Ability of the brain to develop alternative pathways ...
Quality of life care : Not minder-care
Traditional care was minder-care for those with significantly reduced intellectual capacity. An intellectual disability for which they received three meals a day and a bed in an institution where the service priority was just administration, domestic and personal hygiene - in that order of priority.
Little or no consideration was given to improving intellectual capacity, as it was believed that once an adult, the brain's networks became fixed. And, most residents of institutions were adults. This philosophy providing institution staff with little reason to provide other than basic minder-care, where residents did little more than sit around or wandered around day after day.
When most institutions were finally closed, the majority of residents were moved to supported accommodation group homes in the community, where many ex-institution minder-care entrenched staff went as well - ensuring the minder-care tradition remained alive and well entrenched in the new environments.
Although there were a few pockets of staff willing to risk the intimidation of the traditional minder-carers and those they have indoctrinated into such ways, traditional ways won the day.
Movement towards quality of life care was, and is assisted by those service providers who have determined their group homes shall be active support compliant and accepting brain plasticity research and findings.
With the aid of the writings of Dr Norman Doidge MD, et al, we present the following in support of the above.
Research shows that areas of the brain which were damaged, which did not develop properly or were subsequently disrupted, can be taken over by other areas of the brain through extensive and repetitive learning by dedicated support staff providing residents with consistent skill development within quality of life care and support.
In the past two decades an enormous amount of research has revealed that the brain never stops changing and adjusting.
Learning is the ability to acquire new knowledge or skills through instruction or experience. Memory is the process by which that knowledge is retained over time. The capacity of the brain to change with learning is plasticity. So how does the brain change with learning?
Initially, newly learned data is "stored" in short-term memory, which is a temporary ability to recall a few pieces of information. Some evidence supports the concept that short-term memory depends upon electrical and chemical events in the brain as opposed to structural changes such as the formation of new synapses.
According to Dr Daniel A Drubach MD (2000), there appears to be at least two types of modifications that occur in the brain with learning:
- A change in the internal structure of the neurons, the most notable being in the area of synapses and,
- An increase in the number of synapses between neurons.
Plasticity, or neuroplasticity, is the lifelong ability of the brain to reorganize neural pathways based on new experiences. As we learn, we acquire new knowledge and skills through instruction or experience. In order to learn or memorize a fact or skill, there must be persistent functional changes in the brain that represent the new knowledge. The ability of the brain to change with learning is what is known as neuroplasticity.
As learning takes place new pathways are generated. These new pathways allow the brain to perform lost functions in a new and different way. With repeated practice almost everyone with ‘damaged brain cells’ should be able to re-gain lost functions by altering the way in which those functions are practiced. The practice must involve a variety of sensory stimuli and must be repeated over and over.
Hence the need for residents of supported accommodation group homes, and similar, to receive consistent active support, positive behaviour support and skill development to help ensure their quality of life development.
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