By GORDON MUIR GILES AND JO CLARK-WILSON

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Sample text

The final category of good recovery is somewhat unclear - it is defined as a resumption of normal life, but return to work is excluded as a criterion. A more comprehensive outcome scale has been devised by Livingstone and Livingstone (1985). The Glasgow Assessment Schedule (GAS) is a comprehensive rating scale which includes subscates for the assessment of physical, psychological, social, personality and activities of daily living deficits and could be used to note trends in recovery and responses to intervention.

Independence in community living was achieved at 32 months. W. shows that some patients demonstrate a non-standard slope of recovery. Stimulation to maximize recovery The most direct route to stimulating recovery might be via some pharmacological agent, but none have so far proved effective. Therapists have attempted to stimulate patients into accelerated recovery (Ylvisaker, 1985: Soderback and Normell, 1986a, 1986b). In the acute stage, coma stimulation is viewed as an essential component of treatment by many therapists.

Seen within the medical model, an 'either or' approach has been adopted in which disease was either present or absent: the patient was either neurologically impaired or malingering. This 'either or' model may not be helpful in understanding the experience of patients after brain injury. The view that neurological disruption is involved in the production of a set of behaviours need not necessarily support a view which dismisses social, personality and environmental factors as irrelevant. A model of illness behaviour can assist in the understanding of help-seeking behaviour (Mechanic 1986).

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