Save the Date! In this issue: BIATX's next board Letter from BIATX President, Jane Boutte meeting will be January 15th from 10am to 4pm at the Association's Family Letter to the State of Texas: Continue DARS main office in Austin. Funding Please visit Hhttp://www.biatx.org/ who/go/board.htmlH for directions. “What is There to Talk About?: Social Communication after TBI” The 27th Annual Margaret A. Struchen, Ph.D. Statewide Conference, “Coming Together”, Texas Traumatic Brain Injury Model System at will take place in Austin TIRR Memorial Hermann April 14-17, 2011. Baylor College of Medicine Please visit our website for registration and speaker information. Thank You to Our Golf Tournament Sponsors For information, contact us at: White Paper Brain Injury Study commissioned by CORE Health Association of Texas 316 W. 12th Street, Ste Foundation tallies 405 TBI costs related to deaths, ER visits, Austin, TX 78701 hospitalizations, disability Telephone: (512) 326- 1212 Toll Free: (800) 392- Living with Brain Injury and Love 0040 Fax: (512) 478-3370 Email: firstname.lastname@example.org Call for Papers th 27 Annual Statewide Conference “Coming Together” April 14-17, 2011 Letter from BIATX President, Jane Boutte Happy Fall, We had our second annual golf tournament in September at Bear Creek Golf Club in Dallas. The weather could not have been more perfect. We doubled the number of players over last year! BIATX is incredibly grateful for the support we received at both events from our sponsors and vendors. We are happy to have new sponsors and hope all of our sponsors and exhibitors were pleased and gained more knowledge about brain injury. Last month BIATX provided testimony at the Legislative Appropriations Request (LAR) board. We remain very concerned about the possibility of the Texas Department of Assistive and Rehabilitative Services - Comprehensive Rehabilitation Services (CRS) being reduced during the 2012-2013 biennium in order to meet state balanced budget requirements. The proposed budgetary cut is 70% for CRS which would equate to 420 people not getting funding for needed brain injury rehabilitation. Please be on the lookout for updates regarding the potential devastating effects this would have if the cut happens. We must work together to prevent such a tragedy. We also spoke in favor of a pilot Medicaid Waiver for brain injury. The Waiver Proposal would serve individuals with brain injuries ages 21-64. The pilot would serve 200 people, capped at $15,000 per person, per year and would include an array of services from which to choose. As you know, the legislative session begins in January and there are issues this session that will require us to work together to help increase services to fill the gaps currently existing for persons with a brain injury and prevent any additional cuts in services already in existence. We are planning our 2011 annual conference for April 14-17, 2011. We must get the word out across Texas; we need record-breaking attendance since we are planning a visit to the Capitol. We have found that our Legislators do listen, email is effective as well as faxes. If you know anyone interested in getting involved with BIATX please forward this information to them. We have a lot to do and we need folks who are passionate and energetic to help us accomplish our goal: helping those who have suffered from a brain injury have access to services they need to become as independent as possible. Please email me at email@example.com with any thoughts or ideas you may have. All my best, Jane Advocates for Hope Pate Rehabilitation is a post-acute brain injury program with multiple locations in the Dallas-Fort Worth (DFW) area. Each location is designed to meet the specific needs of our patients (i.e. appropriate environment due to behavioral issues and location to family/ home.) We have a 100-acre ranch setting, an excellent environment for patients exhibiting behavioral issues, and an urban setting for patients that are less physically/ behaviorally involved. We are CARF accredited for our brain injury programs for outpatient residential and long term care and vocational services. We provide transportation in the DFW metroplex area for patients being serviced in our day treatment program. We are in-network with many major insurance plans. With our successful return-to-work rate, we are also a preferred provider for many workers compensation companies. Our intensive therapy program consists of physical, occupational, speech and cognitive therapy and is lead by a board certified neuropsychologist. 2655 Villa Creek Drive, Suite 140 ▪ Dallas, TX 75234 ▪ (972) 241-9334 www.paterehab.com ____________________________________________________________________________________ Family Letter to the State of Texas: Continue DARS Funding September 1, 2010 I am sorry that I am not able to appear in person at your commission hearing. However, I would appreciate it if my experience in this area and my comments concerning this issue be reviewed and included in the record. Sometime after 1:00 am on July 9, 2009, my life, and the lives of many other members of our families, was changed forever. On that fateful morning, I was awakened by a knock on the door. It was an officer from the local police department, who advised me that an accident had occurred involving my son. He advised me to contact the emergency room at John Peter Smith Hospital in Ft. Worth, Texas for more details. When I spoke to the hospital staff, I learned that my son, Warren and his wife, Kim had been involved in a serious motorcycle accident, and that both were in critical