TBI Treatment and Rehabilitation

No two brains are exactly alike, therefore, no two brain injuries are exactly alike. Each TBI is as unique and complex as the life it affects. That is why the rehabilitation process is, and should be, different and specialized for each person. A TBI has the power to affect nearly everything associated with a survivor including his or her family, friendships, career, and community. After surviving a TBI, a person is very vulnerable. It is very important that the person with the brain injury and his or her family become very involved in the rehabilitation process.

Even after severe injury, there is hope, in many cases, that the brain has the uncanny ability to heal itself and to change, rearrange itself, and, at times, re-learn how to function. Rehabilitation is vital in order to recover the most independent level of functioning after a TBI. Often, damage suffered by the brain during a TBI is irreversible. During rehabilitation however, many can learn new ways to compensate for lost abilities and functions.

Treatment

Since a TBI is an emergency, treatment begins at the time of the incident. If a person suffers a moderate to severe TBI, chances are they will be taken to a hospital’s Intensive Care Unit, where their injury will be stabilized and managed. Once the injury has been stabilized, the survivor and his or her family is faced with selecting the best setting for rehabilitation. Depending on the type and level of the TBI, there are several options for rehabilitation, including:

• inpatient rehabilitation centers: In this rehabilitation setting, a multidisciplinary team approach is favored. A team of health professionals including neuropsychologists, physiatrists, physical and occupational therapists and speech pathologists work with the injured person and their family achieve the highest level of independent life skills used in activities of daily living.
• hospital outpatient rehabilitation: Continued outpatient therapies that often follow acute or sub-acute rehabilitation. People with less severe brain injuries may attend outpatient therapies to address functional impairments.
• comprehensive day programs at rehabilitation centers: Returning home at night, patients at a day treatment program receive rehabilitation in a structured group setting.
• home-based rehabilitation services: Some hospitals and rehabilitation companies provide rehabilitation therapies within the home for persons with a brain injury.
• supportive living programs: To improve independence in the home, supportive living programs offer a variety of approaches that provide support and training in an individual’s place of residence.

It is vital that a TBI survivor receives an individualized rehabilitation program focused on the person’s individual strengths and capabilities. Along with a team of specialized health professionals, a TBI survivor and his or her family can work together to achieve the highest level of independent living at home and in society.

It is also very important that rehabilitation change over time to adapt to the survivor’s changing needs and continuing healing. This is often a long process. Retraining the brain and body to function and perform even the most mundane tasks can take years. Recovery of a brain injury takes time, patience and perseverance.

The Multidisciplinary Team

Most rehabilitation centers have begun to favor a multidisciplinary team approach to brain injury rehabilitation. This includes specialists from physiatry, psychiatry, neurology, psychology, neuropsychology, occupational therapy, physical therapy, speech therapy, and cognitive therapy.

Physiatrist: Physicians who specialize in physical medicine and rehabilitation are called physiatrists. Physiatrists are generally the primary treating physicians for head-injured patients and direct the comprehensive rehabilitation team of professionals .

Neurologist: Neurologists specialize in illnesses that affect the brain, spinal cord, peripheral nerves, and muscles, including posttraumatic seizures, pain and headaches, cognitive disorders, personality changes, and disturbances of motor function.

Psychiatrist: Psychiatrists are medical doctors who diagnose and prescribe medications and psychotherapy for posttraumatic head-injured patients suffering emotional problems like depression, anger, mood fluctuations, and mania.

Psychologist: Psychologists are not medical doctors. They confine their treatment of posttraumatic emotional problems to psychotherapy (“talk therapy”). While they may advise the use of specific medications, they cannot prescribe them.

Neuropsychologist: A neuropsychologist is a psychologist with additional specialized training in psychological testing. Most have a PhD in psychology with additional years of post-doctoral training in clinical neuropsychology. Their graduate education emphasizes brain anatomy, brain function, and brain injury or disease and their testing helps diagnose and assess patients with a variety of medical conditions that impact intellectual, cognitive, or behavioral functioning. They can administer and interpret certain types of standardized tests that can detect effects of brain dysfunction.

