Living Situation Following Traumatic Brain Injury: A Longitudinal Study

1
Living Situation Following Traumatic Brain
Injury A Longitudinal Study

• Tom Novack, Ph.D.

2
Acknowledgments

• Suzanne Penna, Ph.D.
• Tessa Hart, Ph.D.
• John Corrigan, Ph.D.
• Nichole Carlson, Ph.D.
• Miranda Grote, B.S.

3
Funding Support

• National Institute of Disability and
  Rehabilitation Research Grant H133A980010
  Traumatic Brain Injury Model System Project

4
A Simple Question

• How does living situation change following
  traumatic brain injury?

5
Defining Living Situation

• Living situation implies something about
  independence
• Living by oneself or with non-related people
• Living with parents
• Living with a spouse or significant other
• Living in a facility

6
Prior Research Findings

• Vogenthaler et al (1989) N75, 4-7 years post
  injury
• Age, pre-injury residence, and amount of rehab
  were predictors of current residence
• Bruzuzy Corrigan (1996) N64, 4-10 years
  post injury
• Age, pre-injury residence, education, and
  current income were predictors of current
  residence

7
Living Situation Following TBI

• This is an area that needs to be researched.
  Two aims of the study
• Document change in living situation over time
  following TBI
• Determine what factors are associated with
  return to living alone or with a
  spouse/significant other

8
Living Situation Following TBI

• The TBI MS provides a dataset that can be used to
  answer such questions
• Large pooling of subjects from across the country
• Collected longitudinally
• Standard data collection procedures employed
• Availability of multiple predictors and the
  sample size to examine them

9
Participant Sample 1

• Participants who completed follow-up interviews
  at 1, 2, and 5 years after injury
• Data was used from all 16 TBIMS sites resulting
  in a total sample size of 900.

10
Participant Sample 2

• The entire sample (N 7,925) excluding
• Those who expired prior to discharge
• Those who have not yet reached 1 year following
  injury
• Participated in at least one follow-up interview
  (1, 2, and/or 5 years after injury)
• Analysis sample of 6,933 cases
• 853 were not yet eligible for 2 year follow-up
• 2,296 were not yet eligible for 5 year follow-up

11
Participant Sample

• The data was grouped for analysis in the
  following way
• 1- Living Alone or with roommate at time of
  injury
• 2- Living with spouse/partner at time of injury
• 3- Living with parents or adult children at time
  of injury
• 4-Living in a facility at the time of injury

12
Demographics
Percent (except for age)
13
Living AloneSample 1
Percent of Sample
14
Residing with a SpouseSample 1
Percent of Sample
15
Living with ParentsSample 1
Percent of Sample
16
Living in a FacilitySample 1
Percent of Sample
17
Outcome Over 5 YearsSample 1

• Living alone prior to injury, discharged to
  family , transitioning to living alone

Percentage
18
Outcome Over 5 YearsSample 1

• Participants who were living with parents prior
  to injury transitioning to living alone or with a
  spouse

Percentage
19
Outcome Over 5 YearsSample 1

• Discharged to a facility, remaining in a facility
  at follow-up

Percentage
20
Logistic Regression FindingsSample 1

• At all time points, premorbid living situation
  was most predictive of current living situation
• Younger patients were more likely to be living
  with parents at 1,2 and 5 years post-injury
• The poorer the FIM score at hospital discharge,
  the greater likelihood of living with parents or
  in a facility at 1,2 and 5 years.

21
Generalized Logit AnalysisSample 2

• Logistic regression models are fitted to the data
  comparing outcome to living alone prior to injury
• Odds ratios are generated
• The entire sample of 6,933 cases are analyzed
• The results were similar reassuring us that using
  a subset of subjects with 5 years of follow up
  did not bias our results.

22
So, Whats the Point?

• Using the TBI MS database to derive information
  that is helpful to survivors of TBI, family
  members, and care providers
• What can be expected in the future regarding
  living situation?
• For someone living independently at the time of
  injury
• For someone living with parents at the time of
  injury
• For someone who is discharged to the care of
  parents
• For someone who is discharged to a facility

23
(No Transcript)