condition. When my wife and I arrived at JPS a few hours later, and I saw my son and his wife in the ICU, I learned the ugly details. While both had some fairly serious physical injuries, the most devastating news was that they both had sustained “severe traumatic brain” injuries. The next several days were spent meeting with all kinds of doctors, nurses, and other hospital staff, reviewing the results of a variety of tests, and just hoping and praying that both-or possibly even just one of them would survive to raise their two children, ages 3 and 9. During the past 14 months, I have devoted most of my time dealing with my son’s needs. Fortunately, this story has a relatively happy ending. Today, after both spending many-many months in various hospitals and rehabilitation programs, my son and his wife have spent the past 2 months living together as husband and wife in their home in Ft. Worth. While they are not yet the same people they were before the accident, because of the medical professionals and staff at several different facilities, they have improved to the point that they now have a very good chance to be reunited with their children-and live a reasonably normal life, including one in which we may see one or even both of them returning to work. The journey my family and I have traveled in the past 14 months is not unlike many hundreds or even thousands of other families who experienced similar, or possibly even worse, tragedy in their lives. Before this accident happened, I had little interest in and even less knowledge of what “traumatic brain injury” is and how it is treated. What I have learned from my research and interaction with the professionals in this field is that the brain is a very complex and unpredictable organ; that the treatment plan or process may be different for each person who sustains a brain injury-depending on the nature and severity of such injury; and the expected progress and outcome are difficult to assess-again due to the nature and severity of the injury. A major problem that faces any person or family member that sustains any kind of “traumatic brain injury” is the lack of understanding by some in government or by some insurance carriers who makes funding/coverage decisions for “transitional brain injury programs”. A brain injury is not like a broken arm, leg or any of the thousands of other medical issues handled by doctors and hospitals every day. The difference is that a traumatic brain injury may or may not heal. Further, certain damaged areas of the brain produce a variety of behavioral challenges for the patient and the professionals charged with treating this patient. The issue of not only when, but if, the brain will repair itself is critical to the ultimate treatment plan. What actually occurs in most treatment plans is the professionals who work with brain injury patients design a treatment strategy based on an examination of the patient’s history and behavior. However, each treatment plan or strategy needs to be modified, based on the patient’s response, or lack thereof. Having the experience and expertise to make these strategic changes in a patient’s treatment plan requires a very specialized program, and a staff that has the skills and training to modify and implement these strategy changes. The typical hospital and even most rehabilitation programs are not set up to deal with “traumatic brain injury” patients over long periods of time. Transitional brain injury programs, such as Pate Rehabilitation and many others in the State of Texas are specifically designed to handle patients with this type of injury. They understand that a holistic approach is necessary to achieve a good outcome. The ultimate goal of a transitional “brain injury” rehabilitation program is to provide the patient with the tools and strategies to return to as normal a life as possible. The kinds of programs and activities that are developed by these transitional programs are very specialized and labor intensive. Many insurance carriers and even some government officials do not understand the organization, functions, strategies or activities of these transitional “brain injury” programs. I spent the better part of six months observing my son’s treatment in one of these transitional programs, Pate Rehabilitation. There were several times during my son’s time at Pate that I questioned the relevancy of a particular strategy or activity. And there were other times that I felt nothing was working and that my son was not improving. At one time or another, during the six months that my son was at Pate, I questioned just about everything they did. However, when my son was discharged from Pate, after six months, I was able to take him home to be with his wife. Two months later, he and his wife are enjoying most of the things that we all take for granted, like going out to eat, shopping, watching television, or just going for a walk. Pretty amazing, after I was told by some pretty high powered doctors to be prepared to “think about a nursing home for your son, that is if he survives his injuries and the infections that normally come with this kind of trauma”. My son and his wife survived a catastrophic accident, and both suffered severe traumatic brain injuries. Ironically, both experienced similar recoveries and ended up at Baylor Rehabilitation in Dallas. After several weeks, my son’s wife was transferred to a transitional program in Irving, Texas. Her insurance carrier (BCBS of Texas) followed the State mandate covering traumatic brain injury treatment and covered the cost of the full 6 month transitional program. However, a week