Abstract Thinking
Being able to apply abstract concepts to new situations and surroundings.
To inflict physical or emotional mistreatment or injury on purposely or through negligence or neglect and often on a regular basis.
Acetylcholinesterase Inhibitors
anti-cholinesterases inhibit the cholinesterase enzyme from breaking down ACh, increasing both the level and duration of the neurotransmitter action. According to the mode of action, AChE inhibitors can be divided into two groups: irreversible and reversible.
Administration for Community Living. Full definition below.
Acquired Brain Injury (ABI)
An acquired brain injury is an injury to the brain, which is not hereditary, congenital, degenerative, or induced by birth trauma. An acquired brain injury is an injury to the brain that has occurred after birth.
Activities of Daily Living (ADLs)
Basic tasks that a person performs throughout the course of his/her day, such as: eating, bathing, toileting, grooming, transferring and moving about.
In reference to healthcare for TBI, describes the medical procedures undertaken to stabilize a patient in a hospital; care that is provided on a short-term basis for an immediate need, usually right after the injury occurred.
Adaptive Equipment
A special devices which assists in the performance of self care, work or play/leisure activities, or physical exercise.
Administration for Community Living (ACL)
The U.S. Department of Health and Human Services (HHS) created the Administration for Community Living (ACL) in 2012. The Administration for Community Living (ACL) administers programs authorized through a variety of statutes. ACL brings together the efforts and achievements of the Administration on Aging, the Administration on Intellectual and Developmental Disabilities, and the HHS Office on Disability to serve as the Federal agency responsible for increasing access to community supports, while focusing attention and resources on the unique needs of older Americans and people with disabilities across the lifespan.
Adult Day Care/Adult Day Health Center
Community-based care designed to meet the needs of functionally and/or cognitively impaired adults who, for their own safety and well-being, can no longer be left at home alone during the day. Adult day care facilities such as senior or community centers offer protected settings which are normally open weekdays during business hours and include a mixture of health, social and support services. Specialized programs for individuals with Alzheimer's disease or related disorders also exist. Some facilities offer a wide range of therapeutic and rehabilitative activities as well as social activities, meals, and transportation.
One who pleads, supports or promotes the interests of a cause, individual or group. To argue for a cause, or plead on another’s behalf for education, legal, personal, or vocational rights, or a person who argues for their own, or another person’s rights.
The observable emotional condition of an individual at any given time.
Aging and Disability Resource Consortia’s (ADRCs)
Is an equal partnership between Aging Services Access Points/Area Agencies on Aging (ASAPs/AAAs) and Independent Living Centers (ILCs) in order to provide access to more choices to individuals so they can choose the setting in which they receive Long-Term Services and Supports regardless of age, disability or income. In Massachusetts, they are organized into 11 geographical regions comprised of at least one ILC and one or more Aging Services Access Points. ADRCs have partnerships with many community agencies across the aging and disability network including social and health care services and supports. For example: ADRC organizations provide consumers with access to information and referral services, Option Counseling and assist them with decision support, assessment for services, service authorization and planning, consumer-directed options for LTSS and community integration.
Aging Service Access Point (ASAP)
A private, non-profit, state-designated agency under contract with the Massachusetts Executive Office of Elder Affairs to provide a single-entry point for seniors and caregivers to access a variety of programs and services. Formerly known as "Home Care Corporation".
Excessive restlessness, including increased physical activity which is usually non-purposeful and repetitious.
a condition characterized by uncontrollable motor restlessness. Akathisia is a side effect of older, first-generation antipsychotic drugs used to treat mental health conditions like bipolar disorder and schizophrenia, but it can also occur with newer antipsychotics as well. People with akathisia feel an uncontrollable urge to move and a sense of restlessness. To relieve the urge, they engage in repetitive movements like these: rocking back and forth while standing or sitting; shifting weight from one leg to the other; walking in place; pacing; shuffling while walking; lifting the feet as if marching; crossing and uncrossing the legs or swinging one leg while sitting. Other symptoms include: tension or panic; irritability; and impatience.
loss or impairment of voluntary activity (as of a muscle)
Alcohol Use Disorder
(which includes a level that's sometimes called by the deprecated term of alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking. Unhealthy alcohol use includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems. It includes binge drinking — a pattern of drinking where a male consumes five or more drinks within two hours or a female down at least four drinks within two hours (and for older adults 4 or more drinks for men and 3 or more drinks for women). Binge drinking causes significant health and safety risks. Heavy drinking is defined as 15 or more drinks per week for men and 8 or more for women or men ages 65 .(CDC) If the pattern of drinking results in repeated significant distress and problems functioning in one’s daily life, one likely has alcohol use disorder. It can range from mild to severe. However, even a mild disorder can escalate and lead to serious problems, so early treatment is important.
See Alcohol Use Disorder. Alcoholism is an older term that's currently discouraged.
To walk.
Lack of memory about events occurring during a particular period of time.
An almond shaped mass of gray matter in the front part of the temporal lobe of the cerebrum that is part of the limbic system. The amygdala is involved in the processing and expression of emotions, especially anger and fear.
A balloon like deformity in the wall of a blood vessel. The wall weakens as the balloon grows larger, and may eventually burst, causing a hemorrhage.
Also known as Anorexia Nervosa, is an eating disorder characterized by an abnormally low body weight, intense fear of gaining weight and a distorted perception of body weight. People with anorexia place a high value on controlling their weight and shape, using extreme efforts that tend to significantly interfere with activities in their lives. To prevent weight gain or to continue losing weight, people with anorexia usually severely restrict the amount of food they eat. They may control calorie intake by vomiting after eating or by misusing laxatives, diet aids, diuretics or enemas. They may also try to lose weight by exercising excessively. Some people with anorexia binge and purge, similar to individuals who have bulimia nervosa. However, people with anorexia generally struggle with an abnormally low body weight, while individuals with bulimia typically are normal to above normal weight. No matter how weight loss is achieved, the person with anorexia has an intense fear of gaining weight. Anorexia isn't really about food. It's an unhealthy way to try to cope with emotional problems. When you have anorexia, you often equate thinness with self-worth. Anorexia can be very difficult to overcome. But with treatment, you can gain a better sense of who you are, return to healthier eating habits and reverse some of anorexia's serious complications.
A lack of oxygen. Cells of the brain need oxygen to stay alive. When blood flow to the brain is reduced or when oxygen in the blood is too low, brain cells are damaged.
Factors or events that occur prior to a current situation. Attention to antecedents can assist in promoting desired behaviors and avoiding negative behaviors.
Anterograde Amnesia
Inability to consolidate information about ongoing events. Difficulty with new learning.
Anti-anxiety medications
help reduce the symptoms of anxiety, such as panic attacks, or extreme fear and worry. The most common anti-anxiety medications are called benzodiazepines. Benzodiazepines can treat generalized anxiety disorder. In the case of panic disorder or social phobia (social anxiety disorder), benzodiazepines are usually second-line treatments, behind SSRIs or other antidepressants.
Opposing the actions of the neurotransmitter acetylcholine. Anticholinergic drugs inhibit the transmission of parasympathetic nerve impulses, thereby reducing spasms of smooth muscles (for example, muscles in the bladder).
Type of medication used to treat seizure disorders by decreasing the possibility of a seizure (e.g., Dilantin, Phenobarbital, Mysoline, and Tegretol). Anticonvulsants have been found to help control unstable moods as well.
Anti-Craving medications
These work by blocking of the reward receptors in the brain. Different addictions are being treated with the use of anti-craving medications after detox. These include alcohol, opiate, nicotine, and cocaine use disorders. These medications are used to help prevent relapse.
are medications commonly used to treat depression. Antidepressants are also used for other health conditions, such as anxiety, pain and insomnia.
Antipsychotic medications
Type of medication primarily used to manage psychosis. The word “psychosis” is used to describe conditions that affect the mind, and in which there has been some loss of contact with reality, often including delusions (false, fixed beliefs) or hallucinations (hearing or seeing things that are not really there). It can be a symptom of a physical condition such as drug abuse or a mental disorder such as schizophrenia, bipolar disorder, or very severe depression (also known as “psychotic depression”). Antipsychotic medicines do not cure these conditions. They are used to help relieve symptoms and improve quality of life. Antipsychotic medications are often used in combination with other medications to treat delirium, dementia, and mental health conditions, including: Attention-Deficit Hyperactivity Disorder (ADHD); Severe Depression; Eating Disorders; Post-traumatic Stress Disorder (PTSD); Obsessive Compulsive Disorder (OCD); Generalized Anxiety Disorder.
Antispasticity medications
Medications used to treat cerebral and spinal cord related spasticity. See definition for Spasticity.
people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood. Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment. Whatever form of anxiety one has, treatment can help.
having or showing little or no feeling, emotion, interest or concern.
Absence of feelings or emotions. Person is indifferent.
Loss of the ability to express oneself and/or to understand language. Caused by damage to brain cells rather than deficits in speech or hearing organs.
Inability to carry out a complex or skilled movement; not due to paralysis, sensory changes, or deficiencies in understanding.
Area Agency on Aging (AAA)
A regional agency that is authorized by the Administration on Aging, funded through the Old Americans Act and partners with the Executive Office of Elder Affairs to assist older people with their life-long needs including: information and referral for in-home services, counseling, legal services, transportation, and nutrition
Being awake. Primitive state of alertness managed by the reticular activating system (extending from medulla to the thalamus in the core of the brain stem) activating the cortex. Cognition is not possible without some degree of arousal.
Movement of the lips, tongue, teeth and palate into specific patterns for purposes of speech. Also, a movable joint.
a lack of oxygen or excess of carbon dioxide in the body that is usually caused by interruption of breathing and that causes unconsciousness.
When fluid or food enters the lungs through the wind pipe. Can cause a lung infection or pneumonia.
