Traumatic Brain Injury
Glossary L - Q
brain injury terms:
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ada terms
insurance terms
Lability - State of having notable shifts in emotional state (e.g., uncontrolled laughing or crying).
Laceration - A ragged tear of body tissues.
Language - The system used to communicate thoughts through symbols.
Latency of Response/Delay - The amount of time taken to respond after the stimulus has been presented.
Learning - See Memory/Learning.
Leg Bag - A small, thick plastic bag that can be tied to the leg and collects urine. It is connected by tubing to a catheter inserted into the urinary bladder.
Leisure Counseling - The exploration of what types of leisure/recreation were of interest to a person before the injury and which are of interest now; how to make the best of leisure time, what recreational resources are available in the community and how to take advantage of them; and what changes have to be made to continue previous leisure pursuits.
Leisure Skills - The ability to participate in recreational activities and to independently make effective use of one's leisure time and opportunities.
Lethargic - Awakens with stimulation; drowsy but awake.
Lifelong Living Program - See Program/Service Type.
Linguistics - The study of human speech, including the units, nature, structure and modification of language.
Locked-in Syndrome - A condition resulting from interruption of motor pathways in the ventral pons, usually by infarction. This disconnection of the motor cells in the lower brain stem and spinal cord from controlling signals issued by the brain leaves the patient completely paralyzed and mute, but able to receive and understand sensory stimuli; communication may be possible by code using blinking, or movement of the jaw or eyes, which can be spared.
Log Book - A diary-like listing of the individual's daily activities which can be used to help remember what happened during the course of the day, names of persons with whom contact occurred, and the order in which events occurred. The brain-injured person, family members and staff are encouraged to make entries. Used to compensate for memory deficits.
Logical Ability - Ability to formulate a general rule or principle which one can use to objectively solve a problem. Also the ability to plan, regulate and control one's own activities.
Lucid Interval - A period shortly after injury when the patient was reported to have talked.
Malingering - To pretend inability so as to avoid duty or work.
Manpower Development - Cooperative process in which agencies in the community strive to assure the availability of an adequate present and future supply of qualified personnel to work in programs providing services to persons with disabilities.
Medicaid - See Terms and Definitions Related to Insurance.
Medically Stable - Reaching a point in medical treatment where life-threatening injuries and disease have been brought under control.
Medicare - See Terms and Definitions Related to Insurance.
Memory - The process of organizing and storing representations of events and recalling these representations to consciousness at a later time.
Memory, Audio-Visual - Auditory memory is the ability to recall a series of numbers, lists of words, sentences, or paragraphs presented orally. Visual memory requires input of information through visuo-perceptual channels. It refers to the ability to recall text, geometric figures, maps, and photographs. A brain-injured survivor with impaired visual memory may have to refer to a road map numerous times to reach a nearby destination. A brain-injured inpatient may need frequent assistance from the staff to locate his room. A patient with impaired auditory memory will likely require frequent reminders of orally presented task instructions from staff. Notably, information may be encoded in memory using words or visual images independent of the mode of presentation.
Memory, Delayed - Recall of information after a delay, often with other information presented to prevent active rehearsal. There is no particular specification of the required time interval; typically it is ten minutes or more.
Memory, Episodic - Memory for ongoing events in a person's life. More easily impaired than semantic memory, perhaps because rehearsal or repetition tends to be minimal.
Memory, Fund of Information - A type of remote memory as well as an estimate of the amount of information an individual retains about past experiences. The information can include, for example, knowledge regarding current events, politics, and book learning.
Memory, Immediate - The ability to recall numbers, pictures, or words immediately following presentation. Patients with immediate memory problems have difficulty learning new tasks because they cannot remember instructions. Relies upon concentration and attention.
Memory/Learning - Change in a person's understanding or behavior due to experience or practice. Often thought of as acquisition of new information. For example, a person who learns quickly will likely remember an entire set of instructions after hearing them a single time. A patient with severely impaired learning ability will show little gain in recall after numerous repetitions. Learning and memory are interdependent. If immediate memory is poor, learning will be poor because only a portion of the information will be available for rehearsal/repetition. It is important to note that patients may have intact learning ability, but poor delayed memory. For example, a brain-injured patient may learn a set of instructions after several repetitions, but forget them the next day.
Memory, Long Term - In neuropsychological testing, this refers to recall thirty minutes or longer after presentation. Requires storage and retrieval of information which exceeds the limit of short term memory.