or so before my son was scheduled to be transferred to a similar area transitional program, I was notified that his insurance carrier (BCBS of New York) denied his coverage for this brain injury program. I filed a complaint with his employer as well as the Texas Insurance Commission-but was not successful. I had to take my son out of Baylor in late October of 2009. While he was home, he had such severe deficits and his behavior was so difficult to manage that we had to contemplate a nursing home. Fortunately, one of the transitional program staff located a program in Tulsa, Oklahoma that our insurance carrier would approve, and we got him admitted to that facility the following weekend. However, six weeks later, this same insurance carrier (BCBS of New York) cancelled his coverage and we had five days to get him out of the Tulsa program. Miraculously, just two days before we had to pick up my son from the Tulsa program, a call came from our DARS counselor. She advised me that my son had just been approved for his state funding-and he could be admitted to one of the State of Texas approved transitional programs. He was immediately transferred to the Pate Rehabilitation Transitional Program at Anna, where he spent the next six months as a patient (client). As I have already indicated, at first, my experience with the transitional brain injury program at Pate was difficult to understand-not only for me but for my son. However, as the weeks and months passed. I began to see my son improve, and by the end of the program he had made sufficient enough progress to return to his home, with his wife, and to a somewhat normal life. My son (and his wife) still needs to deal with some issues-ones that can and should be managed through typical out-patient services. As I reflect on this whole experience, I am convinced that-without a transitional brain injury program, such as Pate, my son would not be able function in the real world-and probably would have ended up in some nursing home. How many brain injured people who, for one reason or another, get denied or have no benefits for these transitional brain injury programs? How much will they suffer with these untreated deficits? How will the families cope with these situations? And how much will all of this ultimately cost everyone? I know that there are always competing interests for taxpayer’s dollars, and especially in these tough economic times. However, I hope that in your evaluation of the State’s budgetary priorities you will consider not only what happened to my son and his wife, but all of the sons, daughters and other family members who might have the misfortune to experience or be associated with a tragedy such as that of my son and his wife. If it were not for these transitional “brain injury” programs in the State of Texas, most of which only survive with the help of DARS, I hasten to guess how many people would end up living with family members or in nursing homes. Many of these people would never be able to experience the fullness of life and become productive and happy members of the community. This would indeed be a tragedy. Warren “Pete” Whitton, Ph.D. Father What is there to Talk About?: Social Communication after TBI Margaret A. Struchen, Ph.D. Texas Traumatic Brain Injury Model System at TIRR Memorial Hermann Baylor College of Medicine Talking with others is the main way that we develop relationships with others. It is a basic part of human nature. Conversations can turn strangers into acquaintances, acquaintances into friends, and friends into close friends or intimate partners. Conversations help people share their feelings and to exchange different points of view. This can help people find common interests and can help generate new and interesting ideas. Conversation is an important way that we participate in community life, including the home, workplace, and wider community. After experiencing a brain injury, some people can have difficulties with participating in conversations. Problems with communicating can be subtle (like mild word-finding problems) or can be more widespread. These problems with conversation can make it more difficult to make new friendships after injury, to keep friendships from before the injury, and to get along well with others in the workplace. Some people find that they have problems with initiation, or getting started with things, after brain injury. For such individuals, this may affect their ability to start a conversation with others. This may be due to difficulties in coming up with a topic of discussion or the right words to say. Problems with starting conversations can be due to general problems with initiation that resulted from the injury. That is, some people have difficulty with starting actions of any kind (e.g., getting ready in the morning, beginning to work on daily chores or projects). Problems with getting a conversation going could also be due to feelings of nervousness or anxiety when talking to others. Such nervousness and anxiety may be increased by reduced confidence in one’s abilities due to problems with attention, memory, and so forth. Anxiety in social situations is not unique to persons with brain injury. Social gatherings or conversations with new people can create anxiety for many people. Often, this anxiety can result because an individual doesn’t know what to say or can’t come up with ideas for conversation topics to begin a dialogue. In this article, we will focus on ways to improving conversational skills related to coming up with topics for conversation. Whether challenges to beginning conversations started relate to