Assistive Technology
Such as assistive devices, adaptive technologies, adaptive equipment, relates to any technology that enables a person to live independently and perform self-care, work and community activities (play, leisure, exercise, etc.). Some assistive technologies can be useful in compensating for cognitive impairments. Examples include: personal digital assistants, voice organizers and recorders, reminders, watches and smart phones.
Inability to coordinate voluntary muscle movements.
A wasting away or decrease in size of a cell, tissue, organ, or part of the body caused by lack of nourishment, inactivity or loss of nerve supply.
The ability to focus on a given task or set of stimuli for an appropriate period of time
Attention Deficit Hyperactivity Disorder (ADHD)
Adult attention-deficit/hyperactivity disorder (ADHD) is a mental health disorder that includes a combination of persistent problems, such as difficulty paying attention, hyperactivity and impulsive behavior. Adult ADHD can lead to unstable relationships, poor work or school performance, low self-esteem, and other problems. Though it's called adult ADHD, symptoms start in early childhood and continue into adulthood. In some cases, ADHD is not recognized or diagnosed until the person is an adult. Adult ADHD symptoms may not be as clear as ADHD symptoms in children. In adults, hyperactivity may decrease, but struggles with impulsiveness, restlessness and difficulty paying attention may continue. Treatment for adult ADHD is similar to treatment for childhood ADHD, though some ADHD medications approved for children are not approved for adult use. Adult ADHD treatment includes medications, psychological counseling (psychotherapy) and treatment for any mental health conditions that occur along with ADHD.
Atypical antipsychotic medications
Newer or second generation antipsychotic medications are also called "atypical" antipsychotics. See definition for Antipsychotic Medications.
Axonal shearing
When the brain is moved back and forth against the skull after a head trauma, it is alternatively compressed and stretched because of its soft, gelatin-like structure. The long, fragile axons of the neurons that make up the brain are also compressed and stretched. If the impact is severe enough, axons can be stretched until they are torn. This is called axonal shearing. When this happens, the neuron dies. An injury with substantial axonal shearing is more diffuse -- spread throughout the brain.
Long nerve fibers that conduct impulses away from the cell body of a neuron.
The ability to use appropriate righting and equilibrium reactions to maintain an upright position. It is usually tested in sitting and standing positions.
The total collection of actions and reactions exhibited by a person.
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.
Behavioral impairments
Neurobehavioral effects resulting from TBI include affective changes, including over-emotional or over-reactive affect or flat (i.e., emotionless) affect. Agitation and/or combativeness; anxiety disorder; depression ;difficulty identifying emotions in others (alexithymia);emotional lability and mood changes or mood swings; excessive drowsiness and changes in sleep patterns, including difficulty falling or staying asleep (insomnia), excessive sleepiness (hypersomnia);feeling of disorientation or fogginess; increased state of sensory sensitivity accompanied by exaggerated response to perceived threats (hypervigilance); impulsivity; irritability and reduced frustration tolerance; stress disorders.
A class of medications often used in the treatment of anxiety, panic disorder, seizures or sleep disorders. May also be used as general anesthesia, muscle relaxation and during alcohol withdrawal or drug associated agitation. Examples of benzodiazepines include alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium) and lorazepam (Ativan).
Beta Blockers
any of a group of drugs (as propranolol) that combine with and block the activity of a beta-receptor to decrease the heart rate and force of contractions and lower high blood pressure and that are used especially to treat hypertension, angina pectoris, and ventricular and supraventricular arrhythmias.
Pertaining to both right and left sides.
Bipolar disorder
Formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly. Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any. Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).
Blood Alcohol Concentration (BAC)
is most commonly used as a measure of alcohol intoxication for legal or medical purposes.
Brain injury (BI)
Any injury that results in brain cell death and loss of function. For more specifics see definitions for Brain Injury, Acquired Brain Injury (ABI) and Traumatic Brain Injury (TBI).
Brain Injury Association of Massachusetts (BIA-MA)
A private, nonprofit, statewide organization, the Brain Injury Association of Massachusetts provides Support & Resources to brain injury survivors and their families; Prevention Programs to educate the public on the impact of brain injuries; Education & Training for brain injury survivors, caregivers and professionals; and Legislative Advocacy for improved community services and safety laws (seat belts, helmets).
Brain scan
An imaging technique in which a radioactive dye (radionucleide) is injected into the blood stream and then pictures of the brain are taken to detect tumors, hemorrhages, blood clots, abscesses or abnormal anatomy.
Brain stem
The lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brain stem include those necessary for survival (breathing, heart rate) and for arousal (being awake and alert). It also houses the reticular formation which controls consciousness, drowsiness, and attention.
Brain swelling
Also known as cerebral edema, is when the brain swells after a severe trauma, just like any other part of the body. This is also a major cause of damage after brain injury. Very severe swelling can cause death by compressing the brain stem. Brain swelling can lead to neuronal damage by squeezing the cells or from anoxia caused by disrupting the flow of blood and oxygen to the brain.
Brain Tumor
A brain tumor is a mass or growth of abnormal cells in your brain or close to your brain. Many different types of brain tumors exist. Some brain tumors are noncancerous (benign), and some brain tumors are cancerous (malignant). Brain tumors can begin in your brain (primary brain tumors), or cancer can begin in other parts of your body and spread to your brain (secondary, or metastatic, brain tumors).
Used in medication-assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates, such as pain relievers like morphine. Buprenorphine represents the latest advance in medication-assisted treatment (MAT). Unlike methadone treatment, which must be performed in a highly structured clinic, buprenorphine is the first medication to treat opioid dependency that is permitted to be prescribed or dispensed in physician offices, significantly increasing treatment access. Under the Drug Addiction Treatment Act of 2000 (DATA 2000), qualified U.S. physicians can offer buprenorphine for opioid dependency in various settings, including in an office, community hospital, health department, or correctional facility.
A medication primarily used as an antidepressant and smoking cessation aid. Trade names include Wellbutrin and Zyban. The Zyban brand of bupropion is used to assist smoking cessation by reducing cravings and other withdrawal effects. See definition for Antidepressant Medications.
Capgras Syndrome
a delusional condition characterized by the false belief that known individuals (such as family members) have been replaced by doubles or impostors
An adult (typically a family member or friend) who provides unpaid assistance to another adult who can no longer independently attend to his or her personal needs and/or perform his or her normal activities of daily living.
Case Management
Facilitating the access of a patient to appropriate medical, rehabilitation and support programs, and coordination of the delivery of services. This role may involve liaison with various professionals and agencies, advocacy on behalf of the patient, and arranging for purchase of services where no appropriate programs are available
Centers for Disease Control and Prevention (CDC)
One of 13 major operating components of the Department of Health and Human Services; and leads the nation’s public health efforts to prevent and control infectious diseases, injuries, workplace hazards, disabilities, and environmental health threats.
Central Nervous System
includes the brain, diencephalon, strain stem, and spinal cord.
The portion of the brain (located at the back) which helps coordinate movement. Damage may result in ataxia.
Marked by long duration or frequent recurrence.
Closed Brain Injury
Occurs when the head accelerates and then rapidly decelerates or collides with another object (for example the windshield of a car) and brain tissue is damaged, not by the presence of a foreign object within the brain, but by violent smashing, stretching, and twisting, of brain tissue. Closed brain injuries typically cause diffuse tissue damage that results in disabilities which are generalized and highly variable.
Club Houses
are a comprehensive and dynamic program of support and opportunities for people with severe and persistent mental illnesses.
Related to cognition is the conscious process of knowing or being aware of thoughts or perceptions, including understanding and reasoning.
Cognitive Behavioral Therapy (CBT)
is a common type of talk therapy (psychotherapy). You work with a mental health counselor (psychotherapist or therapist) in a structured way, attending a limited number of sessions. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way. CBT can be a very helpful tool in treating mental health disorders, such as depression, post-traumatic stress disorder (PTSD) or an eating disorder. But not everyone who benefits from CBT has a mental health condition. It can be an effective tool to help anyone learn how to better manage stressful life situations.
Cognitive functioning
A function of the brain that refers to how one thinks, reasons, stores, and processes information.
Cognitive Impairments
Cognitive deficits resulting from TBI may include Attention deficits, (including: reduced attention span (easily distractible); difficulty with selective attention; impaired sustained attention for task completion or conversational engagement; deficits in shifting attention between tasks). Executive function deficits (including difficulty with goal setting, strategy selection, initiating and self-directing, planning and organization, reasoning and problem solving). Information processing impairments (including reduced processing speed and processing length (e.g., difficulty with longer messages and rapid rate of speech), increased processing time for auditory and visual input (e.g., increased response latency when responding to questions in a conversation). Memory and learning deficits (including post-traumatic amnesia marked by impaired memory of events that happened either before (anterograde) or after (retrograde) the injury, deficits in both retrieval of previously acquired knowledge and creation of new memory traces—long-term memory is often less impaired than short-term memory). Impaired metacognition (including deficits in subjective knowledge and insight into one's own cognitive processes; reduced awareness of deficits (anosagnosia); impaired self-monitoring; poor self-regulation). Deficits in orientation (to self, situation, location, and/or time). Impaired spatial cognition (including functional deficits in activities, such as navigation, driving, ambulation, dressing, and self-care (independent of any comorbid motor deficits).
Cognitive Rehabilitation
Therapy programs which aid persons in the management of specific problems in perception, memory, thinking and problem solving. Skills are practiced and strategies are taught to help improve function and/or compensate for remaining deficits. The interventions are based on an assessment and understanding of the person's brain-behavior deficits and services are provided by qualified practitioners.
A state of unconsciousness from which the patient cannot be awakened or aroused, even by powerful stimulation; lack of any response to one's environment. Defined clinically as an inability to follow a one-step command consistently; Glasgow Coma Scale score of 8 or less.
Communicative Disorder
An impairment in the ability to 1) receive and/or process a symbol system, 2) represent concepts or symbol systems, and/or 3) transmit and use symbol systems. The impairment may be observed in disorders of hearing, language, and/or speech processes.
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, and the consumer's home. They may be of short-term (several weeks) or long-term duration (several months).
