HEAD INJURIES AND LONG TERM CARE

When one reviews the literature on head injuries, the complexity of this group of disabilities is somewhat overwhelming.   The research shows almost everyone will likely suffer some sort of head injury trauma during their lifetime, even though most cases will be relatively minor. The question then becomes whether head injuries will dictate a need for long term care if the injury progresses to some form of dementia.

In situations where there is severe trauma to the head, resulting in internal bleeding, or repeated concussions, long term alcohol or drug abuse and other serious assaults on the brain, the odds are that as the person ages they will experience decreasing function and might need some sort of long term care assistance with their activities of daily living.  The basic duties of everyday life that we’ve all been guilty at some point in taking them for granted.  They are:  Eating, bathing, dressing, transferring, toileting, and maintaining continence.  Help with these activities at home or in a nursing home facility can be expensive. 

Perhaps this nebulous scenario can best be illustrated by an old client of mine.  Bill suffered his first concussion at age eleven when he hit his head hard on grassy turf while playing with his cousin.  He reported he was unconscious for about a minute, and had a queasy stomach for several hours after. But the next day he felt fine and thought no more about it.  Later, in high school, he reported several instances where he “got his bell rung,” but survived and went on to college, where he did well. He reported he had an excellent memory in college. Over his lifetime he reported several instances where he received hard blows to the head, but never lost consciousness.  On two occasions he was shocked severely when lightning bolts struck the ground near him, making him feel weak for a while.  At about age forty he reported beginning to have problems remembering people’s names, a new problem for him.  He then noticed that his excellent cursive handwriting began to be scratchy, and would be nearly unreadable if he didn’t take his time.

He was in his mid fifties when he became my client.  He was a moderate to heavy drinker, but had never used drugs.  He said that he had taken up golf at age 26, and became quite good, playing to a 5 handicap at his best.  But he had noticed that when he was young and swung at the ball, his vision was fixed on the ball, while his body swung the club around in a continuous, smooth motion; he said he could feel the whole swing as one smooth process, fully aware of what his whole body was doing while maintaining a fixed gaze on the ball.  But then at some point his swing began to become “disconnected.” When he swung at the ball now, the swing was not a smooth, continuous process, but proceeded in “bits and pieces,” with blank spots in the swing.  This was also true when he putted.

Based on this info I decided to send him for a neuropsychological examination, which could assess him for brain damage.  When the report came in it noted that he did have some brain damage, probably caused from the aforementioned incidents.  When you talked to Bill you could not tell he had suffered any damage, nor could you see it in his physical movements.  Only he was aware that something was wrong.  But even so, it did not affect his every day functioning to a great degree.

I have lost track of Bill, but if he has made it into his 70’s and 80’s we could predict that these head injuries would have worsened to a degree.  If his drinking behavior remained the same, it definitely would have gotten worse. Probably the most dangerous thing that could have happened would be a loss of balance, or getting “wobbly” as another client called it.  Of course, as all we older folks know, about the worst thing that happens to us as we age is falling and breaking bones, often leading to a need for some sort of long term care, either on a temporary or permanent basis.
What we can learn from Bill and those like him is that head trauma suffered in our early years may go unnoticed at first, but often causes decreasing function—both mental and physical—as we age.

There is an insurance product called long term care insurance that will actually pay for someone to help with those activities.  The insurance takes the financial and emotion stress of your finances and your family.  Dementia and other cognitive disorders such as Alzheimer’s which may be caused by head injuries, which are a leading cause of needing long term care.  Although we can’t live life in a padded room, planning ahead with long term care insurance can certainly cushion your nest egg from the devastating high cost of long term care.  If you would like to learn more about long term care insurance please take a moment and fill in the form below.  

 Joe Houston M. ED.

LTC Tree Senior Blog Journalist