able to move one limb more than another, may be able to feel parts of the body that cannot be moved, or may have more functioning on one side of the body than the other. With the advances in acute treatment of SCI, incomplete injuries are becoming more common.
How We Can Help
A neuropsychological evaluation can be critical in understanding which brain functions are impaired and which remain intact. An effective evaluation can provide you with information on how the injury or illness specifically affects thinking and behaviour. Is the person able to concentrate on tasks? For how long and under what conditions? Does it matter whether the information is verbal or nonverbal? Standard neurological or physical exams, and even neuroimaging studies, such as CT scans and MRI’s, cannot provide this information.
Neuropsychological evaluations may be essential in determining whether a person actually has a brain injury, particularly in the case of a “mild” brain injury, when effects of an injury may be subtle and easily confused with other factors, such as stress, medications, or depression.
A number of real-life questions can be answered by neuropsychological evaluation. Is the person who was injured competent? Can he or she be left alone? Can they drive or manage money? Can they live independently or do they require assistance? When is it possible to return to work or school? What type of treatment or therapy will be needed? Neuropsychological evaluations are also critical in monitoring the course of recovery and the effectiveness of rehabilitation.
Information for Caregivers
Family members and caregivers of people suffering from brain or spinal injuries have a very challenging task ahead of them. While you may view it as simply taking care of the one you love, as the months, and even years, go by, caregiving may take a physical, emotional, and financial toll on the family overall.
For some people, caregiving occurs slowly over time, for others, it can happen overnight. It could mean providing basic assistance such as grocery shopping or helping with doctors appointments, or more involved care with activities of daily living, such as bathing, feeding, dressing, and so on.
People with cognitive difficulties, such as those with brain injuries, can face difficulties with communication, reasoning, memory, perception, impulse-control, poor judgement, perseveration (fixation and repetition of a particular task), and aggression. Like any disorder, they will have good days and bad days. It is important to remember that it is the disease-causing these behaviours and not the person.
People with spinal cord injuries encounter challenges they didn’t prior to their injury. A first task that will need to be undertaken is the preparation of the home to be accessible to a wheelchair user and/or person with limited mobility. There are also other issues, such as skin checks for pressure sores, bowel and bladder training, and even respiratory care.
While it is important to care for your loved one, it is even more so to take care of yourself. Burnout can occur quickly and it is essential that you maintain self-health. Ignoring signs of stress can lead to serious health problems including physical illness and depression.
A healthy, balanced lifestyle can bring you a long way when you are caregiving. Get enough sleep, maintain a well balanced and nutritious diet, ask for help when you need it, exercise, make time to spend with friends and family, take some time for yourself, do something you enjoy (taking a hot bath, reading a book, watching a movie, etc), seek emotional support from friends, family, or a professional.