Community Skills
Those abilities needed to function independently in the community. They may include: telephone skills, money management, pedestrian skills, and use of public transportation, meal planning and cooking.
Compensatory Strategies
maximize skills of the individual with TBI by either modifying the environment and/or providing internal and external supports (Shum, Fleming, Gill, Gullo, & Strong, 2011)and capitalizes on intact skills to overcome deficits resulting from TBI (Wilson, 2002). Compensatory strategies can include both internal (e.g., mnemonics, imagery, association) and external (e.g., memory aids, PDAs, calendars) strategies. External strategies involving assistive technology may support a variety of cognitive-communicative impairments, including attention, memory, navigation, time management, organization, and emotional function (Sohlberg et al., 2007; de Joode, van Heugten, Verhey, & van Boxtel, 2010; Gillespie, Best, & O'Neill, 2012; Wild, 2013).
Understanding of spoken, written, or gestural communication.
Computerized Axial Tomography (CT Scan)
A series of X-rays taken at different levels of the brain that allows the direct visualization of the skull and intracranial structures. A scan is often taken soon after the injury to help decide if surgery is needed. The scan may be repeated later to see how the brain is recovering.
The ability to focus on a given task or set of stimuli for an appropriate period of time.
Concrete Thinking
A style of thinking in which the individual sees each situation as unique and is unable to generalize from the similarities between situations. Language and perceptions are interpreted literally so that a proverb such as "a stitch in time saves nine" cannot be readily grasped
The common result of a blow to the head or sudden deceleration usually causing an altered mental state, either temporary or prolonged. Physiologic and/or anatomic disruption of connections between some nerve cells in the brain may occur. Often used by the public to refer to a brief loss of consciousness.
Verbalizations about people, places, and events with no basis in reality. May be a detailed account delivered.
A state in which a person is bewildered, perplexed, or unable to self-orient.
existing at or dating from birth. Acquired during development in the uterus and not through heredity
Congenital condition
Circumstance that is present at birth.
a person, official, or institution appointed by a court to take over and manage the estate of an incompetent.
Bruising and bleeding of the brain due to the tearing of small blood vessels upon impact. It can lead to the death of neurons. Small contusions (as in concussion) are not usually treated unless blood flow is interrupted.
Harmonious working together of muscles or muscle groups to perform complicated movements.
Cortical area
any region of the cerebral cortex, the outer layer of neural tissue of the brain.
Councils on Aging (COA)
A municipally appointed agency that provides services to elders, families and caregivers. While each COA is unique to its community, most councils offer information and referral, transportation, outreach, meals (congregate and home delivered), health screening, fitness and recreation programs and volunteer services.
Coup-contra coup
A pattern of contusion whereby one contusion occurs at the site of the initial impact on the brain ("coup") and another at the site directly opposite ("contra coup"). This pattern is the result of the brain moving back and forth inside the skull upon impact.
act as a prompt or reminder.
Cultural competence
The ability and the will to respond to the unique needs of an individual client or family that arise from the client’s culture and the ability to use the person’s cultural strengths as resources or tools to assist with the treatment, intervention or helping process. Cultural competence is generally regarded as a long term process towards which one strives. In addition, cultural competence can be thought of as an attribute of an individual provider and as an attribute of an organization.
An integrated pattern of socially transmitted human behavior that includes thoughts, communication, actions, customs, beliefs, values, institutions, and all other products of human work or thought, characteristic of a particular community or population (Cross et al., 1989). Though culture is often viewed as simply race and ethnicity, the term encompasses much more. Other groups of people display distinct cultural characteristics and in turn receive culturally insensitive responses from society. Examples of such groups include the poor, the homeless, and the disabled.
Day Treatment
psychiatric outpatient program(s) provided in the community.
Department of Developmental Disabilities
Delirium is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of your environment. The start of delirium is usually rapid — within hours or a few days. Delirium can often be traced to one or more contributing factors, such as a severe or chronic medical illness, changes in your metabolic balance (such as low sodium), medication, infection, surgery, or alcohol or drug withdrawal. Because symptoms of delirium and dementia can be similar, input from a family member or caregiver may be important for a doctor to make an accurate diagnosis
Deterioration of intellectual abilities (e.g., vocabulary, abstract thinking, judgment, memory loss, physical coordination), the loss of which interferes with daily activities. Dementia can be caused by degenerative diseases (e.g., Alzheimer's, Huntington's and Parkinson's diseases), vascular diseases or stroke, metabolic disorders (thyroid, liver kidney dysfunction and certain vitamin deficiencies), AIDS, drugs and alcohol, and psychiatric disorders. Some dementias may respond to treatments, others do not.
Adaptation to a drug that produces physical symptoms of withdrawal when the drug is stopped.
Depressed skull fracture
This is when bones of the skull are broken or cracked with loose bone fragments actually placing pressure or penetrating the brain, thereby causing damage.
a common but serious mood disorder which causes severe symptoms that affect how you feel, think, and handle daily activities such as sleeping, eating, or work. To be diagnosed with depression (major depressive disorder or clinical depression) the symptoms must be present for at least two weeks.
Dialectical Behavior Therapy (DBT)
Dialectical behavior therapy (DBT) is a well-established treatment for individuals with multiple and severe psychosocial disorders, including those who are chronically suicidal. DBT can include group or individual therapy designed specifically to treat borderline personality disorder. DBT uses a skills-based approach to teach one how to manage one’s emotions, tolerate distress and improve relationship. Because many such patients have substance use disorders (SUDs), the authors developed DBT for Substance Abusers, which incorporates concepts and modalities designed to promote abstinence and to reduce the length and adverse impact of relapses.
Diffuse Axonal Injury
A shearing injury of large nerve fibers (axons covered with myelin) in many areas of the brain. It appears to be one of the two primary lesions of brain injury, the other being stretching or shearing of blood vessels from the same forces, producing hemorrhage.
Diffuse Brain Injury
Injury to cells in many areas of the brain rather than in one specific location.
Diffuse injury
An injury to the brain in which damage is not limited to one location in the brain, but affects multiple areas.
Inability to suppress (inhibit) impulsive behavior and emotions.
Not knowing where you are, who you are, or the current date. Health professionals often speak of a normal person as being oriented "times three" which refers to person, place and time.
Department of Mental Health
Domestic Violence (DV)
violence committed by one family or household member against another. Domestic violence involves violence or abuse by one person against another in a familial or intimate relationship. Domestic violence is commonly thought of as an intimate partner violence, but can also include violence or abuse from a family member. The term “intimate partner violence” includes the following acts as inflicted or caused by a current or former intimate partner: Actual or threats of physical violence. Actual or threats of sexual violence. Emotional or psychological abuse (e.g., name calling or putdowns, threats to “out” a person’s sexual orientation to family, work or friends). Stalking (e.g., excessive calls/texts/emails, monitoring daily activities, using technology to track a person’s location). Financial abuse (e.g., withholding money, ruining credit, stopping a partner from getting or keeping a job). Threats to “out” a person’s sexual orientation to family, work or friends. Intimate partners can include: Current or former spouses, Boyfriends or girlfriends, Dating partners or Sexual partners. Domestic violence can occur in heterosexual and same-sex relationships.
a chemical found in the brain that acts as a neurotransmitter and is an intermediate compound in the synthesis of noradrenaline. Dopamine is essential to the normal functioning of the central nervous system. For example, a reduction of dopamine in the brain is associated with the development of Parkinson’s disease.
relating to medications releasing or involving dopamine as a neurotransmitter. Drugs with this effect are used in the treatment of Parkinson's disease and some psychiatric disorders; some are subject to abuse.
Dorsolateral Frontal Injury
injury located in the region by the frontal lobes toward the top and side: hence dorso (top) and lateral (side). The dorsolateral prefrontal cortex is largely responsible for attention, executive function and working memory.
Department of Public Health
Drug Abuse
Drug abuse is the use of illegal drugs or the use of prescription or over-the-counter medications in ways other than recommended or intended. It also includes intentional inhalation of household or industrial chemicals for their mind-altering effects. Tobacco use and problem drinking are sometimes included in the definition of drug abuse. Drug abuse can have serious, even life-threatening, complications, such as drug overdose, alcohol poisoning, trauma, and suicidal or violent behavior.
Drug Addiction
Drug addiction, also called substance use disorder, is a dependence on a legal or illegal drug or medication. Keep in mind that alcohol and nicotine are legal substances, but are also considered drugs. When you're addicted, you're not able to control your drug use and you may continue using the drug despite the harm it causes. Drug addiction can cause an intense craving for the drug. You may want to quit, but most people find they can't do it on their own. Drug addiction can cause serious, long-term consequences, including problems with physical and mental health, relationships, employment, and the law. You may need help from your doctor, family, friends, support groups or an organized treatment program to overcome your drug addiction and stay drug-free.
Drug misuse
The use of prescription drugs without a prescription, or in a manner other than as directed by the prescriber.
Drug Overdose
The term drug overdose (or simply overdose or OD) describes the ingestion or application of a drug or other substance in quantities greater than are recommended or generally practiced. An overdose may result in a toxic state or death.
Drug Use Disorders
Although SAMHSA does not use “Drug Use Disorder” as the names of disorders related to drug use each are named separately. For example, cannabis use disorder, stimulant use disorder, hallucinogen use disorder and opioid use disorder See Substance Use Disorders
Durable power of attorney
a power of attorney that becomes effective immediately and is not affected by the principal's subsequent incapacity or that becomes effective only upon the principal's incapacity.
Department of Veteran’s Services
Difficulty in forming words or speaking them because of weakness of muscles used in speaking or because of disruption in the neuromotor stimulus patterns required for accuracy and velocity of speech.
impairment of voluntary movements resulting in fragmented or jerky motions (as in Parkinson's disease).
A swallowing disorder characterized by difficulty in oral preparation for the swallow, or in moving material from the mouth to the stomach. This also includes problems in positioning food in the mouth.
abnormality or impairment in the regulation of a metabolic, physiological, or psychological process.
