Attend Factsheet 1i:
Introduction
After a person who has suffered a brain injury is medically stable, they are discharged. The problem is that many of these individuals will have a long journey of rehabilitation to fix many of their longer term physical, cognitive and behavioural problems. Rehabilitation aims to minimise the long term impact of the brain injury by helping the brain learn alternative ways of working. Rehabilitation helps the survivor and their loved ones cope with any of the remaining disabilities.
Accessing Rehabilitation
There are many different rehabilitation services across the UK. Choosing which rehabilitation unit to go to should be done with the clinical team, the patient and their family. After the referral is made the rehabilitation unit does an assessment to make sure their services will meet the patient’s needs.
Rehabilitation settings
Rehabilitation has different settings. There is Post-acute rehabilitation which is intensive specialist rehabilitation for those who aren’t ready to return home after being released from the hospital. Another type of rehabilitation is Rehabilitation back into the Community, when after an inpatient’s rehabilitation stay the patient is transferred to a residential transitional living unit. This is a place that allows a patient to redevelop their independent living skills so they can go back to living in a place of their own. Sometimes patients will just go straight home and have community rehabilitation teams or outreach teams that help them make progress. Outpatient rehabilitation is where some patients are well enough to return home and receive their further treatment as an outpatient. Slow-stream rehabilitation is for those patients who are done with intensive post-acute rehabilitation but are still not ready to go home. These patients may require long-term residential care.
Timescale for recovery and rehabilitation
Recovery is a slow process. There is no certainty of how long it will take. Usually six months after the injury it can be clearer to see how long it may take but it is best to wait until a year after the accident before making any important decisions in regards to the future. After a year it is easier to judge the physical recovery, but the psychological one may take much longer. The most changes happen in the first six months, but people may actually continue to improve for a number of years after a brain injury. Some people never stop regaining the skills they lost in the injury, but they are usually more subtle and less obvious than the improvements seen in the first 6 months. Factors that affect a patient’s recovery are: type of injury, age (younger adults do better), pre injury health, pre injury personality (intelligence and lifestyle), social support, and other issues like alcohol or drug use.
The rehabilitation team
In specialist rehabilitation a patient will find that they may have a “multidisciplinary” team of professionals. Usually each therapist will carry out detailed assessments to see the extent of difficulties caused by the brain injury. After the assessment process, the team will discuss with the client and the family what their goals are. Then based on that discussion the team will agree on a rehabilitation programme where these goals and the patient’s cultural background, pre-injury interests and lifestyle are taken into account. The team consists of Clinical Neuropsychologist (specialist in behavioural, emotional and cognitive problems), Occupational Therapist (helps people develop independence in carrying out daily tasks), Speech and Language Therapist, Physiotherapist (helps people regain their muscles and joints after injury), nurses, social worker, case manager and family members.
Psychological recovery
It is possible that cognitive, behavioural and emotional problems may arise. These issues can be treated by a clinical neuropsychologist. It is possible that a patient may experience problematic behavioural developments after a brain injury like verbal or physical aggression or even inappropriate sexual behaviour. There are behavioural modification programmes which can help raise a patient’s awareness of their behaviour and encourage more appropriate responses.
Returning to work
Once a patient is able to look after their personal needs, travel, and manage social interactions, they might be able to go back to work. This depends on how much recovery has been made, what the previous job was and what employment opportunities are now available. It is important not to rush back to work too quickly, because symptoms that were getting better can erupt. Some patients may be able to return to their old jobs, where others may need to take a less taxing role. There may be a need for retraining for work. Vocational rehabilitation service will be provided to help people understand the type of work they can now do and help them achieve their goals.
Support for families
There are many difficulties that may arise after a brain injury, like particular behavioural and emotional problems which can have an effect on family members. There can be added social or financial difficulties for the family. There are many studies that show that families of people with brain injuries need family support and counselling not just in the early days, but for a long time afterwards. Children with a head injured parent should not be overlooked. Relatives should make sure to acknowledge the difficulties they are experiencing and give help when they need it.
Contact
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