Since a brain injury is an emergency, TBI 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.
- 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.