Collection of fluid in the tissue causing swelling.
Electrocardiograph (EKG)
Is a written recording of the electrical activity of the heart. Electrocardiograms are used to evaluate cardiac function and diagnose arrhythmias and other disorders.
any of the ions (as of sodium or calcium) that in biological fluid regulate or affect most metabolic processes (such as the flow of nutrients into and waste products out of cells)
Requirements that need to be met by the applicant, in order to receive services or enroll in a program.
Emotional Freedom Techniques (EFT)
Is a form of counseling intervention that draws on various theories of alternative medicine including acupuncture, neuro-linguistic programming, energy medicine, and Thought Field Therapy (TFT).
Emotional Lability
Exhibiting rapid and drastic changes in emotional state (laughing, crying, and anger) inappropriately without apparent reason.
Disorder of the brain.
Endocrine Disorders
Endocrine disorders are diseases related to the endocrine glands of the body. The endocrine system produces hormones, which are chemical signals sent out, or secreted, through the bloodstream. Hormones help the body regulate processes, such as appetite, breathing, growth, fluid balance, feminization and virilization, and weight control. The endocrine system consists of several glands, including the pituitary gland and hypothalamus in the brain, adrenal glands in the kidneys, and thyroid in the neck, as well as the pancreas, ovaries and testes. The stomach, liver and intestines also secrete hormones related to digestion. Most common endocrine disorders are related to improper functioning of the pancreas and the pituitary, thyroid and adrenal glands. Common endocrine disorders include diabetes mellitus, acromegaly (overproduction of growth hormone), Addison’s disease (decreased production of hormones by the adrenal glands), Cushing’s syndrome (high cortisol levels for extended periods of time), Graves’ disease (type of hyperthyroidism resulting in excessive thyroid hormone production), Hashimoto’s thyroiditis (autoimmune disease resulting in hypothyroidism and low production of thyroid hormone), hyperthyroidism (overactive thyroid), hypothyroidism (underactive thyroid), and prolactinoma (overproduction of prolactin by the pituitary gland). These disorders often have widespread symptoms, affect multiple parts of the body, and can range in severity from mild to very severe. Treatments depend on the specific disorder but often focus on adjusting hormone balance using synthetic hormones.
The Executive Office of Elder Affairs
a crystalline sympathomimetic hormone C9H13NO3 that is the principal blood-pressure raising hormone secreted by the medulla of the adrenal glands, is prepared from adrenal extracts or made synthetically, and is used medicinally especially to stimulate the heart during cardiac arrest and to treat life-threatening allergic reactions —called also adrenaline
Episodic Memory
Memory for ongoing events in a person's life. More easily impaired than semantic memory, perhaps because rehearsal or repetition tends to be minimal.
Excessive Drinking
Excessive drinking includes binge drinking, heavy drinking, and any drinking by pregnant women or people younger than age 21. Binge drinking, the most common form of excessive drinking, is defined as consuming: For women, 4 or more drinks during a single occasion. For men, 5 or more drinks during a single occasion. For women 65 , 3 or more drinks during a single occasion. For men 65 , 4 or more drinks during a single occasion. Heavy drinking is defined as consuming For women, 8 or more drinks per week (and men 65 ). For men, 15 or more drinks per week. Most people who drink excessively DO NOT have an alcohol use disorder.
Executive functioning
Cognitive functions having to do with planning, abstract reasoning, problem-solving, information processing, judgment, working memory, etc.
Executive Office of Health and Human Services (EOHHS)
Executive office of Health and Human Services.
Arm or leg.
Food and Drug Administration.
Fight or Flight System
Is the response to an acute threat to survival that is marked by physical changes, including nervous and endocrine changes, that prepare a human or an animal to react or to retreat. The fight or flight response is characterized by an increased heart rate (tachycardia), anxiety, increased perspiration, tremor, and increased blood glucose concentration (due to glycogenolysis, or breakdown of liver glycogen). These actions occur in concert with other neutral or hormonal responses to stress, such as increases in corticotropin and cortisol secretion, and they are observed in some humans and animals affected by chronic stress, which causes long-term stimulation of the fight-or-flight response.
Stands for Functional Magnetic Resonance Imaging (FMRI). FMRI is a technique that directly measures the blood flow in organs like the brain, thereby providing information on brain activity. For example, FMRI images are used to determine which parts of the brain “light up” when a function such as speech or recognition is performed by the patient.
Frontal Lobe
Front part of the brain; involved in planning, organizing, problem solving, selective attention, personality and a variety of "higher cognitive functions."
Frustration Tolerance
The ability to persist in completing a task despite apparent difficulty. Individuals with a poor frustration tolerance will often refuse to complete tasks which are the least bit difficult. Angry behavior, such as yelling or throwing things while attempting a task is also indicative of poor frustration tolerance.
Also known as Gamma-Amino Acid (GABA). GABA is a chemical that is made in the brain. GABA works by blocking brain signals (neurotransmissions). GABA is taken by mouth for relieving anxiety, improving mood, reducing symptoms of premenstrual syndrome (PMS), and treating attention deficit-hyperactivity disorder (ADHD). It is also used for promoting lean muscle growth, burning fat, stabilizing blood pressure, and relieving pain. GABA is used under the tongue for increasing the sense of well-being, relieving injuries, improving exercise tolerance, decreasing body fat, and increasing lean body weight.
GABA agonist
A drug that is an agonist for one or more of the GABA receptors, typically producing sedative effects.
A physician who specializes in the care of the elderly, primarily those who are frail and have complex medical and social problems.
a structure, arrangement, or pattern of physical, biological, or psychological phenomena so integrated as to constitute a functional unit with properties not derivable by summation of its parts
Glasgow Coma Scale (GCS)
The GCS is commonly used for initial assessment of brain injury severity. The GCS uses a 15-point scale to rate eye opening, motor, and verbal response functions. Unfortunately, in practice, the time of the assessment can vary (e.g., at the scene of injury, upon arrival in the emergency department, etc.) -- making results from one patient to the next difficult to compare. Moreover, GCS results may not be valid for children, people under the influence of alcohol, or people with language differences.
is someone who takes on the legal responsibility to care for another person or for another person's property (guardianship).
a perception of something (as a visual image or a sound) with no external cause usually arising from a disorder of the nervous system (as in delirium tremens or in functional psychosis without known neurological disease) or in response to drugs (as LSD)
Head Injury
Refers to an injury of the head and/or brain, including lacerations and contusions of the head, scalp and/or forehead.
Health Care Proxy
Is a type of power of attorney authorizing an agent to make health care decisions in the event of incapacity —called also medical power of attorney.
Hearing Disorders
A TBI may cause concurrent damage to the auditory pathway. Damage can occur at any point within auditory pathway, from the outer ear to the cortex, which can result in a variety of complex symptoms. Impairment due to trauma can produce conductive and sensorineural hearing loss, central auditory processing deficits, vestibular impairments, and tinnitus.
Heart Attack
an acute episode of coronary heart disease marked by the death or damage of heart muscle due to insufficient blood supply to the heart usually as a result of a coronary artery becoming blocked by a blood clot formed in response to a ruptured or torn fatty arterial deposit. NOTE: Symptoms of heart attack include discomfort or pain in the chest, shoulder, arm, back, neck, or jaw, shortness of breath, dizziness or light-headedness, heartburn, nausea, excessive sweating, and extreme fatigue.—called also myocardial infarction
Acronym for the brain injury screening tool described in this training. Each letter of the acronym stands for one of the five questions of the tool. The HELPS tool was developed by Dr. Piccard and team in 1991 and is a tool used by many agencies to date.
If the blood vessels damaged by the impact inside the skull are large enough, they may bleed enough to create a pool of blood or hematoma. A hematoma can cause brain injury by directly damaging the neurons it comes in contact with or by squeezing neurons through increased pressure in the brain due to its volume. The treatment for a hematoma is to surgically drain it, if possible.
Weakness of one side of the body.
a condition in which a person bleeds too much and cannot stop the flow of blood. A copious or heavy discharge of blood from the blood vessels. For example, cerebral hemorrhage.
A convoluted, seahorse-shaped structure in the cerebral cortex of the temporal lobe of the brain, composed of two gyri with white matter above the gray matter. The Hippocampus forms part of the limbic system and is involved in processing emotions and memory.
Hoarding Disorder
This disorder is defined by the drive to collect a large amount of useless or valueless items, coupled with extreme distress at the idea of throwing anything away. Over time, this situation can render a space unhealthy or dangerous to be in. Hoarding disorder can negatively impact someone emotionally, physically, socially and financially, and often leads to distress and disability. In addition, many hoarders cannot see that their actions are potentially harmful, and so may resist diagnosis or treatment.
Home and Community Services
Programs that provide opportunities for Medicaid beneficiaries to receive services in their own home or community. These programs serve a variety of targeted population groups, such as people with intellectual or developmental disabilities, mental illnesses and/or physical disabilities.
The term homeless means a person sleeping in a place not meant for human habitation (e.g. living on the streets) or in an emergency homeless shelter.
There are three categories of homelessness – chronic, transitional, and episodic – which can be defined as follows: Chronic Homelessness - HUD defines a chronically homeless person as “either (1) an unaccompanied homeless individual with a disabling condition who has been continuously homeless for a year or more, OR (2) an unaccompanied individual with a disabling condition who has had at least four episodes of homelessness in the past three years.” Such persons represent a far smaller proportion of the population compared to the transitionally homeless. TRANSITIONAL HOMELESSNESS - Transitionally homeless individuals generally enter the shelter system for only one stay and for a short period. Such persons are likely to be younger, are probably recent members of the precariously housed population and may have become homeless because of some catastrophic event, and have been forced to spend a short time in a homeless shelter before making a transition into more stable housing. Over time, transitionally homeless individuals will account for the majority of persons experiencing homelessness given their higher rate of turnover. EPISODIC HOMELESSNESS -Those who frequently shuttle in and out of homelessness are known as episodically homeless. They are most likely to be young, but unlike those in transitional homelessness, episodically homeless individuals often are chronically unemployed and experience medical, mental health, and substance use disorders.