Memory, Recall - Ability to retrieve information without renewed exposure to the stimulus.
Memory, Recognition - Ability to retrieve information when a stimulus cue is presented. Free recall of the information is often deficient if cues must be provided.
Memory, Remote - Information an individual correctly recalls from the past, stored before the onset of brain injury. There is no specific requirement for the amount of elapsed time, but it is typically more than six months to a year. Preserved information from delayed memory becomes part of remote memory.
Memory, Semantic - Memory for facts, usually learned through repetition.
Memory, Short Term - Primary or "working" memory; its contents are in conscious awareness. A limited capacity system that holds up to seven chunks of information over periods of 30 seconds to several minutes, depending upon the person's attention to the task.
Mental Competence - The quality or state of being competent; having adequate mental abilities; legally qualified or adequate to manage one's personal affairs. An individual found by a court to be mentally incompetent has a guardian appointed to make personal and/or economic decisions on their behalf.
Mental Disability - All of the recognized forms of mental illness, severe emotional disorders, or mental retardation. Terms such as neurotic, psychotic, and schizophrenic should be reserved for technical medical writing only.
Mental Illness - A condition where there is loss of social and/or vocational skills due to impaired thought processes or emotional distress. Terms such as "mentally deranged", "crazy", "deviant" are not used.
Metacognition - Insight into accurately judging one's own strengths and limitations, particularly with regard to cognitive skills.
Microcomputer - A small computer; may be used to present information and stimuli to a patient as part of a cognitive rehabilitation program.
Mobility - Ability of an individual to move within, and interact with, the environment, usually involving utilization of public and/or private transportation, wheelchairs or ambulation.
Money Management - Ability to distinguish the different denominations of money, count money, make change, budget.
Monitor, Intensive Care - A TV-like screen with a continuous display of different wave forms representing different pressures and activities in the body such as blood pressure, intracranial pressure, and EKG. It may also show a corresponding number value for them (digital readout).
Monoplegia - Paralysis of one arm or one leg.
Motivation - Requires initiative and refers to the extent to which an individual desires to reach a goal and demonstrates actual follow-through. A greater level of motivation is required for completion of difficult tasks. A brain-injured person with reduced motivation may need frequent cueing to finish dressing even though being able to verbalize the complete procedure.
Motor - Pertaining to movement.
Motor Control - Regulation of the timing and amount of contraction of muscles of the body to produce smooth and coordinated movement. The regulation is carried out by operation of the nervous system.
Motor ControL, Fine - Delicate, intricate movements as in writing or playing a piano.
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Motor Control, Gross - Large, strong movements as in chopping wood or walking.
Motor Lag - A prolonged delay between stimulus and initiate of motor response.
Motor Planning - Action formulated in the mind before attempting to perform.
Movement Therapy - Using bodily expression, dance and exercise to facilitate movement, self expression and self esteem.
Multidisciplinary - See Team.
Muscle Tone - Used in clinical practice to describe the resistance of a muscle to being stretched. When the peripheral nerve to a muscle is severed, the muscle becomes flaccid (limp). When nerve fibers in the brain or spinal cord are damaged, the balance between facilitation and inhibition of muscle tone is disturbed. The tone of some muscles may become increased and they resist being stretched - a condition called hypertonicity or spasticity.
Music Therapy - Use of music and singing to develop language and movement skills.
Myelography - A medical test involving injection of dye into the spinal subarachnoid space so that an x-ray of the spinal cord can be taken. Used to detect spinal cord tumors, anatomical defects and disc problems.
Nasogastric Tube (NG Tube) - A tube that passes through the patient's nose and throat and ends in the patient's stomach. This tube allows for direct "tube feeding" to maintain the nutritional status of the patient or removal of stomach acids.
NDT - See Neuro Developmental Treatment.
Neglect - Paying little or no attention to a part of the body.
Neologism - Nonsense or made-up word used when speaking. The person often does not realize that the word makes no sense.
Neuro Developmental Treatment (NDT) - A therapeutic approach based on the development of movement and emphasizing the restoration of normal movement in performing functional activities.
Neurolaw - The field of jurisprudence designed to meet the challenges presented by litigation regarding injuries to the central nervous system (brain or spinal cord).
Neurologist - A physician who specializes in the nervous system and its disorders.