initiation problems, anxiety, or a combination of both, the following tips may help. 1. Generate general ideas for conversation topics ahead of time. Anxious and uncomfortable situations can be prevented by coming up with some ideas for conversation topics in your free time. This will help you avoid the difficulty of generating ideas “on the spot”, where your anxiety is likely to affect you most and where initiation problems will be most difficult. You may want to develop a list of three or four general “go-to topics” that you might use when in virtually any conversation. If memory or initiation problems are interfering, it may be helpful to have a written card in your wallet or handbag that you can refer to just before meeting with others to help you recall these “go-to” ideas. What makes a conversation topic interesting? If the topic is about a generally popular subject, it invites more participation from others. A topic that involves interesting facts, current highly talked-about subjects, or popular personalities can get others interested in the conversation. Some ideas for conversation topics might include: • Current news events • Sports or sports events • Movies and actors/directors • Music events or artists • Books/authors • Travel or vacation plans 2. Use open-ended questions. One of the best ways to get a conversation going is to get the other person talking about something that they are interested in or enjoy. Ask open-ended questions (that is, ones that can’t be answered by a yes/no or one-word response) to try to find out more about the other person. Showing interest in others is a great way to make friends. After you ask the open-ended question, really listen to what the person is saying (rather than waiting for your opportunity to jump back in with your turn to talk). You may find that by careful listening to their response, you may discover several new topics of conversation that might be used to continue the conversation. 3. If possible, find out a little about the interests of the person/persons you will be meeting. If you know who will be present in a social situation, you might take the time to find out a little bit about the people that you will be meeting. For example, you might be able to find out what kind of work they do, what sports/hobbies they are involved in, and so forth. Then, you can generate a tailor-made list of topics that you can use as your “go-to topics” that will likely be of interest. You can also take some time to find out about the areas of interest, so that you are prepared for a conversation. For example, if you know that the person you are meeting is a movie buff, you can find out about what new movies are playing and how they are being reviewed. 4. Avoid topics that may be uncomfortable for others, especially if you do not know your conversational partner(s) well. Certain conversational topics can be considered too overly- personal or controversial, can may lead to discomfort and awkward social situations. Remember that one of your goals in talking with others is to improve your overall relationship with them. If people experience discomfort when talking with others, they tend to avoid this discomfort. The selection of conversation topics should help others to feel interested and to want to talk more with you. You may want to avoid some of the following topics, unless you are close with the individual(s) with whom you are talking. • Personal finances • Sexuality • Abortion or other highly controversial “hot-button” topics • “Creepy” subjects like serial killers and the like 5. Practice introductions and starting conversations with your family members or close others. Take time to practice introducing yourself to others and starting conversations with people that you know well. Practice using open-ended questions and using active listening to identify possible conversation topics that you could follow up with in conversation. The more practice you have in starting conversations in “safe” situations, such was with those you are already close to, the more comfortable you may feel when meeting new people or others who you do not know well. These tips may be a useful way to assist in increasing your comfort level and confidence when conversing with others. For additional ideas on conversation topics, consider searching on the internet, using the search term “conversational topics.” There are many websites and blogs that may help you in finding conversation topics of interest. Such assistance may be useful in helping you get around initiation or anxiety problems that affect your communication skills. ____________________________________________________________________________________ BIATX would like to thank the following sponsors for their support of our 2nd Annual Golf Tournament Presenting Sponsor Dinner Sponsor Baylor Institute for Rehabilitation Gift Sponsor ______________________________________ Economic toll of traumatic brain injury adds up to $6.8 billion a year in Texas Study commissioned by CORE Health Foundation tallies TBI costs related to deaths, ER visits, hospitalizations, disability AUSTIN, Texas—Each year in Texas, traumatic brain injury (TBI) causes an estimated $6.8 billion worth of economic trauma in terms of deaths, emergency room visits, hospitalizations and disability, according to a study commissioned by the CORE Health Foundation. To put that dollar amount in perspective, it equals Coca-Cola’s corporate profit for fiscal 2009. “While this estimate appears large, it is at the low end of the range of costs expected to occur from TBIs in Texas every year,” said Eric Makowski, a