Human Immunodeficiency Virus (HIV)
Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body's ability to fight the organisms that cause disease. HIV is a sexually transmitted infection. It can also be spread by contact with infected blood or from mother to child during pregnancy, childbirth or breast-feeding. Without medication, it may take years before HIV weakens your immune system to the point that you have AIDS. There's no cure for HIV/AIDS, but there are medications that can dramatically slow the progression of the disease.
Hydrocephalus is the buildup of fluid in the cavities (ventricles) deep within the brain not due to brain atrophy. The excess fluid increases the size of the ventricles and puts pressure on the brain. Cerebrospinal fluid normally flows through the ventricles and bathes the brain and spinal column. But the pressure of too much cerebrospinal fluid associated with hydrocephalus can damage brain tissues and cause a large spectrum of impairments in brain function. Although hydrocephalus can occur at any age, it's more common among infants and older adults.
a sleep-inducing agent
Hypovolemic shock
After injury, loss of blood volume can further compromise healthy brain tissue.
Insufficient oxygen reaching the tissues of the body.
Correlates with the electrical seizure activity in the brain in the middle of a seizure event. This is often called the ictal phase
Impulse Control
Refers to the individual's ability to withhold inappropriate verbal or motor responses while completing a task. Persons who act or speak without first considering the consequences are viewed as having poor impulse control.
is the rate of occurrence or influence. In reference to TBI data, incidence refers to the number of a given type of events, or new instances of TBI, in a year.
not legally qualified. Or lacking legal capacity (as because of age or mental deficiency). Or incapable due to mental or physical condition.
Independent Living
a person's ability to be empowered and self-directed. An individual choice to live in one's own home with maximum personal control over how services are delivered, combined with the opportunity to work as appropriate.
Independent Living Centers
Are private, nonprofit, consumer-controlled, community-based organizations providing services and advocacy by and for persons with all types of disabilities. Their goal is twofold; to create opportunities to promote independence and to assist individuals with disabilities to achieve their maximum level of independent functioning within their families and/or communities.
Treat (someone) as a child or in a way which denies their maturity in age or experience.
The inability to adjust to everyday changes in routines, usually related to injury to the frontal lobes. Some head-injured persons may have little difficulty following a structured routine but may exhibit sudden frustration and confusion when their routine is changed.
In-home support(s)
services with the purpose of improving individual skills related to personal finance, health, shopping and use of community resources, and other individual skills to help the individual live more independently in the community.
The act of beginning a task or setting in motion a course of events.
Refers to the individual's ability to begin a series of behaviors directed toward a goal.
prolonged and usually abnormal inability to get enough sleep
Instrumental Activities of Daily Living (IADLs)
are tasks that are related to independent living and include: taking medications, preparing meals, laundry, housework, shopping, and errands.
Interdisciplinary Approach
A method of diagnosis, evaluation, and individual program planning in which two or more specialists, such as medical doctors, psychologists, recreational therapists, social workers, etc., participate as a team, contributing their skills, competencies, insights, and perspectives to focus on identifying the developmental needs of the person with a disability and on devising ways to meet those needs.
Intracranial Pressure (ICP)
Cerebrospinal fluid (CSF) pressure measured from a needle or bolt introduced into the CSF space surrounding the brain. It reflects the pressure inside of the skull.
quick excitability to annoyance, impatience, or anger
Spoken language that has a normal rate and rhythm but is full of nonsense words.
The process of forming an opinion, based on an evaluation of the situation at hand. "Good" judgment refers to choosing the most optimal course available. Judgment involves cognitive skills, personal values and preferences, and insight into what our abilities and disabilities are. For example, a client with judgment deficits may be able to make decisions, but the decisions may be unsafe or unsuccessful.
State of having notable shifts in emotional state (e.g., uncontrolled laughing or crying).
Loss of consciousness. As to level of consciousness/awareness.
Long Term Care services
Long term care (LTC) services are the medical, social, personal care, and supportive services needed by people who have lost capacity for self-care due to a chronic illness or condition. It's different from acute health care because assistance is required for an indefinite period of time, and because recovery of function may be incomplete.
Magnetic Resonance Imaging (MRI)
A type of diagnostic radiography using electromagnetic energy to create an image of soft tissue, central nervous system and musculoskeletal systems.
To pretend inability so as to avoid duty or work.
Massachusetts Commission for the Blind
Massachusetts Commission for the Deaf and Hard of Hearing
In Massachusetts it’s called MassHealth— the medical assistance and benefit programs administered by the MassHealth agency pursuant to Title XIX of the Social Security Act (42 U.S.C. 1396), Title XXI of the Social Security Act (42 U.S.C. 1397), M.G.L. c. 118E, an 118E, and other applicable laws and waivers to provide and pay for medical services to eligible members.
Medicaid waiver
A tool available to states that grants authority to modify certain requirements of publicly funded programs to allow for new approaches in service delivery.
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). The different parts of Medicare help cover specific services such as Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage Plans), and Part D (Prescription coverage).
Medication Assisted Treatment
Medication-assisted treatment (MAT), including opioid treatment programs (OTPs), combines behavioral therapy and medications to treat substance use disorders. Medication-Assisted Treatment (MAT) is the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. Research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery. (SAMHSA) Can include similar approaches for alcohol use disorders.
a vertebrate hormone that is derived from serotonin, is secreted by the pineal gland especially in response to darkness, and has been linked to the regulation of circadian rhythms (sleep).
The process of perceiving information, organizing and storing it, and retrieving it at a later time as needed. Memory is a complex function that involves many parts of the brain working together. There are different types of memory, including immediate (repeating a phone number just related), recent (recalling what occurred the previous day), and remote (recalling the name of a childhood friend).
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, 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, 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, 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.
Meningitis is an inflammation of the membranes (meninges) surrounding your brain and spinal cord. The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck. Most cases of meningitis in the U.S. are caused by a viral infection, but bacterial and fungal infections are other causes. Some cases of meningitis improve without treatment in a few weeks. Others can be life-threatening and require emergent antibiotic treatment. Seek immediate medical care if you suspect that someone has meningitis. Early treatment of bacterial meningitis can prevent serious complications. If left untreated in bacterial forms, may progress to confusion, stupor, convulsions, coma, and death.
Mental Illness
Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors. Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function. A mental illness can make you miserable and can cause problems in your daily life, such as at school or work or in relationships. In most cases, symptoms can be managed with a combination of medications and talk therapy (psychotherapy).
Mental illness (MI)
A mental condition characterized by a substantial disorder of thought or mood that interferes with an individual’s ability to function in day-to-day life.
refers to the biochemical and physiological activities (e.g. Oxygen utilization)
A medication used in medication-assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates. Methadone has been used for decades to treat people who are addicted to heroin and narcotic pain medicines. Methadone works by changing how the brain and nervous system respond to pain. It lessens the painful symptoms of opiate withdrawal and blocks the euphoric effects of opiate drugs such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone.
A strong central nervous system stimulant, primarily used as a recreational drug. See definition for Stimulants.
Mild TBI
Medically defined as any period of loss of consciousness (typically less than 15 minutes); any loss of memory for events immediately before or after the accident; or any alteration in the mental state at the time of the accident (e.g., feeling dazed, disoriented or confused). Mild TBI generally does not include posttraumatic amnesia greater than 24 hours (NIH, 1998). Mild TBI is associated with a Glasgow Coma Scale score of 13-15.
In relation to alcohol and drug use, this term describes unhealthy use or patterns of use that put a person at risk for immediate or future harm. Misuse of prescription drugs means taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint such as pain; or taking a medication to feel euphoria (i.e., to get high). The term nonmedical use of prescription drugs also refers to these categories of misuse. (NIDA)
Moderate TBI
Medically defined as a loss of consciousness that can last minutes or a few hours and is followed by a few days or weeks of confusion. Persons with moderate TBI may have a longer period of impaired consciousness, more impaired verbal memory shortly after the injury and a lower likelihood of achieving a good recovery within 6 months than persons suffering mild TBI (NIH, 1998). Moderate TBI often is associated with a GCS of 9 - 12.
Money Management Service
Bill payer services provided to a person who requires assistance in managing his/her finances due to physical or cognitive difficulties.
Mood stabilizers
are used primarily to treat bipolar disorder, mood swings associated with other mental disorders, and in some cases, to augment the effect of other medications used to treat depression. Mood stabilizers work by decreasing abnormal activity in the brain and are also sometimes used to treat: Depression (usually along with an antidepressant); Schizoaffective Disorder, Disorders of impulse control; certain mental illnesses in children.
Refers to the diseased state, includes complications and residual impairments.
Motivational Interviewing
Motivational interviewing (MI) is a technique in which you become a helper in the change process and express acceptance of your client. It is a way to interact with substance-using clients, not merely as an adjunct to other therapeutic approaches, and a style of counseling that can help resolve the ambivalence that prevents clients from realizing personal goals.
relating to, concerned with, or involving muscular 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 Disorders
is a neurological condition that affect the speed, quality and ease of movement. Example of movement disorders include balance disorders, corticobasal degeneration, dystonia, essential tremor, Huntington’s disease, multiple system atrophy, Parkinson’s disease, and progressive supranuclear palsy. Examples of Motor disorders under DSM-5 include Developmental Coordination Disorder, Stereotypic Movement Disorder, Tourette syndrome (also called Tourette's disorder), Persistent (chronic) vocal or motor tic disorder, Provisional tic disorder, etc.
Motor functioning
Involving or relating to movements of the muscles.
Motor Impairments
changes that affect the speed, quality and ease of movement.
Motor Planning
Action formulated in the mind before attempting to perform.
Massachusetts Rehabilitation Commission
Multidisciplinary Evaluation Team (MDT)
The team that assesses students to determine eligibility for special education or early intervention services.
