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Our Mission at Plus One:
According to the World Health Organization (WHO), neurological disorders, ranging from epilepsy to Alzheimer’s disease, Traumatic Brain Injury to Multiple Sclerosis, affect up to one billion people worldwide. They affect people in all countries, irrespective of age, sex, education or income. More than 500 different conditions are considered neurological disorders. We have a lot of work to do.
The Plus One Foundation assists children and adults with a neurological injury, disorder, or disease to achieve goals, expand opportunities and ‘feed the soul’ through activities that offer education, rehabilitation and training. Plus One Foundation is also dedicated to assisting people that have had COVID-19.
We fund classes, workshops and life experiences that are proven to assist individuals on their path of rehabilitation and recovery, but are rarely covered by insurance, such as; art and music therapy, therapeutic horseback riding, integrated movement therapy, martial arts, meditation, yoga, and aquatic therapies.
New Article
Thomas Lehrich discusses New TBI Assessment Protocols
A Paradigm Shift in Brain Injury Care
By Thomas Lehrich, President of the Board, Plus One Foundation
Traumatic Brain Injury (TBI) remains one of the most challenging and medical conditions treated in trauma centers today.
Recognizing the complexity and long-term impact of TBIs, trauma centers across the nation are implementing a new, comprehensive approach to assessing TBIs. It is a framework that moves beyond traditional measurement tools to capture a fuller picture of brain injury and optimize outcomes.
Change
For more than five decades, the Glasgow Coma Scale (GCS) has been the cornerstone of TBI assessment in emergency and trauma settings. While revolutionary in its time, the GCS categorizes injury based on eye, verbal, and motor responses.
Recognizing GCS had limitations a coalition of experts, clinicians, and researchers collaborated with the National Institutes of Health (NIH) to design a more holistic model known as CBI-M.
This framework reflects the latest brain injury science and expands traditional assessment practices by incorporating four pillars:
Clinical: Retains the core strengths of the Glasgow Coma Scale while broadening symptom evaluation to include amnesia, dizziness, headache severity, and other indicators of neurological dysfunction.
Biomarkers: Utilizes objective blood-based markers of brain injury to complement clinical findings, helping detect subtle structural damage that might be missed in early assessment.
Imaging: Advances in CT, MRI, and potentially future imaging modalities provide detailed views of brain structures, identifying contusions, microbleeds, and diffuse injury patterns that influence management decisions.
Modifiers: Considers patient-specific factors — including age, pre-existing conditions, mechanism of injury, and other contextual elements — that affect both immediate presentation and long-term recovery.
By uniting these pillars, the CBI-M framework offers clinicians a multidimensional profile of injury severity, enabling more precise triage and tailored care.
What This Means for Trauma Centers
The adoption of these expanded TBI assessment protocols represents a significant evolution in trauma care. Instead of relying solely on consciousness level at presentation, providers now have tools to:
Stratify patients more accurately, reducing under-triage and ensuring that subtle but serious injuries are not overlooked.
Tailor early interventions, including decisions about neurosurgical consultation, monitoring intensity, and rehabilitation planning.
Improve communication among multidisciplinary trauma teams by standardizing how injury severity is defined and shared.
While ongoing research continues to refine the role of biomarkers and advanced imaging in acute care, early adoption of the CBI-M framework across pilot trauma centers highlights a growing consensus:
Education and the Think aBout It Program
Alongside clinical innovation, education remains central to improving outcomes for individuals affected by TBI. The Think aBout It educational program, developed by the Plus One Foundation, seeks to bridge gaps in public understanding and clinical knowledge by highlighting emerging research and practical insights into neurological health — including expanded TBI assessment protocols.
Looking Ahead
As trauma centers continue to evaluate and refine these updated protocols, the healthcare community moves closer to a future where TBI assessment is less about assigning a category and more about understanding a patient’s unique neurobiological profile. This evolution promises not only improved acute care, but also more effective long-term strategies for rehabilitation, recovery, and quality of life following brain injury.
Thomas Lehrich
Plus One provides grants to children and adults with neurological diseases and disorders.
Image Description: A family with two parents hugging their three children. They are posing in a tulip farm. Parent Cara has sunglasses resting in their head. In their left arm, they’re holding a baby that’s looking at a distant and that is wearing a pink baby onesie. In parent Cara's right arm there is a child with red rain boots, green cargo pants, and blue sweater. Parent Matt is wearing a brown mariners cap. They are hugging a child with a black and gray stripped beanie. The child has a gray long sleeved shirt, metallic pink puffer vest, has black and white stripped leggings, and pink rain boots.
Usually this means individuals, but sometimes our grants can help whole families. Summer's a time when kids are out of school and at home with their family, and we wanted to highlight a family that you've helped with your donations.
Cara and Matt both are parents to three young children. They also live with MS. We were able to provide a grant to get Cara and Matt a membership to the YMCA. With this membership, not only can Cara and Matt focus on their own health and wellness, they can also set a great example for their children.
Please consider making a donation today so we can help more individuals and families like Cara and Matt.
our mermaid pool pass
Co-founder Kacey Jeniene Kroeger had the privilege of swimming at the Seattle Public Swimming Pools with Mary McKillop for many years. Those who knew Mary saw her constant smile, giving ways, and positive spirit. She thoroughly loved swimming and strongly believed in its healing effects on the mind and body. Mary exuded unconditional support and generosity to those around her. Unfortunately, in late 2010, just as Kacey was going to tell her we were launching Plus One Foundation, Mary suddenly became ill and passed away.
With the support of Mary's family and our generous donors, Plus One Foundation created the Mary 'Mermaid' McKillop Fund. 100% of the donations to this fund are used to buy three-month, all-access swimming pool passes to the Seattle Public Swimming Pools for people with neurological disorders. Many people rely on access to the pool for their rehabilitation and recovery process. Aquatic therapy of all levels has been proven to assist individuals to continue to walk, function in life and society, and maintain their independence.
Mary always said, "Whenever you can, do something kind for someone else!" This fund continues to honor her way of life.
