What is Acquired Brain Injury (ABI)?
An acquired brain injury is damage to the brain which occurs after birth and may be caused by:
- a traumatic event (i.e. from an outside force, as a result of a motor vehicle collision, fall, assault or sports injury)
- a non-traumatic event (i.e. through a medical problem or disease which causes damage to the brain, such as stroke, aneurysm, infection of the brain, tumour, etc.)
ABI is not related to:
- a genetic disorder
- a developmental disability (e.g. Down’s syndrome), or
- a process which progressively damages the brain (e.g. Alzheimer’s, multiple sclerosis).
What is a Traumatic Brain Injury (TBI)?
Traumatic Brain Injury is a form of acquired brain injury caused by the head being hit or hitting an object violently, or when an object pierces the skull and damages brain tissue.
Many of the causes of TBI stem from accidents and assaults. Accidents that cause traumatic brain injury are motor vehicle incidents, bullet wounds, physical assaults, physical battering, shaken baby syndrome, domestic violence, falls, sports and recreation injuries. Consequences may include; cognitive, speech, hearing, taste, smell, /balance/vestibular, vision, physical mobility dysfunctions, and psycho-social, behavioral and/or emotional impairments.
Symptoms of TBI can be mild, moderate or severe, depending on the extent of damage to the brain. Some of the common signs of TBI include:
- Headaches or neck pain that do not go away;
- Difficulty remembering, concentrating, or making decisions;
- Slowness in thinking, speaking, acting, or reading;
- Getting lost or easily confused;
- Feeling tired all of the time, having no energy or motivation;
- Mood changes (feeling sad or angry for no reason);
- Changes in sleep patterns (sleeping a lot more or having a hard time sleeping);
- Light-headedness, dizziness, or loss of balance;
- Urge to vomit (nausea);
- Increased sensitivity to lights, sounds, or distractions;
- Blurred vision or eyes that tire easily;
- Loss of sense of smell or taste; and
- Ringing in the ears.
Children with a brain injury can have the same symptoms as adults, but it is often harder for them to let others know how they feel. Call your child’s doctor if they have had a blow to the head and you notice any of these symptoms:
- Tiredness or listlessness;
- Irritability or crankiness (will not stop crying or cannot be consoled);
- Changes in eating (will not eat or nurse);
- Changes in sleep patterns;
- Changes in the way the child plays;
- Changes in performance at school;
- Lack of interest in favorite toys or activities;
- Loss of new skills, such as toilet training;
- Loss of balance or unsteady walking; or
Brainline.org. Traumatic Brain Injury Signs and Symptoms, 2010
What types of rehabilitation are available after a brain injury?
After a brain injury, people can go through a number of different stages of medical treatment and care. If the person requires hospitalization after a brain injury they will be admitted to an acute care hospital where the doctors address the urgent medical issues and the person begins the rehabilitation process.
The rehabilitation process is not the same for everyone. Some people are able to be discharged relatively quickly from hospital and others will need to participate in an inpatient rehabilitation program before they are able to go home.
Rehabilitation is provided in three settings:
- Inpatient – For patients admitted to a hospital bed. Rehabilitation may take place in a community, acute teaching or rehabilitation hospital, depending on the needs of the patient.
- Outpatient (also known as Day Hospital or Ambulatory Care) – For individuals who can travel to the hospital for each rehabilitation session.
- Community (or Home-Based Service) – When the rehabilitation professional comes to the individual’s home or place of residence, usually because the individual cannot travel to the hospital or outpatient clinic.
For more information, please visit the Family Resource Guide available at http://www.abinetwork.ca/home.htm
Some of the following questions may be helpful in selecting the right rehabilitation provider that will fit your needs:
- Are the services located close to home or easily accessible, or will the service provider come to your home?
- Does the staff have experience with ABI? What other training and experience do they have?
- What is the range of services available to assist me?
- Could I meet the staff to ensure there is a fit and they understand my goals?
- Will both my caregivers and I be involved in the planning of my rehabilitation?
- Are they accredited by an outside body?
Who will be involved in my rehabilitation?
Your rehabilitation team will work with you, your family and caregivers to develop a plan that is right for you. Your team may consist of a variety of health care professionals inluding:
- behaviour therapists
- a physician
- behaviour analyst
- rehabilitation therapists
- a social worker
- occupational therapists
How can I find rehabilitation services in Toronto for someone with ABI?
In Toronto, all referrals for publicly funded services are coordinated through the Toronto ABI Network. This includes inpatient and outpatient programs, as well as community based support. Please visit www.abinetwrok.ca or call (416) 597-3057.
The Ontario Brain Injury Association (OBIA) also website has a directory of service providers where you can search for rehabilitation providers. Go to www.obia.ca and so to Directory of Services.
If you were injured at work, or in a car accident, you will have benefits that provide for rehabilitation services. The details of coverage will depend on your unique circumstances. A case manager will be assigned to you and can help explain what is available to you. Your case manager can also help you find the service provider that is right for you.
What services are available for people living with acquired brain injury in Toronto?
The Toronto ABI Network is a central coordinating organization for many of the services for people with ABI in Toronto, including in-patient and out-patient hospital programs, as well as a complete listing of support services available in the community or home setting. You can find out more about the network at www.abinetwork.ca.
BIST coordinates the Peer Mentoring program, which matches people with ABI or family members with volunteer Mentors who can share their experiences, offer support and share practical tips and information. BIST participates in this program with many other brain injury associations across Ontario, allowing access to a wide variety of Mentors with diverse experience and information. To find out more, contact Kat Powell, Peer Support Coordinator at email@example.com, or 647.990.1485.