Multiple Sclerosis (MS)
Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system).In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause the nerves themselves to deteriorate or become permanently damaged. Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms. There's no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms.
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.
A medication used in medication-assisted treatment (MAT) to treat both opioid and alcohol use disorders. Naltrexone is a medication approved by the Food and Drug Administration (FDA) to treat opioid use disorders and alcohol use disorders. It comes in a pill form or as an injectable. Naltrexone blocks the euphoric and sedative effects of drugs such as heroin, morphine, and codeine. It works differently in the body than buprenorphine and methadone, which activate opioid receptors in the body that suppress cravings. Naltrexone binds and blocks opioid receptors, and is reported to reduce opioid cravings. There is no abuse and diversion potential with naltrexone.
a drug (such as opium or morphine) that in moderate doses dulls the senses, relieves pain, and induces profound sleep but in excessive doses causes stupor, coma, or convulsions. Subject to restrictions.
Negative reinforcement (escape and avoidance)
When the consequence of a behavior resulted in avoiding or getting out of an unpleasant situation, and the effect is to encourage the behavior again in the future.
A disregard of duty resulting from carelessness, indifference, or willfulness; especially: a failure to provide a dependent under one's care with proper food, clothing, shelter, supervision, medical care, or emotional stability.
Related to the nervous system and its structure and functions.
Neurological exam
An examination conducted by a neurologist, which might include the following: a detailed medical history and assessment of neurologic functions (reflexes, cranial nerve functioning, gross movements, muscle tone, and perception of sensory stimuli).
A physician who specializes in the nervous system and its disorders.
Impulse conducting cells that constitute the brain, spinal column, and nerves, consisting of a nucleated cell body with one or more dendrites and a single axon.
Neuropsychological assessment
A thorough testing of cognitive, emotional, and intellectual functioning that can assist in diagnosing brain injury and planning care.
Neuropsychological disorders
Cerebral dysfunction from any physical cause manifested by changes in mood, behavior, perception, memory, cognition and/or judgement.
A professional who evaluates the relationship between brain and behavior; conducts extensive testing and counseling; does not prescribe medication.
refers to any toxic agent that affects or damages the nervous system.
A chemical by which a nerve cell communicates with another nerve cell or with a muscle. Any of several chemical substances, asepinephrine or acetylcholine, that transmit nerve impulses across a synapse to a postsynaptic element, such as another nerve, muscle, or gland. Any one of a number of chemicals that are used to transmit nerve signals across a synapse, are sprayed from the end of the “upstream” nerve cell and absorbed by receptors in the “downstream” cell. For example, drugs like Prozac and alcohol affect the emission and reception of neurotransmitters.
NMDA receptor antagonists
A class of medications that work to antagonize, or inhibit the action of, the N-Methyl-D-aspartate receptor (NMDAR). They are used as anesthetics for animals including humans. Examples include methadone, tramadol and ketamine.
liberating, activated by, or involving norepinephrine in the transmission of nerve impulses a progressive deterioration of central noradrenergic pathways.
a catecholamine C8H11NO3 that is the chemical means of transmission across synapses in postganglionic neurons of the sympathetic nervous system and in some parts of the central nervous system, is a vasopressor hormone of the adrenal medulla, and is a precursor of epinephrine in its major biosynthetic pathway.
Norepinephrine-dopamine reuptake inhibitor (NDRI)
A class of medications that inhibit the reuptake of both norepinephrine and dopamine, therefore increasing levels of both in the brain. Examples include buproprion (Wellbutrin) and methylphenidate (Ritalin, Concerta).
Nucleus Accumben
Is a nucleus forming the floor of the caudal part of the anterior prolongation of the lateral ventricle of the brain and receiving dopaminergic innervation from the ventral tegmental area as part of the mesolimbic pathway.
Nursing Home
A state-licensed residential facility that provides a room, meals, help with activities of daily living, recreation, and general nursing care to people who are chronically ill or unable to take care of their daily living needs. It may also be called a Long-Term Care Facility. While the terms are used somewhat interchangeably, a Skilled Nursing Facility requires certification by Medicare, and provides rehabilitative therapies and more intensive nursing care. Sometimes a Long Term Care Facility will have a section or floors that provide Skilled Nursing – often on a more short term basis.
Obsessive-Compulsive Disorder (OCD)
is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). Although people with OCD may know that their thoughts and behavior don't make sense, they are often unable to stop them. Symptoms typically begin during childhood, the teenage years or young adulthood, although males often develop them at a younger age than females. More than 2% of the U.S. population (nearly 1 out of 40 people) will be diagnosed with OCD during their lives. The exact cause of obsessive-compulsive disorders is unknown, but researchers believe that activity in several portions of the brain is responsible. More specifically, these areas of the brain may not respond normally to serotonin, a chemical that some nerve cells use to communicate with each other. Genetics are thought to be very important. If you, your parent or a sibling, have an obsessive-compulsive disorder, there's close to a 25% chance that another immediate family member will have it. To be diagnosed with OCD, a person must have must have: Obsessions, compulsions or both. Obsessions or compulsions that are upsetting and cause difficulty with work, relationships, other parts of life and typically last for at least an hour each day. A typical treatment plan will often include both psychotherapy and medications, and combined treatment is usually optimal.
Occipital Lobe
Region in the back of the brain which processes visual information. Damage to this lobe can cause visual deficits.
Occupational Therapist
is a professional who helps a person to regain skills in activities of daily living (e.g., dressing, eating, bathing, etc.) and routine occupations (e.g., cooking, shopping, scheduling, driving, etc.).
Occupational Therapy (OT)
The use of self-care, work and play activities to increase independent function, enhance development and prevent disability; OT may include the adaptation of a task or the environment to achieve maximum independence.
encompasses drugs naturally derived from the active narcotic components of the opium poppy, whereas the "opioid" label includes synthetic and semi-synthetic drugs that are modified versions of these opiate building blocks. "Opioid" is usually used in reference to prescription drugs. The terms “Opiates and Opioids are often used interchangeably. Opiates cover a huge variety of drugs, ranging from legal and illegal drugs such include: Heroin, Morphine, Oxycodone (trade names include: OxyContin and Percocet), Hydrocodone (trade names include: Vicodin and Lortab), Codeine and Fentanyl.
Opioid Use Disorder
A problematic pattern of opioid use that causes clinically significant impairment or distress. A diagnosis is based on specific criteria such as unsuccessful efforts to cut down or control use, as well as use resulting in social problems and a failure to fulfill obligations at work, school, or home. Opioid use disorder has also been referred to as “opioid abuse or dependence” or “opioid addiction.”
Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others. These drugs are chemically related and interact with opioid receptors on nerve cells in the body and brain. Opioid pain relievers are generally safe when taken for a short time and as prescribed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused (taken in a different way or in a larger quantity than prescribed, or taken without a doctor’s prescription). Regular use—even as prescribed by a doctor—can lead to dependence and, when misused, opioid pain relievers can lead to overdose incidents and deaths. (NIDA)
Orbital Frontal Injury
injury located in the region that sits just above the orbits (also known as the eye sockets). It is thus found at the very front of the brain, and has extensive connections with sensory areas as well as limbic system structures involved in emotion and memory. The Orbital frontal cortex is associated with decision-making and affect control.
Awareness of one's environment and/or situation, along with the ability to use this information appropriately in a functional setting.
The patient residing outside the hospital but returning on a regular basis for one or more therapeutic services.
Injury to the body that happens when a drug is taken in excessive amounts. An overdose can be fatal or nonfatal.
Paralysis of the legs (from the waist down).
Parietal Lobe
One of the two parietal lobes of the brain located behind the frontal lobe at the top of the brain. The upper middle lobe of each side of the brain, involved in receiving and understanding sensations, and closely linked to speech fluency and writing.
Parkinson's disease
is a progressive disorder of the nervous system that affects movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But while a tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes stiffness or slowing of movement.
the study of diseases and of the changes that they cause.
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.
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.
Personal Care Attendant (PCA)
A person trained to provide assistance with the personal care activities of daily living, such as bathing, shampooing, personal hygiene, and medication reminders, usually arranged by a home care agency.
Personal Care Service
Assistance with one or more of the Activities of Daily Living and Self-administered Medication Management, either through physical support or supervision. Supervision includes reminding or observing Residents while they perform activities.
PET Scan
Stands for Positron Emission Tomography (PET). A PET Scan is a medical test that is especially useful in showing tissue or an organ is functioning, as opposed to just showing the structure. In a PET Scan, radioactive atoms are introduced into the body, where their chemical behavior is the same or as similar as non-radioactive atoms. For example, A PET scan show blood flow through the brain, areas of high metabolic activity that indicate potential tumors, as well as areas of damaged heart tissue.
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 Therapist
is a professional who treats injury or physical dysfunction with exercises and other physical treatments to restore or facilitate recovery of physical abilities.
Physical Therapy (PT)
Treatment that uses physical agents such as exercise and massage to restore or facilitate recovery of physical abilities.
The ability of cellular or tissue structures and their resultant function to be influenced by an ongoing activity.
A temporary or permanent leveling off in the recovery process.
The simultaneous use of multiple drugs to treat a single ailment or condition.
Positive reinforcement (rewards)
When good things happen following a behavior and that behavior is repeated in the future in order to achieve that result, the behavior is likely to continue -- it has been reinforced.
Post ictal
As the seizure ends, the postictal phase occurs - this is the recovery period after the seizure. Some people recover immediately while others may take minutes to hours to feel like their usual self. Common symptoms after a seizure impact: Awareness, Sensory, Emotional or Thought Changes (may include Slow to respond or not able to respond right away; Sleepy; Confused; Memory loss; Difficulty talking or writing; Feeling fuzzy, lightheaded or dizzy; Feeling depressed, sad, upset; Scared; Anxious; Frustrated, embarrassed, ashamed) and/or Physical Changes (which may include injuries, such as bruising, cuts, broken bones or head injury if fell during seizure; May feel tired, exhausted or sleep for minutes or hours; Headache or other pain; Nausea or upset stomach; Thirsty; General weakness or weak in one part or side of the body; Urge to go to the bathroom or lose control of bowel or bladder)
Post-acute care
related to health care for TBI, describes the care provided after initial stabilization is achieved after the injury occurred on a longer-term basis.
