Rehabilitation for individuals who have suffered from a traumatic brain injury is often undertaken by a team of experts who include physiatrist, physical therapy, occupational therapy, speech pathology, dietary, social work and case management. The number of professionals required to adequately address the needs of individuals who have suffered from a traumatic brain injury is large because of the comprehensive treatment required in order to help the individual become as independent as possible once again.
The quality of life that follows rehabilitation for traumatic brain injury often depends upon making the right decisions about neurological, cognitive and physical rehabilitation. But of those three, neurological rehabilitation is the factor which drives the quality of recovery. Reaching the best possible outcomes for an individual requires a comprehensive plan of action. Just as no two people are like, also no two brain injuries are the same. It is important to recognize that more therapy does not necessarily mean better therapy.
And, while a significant amount of appropriate therapy will help an individual to regain lost skills, the likelihood is that they will never be the same person they were before a moderate or severe traumatic brain injury. This is a hard truth that challenges the best rehabilitation specialists and most intact families.
Brain injury rehabilitation should be designed to take into account the range of strengths and weaknesses which an individual possesses currently and which they possessed prior to the injury. Basic skills should be strengthened before more complex skills are added to the rehabilitation process. Often times a neuropsychological evaluation will help the rehabilitation specialists to sort out the effects the trauma has had on the brain and the direction in which rehabilitation should be taken.
On a broader scale, brain recovery usually follows a pattern of brain development that occurred as a child. For instance, gross large-scale systems will develop first, or be re-trained first, before fine motor skills. This also means that the individual must learn attention, focus and perceptual skills before they are able to achieve more complex intellectual activity.
Rehabilitation specialists will often find individuals suffer from cognitive and communication problems, cognitive functioning deficits, executive functioning deficits (ability for self-care), and physical problems that were controlled by the focal area in the brain that was damaged. All of these issues must be fully evaluated and determined before an individualized rehabilitation plan of action can be recommended and initiated.
The effects of the damage to the brain are usually greatest immediately following the injury. However, areas of the brain that may initially swell following the trauma may not retain permanent damage. Therefore, it is difficult to predict the expense of long-term problems in the first weeks following a brain injury. And it is for this reason that individuals appear to make the quickest progress in those first couple weeks.
The good news is that there is no limit to the extent of rehabilitation but, the bad news is that success of rehabilitation is dependent solely on the individual and their family when they are afforded an experience rehab team. Rehabilitation following a traumatic brain injury is hard work and the rewards are slow and difficult.
During rehabilitation medical status should also be monitored. This isn\’t just for rehabilitation but also to detect new neurological problems that may have developed as a result of the damage to the brain. These new neurological deficits can include seizure disorders, visual disturbances, balance problems or a host of other conditions which will significantly limit the potential of rehabilitation unless they are addressed themselves.
During rehabilitation of an individual with a traumatic brain injury it is important to first regain control of behavior before cognitive and physical rehabilitation begins. If behavior is completely out of control it is unreasonable to expect that the individual will be able to integrate new learning. Unfortunately, inappropriate behavior can also preclude admission into a rehabilitation program.
As part of the rehabilitation process both in an inpatient setting and at home, head injured individuals require a tight structure in their daily lives. Most of us do lead highly structured lives where we awaken at the same time and follow a particular pattern. This kind of structure allows our minds to reserve energy for creativity, and memory. Too many times individuals who have been had injured have no specific structure in their daily lives once they have been discharged from the hospital. Tightening up their daily structure will reduce the need to continually make decisions and will increase their capability while reducing the demands placed upon their caregiver.
Each part of the puzzle of the rehabilitation process for an individual with a traumatic brain injury inter-relates to another piece. The brain itself is a complex organ designed to monitor a bodily systems, initiate muscle activity and perform complex cognitive functions. When rehabilitation is approached from a simplistic standpoint to a complex organ the results themselves will be simplistic. For this reason it is important for individuals who suffer from a traumatic brain injury to be treated by professionals who are familiar with the process with the necessary factors integrated into a comprehensive plan.
RESOURCES
National Institute of Neurological Disorders and Stroke: Traumatic Brain Injury
Brain Injury Resource Center: Brain Injury Rehabilitation
Traumatic Brain Injury: Rehabilitation Center