Neurophysiology - The study of the functions of the nervous system.
Neuropsychologist - A psychologist who specializes in evaluating (by tests) brain/behavior relationships, planning training programs to help the survivor of brain injury return to normal functioning and recommending alternative cognitive and behavioral strategies to minimize the effects of brain injury. Often works closely with schools and employers as well as with family members of the injured person.
Non-ambulatory - Not able to walk.
Non-disabled - Term for persons without disabilities. The terms normal, able-bodied, healthy, or whole are less appropriate when contrasting those with and those without disabilities.
Non-Purposeful Movement - Movement that a person may make which has no apparent goal.
Normalization - Philosophy that developmentally disable individuals should be exposed to patterns and conditions of daily life which are consistent with the norms of society and that training should be provided to enable persons with developmental disabilities to function appropriately in the mainstream of society.
NPO - Latin initials that stand for "Nothing by Mouth". This means no food or liquids for a set period, usually in preparation for certain tests, or when the person cannot safely swallow.
Numerical Ability - Ability to solve numerical problems using the four fundamental rules of arithmetic: addition, subtraction, multiplication, and division.
Nursing Home - A residential facility for the patient who requires supervision in all activities, including assistance with medication, meal preparation, bathing, dressing, and moving about; the patient may also require special nursing care and/or ongoing therapy. There are nursing homes that provide minimal to maximum care; also called extended care facilities. See Program/Service Types.
Nystagmus - Involuntary horizontal, vertical, or rotary movement of the eyeballs.
O.T. - See Occupational Therapy.
Observational Procedure - An organized method of recording what a client does for the purpose of documenting behavior; the emphasis is usually upon productivity, behavior patterns, expressed interest, and worker interaction. Used to gain information concerning a client's overall level of functioning.
Obtunded - Mental blunting; mild to moderate reduction in alertness.
Occipital Lobe - Region in the back of the brain which processes visual information. Damage to this lobe can cause visual deficits.
Occupational Information - All pertinent facts about a job, or job cluster, which accurately define the characteristics and requirements of the job so that an individual looking for work will have correct, adequate information for making a vocational decision.
Occupational Therapy - Occupational Therapy is the therapeutic use of self-care, work and play activities to increase independent function, enhance development and prevent disability; may include the adaptation of a task or the environment to achieve maximum independence and to enhance the quality of life. The term occupation, as used in occupational therapy, refers to any activity engaged in for evaluating, specifying and treating problems interfering with functional performance.
On-the-Job Training - A planned experience in an actual work situation through which the client, under supervision, learns to perform all job operations of an occupation.
Organization, Cognitive - Using selective attention skills, the individual correctly perceives stimulus attributes or task elements, selects a strategy, monitors use of the strategy and reaches a correct solution.
Low Level: Those individuals who can sustain attention and appropriately switch sets. Persons with low level organization ability usually "fall apart" in high stress situations.
High Level: Those individuals who can deal with multiple pieces of information and integrate them for accomplishing relatively complex tasks. Some persons demonstrating high level cognitive organization may still "fall apart" in high stress situations.
Orientation - Awareness of one's environment and/or situation, along with the ability to use this information appropriately in a functional setting. See Disorientation.
Orientation, Left-Right - The ability to discriminate between left and right body parts on oneself and on others, as well as the ability to discriminate between left and right within the environment.
Orientation, Personal - General knowledge related to oneself includes information regarding date of birth, age, name, and location of home.
Orientation, Situational - The ability to accurately describe present circumstances. For example, in the acute stages of injury, brain-injured patients may be unable to respond accurately to questions such as, "Why are you in the hospital?" Situational disorientation is commonly observed during the period of post-traumatic amnesia (PTA).
Orientation, Temporal - Knowledge of the current date, day, month and year. Includes knowledge of facts related to time of day. For example, a disoriented patient asked to name the next meal at 4 pm might say, "breakfast."
Orientation to Environment - Knowledge regarding the present environment including where one is at the time of the evaluation. Accurate awareness of place.
Orthopedics - The branch of medicine devoted to the study and treatment of the skeletal system, its joints, muscles and associated structures.
Orthosis - Splint or brace designed to improve function or provide stability.
Orthotist - A skilled craftsman who develops and fits mechanical devices, such as a brace, splint or body jacket, designed to support or supplement a weakened body part, or function.