Post-acute Rehabilitation
Are programs designed to provide intensive, 24-hour rehabilitation to improve cognitive, physical, emotional, and psychosocial abilities, to facilitate better independent living skills. Facilities typically provide a full spectrum of clinical therapies, as well as life-skills training in a residential setting.
Posttraumatic amnesia (PTA)
The loss of memories of events after the brain injury; also refers to the length of time that it takes for the return of full consciousness and memory for recent events following trauma.
Posttraumatic depression
The occurrence of the psychiatric condition of depression following brain injury.
Post-Traumatic Stress Disorder (PTSD)
is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD. Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.
Power of Attorney (POA)
a legal instrument authorizing one to act as the attorney or agent of the grantor. There are many types of POAs.
Prefrontal Cortex
part of the brain located at the front of the frontal lobe. Impairments related to injury to this site include: personality change; executive skill deficits; diminished cognitive flexibility; compromised capacity to initiate and sustain goal-directed behavior; behavioral disinhibition; attention deficits; diminished verbal and non-verbal fluency.
Pre-Morbid Condition
Characteristics of an individual present before the disease or injury occurred.
number of existing cases of a disease/disorder at any point in time.
Primary event
In reference to TBI, brain damage, such as contusion and axonal shearing, that occurs during the initial phase of injury (during impact). The primary event is distinguished from the secondary event, or subsequent brain damage, that occurs because of the body’s reaction to the primary event (such as brain swelling and anoxia).
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.
The prospect as to recovery from a disease or injury as indicated by the nature and symptoms of the case.
Program of All-inclusive Care for the Elderly (PACE)
A full-service Medicare and Medicaid managed care program that serves frail individuals 55 and older who meet the clinical criteria for admission to a nursing facility, and who, at the time of enrollment in PACE, are able to remain in the community with supports. PACE sites use an interdisciplinary team of clinicians in an expanded adult day health model to provide and manage all health, medical and social service needs.
Protective Services
A statewide system for receiving and investigating reports of abuse, and for providing needed protective services to abused persons when warranted. Abuse includes physical, emotional and sexual abuse, neglect by a caregiver, self-neglect and financial exploitation. The goal of protective services is to remedy or alleviate the abusive situation and to prevent the reoccurrence of abuse.
Psychiatric evaluation
An assessment of mental, emotional, or behavioral disorders.
is a physician who specializing in assessing, diagnosing and treating mental, emotional, or behavioral disorders. Unlike psychologist in most states, psychiatrists can prescribe medication for treatment of these disorders.
Psychological testing
Standardized assessment of emotional and intellectual functioning, and the personality characteristics of an individual.
Psychological/behavioral strategies of pain management
Behavioral techniques to deal with physical pain. The focus of treatment is to increase a person’s ability to manage, function, and cope with pain. Such techniques may include relaxation training, developing coping skills to deal with emotions such as sadness, anxiety, or anger, and to deal with beliefs and expectations related to pain. Problem-solving techniques and communication skills regarding expressing and dealing with pain may also be included.
A professional specializing in counselling, 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
the study of the effect of drugs on the mind and behavior.
a serious mental illness (such as schizophrenia) characterized by defective or lost contact with reality often with hallucinations or delusions
Psychotropic medications
affecting mental activity, behavior, or perception, as a mood-altering drug.
QT Interval
As it relates to prolonged QT Interval is when an ECG measures electrical impulses as five distinct waves. Doctors label these five waves using the letters P, Q, R, S and T. The waves labeled Q through T show electrical activity in your heart's lower chambers (ventricles).The space between the start of the Q wave and the end of the T wave (QT interval) corresponds to the time it takes for your heart to contract and then refill with blood before beginning the next contraction. By measuring the QT interval, doctors can measure whether the QT interval occurs in a normal amount of time. If it takes longer than normal to occur, it's called a prolonged QT interval. The upper limit of a normal QT interval takes into account age, sex, and regularity and speed of the heart rate. Long QT syndrome results from abnormalities in the heart's electrical recharging system. However, the heart's structure is normal. Abnormalities in your heart's electrical system might be inherited or acquired due to an underlying medical condition or a medication.
Rapid Eye Movement (REM)
a rapid conjugate movement of the eyes associated especially with REM sleep—called also REM.
Reasoning, Abstract
Mode of thinking in which the individual recognizes a phrase that has multiple meanings and selects the meaning most appropriate to a given situation. The term "abstract" typically refers to concepts not readily apparent from the physical attributes of an object or situation.
Reasoning, Concrete
The ability to understand the literal meaning of a phrase.
Reasoning, Problem Solving
The ability to analyze information related to a given situation and generate appropriate response options. Problem solving is a sequential process that typically proceeds as follows: identification of problem; generation of response options; evaluation of response option appropriateness; selection and testing of first option; analysis as to whether solution has been reached. A patient/client may discontinue making a cup of coffee because the sugar bowl is empty, even though sugar is readily available in a nearby cabinet. A patient/client may easily navigate his way into a room crowded with furniture, but request staff assistance to navigate his way out.
Reasoning, Sequencing
The ability to organize information or objects according to specified rules, or the ability to arrange information or objects in a logical, progressive manner. Nearly every activity, including work and leisure tasks, requires sequencing. For example, in cooking certain foods it is important that ingredients be added and mixed in a specified order; in dressing, undergarments must be put on prior to outer garments.
Recreation Therapist
Individual within the facility responsible for developing a program to assist persons with disabilities plan and manage their leisure activities; may also schedule specific activities and coordinate the program with existing community resources.
Comprehensive program to reduce/overcome deficits following injury or illness, and to assist the individual to attain the optimal level of mental and physical ability.
Rehabilitation Facility
Agency of multiple, coordinated services designed to minimize for the individual the disabling effects of one's physical, mental, social, and/or vocational difficulties and to help realize individual potential.
A consequence of a response that increases the probability of that response occurring again.
REM Sleep
a state of sleep that recurs cyclically several times during a normal period of sleep and that is characterized by increased neuronal activity of the forebrain and midbrain, by depressed muscle tone, and especially in humans by dreaming, rapid eye movements, and vascular congestion of the sex organs—called also desynchronized sleep, paradoxical sleep, rapid eye movement sleep; compare slow-wave sleep
a medicine, application, or treatment that relieves or cures a disease.
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 Post Acute Committee of ISIG on Head Injury October 28, 1991.)
Respite Care
Temporary care service to relieve a family caregiver of responsibility for an individual with long-term care needs. Relief care can be provided in the home, in day programs, nursing facilities, rest homes or an Adult Foster Care program.
Retrograde Amnesia
Inability to recall events that occurred prior to the accident; may be a specific span of time or type of information.
Schizophrenia is a severe mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling. Schizophrenia is a chronic condition, requiring lifelong treatment.
Seasonal Affective Disorder (SAD)
is a type of depression that's related to changes in seasons. SAD begins and ends at about the same times every year. If you're like most people with SAD, your symptoms start in the fall and continue into the winter months, sapping your energy and making you feel moody. Less often, SAD causes depression in the spring or early summer. Don't brush off that yearly feeling as simply a case of the "winter blues" or a seasonal funk that you have to tough out on your own. Take steps to keep your mood and motivation steady throughout the year.
Seasonal Affective Disorder Light(s)
is a treatment for SAD which involves light therapy (phototherapy). Also known as light boxes. For some people, light therapy may be more effective when combined with another SAD treatment, such as an antidepressant or psychological counseling (psychotherapy). Features such as light intensity, safety, cost and style are important considerations. Speak to a medical provider for guidance.
Secondary event
In reference to TBI, this is the injury or complication resulting from the reaction of the brain to the primary event, including: brain swelling (edema), pooling of blood (hematoma), increased intracranial pressure, hypovolemic shock, and loss of oxygen (anoxia).
a relaxed, calm, or sleepy condition that results from taking a drug (called a sedative)
Sedation-aggression cycle
State in which the patient is sedated by the medication, but again becomes aggressive as the sedation starts to lift enough to allow for disinhibited, aggressive behavior. The patient can again be sedated enough to be quieted, this may continue the cycle of sedation alternating with aggression.
Seizure Disorder
A medical condition that are characterized by episodes of uncontrolled electrical activity in the brain (seizures). Some seizure disorders are hereditary, while others are caused by birth defects or environmental hazards, such as lead poisoning etc. Seizure disorders are more likely to develop in patients who have other neurological disorders, psychiatric conditions, or immune-system problems. In some cases, uncontrolled seizures can cause brain damage, lowered intelligence, and permanent mental and physical impairment. Diagnosis is by observation, neurological examination, electroencephalogram (EEG), and in some cases more advanced brain imaging techniques.
Waves of synchronized nerve cell activation that can involve the entire brain, or can be confined to a particular area of the brain. When the entire brain is involved it is called a generalized seizure or grand mal; and symptoms include loss of consciousness, rhythmic jerking body movements, and other possible symptoms. If only part of the brain is involved, it is called a partial or focal seizure; generally the person does not lose consciousness and other symptoms depend on the area of the brain affected.
Selective Serotonin Reuptake Inhibitor (SSRI)
any of a class of antidepressants (as fluoxetine or sertraline) that inhibit the inactivation of serotonin by blocking its reuptake by presynaptic nerve cell endings.
Regarding behavior, the ability to act appropriately and refrain from inappropriate behavior based on a given social situation.
Senior Care Options (SCO)
An innovative full-service Medicare and Medicaid managed care program that is being offered to eligible Mass Health members age 65 and over, at all levels of need, in both the community and institutional settings. Qualified senior care organizations have been selected to contract with Mass Health and the Centers for Medicare and Medicaid Services (CMS), and have established large provider networks that are coordinating and delivering all acute, long-term care, and mental health and substance abuse services. Senior Care Options is based on a geriatric model of care, and is available nearly statewide.