co-founder and trustee of the Austin-based CORE Health Foundation and immediate past president of the Brain Injury Association of Texas. The study urges more funding for TBI rehabilitation, research, prevention and education. “Money does not cure all problems, but when money is spent with a plan and a mission, the results can be significant,” said Dennis Borel, board member of the CORE Health Foundation and executive director of the Coalition of Texans with Disabilities. “A comprehensive effort to fund future rehabilitation, research, prevention and education programs can have lasting effects for TBI patients, families, medical care providers and society.” As the study notes, the percentage of injury-related productivity loss attributed to TBI (15.7 percent of all cases) is 14 times greater than that associated with spinal cord injuries. The nonprofit CORE Health Foundation, founded in 2006, advocates for people with disabilities through research, public works projects and public awareness initiatives. The foundation’s brain injury research is performed under the Resilient Mind brand. The CORE-financed study estimates that 4,100 TBI-related deaths will occur this year in Texas, with lost earnings from those deaths adding up to nearly $4 billion a year. The study also estimates that: • TBI produces 119,500 emergency room visits each year in Texas, resulting in an annual cost of $740 million. • Costs for extensive medical treatment connected with TBI-related deaths total $186 million a year in Texas. • TBI prompts 22,000 hospitalizations annually in Texas, leading to a yearly cost of $623 million. • Nearly half of the TBI-related hospitalizations in Texas result in long-term or lifelong disabilities, resulting in $1.3 billion worth of annual expenses. “As we close out the first decade of the 21st century, Texas has seen significant medical advances that can increase the rate of survival for a TBI. Unfortunately, the number of cases continues to increase, which puts added strain on the financial systems supporting these injuries,” said Jim Misko, Psy.D., co- founder of the CORE Health Foundation, chairman of the Academy of Certified Brain Injury Specialists and board member of the Brain Injury Association of America. A TBI is a blow or jolt to the head or a penetrating head injury. It disrupts the function of the brain and produces a diminished or altered state of consciousness, impairment of cognitive abilities or physical functioning, or both. The two leading causes of TBI are falls (35 percent) and traffic crashes (17 percent). Other causes include gunshot wounds, sports injuries, workplace injuries, shaken baby syndrome, child abuse, domestic violence and military action. The U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics estimates 1.7 million Americans sustain a TBI every year. The CORE-financed study, The Estimated Economic Cost of Traumatic Brain Injuries in the State of Texas, was conducted by Austin-based Actuarial Risk Management Ltd. using a variety of federal and state statistics. To read the entire study, visit www.corehealthfoundation.org/economic-impact-of-tbi. The study makes several recommendations aimed at reducing the incidence and costs of TBI in Texas and at improving TBI care: • Create a statewide TBI prevention awareness program. • Promote compliance with Brain Trauma Foundation treatment guidelines among providers of medical and rehabilitation services. • Boost state funding for the Texas Department of Assistive and Rehabilitative Services’ Comprehensive Rehabilitation Services program. The program “has a waiting list as a result of a limited budget,” according to the study. • Require that Texas join the Centers for Disease Control and Prevention’s CORE State Injury Program. The program conducts TBI surveillance in 30 states, but not in Texas. • Promote funding for research to improve TBI rehabilitation. The research should focus on such subjects as cardiovascular exercise, sleep and nutrition. Findings of the research would help insurers, the Texas Department of Assistive and Rehabilitative Services, accreditation boards and others know what to expect of TBI rehabilitation facilities. • Revise qualification criteria for Texas state services to take into account the characteristics and long-term needs of people with TBI. • Encourage funding for in-home interventions to educate caregivers about preventing TBI re- injury and long-term chronic complications. • Conduct annual meetings that provide medical professionals and others with the latest research and treatment options to enhance neuroplasticity—the brain’s ability to reorganize itself. “Examining TBI as a chronic illness that has lasting effects for multiple areas of the individual and their family’s lives is the best course of future action,” the study concludes. ### About the CORE Health Foundation The CORE Health Foundation was established in 2006 by leading experts in the fields of brain injury and recovery who came together through their work at CORE Health Care, a specialty residential treatment facility in Dripping Springs, Texas, for people with traumatic brain injuries, complex psychiatric disorders, autism and other special needs. For more information, visit www.corehealthfoundation.org. ____________________________________________________________________________________ Living with Brain Injury and Love TBI, Blended Families w/Adult Children, and Life Disclaimer: The following is actual events that are part of our lives. Thus, it is anonymous out of respect for our families. It is also not intended as advice; one must find what works for their