Neuropsychology

The service provided by the Neuropsychology Department at Calvary Health Care Bethlehem includes assessment of the psychological sequelae of neurological illness, supportive counseling of patients and their families and behavior management. The Department is also committed to research that extends current knowledge about the impact of neurological disease.

Assessment

Changes in cognition (thought processes and skills), behavior and emotion are features of many neurological conditions and occur as a result of brain injury. In chronic progressive neurological diseases, for example, such changes occur commonly in Huntingtons disease and advanced cases of multiple sclerosis and infrequently in cases of motor neurone disease.

It is the neuropsychologists' role to identify and document such changes. Using interview and neuropsychological assessment techniques, cognitive processes (including memory, learning, planning, reasoning, language and perception) are assessed. Changes in the ability to control behavior are documented. The person’s emotional and psychological reaction to their illness is also evaluated. This type of objective measurement of an individuals thinking skills, memory and behavior, allows identification of the individual’s strengths (areas of preserved functioning) and weaknesses (areas of deterioration). Identification of strengths and weaknesses is fundamental to patient management.

Information from Neuropsychological assessment is used to:

understand how the illness has affected the patient both psychologically and emotionally
establish realistic expectations of the patient both in hospital and at home
help set appropriate goals for therapy, capitalising on cognitive strengths and offering suggestions for compensating for cognitive weaknesses
develop and implement strategies to help staff and family members cope with behavioral problems
provide information for specific decisions for: safety at home; ability to manage personal affairs; ability to give informed consent; driving ability; testamentary capacity; capacity to work/retrain; rehabilitation prospects; placement; ability to benefit from psychotherapy/counseling/behavior modification.

Neuropsychological assessment forms the basis for supportive counseling:

For the Patient:

to clarify changes in cognitive functioning that have been causing them concern

to suggest strategies to circumvent problems (where appropriate)

to advise on changes needed in domestic/work/recreational pursuits

support in adjusting to changes in brain functioning

For the Family/Carer

to explain the often puzzling changes noted in the patient

to help adjust their expectations of the patient

to give practical advise when managing alterations in the patient’s role within the family

to give practical advise on managing behavioral problems

to offer supportive counseling in the ongoing process of adjusting to and coping with cognitive/behavioral changes in the patient

Behavioral problems can be a direct result of brain injury or can occur in response to the personal and physical losses that result from neurological disease. Behavioral problems can include lack of motivation, lack of cooperation and aggressiveness. These problems can alter with progression of the disease. The Neuropsychologist leads a team-based approach to manage behavioral problems and to promote more appropriate patient behavior.