TBI - Traumatic Brain Injury > Brain Injury Rehabilitation

There are different types of hospitals, rehabilitation programs and health care professionals that one should become familiar with during the brain injury recovery process.

The rehabilitation process is different for everyone who sustains a brain injury. How well a person does following a brain injury depends on the individual's health prior to the injury, the nature of the injury and the post-injury course of recovery. Rehabilitation programs following a brain injury should cater to each person's needs.

A comprehensive Traumatic Brain Injury rehabilitation consists of at least the following elements:

• The rehabilitation physician (physiatrist) and the rehabilitation nurse have special training in diagnosing and treating people with disabilities. Their goal is to help patients who have suffered a brain injury, regain the most independent level of functioning possible.
• The prevention of secondary injuries is important. Rehabilitation facilities and the rehabilitation process are in place to prevent these secondary injuries from occurring.
• Rehabilitation builds upon natural recovery processes this allows the body to regain strength and re-learn natural functions, which aid in a quick recovery.

An optimal environment for neurological recovery is also provided by rehabilitation settings.

• Various techniques are provided and taught to promote recovery and help with the tasks of daily living.
• Adaptive and specialized equipment, such as wheelchairs or others are available in this setting.
• Environmental modifications are available. These include architectural and transportation interventions. Even more important may be interventions in the patient's social milieu, which include modifications at home, at work and in the community.

Report of the Panel for Consensus Development Conference on the Rehabilitation of Persons with TBI, October 26-28, 1998. Cope, Nathan, "The Effectiveness of Traumatic Brain Injury Rehabilitation, a Review of Brain Injury," Volume 9, No. 7 1995, pages 649-670.

Emergency Rescue

• Most of the time, an emergency team will be the first to attend to the person with a brain injury. They are the first to arrive and the brain injury care begins at the site of the emergency.

Intensive Care Unit (ICU)

• After the brain injured person arrives at the hospital, he/she may be admitted to the intensive care unit. Sometimes the injured person may be unconscious, in a coma or medically unstable at arrival.
• During this phase, the goal is for the injured person to achieve medical stability and to prevent a medical catastrophe.
• For this reason, the medical professionals may need to attach medical equipment to the patient in order to help sustain his/her life.

Acute Rehabilitation

• The next step in the continuum of care is acute rehabilitation.
• The transfer to an acute rehabilitation facility or unit within the hospital occurs when the brain injured patient is medically stable and has reached a point where he/she is able to participate in therapy.
• Here, a team of health professionals assists persons with brain injury to achieve the highest level of independent skills used in activities of daily living.

Rehab Team Members

• Physiatrist
  Doctor of physical medicine rehabilitation. The physiatrist typically serves as the leader for the rehabilitation treatment team and makes referrals to the various therapies and medical specialists as needed. The physiatrist works with the rehabilitation team, patient and the family to develop the best possible treatment plan.
• Physical Therapists
  Therapists who evaluate and treat a person's ability to move the body. They focus on improving physical function by addressing muscle strength, flexibility, endurance, balance, and coordination. Physical therapists provide training with assistive devices such as canes or walkers for ambulation. Physical therapists can also use physical modalities, including treatments of heat, cold and water to assist with pain relief and muscle movement.
• Occupational Therapists
  Therapists who use purposeful activities as a means of preventing, reducing or overcoming physical and emotional challenges with the purpose of aiding the person with a brain injury to function independently.
• Speech/Language Pathologists
  Therapists who evaluate a person's ability to express oneself (speech, written or otherwise) and comprehend what is seen or heard. They use assistive technology as an alternative form of communication if the person is unable to verbalize. The speech/language pathologist focuses on the muscles in the face, mouth and throat and addresses swallowing issues.
• Rehabilitation Nurses
  Nurses who monitor all body systems by maintaining the person's medical status and set goals to allow the person to reach his/her maximum medical improvement. They are responsible for the assessment of the patient's care and for coordinating with physicians and team members to allow patients to become as independent as possible.
• Case Managers/Social Workers
  Responsible for assuring appropriate and cost-effective treatment and the facilitation of discharge planning. They maintain regular contact with the patient's insurance carrier, family and referring physician to assure that treatment goals are understood and achieved.
• Recreational Therapists
  Therapists who provide activities to improve and enhance self-esteem, social skills, motor skills, coordination, endurance, cognitive skills, and leisure skills. They plan community activities that allow the person to directly apply learned skills in the community.
• Neuropsychologists
  Physiologists who focus on aiding the brain injured person to think, behave and to control his/her emotions. They provide services to reduce the impact of setbacks and to help the person return to a full, productive life. The neuropsychologist's evaluations provide valuable information to assist with school, community or employment re-entry.
• Aquatic Therapists
  Occupational therapists, physical therapists or recreational therapists with specialized training to provide therapy in a heated water pool. Aquatic therapists assist a person to increase strength, coordination, endurance, muscle movements, and reduce pain, using water resistance. The ultimate goal is to increase the person's functional ability for activities of daily living.

Sub-acute Rehabilitation

• Sub-acute rehabilitation provides services for persons with brain injury who need a less- intensive level of rehabilitation services, over a longer period of time.
• These programs may also be designed for persons who have made progress in the acute rehabilitation setting and are still progressing, but are not making rapid functional gains.
• Sub-acute rehabilitation may be provided in a variety of settings but is often in a skilled nursing facility or nursing home.

Day Treatment (Day Rehab or Day Hospital)

• Day treatment provides rehabilitation in a structured group setting during the day and allows the brain injured patient to return home at night.

Outpatient Therapy

• Outpatient therapy is offered for those who do not need to be hospitalized, but require therapy to meet certain goals.

Home Health Services

• Some hospitals and rehabilitation companies provide rehabilitation therapies within the home for persons with brain injury who are unable or find it difficult to reach a facility.

Community Re-entry

• Community re-entry programs generally focus on developing higher level motor, social and cognitive skills in order to prepare the person with a brain injury to return to independent living, and potentially, to work.
• Treatment may focus on safety in the community, interacting with others, initiation, and goal setting and money management skills.
• Vocational evaluation and training may also be a component of this type of program.

Independent Living Programs

• Independent living programs provide housing for persons with brain injury, with the goal of getting the patient to regain the ability to live as independently as possible.
• Some facilities will give the patient different levels of independence according to his or her needs.

Brain Injury Support Groups

• Brain injury support groups exist to help individuals with brain injury and their family members to understand the effects of brain injury and to help cope with issues related to the injury.
• These groups also provide emotional support, networking opportunity and education for a better understanding of the impact and effects of brain injury.

If you or a loved one is suffering from a Traumatic Brain Injury, please contact the South Florida TBI Attorneys at Wolf & Pravato, P.A. for a free, no-obligation, and confidential consultation. Justice is not automatic and we are prepared to fight for you.