own situation because even though results may be similar, every person/family is unique. This is my perspective on the results of following my heart. A man and a woman, in their late 50’s crossed paths on their journey in life. Both had marriages that were void of affection and carried a hole in their souls that only another could fill. We had known one another for a few weeks when we both learned that we were both TBI survivors. How ironic! And, we both even did our very own rehabilitation, not of choice, and not always a conscious effort, but of no other option available to us at the time. I acquired my BI about 5 years ago living in Alaska, slipping and falling on black ice, with no loss of consciousness. He on the other hand, was involved in a motorcycle accident in the late 60’s and was in a coma for several days. The hospital records do not even mention this. The sad thing about his is that he doesn’t remember much of anything, so it is not easy for him to understand the ramifications of a TBI, but he is learning. Neither of us “physically appear” to have sustained a TBI. Believe me though, the damage is present within. I am in no way making light of or lessening the difficulties those that are physically apparent experience. My heart goes out to those. An awareness of those of us who live with this traumatic occurrence on a daily basis is badly needed. Listen To Your Heart……and….follow… such a simple statement, one that after I no longer walk this earth, hopefully will echo in my children’s minds that I have taught them… It was a beautiful day when these two met. Unbeknownst to them both at the time, they were headed down a path that would fill that emptiness in their souls with a love that they both had only dreamed of. Not long after divorces were manifested in reality, the last step that would end the marriages that were going nowhere but down, they knew they were destined to be together. Suspended in time, they rode the waves of intenseness with a smile and joyful hearts, looking forward to their future together. Finally, they each had found that special someone that mirrored each other. They had found unconditional love! Dad, Mom, Grandmother, Grandfather, they had paid their dues raising children, 3 each and was enjoying the grandchildren, watching them grow and learn. What a happy time it was! And the icing on the cake was going to be having a true “family” with genuine love in the home finally. As the time came nearer to tell the children about this great love we had found, we were so excited and just knew that our children would be ecstatically happy for us both to have finally found someone that would fill the emptiness inside of us that had been missing for so many years. Surely if nothing more than just out of respect for us as their parents, they would be happy for us. Especially knowing that we had found someone to grow old with that would care for us in our times of needs. They all had their own families and lives to live. We had surely taught them to be independent and they would respect our independence. Well, to our surprise, it did not turn out this way. We were quiet shocked to learn that only 2 out of the 6 would welcome our new found love in the fall of our lives. Two of his children refused to meet me or tell the grandchildren about our new life until the divorce was finalized. They were not surprised at the divorce and knew it was inevitable along with knowing that the marriage was over with a long long time ago. They admittedly did not want to share their dad. They were met with their dad’s decision to not give in to this for almost a year. With a new grandbaby born on both sides, this changed things a bit. Two of mine refused to accept a new man in my life, even knowing how very unhappy I had been. One even went so far as to not allow us to be affectionate to one another in his presence. We tried so very hard to understand these adult children, in their 30’s who were frankly acting childish, selfish, and immature. Tough love was not budging them one bit. We both love our children so very much but were determined that they were not going to tell us how to live our lives. We both know that life is short and I knew that if something dreadful were to happen to either of us, none of them would ever forgive themselves for the way they were acting. You see, we both had lost our dad’s at a very young age and we know what it is like to be without him. No parent should ever be taken for granted because you never know when their number is up, or anyone for that matter. The divorce on his side was very ugly and the things that this person put him through, well, I am just glad my mother never did anything like that to my dad. It is coming upon the holidays now and we are working on our first year together. I have really tried not to take it personal, the way the children have behaved, but it is hard not to. I am human after all. But I do realize that no matter who the man or woman would be, they all would react the same way. It should not come as a surprise to me because we have friends that are going through the same thing and their adult children are acting out the same way. I begin to research this matter and found that it is a very common thing among adult children who are grown when their parents get a divorce. So, we decided that we might need to rethink our situation. Yes, we are very much in love and yes, we will marry, but we need to do something different with our children. Even though they may be grown, we are still mom and dad, grandmother and grandfather. So, we are working on having a different view, but