• brain injury patient talks with doctor

    A Detailed Description of Traumatic Brain Injury Rehab Programs and Specialists

    Traumatic Brain Injury (TBI) occurs when a sudden injury causes damage to your brain. Per the CDC, the leading cause of TBI for young children and adults over age 65 is falls. Other typical causes of TBI include motor vehicle collisions, blunt force trauma and assaults.

    Symptoms of TBI vary. Common symptoms include:

    • Headache
    • Fatigue and/or Poor Sleep
    • Dizziness and Balance Changes
    • Sensitivity to Light/Sound
    • Nausea and/or Vomiting
    • Confusion
    • Difficulty Multi-Tasking
    • Loss of Coordination
    • Slurred Speech
    • Word Retrieval Difficulty
    • Poor Concentration
    • Memory Problems
    • Personality Changes
    • Depression and Anxiety
    • Vision Changes
    • Hearing Changes

    After being diagnosed with a TBI, you can expect to see multiple different providers within various treatment settings as part of your rehab. Brain rehabilitation helps brain injury survivors recover or relearn functions lost, such as eating, dressing, walking, and speech. The rehab for the specific need can take many forms, including physical, mental and behavioral therapies. Below is a list and description of the various rehabilitation providers involved in TBI recovery.

    • Acute Rehabilitation. As early as possible in the recovery process, individuals with TBI often begin acute in-patient rehabilitation. The treatment is provided in a special unit of a trauma hospital, a rehabilitation hospital, or another inpatient setting. During acute rehabilitation, a team of health professionals with experience and training in brain injury work with the patient to regain as many activities of daily living as possible. Activities of daily living include dressing, eating, using the bathroom, walking, and speaking.
    • Aquatic Therapists. Occupational therapists, physical therapists, or recreational therapists with specialized training to provide therapy in a heated water pool. Aquatic therapists assist a person to increase strength, coordination, ambulation skills, endurance, muscle movement, and reduce pain.
    • Case Managers/Social Workers. Responsible for assuring appropriate and cost-effective treatment and the facilitation of discharge planning. Case Managers/Social Workers maintain regular contact with the individual, insurance company, family, and physician to make certain that treatment goals are understood and achieved.\
    • Cognitive rehabilitation. In individual therapy sessions, cognitive rehabilitation therapists work with you to improve your thinking (cognitive) skills and maximize your success in personal and occupational roles.
    • Day Treatment (Day Rehab or Day Hospital). Day treatment provides rehabilitation in a structured group setting during the day and allows the person with a brain injury to return home at night. Some people may transition to a day program following their discharge from an inpatient post-acute rehabilitation facility, while others may proceed directly to sub-acute rehabilitation after discharge from the hospital.
    • Neurologists. Doctor who specializes in treating injury or illness to the nervous system, including the brain, spinal cord, and nerves.
    • Neuro-optometrists and Neuro-ophthalmologists. Trained in the sub-specialty of both neurology and ophthalmology, these physicians understand how the nervous and vision system operate and, therefore, are able to diagnose vision problems related to brain injury.
    • Neuropsychologists. These doctors focus on an individual’s thinking skills, behavior, and emotional processing. Neuropsychologists provide services to reduce the impact of setbacks and help the person return to a full, productive life. Neuropsychologists’ evaluations provide valuable information to assist with rehabilitative planning and school, community, or employment re-entry.
    • Neurosurgeons. Doctors that perform brain/spinal cord surgery. Initial assessments include brain imaging and evaluation on whether brain surgery is necessary.
    • Nutritionist or dietitian. The dietitians will assess the patient’s nutritional status, and make recommendations about good nutrition and the patient’s diet. Patients are often underfed and underweight after a hospital stay. Focusing on the patient’s diet and how many calories the patient eats each day will help with recovery. The dietitian will also talk to the patient and their family about choosing a menu, the right food consistencies, and diet changes that fit their needs.
    • Occupational therapists (OT). The OT works on the patient’s activities of daily living to help the patient become more independent. These activities include eating, bathing, grooming, and dressing. They also include moving to and from your bed, wheelchair, toilet, tub, and shower.
    • Outpatient Therapy.  Following acute, post-acute, and/or sub-acute rehabilitation, a person with a brain injury may continue to receive outpatient therapies to maintain and enhance recovery. Individuals whose injuries were not severe enough to require hospitalization or who were not initially diagnosed with a brain injury when the incident occurred may attend outpatient therapies to address problem areas as a result of their injury.
    • Physiatrist. A doctor of physical medicine and rehabilitation. The physiatrist typically serves as the lead of the treatment team and makes referrals to the various therapies and medical specialists as needed. The physiatrist works with the rehabilitation team, the person with a brain injury, and their family to develop the best possible treatment plan.
    • Physical therapists (PT). The PTs help the patient improve their physical function and ability to move. The PT’s role is to teach the patient how to be as independent and safe as possible in their environment. The PT will give the patient exercises and re-train their muscles and nerves. The aim is to restore normal function. The PT will also help the patient strengthen their muscles and improve endurance, walking, and balance.
    • Post-Acute Rehabilitation. When patients are well enough to participate in more intensive therapy, they may be transferred to a post-acute rehabilitation setting, such as a transitional rehabilitation facility. Transitional rehabilitation facilities are sometimes called residential rehabilitation or transitional living facilities. The goal of post-acute rehabilitation is to help the person become as independent as possible. Patients undergo at least six hours of therapy per day. This type of comprehensive rehabilitation in a post-acute facility is considered the gold standard for care and treatment following brain injury.
    • Psychologists. These doctors will assess and treat any problems the patient has with thinking, memory, mood, and behavior. He or she may counsel the patient’s family members or educate them on how to help the patient. The goal is to ensure that the patient’s family understands the treatment plan and possible outcomes.
    • Recreation therapists. These therapists will help the patient find activities to help improve their health and wellbeing and get the patient back into the community. Getting back into recreation or finding new activities is an important part of recovery. This may include going on outings or taking part in social and group activities in the hospital..
    • Rehabilitation Nurses.  They monitor all body systems. A rehabilitation nurse attempts to maintain the person’s medical status, anticipate potential complications, and work to restore a person’s health. A rehabilitation nurse is responsible for the assessment, implementation, and evaluation of each individual’s nursing care based on specific problems.
    • Respiratory Therapists. Provide set-up and instruction for breathing-related equipment, such as oxygen tanks and suction devices, as well as providing breathing or suctioning care.
    • Speech and Language Pathologists. In individual therapy sessions, speech and language pathologists work with you to reduce any language-based or other limitations to effective communication you may experience. They often provide cognitive aids and coping skills to improve memory and concentration as well.
    • Vocational case coordination. Help develop a plan to resume work in your previous job field, help you develop new career goals or find ways to best resume other productive activities.


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