Tool 6: Sources of information  

When a case manager is setting goals and developing individual program plans there are multiple sources of information that may be relevant.

Agency reports

Obtain copies from family, hospitals, legal representatives

Discharge summaries - can be obtained from acute hospitals or rehabilitation services, Commonwealth Rehabilitation Service, private rehabilitation providers.

Neuropsychological reports – done by neuropsychologists or clinical psychologists. Usually focus on changes to cognitive function. Some assessments include I.Q. score, usually not very helpful as the overall score does not usually vary greatly from the preinjury score.

Rehabilitation/medical reports – done by rehabilitation specialists, physiotherapists, speech pathologists, social workers, rehabilitation counsellors.

Other therapist reports – include occupational therapy, physiotherapy, speech pathology, social work and rehabilitation counsellor reports.

Self report

Pre-morbid functioning vs. current status - It is important to get an idea of a person's ability before the injury and compare that with current functioning. Otherwise you can make any number of erroneous conclusions about the impact of the TBI.

Verbal vs functional ability - Some people are verbally articulate, but still have significant problems at a practical level that may be identified in an interview.

Difficulties with insight - Some people have reduced awareness about their needs, and may not fully understand the level of support being provided by key people in their lives.

Family report

Impact on the family - Families are often a key support for people with ABI. Information from families can provide valuable additional information in making an assessment.

Under reaction vs over-reaction - Family members sometimes minimise or over-emphasise the disabilities of their relative.

Others

Other people may have valuable additional information - This may include agency/staff/friends/ employers, etc. The more sources of information, the better the quality of the assessment.

Where relevant sources of information are not available
Case managers may need to make arrangements to have a person with an ABI assessed appropriately.

(c) Copyright - See: Module 7. Case management - www.TBIStaffTraining.info