with boundaries and better communication. They need to know that our decision to change our course where they are concerned is not a “give in” due to their behavior, but due to the fact that they are our children and we love them. We are not at “war” with them and time will show them that “actions really do speak louder than words”. Sometimes a parent does not realize exactly what we do teach our children. Through ongoing counseling, we are learning that most things are ingrained in our personalities at a very young age. So, not only is one dealing with life changes a divorce brings about, but also changes that need to take place within in order to be a better “you”. Why? Why are they reacting the way they are when you have tried to teach them all about respect? You think that regardless of your choices, your children will accept your life when you are happy & healthy just out of plain respect for you as a parent. That did not happen in either case even though they say they understand. What is the bottom line then? In my opinion, it is all about trust. At some point in time in their lives, they learned to not trust you as a parent. For me, I can look back and see where I made mistakes along the way. I can understand why mine would not totally trust me. Even though it hurts my heart, there is nothing I can do to change the past. I have explained my life away and apologized, it is up to them to forgive me and if they do not, well, unforgiveness can eat you alive. I can’t speak for his family, but it would seem that somewhere along the way, a matter of trust was broken. In order for healing to take place in their lives, it will have to be dealt with. There are so many issues in a person’s life that must be resolved in order to live a happy life. A lot of things are very personal and serves no purpose in being shared with your children, as I am sure the same applies in their lives. Not that we should hide things; it is just that we all have a private part of our self that nurtures our self esteem, sense of self, and our own identity. Hiding things from one another in a relationship is toxic to that relationship. This includes relationships with your children. There must be a balance. Not that you involve your children in all the details of your marriage or divorce, that would be including them in the intimate area of your life, which is more than likely not discussed out of respect for one another. What should not be hidden from your children are basic lessons in life. Were you hiding the fact that you were totally miserable living a life with someone you knew you did not love? Were you hiding the fact that you did not want to be where you were? Did you make decisions that led to actions that made your life look like it was where you wanted it to be/go? They were always watching us. What were our actions telling them? If our children trusted us, we would not have to explain our lives away in order to help them understand. What should be addressed is the trust issue with them. What happened in their lives to facilitate them not trusting us? Knowledge breeds understanding. Ironically, both of us are brain injury survivors. His was over 30 yrs ago and mine being about 5 yrs ago. I don’t even know if his children are aware of this fact. Mine are aware, but like most of society, when there is no physical evidence of a brain injury, there is very little understanding of how it affects one’s life. Even in the person it happened to, there can sometimes be no recognition of how it has affected them. A blended family with adult children is a challenge in itself. Add that to the challenge of being a TBI survivor and you have plenty on your plate. We will not put our lives on hold in either case as we see it all as a blessing, a chance to grow and learn, and a chance to continue to make a firm foundation for our relationship as we grow old together. All that happened in our lives brought us to this place we are today, together. It is our hope that we can give hope to others who find themselves with these challenges in their lives as TBI survivors. ____________________________________________________________________________________ BIATX is issuing a Call for Papers for our 27th Annual Statewide Conference “Coming Together” April 14-17, 2011 at the Marriott Austin South All submissions are due by January 15, 2011 Click here for submission form Registration and sponsorship information will be posted at www.biatx.org by December 1, 2010 Have You Been Denied Insurance Coverage for Brain Injury Rehabilitation? We Want to Hear Your Story The Brain Injury Association of Texas is seeking out individuals with brain injury who have been denied cognitive rehabilitation benefits through their insurer on health benefit plans issued or renewed on or after January 1, 2008. In some cases this may be a violation of HB 1919 which was passed in the last Texas legislative session. The Association is encouraging members and their families to file a complaint with the Texas Department of Insurance (TDI) directly. TDI's website links for filing complaints: 1. Go to http://www.tdi.state.tx.us/ 2. Click on “Online Services” 3. Click on “Online Services-Complaints” 4. Follow Instructions General Information on Complaints: http://www.tdi.state.tx.us/pubs/consumer/cb003.html The Brain Injury Association of Texas is grateful for all the support it receives and for the contributions provided for inclusion in this newsletter. But it should be understood that BIATX does not endorse any entities mentioned herein and has undertaken no efforts in assessing any representations or claims.