Outcome, Socio-Ecologic - The Interdisciplinary Special Interest Group (ISIG) Subcommittee on Outcome (of the American Congress of Rehabilitation Medicine) drafted the following statement at its meeting in June 1990: "Brain-injured persons have a capacity to function in the community. Rehabilitation can increase the ability to contribute to society and reduce the negative socio-ecological factors. Outcome measures can be viewed from a variety of perspectives, including impairment, disability and handicap. We recommend that in our Standards of Practice, we not limit measurement of outcome to the realms of impairment or disability. We advocate for outcome measures to include the issue of handicap or the socio-ecological context so that we define outcome around individuals inside of a support system or context."
Outcome - The end result.
Outpatient - The patient residing outside the hospital but returning on a regular basis for one or more therapeutic services.
Overnight Drainage Bag (ONDB) - A large thick plastic bag that is connected to a urodrain. It hangs on the bed and is used to collect urine at night or when someone needs to be in bed during the day.
P.A. - Physician's Assistant
P.T. - See Physical Therapist.
Palliative Care - A program designed to reduce the severity of symptoms and/or decrease their impact on the individual, and to improve the quality of life.
Paraparesis - Weakness of the lower limbs.
Paraphasic Error - Substitution of an incorrect sound (e.g., tree for free) or related word (e.g., chair for bed).
Paraplegia - Paralysis of the legs (from the waist down).
Parapnasias - Use of incorrect words or word combinations.
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Parenteral - Not through the alimentary canal (gastrointestinal tract) but rather by injection through some other route, such as subcutaneous, intramuscular or intravenous.
Parietal Lobe - One of the two parietal lobes of the brain located behind the frontal lobe at the top of the brain.
Parietal Lobe, Left - Damage to this area may disrupt a patient's ability to understand spoken and/or written language.
Parietal Lobe, Right - Damage to this area can cause visuo-spatial deficits (e.g., the patient may have difficulty finding their way around new, or even familiar, places).
Pathology - Interruption or interference of normal bodily processes or structures.
Patient - One who is acted upon; an individual awaiting or under medical care and treatment. (Also, see Consumer and Client.)
Pattern of Movement - Motion of particular parts of the body (such as the hand and arm) in a typical, reproducible, sequence and direction.
Perception - The ability to make sense of what one sees, hears, feels, tastes or smells. Perceptual losses are often very subtle, and the patient and/or family may be unaware of them.
Perceptual-Motor - Interaction of the perceptual abilities with motor abilities.
Perseveration - The inappropriate persistence of a response in a current task which may have been appropriate for a former task. Perseverations may be verbal or motoric.
Persistent Unawareness - The transition of a person who remains unconscious from a state of "coma" to one of "vegetative behaviors" reflects subtle changes over a period of several weeks from a condition of no response to the internal or external environment (except reflexively) to a state of wakefulness but with no indication of awareness (cortical function). A patient in this state may have a range of biological responses at the sub-cortical level such as eye opening (with sleep and wake rhythms) and sometimes the ability to follow with their eyes. Normal levels of blood pressure and respiration (vegetative functions) are maintained automatically. The label "persistent" is not applicable until the person has been unconscious for a year or more. Also called Coma Vigil.
Persistent Vegetative State (PVS) - A long-standing condition in which the patient utters no words and does not follow commands or make any response that is meaningful. See Persistent Unawareness.
Personal Adjustment Training - Process of modifying behavior to conform to measurable criteria based on socially appropriate behavior; process of modifying behavior to enable one to adequately deal with one's environment.
Phlebitis - Inflammation of a vein.
Phonation - The production of sound by means of vocal cord vibration.
Physiatrist [pronounced fizz ee at' rist] - A physician who specializes in physical medicine and rehabilitation. Some physiatrists are experts in neurologic rehabilitation, trained to diagnose and treat disabling conditions. The physiatrist examines the patient to assure that medical issues are addressed; provides appropriate medical information to the patient, family members and members of the treatment team. The physiatrist follows the patient closely throughout treatment and oversees the patient's rehabilitation program.
Physical Demands - The physical requirements made on the worker by the specific job/work situation. They include strength (lifting, carrying, pushing, and/or pulling), climbing, or balancing, stooping, kneeling, crouching and/or crawling, reaching, handling, fingering and/or feeling, talking and/or hearing and seeing.
