What Is Traumatic Brain Injury And How Is It Treat

Rehabilitation Of The Brain Injured

Having spent 13 years working in Rehabilitation units has given me many experiences, as well as the opportunity to gain a great deal of knowledge and skills not only about the physical components of trauma but the hospitalization process.  The process from injury to discharge is long and difficult, not only for the patient but for the family and friends as well.  The course of treatment for a patient with a traumatic brain injury may be more dependant more on the cognitive and behavioral aspects than the physical

After receiving care in the Emergency Unit and an Intensive Care Unit, the patient is then usually transferred to a subacute unit or directly to the Rehabilitation Unit, depending on the level the patient is able to participate in therapy.  Prior to transferred, the patient is evaluated as to the tolerance, understanding and physical endurance as reimbursing regulations require the ability to tolerate 3 hours of therapy daily .  A patient admitted to Rehab is evaluated by physical therapy, occupational therapy, speech therapy, nursing, psychiatry and psychology, social services and at least the physiatrist (Rehab physician), if not other specialty physicians.  The goal of the entire Rehab team is to assist the patient achieve his maximum level of independence. Guidelines for staff behavior, as well as the patient's, are determined, and a plan of care developed for Rehab staff and the involvement of family and friends to ensure consistent treatment and interactions.  Many times, that consistent behavior is one of the first learnings the TBI patient encounters.

Physical skills such as those to complete activities of daily living are taught by occupational therapy and reinforced by a medical staff; physical therapy teaches the patient skills such as walking, transferring from bed to wheelchair or to a standing position. Speech therapy evaluates for any swallowing difficulties as well as speech needs.  Family is requested to perform one of the most difficult tasks - to allow the patient do for themselves, and not to "help" their family member wheel themselves to the room, or cut their meat, or get back into bed.   That kind of help doesn't help the patient in the long run, only delays the attainment of the maximum level of independence.  Social Services works with the family and staff in determining the discharge needs, whether for home equipment or modification, care givers, or transfer to an assisted living environment or group home.  Vocational counseling and/or rehabilitation may be required. 

Medication may be required to promote physical and or psychological progress or maintenance.

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