Derick Wade

A new page on service design for patients with a prolonged disorder of consciousness, with a suggested key first step to achieving an comprehensive service. https://t.co/1OH3Fro0p3 I am now mainly posting on Bluessky with the same name

A further reminder; most of my posts are now on Bluesky; same name (@derickwaderehab)

I have seen 1500 or more people with prolonged disorders of consciousness (PDOC) since 1980; what have I learned?! That we have overlooked intrinsic variability within and between patients. We must improve our understanding of PDOC. https://t.co/mdoYlgKgr4

A reminder: I am now mainly posting on BlueSky - same name. My latest blog post is here: https://t.co/QDlBAefnSE I review how to improve services for people with a prolonged disorder of consciousness

Being an expert in prolonged disorders of consciousness leads to appearing in Court. I have written a blog post discussing the challenges. One must acknowledge uncertainty. Comments are welcome, as I will talk about it in 5 weeks. https://t.co/9CRiUtcuHn

I now post on Bluesky using the same handle @derickwaderehab

My latest blog post considers whether acquired brain injury is a helpful category in rehabilitation (or anywhere else); the answer is no. https://t.co/7YmZ4dkl3H

I am movingto BlueSky and will soon stop tweets here; in the interval I may tweet the same post in both. My bluesky handle is the same (@derickwaderehab) so it is easy

How to ... provide a second opinion on someone's best interests on continuing medical treatment (e.g. gastrostomy) when they have a prolonged disorder of consciousness. My recent article emphasises that the report is educational and written for the family. https://t.co/gSXKZEq9uw

Recovery, recuperation, and rehabilitation sound like three separate concepts. In a post, I show that their common feature is the adaptive response to illness. I suggest that recovery refers to a state & needs to be replaced by a process. https://t.co/LeJOsbx85B

Over the last seven weeks I have added four posts to my website. You can read a brief introduction to recent changes and additions here: https://t.co/IgKLJTD9im

I have posted a reflection on how I approach challenging cases when asked to give a second opinion. The basic message is to think and look more broadly; the team and patient become stuck on a minor issue (in the context of the patient's life). https://t.co/PWsQ9aa8lA

Hope is the key to person-centred rehabilitation, is my latest blog post. Having an early discussion on 'What do you hope to be like in a year?' may elucidate goals, beliefs, and treatment expectations. I have made some practical suggestions. https://t.co/fkmAbPYgbs

Multi-item rehabilitation assessment questionnaires are ubiquitous, increasing patient burden and reducing treatment time. A simple question is considered OK (for fear after head injury). Diagnosis is a process, not the result of a questionnaire. https://t.co/lnC7wXaJFD

Virtual reality in rehabilitation is increasingly popular, researched, & reviewed. But what is it, & are systematic reviews potentially flawed because the treatments vary so much? I conclude that computer-assisted treatment would be a better term. https://t.co/EFCA4nYw7y

Pain in people who are unconscious is a contentious matter (see Court of Appeal https://t.co/gaMfy5sriE). Pain appreciation is personal, and therefore one should measure pain experienced with a known pain-inducing stimulus, usually muscle stretching. https://t.co/rjgvAyS0PX

Case management has long been advocated for people with acquired brain injury despite two small RCTs failing to support it. A third large good study (n=219) has failed to find any detectable benefit. We must reconsider how we improve outcomes. https://t.co/xvtYR9gR3A