Physical Therapist - The physical therapist evaluates components of movement, including: muscle strength, muscle tone, posture, coordination, endurance, and general mobility. The physical therapist also evaluates the potential for functional movement, such as ability to move in the bed, transfers and walking and then proceeds to establish an individualized treatment program to help the patient achieve functional independence.
Plasticity - The ability of cellular or tissue structures and their resultant function to be influenced by an ongoing activity.
Plateau - A temporary or permanent leveling off in the recovery process.
Policy - See Terms and Definitions Related to Insurance.
Posey Roll - A bar placed on the wheelchair to prevent a person from standing up or falling out.
Posey Vest/Houdini Jacket - A vest worn to keep the person in bed or in the wheelchair. This is for the person's safety.
Position sense - The sensory awareness of the location and orientation of body parts without moving them. See Kinesthesia and Proprioception.
Post Traumatic Amnesia (PTA) - A period of hours, weeks, days or months after the injury when the patient exhibits a loss of day-to-day memory. The patient is unable to store new information and therefore has a decreased ability to learn. Memory of the PTA period is never stored, therefore things that happened during that period cannot be recalled. May also be called Anterograde Amnesia.
Postural Tone, Excessive - Greater than normal tone of muscles used to hold the body in ordinary positions such as sitting or standing.
Posture - The attitude of the body. Posture is maintained by low-grade, continuous contraction of muscles which counteract the pull of gravity on the body parts. Injury to the nervous system can impair the ability to maintain normal posture, for example holding up the head.
Pre-Morbid Condition - Characteristics of an individual present before the disease or injury occurred.
Pre-Screening - The process of reviewing all available pertinent data on referrals to determine the need for additional information.
Prevocational Evaluation - An assessment, prior to work training, of the client's potential as a worker, giving special attention to one's work attitudes and habits, and evidence of personal responsibility.
Primary Care Nurse - The nurse principally responsible for the nursing care of a given patient. The primary care nurse develops and implements a care plan, participates in conferences, collaborates with the patient, the rehabilitation team, and the family, as well as evaluating the outcome of care.
Problem-Solving - Ability of the individual to bring cognitive processes to the consideration of how to accomplish a task.
Problem-Solving Skill - Ability to consider the probable factors that can influence the outcome of each of various solutions to a problem, and to select the most advantageous solution. Individuals with deficits in this skill may become "immobilized" when faced with a problem. By being unable to think of possible solutions, they may respond by doing nothing.
Production Work Evaluation - This is a method of evaluating clients through the use of actual industrial work brought into the evaluation facility. It is possible for the evaluation staff to vary all the customary conditions of the real job in an effort to discover difficulties that prevent the client from working effectively.
Productive Activity - Can be classified into the following categories: 1) Competitive. Competitive employment is defined as employment with a competitive wage and in a regular workplace. No formally structured extra supervision or assistance is provided outside of that normally expected for the job. (This category includes, however, subjects who work in competitive situations but who may nevertheless require some irregular or informed assistance, or who may have somewhat lowered productivity). Competitive academic enrollment means participating in regular course work in a mainstream curriculum at an accredited institution of education.
2) Vocational training. This is enrollment in a formal vocational training program with a goal of competitive employment.
3) Noncompetitive or sheltered program. This is participation in a sheltered (noncompetitive), but paid, employment or therapeutic productive work environment that does not provide the demands of a normal work situation, or a noncompetitive academic program specifically designed for those having some form of disability, such as learning disabled or brain-injured class.
4) Volunteer. Participation in a nonpaid, but formally organized and routine, therapeutic work situation.
5) Recreational or day activity program. Participation in programs specifically designed to meet the subjects' socialization and activity needs, but which are unpaid, with little in the way of performance demands beyond acceptable social behavior, and which require formal staff input for structure and guidance.
6) No Productivity. No involvement in organized social, avocational, educational or vocational activity. No personal routine activity of socially goal-oriented nature.
7) Independent homemaker or retired person living at home with or without requirement for attendant care or supervision.
8) Other.
Prognosis - The prospect as to recovery from a disease or injury as indicated by the nature and symptoms of a case.
Program Manager - Vocational Evaluation - That professional person who is responsible for the entire evaluation program of an individual client. This includes reviewing all referral information, orientation of the client, scheduling services, planning the individual program, maintaining integration and coordination in the program, maintaining a written case record, holding formal and informal conferences as appropriate, making the termination decisions, preparing the final report and follow up.
