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A Medical Student's Reflections on CONNECT

By Amanda Ho, UBCO Medical Student

CONNECT Lake Country is a specialized, rehabilitative residence for individuals with acquired brain injury. Its mission is to transform the way this population is supported, with an approach that is resident-centered and strengths-based.

To help guide the residents in achieving their goals, there is a collaborative team of coaches that directly work with the residents, including an occupational therapist (Independence Coach), physiotherapist (Physical Coach), nurse (Health and Wellness Coach), speech therapist (Communication Coach), neuropsychologist (Thinking Coach) and recreational therapist (Play Coach). There are also staff members working in each "house" that encourage the residents to become more independent, and if need be, to provide assistance in day-to-day activities. Overall, there are about 75 staff members at CONNECT and up to 42 residents.

The population at CONNECT consists of individuals that reside there long-term, and those that are transitional. While the average resident is middle-aged, there are also residents in their early twenties. The mechanisms of their injuries are variable and include stroke, trauma and hypoxia. My main role at Connect was to spend as much time as I could with the residents, and to learn from them, as well as the coaches and staff. My other role was to provide them with a deliverable pertaining to an area of need, which was in primary care.

My time at CONNECT has been an incredible experience of learning and growth. I believe that my most valuable lessons were learned through my interactions with the residents, who showed me what life was like for them to have experienced brain injury, as well as their past and their future plans. Looking back at my first reflection and my initial expectations, I was accurate in believing that I would be learning mostly about their daily lives, but I did not expect to be learning so much about their lives prior to their injury. I was able to hear directly from some individuals about the people that they were before their injury, and how that may or may not have changed.

From the perspective of the resident, the injury affected all aspects of their lives. Cognitively, some of the residents experienced difficulties with short term and working memory, and attention. I learned that these cognitive capabilities could be rehabilitated with cognitive exercises, which were spearheaded by the Thinking Coach. From sitting in at one of the weekly group counseling sessions, I learned about the frustration of having experienced an injury, the devastation of having one's life drastically changing in an instant, and the stigma that was felt when they were seen in public. When one of the residents received the news from his physiatrist that his arm would likely never heal enough for him to return back to work as a heavy machinery operator, the reality of the situation hit him quite hard. He also happened to be working on his PWD application that same day. It was eye-opening for me to see what that news meant for him, and the implications for what his future goals would be in terms of eventually moving out of CONNECT and perhaps finding alternative employment.

A strengths-based approach seemed vital to the successes of the staff and residents at CONNECT, as well as a positive attitude. Goals were established by the resident from the very beginning and plans were thoroughly created to meet such goals, with trust in the capacity of the affected individual. I also observed the glowing sense of community that permeated throughout CONNECT, for example, evidenced by the laughter and jokes at the dinner table where everyone was gathered for breakfast. I think it really helped to create a sense of home and of belonging, fostering an acceptance of oneself and a positive outlook.  

There are so many ways in which my time at CONNECT will enable me to become a better physician for individuals in general, and those of the population with brain injury. This includes improved CanMEDs Competencies in Medical Expertise, Communicating and Health Advocacy. Medically, I now know to specifically screen for health concerns, such as pressure sores, depression, incontinence and chronic pain. With chronic pain especially, I am more aware of how some individuals are very wary of becoming permanently dependent on medications, and that they may be interested in seeking alternatives for treatment.

From a biopsychosocial perspective, I understand how brain injury can drastically change one's sense of self and belonging, and that individuals simply want to be treated like human beings, regardless of their ability or appearance. And whenever an individual shows a lack of understanding towards individuals with brain injury or disability, I am compelled to provide them with some knowledge gained from my experiences, so that I may help to dissipate some of the stigma. In addition to addressing health concerns, I will know to screen for adequate social supports, vocational concerns and to be their advocate in applications for disability.

Lastly, on a more personal level, I will take with me the insightful conversations with the individuals that I came to know, and remember their frustrations and resiliency in the face of challenges and transition, their humour, and their optimism.