The Ontario Brain Injury Association (OBIA) provides on-going support to those affected by ABI in the areas of:
- Questions about ABI, rehabilitation programs, WSIB financial assistance (ODSP, CPP etc.)
- information about the services and benefits you may be entitled to receive
- issues you should be raising with medical and legal professionals
- explaining the often confusing terminology associated with ABI
- contact information for your local brain injury community association
OBIA has also published a directory of services that includes a wide range of public and private service providers that offer health, rehabilitation, community support and legal services. You can find the directory under Resources at www.obia.ca
Many hospital and community based programs also offer support groups for people in their programs. Make sure you ask the Social Worker or intake coordinator if you are involved with a program or service
What support is available for the caregivers of people living with ABI in Toronto?
ABI is a life-altering event in the life of the individual and their family and friends. It is common for caregivers to experience feelings of burden, distress, anxiety, anger and depression. Information and support can make a huge difference in helping family and friends to cope and support their loved one.
The Peer Support Mentoring Program offered through BIST is available for caregivers. They can be linked with another caregiver for individual support through phone and they can share experiences, offer support and share practical tips and information. For more information contact Kat Powell, Peer Support Coordinator at firstname.lastname@example.org, or 647.990.1485.
Some inpatient and community programs also include support groups for caregivers. The Toronto ABI Network web site includes information on support groups for caregivers. You can find details at www.abinetwork.ca.
It is important for family and friends to realize that they are not alone and there are resources available to support them.
Are there any activities in Toronto for people living with acquired brain injury or their families?
BIST organizes activities on a regular basis in Toronto for persons living with brain injury and their families to enable them to socialize and have fun. There are also monthly Community Meetings put on by BIST at which speakers address topics of interest to the brain-injured community. Please visit Upcoming Events on this website.
How can I find a lawyer in Toronto who is knowledgeable about acquired brain injury?
The Ontario Brain Injury Association website has a directory of service providers where you can search for a lawyer. Visit www.obia.ca and go to the Directory of Services under Resources
Your lawyer should be experienced with personal injury cases. Your lawyer should also be able to fully explain all of your rights.
Some of the specific questions you may wish to ask a potential lawyer include:
(a) Do you practice in the area of personal injury law?
(b) How long have you practiced in this area?
(c) What percentage of your practice is focused on personal injury law?
(d) Do you have a trained staff that would assist with my case?
(e) How do you charge for services?
(f) What is a contingency fee arrangement?
(g) How much will your services cost me at the end of my case?
(h) Is there a charge for our first meeting?
(i) Are you accessible and easy to get in touch with?
(j) How do you keep me informed on what you are doing?
(k) Have you handled cases like mine? If so, how many?
(l) How long do personal injury cases take to reach a final resolution?
How can I get help in my efforts to return to work?
The needs of a person must be accommodated by an employer unless it involves undue hardship on the employer, considering the cost, outside sources of funding, if any, and health and safety requirements, if any. (The Ontario Human Rights Code section 17(2))
The help available to you will depend on the circumstances of your injury. If you have access to insurance funding, WSIB benefits or long term disability, they will have a mandate to assist you to return to work. Efforts to assist you to return to work may include help from your case manager, an Occupational Therapist and/or a job coach.
If you don’t have access to third party funding, assistance is available through the Ontario Disability Supports Program (ODSP), Employment Supports. ODSP contracts with several agencies throughout the GTA who are available to help you. You can find out how to apply to this program by visiting www.mcss.gov.on.ca
If you have access to Employment Insurance (EI) benefits, you can get assistance from Human Resources and Social Development Canada. You can find out more from your local office, or by visiting www.hrsdc.gc.ca
There is no way to force your employer to help you return to work, although employers are required to offer reasonable accommodation to people with disabilities. Show your employer literature on brain injury to help him or her understand the effects. If you feel you are being discriminated against, you can contact the Human Rights Commission (ohrc.on.ca) for more information and advice.
Are there any special tax breaks for people with disabilities?
Persons with disabilities may be able to claim the following as a deduction or credit:
(a) The Disability Tax Credit (usually called the disability amount) reduces the income tax that a person with a disability has to pay.
To get the credit, you must complete a Disability Tax Credit Certificate (Form T2201), have it signed by a qualified doctor, optometrist, audiologist, occupational therapist, psychologist or speech language pathologist, and return it to the Canada Revenue Agency.
(b) Child Disability Benefit: If your children are under 18 and qualify for the Disability Tax Credit, they may be eligible for the Child Disability Benefit.
(c) Medical Expenses: If you have medical expenses associated with a disability, you may be able to claim them to reduce your taxes. Or, a supporting person such as your spouse, common-law partner or other family member may be able to claim them.
(d) The Disability Supports Deduction allows you to deduct certain expenses for supports that enable you to work or go to school.
Other items that may be claimed as a deduction or tax credit include:
• Amount for an eligible dependent;
• Caregiver amount;
• Disability amount transferred from a dependent;
• Amounts transferred from your spouse or common law partner;
• Tuition, education and textbook amounts;
• Allowable amount of medical expenses for other dependents;
• Working income tax benefit;
• Amount for infirm dependents age 18 or older.
For more information about tax credits, deductions and medical expenses, go to www.cra.gc.ca/disability. To get the forms you need, click on www.cra.gc.ca/forms, or call Canada Revenue Agency at 1-800-959-8281.
The information provided herein is for informational purposes only. The information does not constitute legal advice, medical advice, tax advice, or other professional advice and you may not rely on the contents of this website as such. This information is NOT intended to be legal advice, medical advice, tax advice, etc., and should NOT be relied on to make decisions in any of these areas. Your legal, medical and tax needs are very specific and depend on the unique circumstances of your situation. As such, it is advised that you contact a competent lawyer, medical professional and/or accountant to address your specific questions and concerns.