Program Standards - Requirements that are judged to be necessary for the satisfactory operation of a program. In June, 1990, the Subcommittee on Standards of the American Congress of Rehabilitation Medicine (ACRM), Interdisciplinary Special Interest Group (ISIG) on Head Injury proposed that standards could be conceptually organized into the following categories:
Inpatient Rehabilitation Programs
Postacute Treatment Program
Residential
Day Treatment
Postacute Care Program
Residential
Day Care
Key Rehabilitation Services
Vocational
Cognitive
Behavioral
Academic
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Program/Service Types - The following program/service categories describe the array of organized services (not mutually exclusive) and not an exhaustive list available for the rehabilitation of persons with brain injury:
Acute Rehabilitation - Based in a medical facility; accepts patient as soon as medically stable; focuses on intensive physical and cognitive restorative services in early months after injury; typical length of stay one week to several months (short term); identifiable team and program with specialized unit.
Behavior Disorders - For the patient exhibiting patterns of behavior preventing participation in active rehabilitation, including destructive patient behavior to self and others; continuum of controlled settings.
Case Management - Services designed to maximize the effective use of resources and to achieve the highest level of functioning. Case management services may include assessment of client needs, development or a plan based on needs and goals, identification of programs, services, practitioners and funding resources, coordination and monitoring of services, and ongoing evaluation of current and future needs.
Coma Management - Accepts patients as soon as active intervention is indicated; Patient functioning at Ranch Los Amigos Scale levels I-IV; and unable to actively participate in therapy.
Community Integration Program - Provides services designed to accomplish functional outcomes focused on home and community integration, including productive activity. Services may be provided in residential facilities, day treatment programs, the consumer's home. They may be of short-term (several weeks) or long-term duration (several months).
Community/Home Services - Services are provided in the client's home and/or the client's own community. Personnel providing services must have appropriate qualifications and training to meet the client's needs. (Adopted by the Post-Acute Committee of ISIG on Head Injury October 28, 1991.)
Congregate Living - Setting is a shared living arrangement in a dormitory style facility. Individual care, supervision, support and training services are provided to maintain/promote self-sufficiency. Staff is present at night and other times when the consumer is present.
Day Treatment Program - Non-residential program intended to increase the functional ability of the consumer through therapeutic intervention and supervised activities. Day treatment seeks to facilitate successful community integration.
Education Program - Provides primary, secondary, and/or higher level education and support services to achieve realistic academic goals. May include evaluation, academic tutoring, school reentry services and/or General Education Diploma (GED) preparation.
Employment - Vocational rehabilitation services that are designed to lead to an employment goal; services can range from assessment to basic on-the-job supports; includes one or all of the following: vocational assessment, vocational training, vocational placement, sheltered employment, supported employment.
Family Living - Setting is the home of a family other than the family of origin of the consumer. Through a contractual relationship, a family environment is provided to maximize the consumer's potential. Monitoring, support, and training are provided by the organization offering the program.
Homecare - Comprehensive training available for family/caretaker; case management services available prior to home care; team integrated home program.
Independent Living - Community-based to maximize a person's ability to be empowered and self-directed; allows an individual to live in one's own home with maximum personal control over how services are delivered, combined with the opportunity to work as appropriate.
Lifelong Living - For persons discharged from rehabilitation who need ongoing lifetime supports; located in residential or skilled nursing environment; structured activities available on individual and group basis.
Long-term Medical Inpatient Program - Designed to improve the functional ability of a severely disabled person through a long-term program of coordinated medical and rehabilitation services. The resident typically has significant limitations in functional capabilities, both physically and cognitively. The program is generally provided on a specialized unit within a hospital; the staff is trained in managing problems exhibited by persons with severe disabilities. Residents are accepted as soon as medically stable.
Medical Inpatient Program - Designed to improve the functional ability of the patient through a coordinated program of medical care, evaluation and intensive rehabilitation services. The program is generally provided on a specialized unit within a hospital; the staff is trained in rehabilitation of persons with TBI. Consumers are accepted as soon as medically stable and typically remain in this program 1-3 months. (See acute rehabilitation.)
Nursing Facility - Long-term care facility which provides 24-hour skilled nursing care prescribed by a physician.
