Monthly Archives: July 2017

Signs of Left Neglect

Left neglect is one of the odder symptoms of a brain injury.  Briefly, left neglect is an attention deficit in which a patient’s brain essentially tells the patient to ignore the left side of the world.  It is almost as if the left side of the world does not exist.  It is most commonly observed when a patient ignores items in the left visual field (even when visual acuity is perfect) but can also involve hearing and sensation on the left side.  Left neglect is due to an injury to the right side of the brain.  Different techniques, such as practicing scanning skills, are used to manage left neglect.  For more general information on left neglect, please see these previous posts on the topic:

What is Left Neglect? https://tlcrehab.wordpress.com/2015/01/08/what-is-left-neglect/

Left Neglect vs. Field Cut https://tlcrehab.wordpress.com/2015/06/25/left-neglect-vs-field-cut/

What I would like to do with this post is to give a few signs that rehabilitation professionals commonly observe with cases of left neglect.  Below is a list of these common left neglect signs:

1. The patient only eats food on the right side of the plate and does not notice the food on the left side of the plate.  Often the patient will complain that he or she is not being fed enough because the patient believes that he or she is only being fed half-sized portions since the food on the left is ignored.

2. The patient bumps against objects with the left side of the body or wheelchair.  For instance, the patient may bump on the left side of a door frame as he or she attempts to exit a room.  Typically, patients who are just beginning to understand their left neglect and have not become proficient in scanning techniques will have bruises on the left arm or leg.  Staff often have to monitor patients in wheelchairs who have left neglect to ensure that the patients’ arms do not fall down and get caught in the wheels of the wheelchairs.

3. The patient does not face people on their left, even when talking with these people.  Many times, the patient may begin the conversation face to face but slowly their head drifts to the right during the conversation.

4. The patient only shaves the right side of the face, only washes the right side of the face or only puts make-up on the right side  of the face.

5. The patient misses words on the left side of the page.  Often a patient will complain that the reading material he or she is given does not make sense because the patient does not realize that he or she is only reading words on the right side of the page.

6. The patient is unable to find rooms located on the left side of a hallway.  Sometimes a patient will claim that a room has “moved” or “disappeared” since the patient cannot find the room.

7. The patient will start all activities on the right side and not make it to the left. For instance, a patient may play Connect 4 and always place their chips on the right side of the game.  Similarly, the patient may squeeze all of his or her writing on the right side of the page while the left side of the page is blank.  The patient will often draw the right side of a picture.

8. The patient complains that he or she is losing hearing in their left ear even though an audiological test shows no hearing loss.

9. In extreme cases, a patient may not recognize their left arm or leg as being their own body part.  When the patient sees their arm or leg but does not recognize it, he or she may make a complaint such as that a stranger is in their bed with them.

I hope this post helps everyone understand some of the more common signs of left neglect that rehabilitation professionals commonly observe!

Learn about brain injury treatment services at the Transitional Learning Center! Visit us at: http://tlcrehab.org/

The Overlooked Release

One of the most important things for a health care provider to have is all of the information on their patient’s health.  For instance, knowing that a patient has a history of seizures may influence the type of attention medication that a doctor will prescribe.  Similarly, knowing that a patient has a history of learning disabilities will affect the interpretation of neuropsychological and speech pathology testing.  On the surface, it would seem pretty obvious that a health care provider needs all the information he or she can get on their patient.  But in reality, the provider usually has very limited information which makes assessment and treatment more difficult than it needs to be.

Many patients and their families simply assume that each health care provider they see knows what each other provider is doing.  Unless the health care providers all work for the same facility, the providers do not have access to each others’ information.  Patients, or loved ones that have the legal right to do so, must request that the information from one health care provider be sent to the other health care provider.  This will always be done with a written form called a Release of Information or Release of Records.  This release allows the providers specified on the form to share information.  So, if you want your family care physician to know what happened to you in the hospital, you want to make sure that you have signed a release of information for the hospital to send information to the physician.

There will often be check boxes on these forms specifying what information is being sent.  For instance, certain information such as psychological records have added legal protections so they cannot simply get sent automatically with other records (For instance, do you really want your insurance company to have the same access to session notes from your marital therapy session as they do for your physical therapy session?).  Moreover, doctors/facilities will only send the records from their offices, and not the records from other offices.  For example, if you are requesting notes from a rehabilitation facility to your family doctor, the rehabilitation facility will only send their records to the doctor.  They will not send the notes from the hospital you were at prior to the rehabilitation facility even if the facility has the hospital records.  Each doctor/facility will require a release of information to be signed and often they will insist that it be on a release form from their office.  Though this may seem like a bit of an inconvenience, having a full set of records greatly improves the ability of health care providers to give the best possible treatment to their patients and reduces the likelihood of wasted time/errors.

Learn about brain injury treatment services at the Transitional Learning Center!  Visit us at: http://tlcrehab.org/