Refers to all aspects of movement and sensation and the interaction of the two.
Sensory Disorders
Also known as Sensory Processing Disorder (SPD). Formerly referred to as sensory integration dysfunction. Sensory processing disorder may affect one sense, like hearing, touch, or taste. Or it may affect multiple senses. And people can be over- or under-responsive to the things they have difficulties with. Subtypes include: Sensory Modulation Disorder (Sensory Over-Responsive, Sensory Under-Responsive and Sensory Craving); Sensory-based Motor Disorder (Postural Disorder, and Dyspraxia); Sensory Discrimination Disorder (Auditory Discrimination Disorder, Visional Discrimination Disorder, Tactile Discrimination Disorder, Vestibular Discrimination Disorder, Proprioceptive Discrimination Disorder, Gustatory Discrimination Disorder, Olfactory Discrimination Disorder, and Interoception).
Sensory Impairments
when the brain has trouble receiving and responding to information that comes in through the senses.
Impairments, disorders and consequences of disease.
The ability to recognize the necessary order of events.
a neurotransmitter, derived from tryptophan, which is involved in sleep, depression, memory, and other neurological processes.
Serotonin and Norepinephrine Reuptake Inhibitors (SNRI's)
any of a class of drugs (as desvenlafaxine and duloxetine) that inhibit the inactivation of serotonin and norepinephrine by blocking their reuptake by presynaptic nerve cell endings and that are typically used to treat depression, anxiety, and chronic pain (such as that associated with osteoarthritis, fibromyalgia, or peripheral neuropathy)
Service Plan
A document that describes in detail the individualized services that the Assisted Living Residence will provide to the Resident.
Severe TBI
Medically defined by a loss of consciousness, or coma, for 6 hours or longer, either immediately after the injury or after an intervening period of clarity. Severe TBI is often associated with a GCS of 8 or lower.
SHINE (Serving the Health Information Needs of Elders Program)
A program of the Executive Office of Elder Affairs providing free, confidential and unbiased health insurance counseling through a volunteer network of health benefits counselors. Information is provided to elders about Medicare, Medicare Advantage, Medigap Insurance, Medicaid, public benefits, retiree health plans, individual insurance, prescription drug coverage, health insurance counseling, and other health insurance options. Contact a SHINE counselor 1-800-age-info (1-800-242-4636)
Statewide Head Injury Program
A procedure to draw off excessive fluid in the brain. A surgically-placed tube running from the ventricles which deposits fluid into either the abdominal cavity, heart or large veins of the neck.
Skilled Nursing Facility (SNF)
A nursing facility (in some cases, within a nursing home; sometimes a special unit inside a hospital) that has been certified by Medicare, with the staff and equipment to give skilled nursing care and/or skilled rehabilitation services and other related health services.
Skull fracture
Bones of the skull are broken or cracked. Injury severity can range from simple, displaced fractures to compound fractures which involve loose bone fragments placing pressure on or penetrating the brain.
Sleep Apnea
Brief periods of recurrent cessation of breathing during sleep that is caused especially by obstruction of the airway or a disturbance in the brain's respiratory center and is associated especially with excessive daytime sleepiness.
Sleep Disorder
A medical problem that prevents a person from sleeping normally. Sleep disorders are changes in the way that you sleep. A sleep disorder can affect your overall health, safety and quality of life. Sleep deprivation can affect your ability to drive safely and increase your risk of other health problems. Some of the signs and symptoms of sleep disorders include excessive daytime sleepiness, irregular breathing or increased movement during sleep, and difficulty falling asleep. There are many different types of sleep disorders. They're often grouped into categories that explain why they happen or how they affect you. Sleep disorders can also be grouped according to behaviors, problems with your natural sleep-wake cycles, breathing problems, difficulty sleeping or how sleepy you feel during the day. Some common types of sleep disorders include: Insomnia, Sleep apnea, Restless legs syndrome (RLS), and Narcolepsy. There are many ways to help diagnose sleep disorders. Doctors can usually treat most sleep disorders effectively once they're correctly diagnosed.
Sleep routines
Also known as sleep hygiene, relates to the activities and environment surrounding sleep can affect a person’s ability to get enough rest. The following might have an impact: going to bed on a consistent schedule, limiting sleep during the day, having a relaxing bedtime routine, having a comfortable sleeping environment, etc.
Sleep study
is a non-invasive, overnight exam that allows doctors to monitor you while you sleep to see what's happening in your brain and body. Monitoring the cycles and stages of sleep using direct observation or by using electrodes to make continuous recordings of brain waves, electrical activity of muscles, eye movement, respiratory rate, blood pressure, blood oxygen saturation, and heart rhythm. The test is performed for people who suffer from insomnia, excessive daytime sleepiness, obstructive sleep apnea, breathing difficulties during sleep, or behavior disturbances during sleep.
Sleep-Wake Cycle
the biological pattern of alternating sleep and wakefulness, in humans roughly 8hrs of nocturnal sleep and 16 hours of day time activity.
the quality or state of being drowsy
An involuntary increase in muscle tone (tension) that occurs following injury to the brain or spinal cord, causing the muscles to resist being stretched and moved in a coordinated fashion. Characteristics may include increase in deep tendon reflexes, resistance to passive stretch, clasp knife phenomenon, and clonus.
also known as Single Photon Emission Computed Tomography, is a technique for measuring brain function similar to PET. See PET Scan definition.
Speech and Language Therapist
A professional who evaluates and treats communication and cognitive skills including speaking and understanding written and spoken language.
Speech and Language Therapy
A continuum of services including prevention, identification, diagnosis, consultation, and treatment of patients regarding speech, language, oral and pharyngeal sensorimotor function.
increase alertness, attention, and energy, as well as elevate blood pressure, heart rate, and respiration (National Institute on Drug Abuse, 2014). Stimulant medications are often prescribed to treat children, adolescents, or adults diagnosed with ADHD.
Increase alertness, attention, and energy, as well as elevate blood pressure, heart rate, and respiration (National Institute on Drug Abuse, 2014). Stimulant medications are often prescribed to treat children, adolescents, or adults diagnosed with ADHD.
A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die. A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.
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.
Beneath the dura (tough membrane) covering the brain and spinal cord.
Substance abuse
Excessive use of a drug (such as alcohol, narcotics, or cocaine). Also the use of a drug without medical justification. See Drug abuse and Substance-use disorder.
Substance Use Disorder services
Services to treat substance use disorders that may include types of outpatient therapy, short-term and long-term residential treatment, detoxification, and intensive outpatient services.
Substance Use Disorders
A cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems. Areas include impaired control over substance use, social impairment, risky use and indication of tolerance or withdrawal symptoms. Diagnosis is based on a pathological pattern of behaviors related to use of the substance.
stoppage of breathing.
Support Group
A group of people with a common experience, such a disease, disorder, caregiving, etc., where one can share one's thoughts, feelings and concerns and receive information and support from other members of the group. Groups may or may not be facilitated by an expert.
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.
To reduce gradually.
Tardive Dyskinesia (TD)
a neurological disorder characterized by involuntary uncontrollable movements especially of the mouth, tongue, trunk, and limbs and occurring especially as a side effect of prolonged use of antipsychotic drugs (as phenothiazine).
Temporal Lobes
There are two temporal lobes, one on each side of the brain located at about the level of the ears. These lobes allow a person to tell one smell from another and one sound from another. They also help in sorting new information and are believed to be responsible for short-term memory. Right Lobe--Mainly involved in visual memory (i.e., memory for pictures and faces). Left Lobe--Mainly involved in verbal memory (i.e., memory for words and names).
Reduced response to a drug with repeated use.
Traumatic Brain Injury (TBI)
TBI is defined as an alteration in brain function, or other evidence of brain pathology, caused by external force.
Typical antipsychotic medications
Older or first-generation antipsychotic medications are also called conventional “typical” antipsychotics. See definition for Antipsychotic Medications.
Ventral tegmental area
An area of the midbrain lying adjacent to the substantia nigra that contains the cell bodies of dopaminergic neurons projecting especially to the nucleus accumbens, amygdala, and olfactory tubercle as part of the mesolimbic system
Visual disorders
Conditions impacting the eye due to disease, trauma, congenital or degenerative which decrease once ability to see partially or fully. Also see Visual Impairments.
Visual Impairments
Visual effects resulting from TBI include changes in visual acuity. Double vision (diplopia). Problems with visual convergence and accommodation. Sensitivity to light. And visual field deficits/visual neglect.
Vocational Evaluation
A tool used to gather the medical, psychological, social, vocational, educational, cultural, and economic data of an individual for the establishment and attainment of individual goals in vocational rehabilitation. The evaluation incorporates information obtained in available documents such as psychological testing, counseling, social summaries, occupational information, etc provided to the VR counselor.
Vocational Rehabilitation
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.
Vocational Rehabilitation Counselor
VR Counselors are specialists in social and vocational issues who help the individuals develop the skills and aptitudes necessary for return to productive activity and the community.
As it relates to Home and Community Based Services - 1915(c) Waivers, these waivers under the Center for Medicare and Medicaid Services (CMS) can waive certain requirements that otherwise apply to the Medicaid program, giving the state flexibility to define, such as: the target group of Medicaid beneficiaries to be served, subject to certain requirements; the maximum number of participants who may be served in a given HCBS waiver program; and the services available to the waiver target group (in addition to what is already available through the Medicaid State Plan).
West Nile Virus
A mosquito-transmitted virus causes most cases of West Nile infection. Most people infected with West Nile virus either don't develop signs or symptoms or have only minor ones, such as fever and mild headache. However, some people develop a life-threatening illness that includes inflammation of the spinal cord or brain. Mild signs and symptoms of a West Nile virus infection generally go away on their own. But severe signs and symptoms — such as a severe headache, fever, disorientation or sudden weakness — require immediate attention.