Outpatient/Day Services - Services are usually delivered (or coordinated) in a fixed location during some portion of the day. The environment must have adequate amenities to meet health safety and dignity needs of the client. Services must be provided by personnel with appropriate qualifications and training to meet the clients needs. (Adopted by the Post-Acute Committee of ISIG of Head Injury, October 28, 1991.)
Outpatient Medical Rehabilitation - Provides coordinated and integrated evaluation and treatment with an emphasis on improving the functional abilities of the client. At minimum must include medical supervision, medical support services and consultation, rehabilitation therapies and other services.
Recreation Program - Program designed to enhance participation in social and recreational activities and/or the development of recreational skills.
Residential Services - Assumes a 24-hour residential environment outside the home and includes 24-hour provision of or access to support personnel capable of meeting the client's needs. (Adopted by the PostAcute Committee of ISIG on Head Injury October 28, 1991.)
Respite Care - A program or plan designed to provide time-limited relief to the family or other primary caregiver from the ongoing responsibilities of caregiving.
Respite/Recreation - Program allows person and family to adapt psychologically and environmentally to the residual deficits of brain injury; the program is based on a noninterventional model to address socialization, recreation, and respite for the primary care givers.
Subacute - May follow a period of acute rehabilitation; not necessarily hospital based; typical length of rehabilitation stay 6-24 months (short to intermediate term); stay based on demonstrated improvement; identifiable team and program with specialized unit.
Supervised Living - Setting is a home which is like other homes in the neighborhood in terms of size and number of residents. Consumers are provided individualized care, supervision, support and training services to maximize and/or maintain function and self-direction. Staff is present at night and other times when the consumer is present.
Supported Independent Living - Setting is a home chosen by the consumer who is primarily independent. Program offers support to assist the resident in maximizing and/or maintaining independence and self-direction. Staff is available as needed and at planned intervals to offer assistance and support but not to provide supervision.
Transitional Living - Non-medical residential program providing training for living in a setting of greater independence. The primary focus is on teaching functional skills and compensating for abilities that cannot be restored.
Vocational Evaluation - An organized and comprehensive service staffed by specialists who systematically and comprehensively utilize work activities (real or simulated) and/or educational services as the focal point for educational and vocational assessment and exploration. In addition, psychological testing, counseling, social summaries, occupational information, etc., are other evaluation tools that are used. It incorporates the medical, psychological, social, vocational, educational, cultural, and economic data for establishment and attainment of individual goals.
Vocational Rehabilitation Program - Offers employment services which may include vocational evaluation, skill training, work adjustment, job training, job placement, job coaching, sheltered and/or supported employment.
Prone - Lying on one's stomach.
Proprioception - The sensory awareness of the position of body parts with or without movement. Combination of kinesthesia and position sense.
Prosody - The inflections or intonations of speech.
Prosthesis - An artificial substitute for a missing body part, such as an arm or leg, eye or tooth, used for functional or cosmetic reasons or both.
Proximal - Next to, or nearest, the point of attachment.
Proximal Instability - Weakness of muscles of the trunk, shoulder girdle or hip girdle which causes poor posture, abnormal movement of the arms or legs and the inability to hold one's head up. Strength of muscles of the hands or legs may be normal.
Psychologist - A professional specializing in counseling, including adjustment to disability. Psychologists use tests to identify personality and cognitive functioning. This information is shared with team members to assure consistency in approaches. The psychologist may provide individual or group psychotherapy for the purpose of cognitive retraining, management of behavior and the development of coping skills by the patient/client and members of the family.
Psychometric Instruments - Standardized tests (utilizing paper and pencil) which measure mental functioning.
Psychomotor Skills - Skills that involve both mental and muscular ability such as playing sports or other activities where practice or concentration is involved.
PTA - See Post-traumatic amnesia.
Ptosis - Drooping of a body part, such as the upper eyelid, from paralysis, or drooping of visceral organs from weakness of the abdominal muscles.
Purposeful Movement - Motor activity with an apparent goal.
Quadriparesis - Weakness of all four limbs.
Quadriplegia - Paralysis of all four limbs (from the neck down). British authors often use the prefix "tetra" to mean four, so they may describe a patient as having tetraplegia.
Qualify of Life - A rating of what kind of existence a person experiences. In estimating the quality of life the following terms are usually considered: 1) mobility and activities of daily life; 2) living arrangements; 3) social relationships; 4) work and leisure activities; 5) present satisfaction; and 6) future prospects.