Cognitive Therapist: Cognitive therapists help brain-injured patients develop new strategies for remembering and exercising higher intellectual tasks.

Occupational Therapist: Occupational therapists help patients recover fine dexterity when manipulative skills have diminished, such as figuring out how to button clothes, use utensils, and count currency.

Physical Therapist: Physical therapists work with patients to improve motor skills like walking, climbing stairs, reaching, and lifting.

Speech Therapist: Speech therapy following a brain injury usually addresses a variety of issues including speech quality, and understanding and expressing the spoken and written word.

Life Care Planner: Life care planners are professionals who work with the health care team to provide a life care plan. A life care plan is a dynamic document based upon published standards of practice, comprehensive assessment, data analysis and research, which provides an organized, concise plan for current and future needs, with associated costs, for individuals who have experienced catastrophic injury or have chronic care needs.

Coping

When someone survives a traumatic brain injury, there may be changes that impact an individual’s life as well as their family, friends and community. These changes include physical (muscle coordination problems, full or partial paralysis, changes in senses), cognitive (memory problems, difficulty communicating, poor judgment) and behavioral changes (depression, irritability, difficulty with social skills). Coping with these changes requires patience and time.

Just as a person who is injured is changed, all others who care about the injured individual are impacted in a variety of ways. In order to cope with these inevitable changes, everyone affected by the injury must get through it in an emotionally and physically healthy manner.

Brain injury is a major public health problem worldwide, so you know you are not alone when it comes to coping with this type of injury. There are a great amount of resources available to the TBI survivor and their loved ones. It is incredibly important to become informed about the particular TBI and also as important to educate others about it.
Brain Injury Association: The Unvarnished Truth - There Is No Cure For Brain Injury

TBI Treatment and Rehabilitation Costs

Below are a few resources for the care and management of TBI:

Brain Injury Association of America
BIAA is the leading national organization serving and representing individuals, families and professionals who are touched by a life-altering, often devastating, traumatic brain injury (TBI). Together with its network of more than 40 chartered state affiliates, as well as hundreds of local chapters and support groups across the country, the BIAA provides information, education and support to assist the 3.17 million Americans currently living with traumatic brain injuries.

Brain Injury Association of America Treatment and Rehab
The goal of rehabilitation is to help people regain the most independent level of functioning possible. This website describes the different types of hospital and rehabilitation programs; healthcare professionals; and tests and scales used in the recovery process for brain injury.

National Association of State Head Injury Administrators
NASHIA is the only forum addressing state government’s significant role in brain injury. NASHIA is the premier source of information and education for State Agency employees who are responsible for public brain injury policies, programs, and services.

North American Brain Injury Society
NABIS is a society comprised of professional members involved in the care or issues surrounding brain injury. The principal mission of NABIS is moving brain injury science into practice. Whether it is in the area of clinical care, research, policy or litigation, the organization stands behind the premise that advances in science and practices based on application of the scientific evidence will ultimately provide the best outcomes for those with brain injuries and the community as a whole.

Brain Injury Recovery Kit
Praised by leading brain injury experts as an innovative system for guiding individuals through the day-to-day challenges faced after brain injury, while providing information and support to family and friends. The Brain Injury Recovery Kit is a step-by-step approach to recovery that can be tailored to each individual’s needs and can be used at an individual’s own pace.

BrainInjurySuccess.org
Successfully Surviving a Brain Injury: A Family Guidebook, From the Emergency Room to Selecting a Rehabilitation Facility. This is an easy-to-read guidebook, which is intended for families in the first days, weeks, and months after a brain injury. The book covers the wide range of medical, financial, legal, insurance, family, and personal issues caregivers encounter following a brain injury.

The Centers for Disease Control’s National Center for Injury Prevention and Control TBI information
The CDC’s research and programs work to prevent TBI and help people better recognize, respond, and recover if a TBI occurs. They cover Traumatic Brain Injury Topics, Concussion and Mild TBI, Concussion in Sports, Clinical Diagnosis and Management, and Statistics.

Additional Links:
http://www.tbindsc.org/
http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm#132053218
http://mayoclinic.com
www.cdc.gov