After a significant brain injury, you will need medical treatment as well as extensive rehabilitation. The rehabilitation period can be short or lengthy depending on the extent of the injury; the amount of function regained can vary after rehab, too. A group of specialists and therapists will work together to help you regain as much function as possible after the injury.
What Is an Acute Brain Injury?
Brain injuries are divided into two categories: traumatic and acquired brain injuries. Traumatic brain injuries result from a blow to the head that may fracture the skull or cause the brain to move around in the head causing an injury to a specific area of the brain; examples include falls, gunshots or car crashes. In acquired brain injury, cells throughout the brain are affected; this can occur in instances of near drowning or choking, heart attacks or strokes. Both types of acute brain injuries can alter the way that you function, think, walk and feel. Rehabilitation will play a large role in your level of future functioning.
Preparing for Rehabilitation
With an acute brain injury, your clinical care team will begin working immediately to prepare you for rehabilitation services. The goal is to address any immediate medical needs; doctors typically will monitor vital functions and administer medications or surgeries to prevent more brain damage. These treatments are incorporated with getting you out of bed as soon as possible. Even for patients who are on a ventilator after the brain injury, getting the patient out of the intensive care unit and to a rehabilitation center quickly is still a health care goal. The team of professionals --- including doctors, therapists and nutritionists --- will develop a plan of rehab and educate both you and the family on what to expect in the coming months and years.
Cognitive Rehabilitiation after Brain Injury
Rehabilitation after acute brain injury can help to restore as much cognitive function as possible; cognitive function refers to the ability to learn, think, remember and plan. Patients will also learn strategies to compensate for functions that may have been lost long-term. The doctors can estimate which functions may have been lost depending on the location and type of brain injury and plan rehabilitation exercises accordingly. During this part of the rehabilitative process, physicians and therapists will work to re-teach basic skills like attention and then will move on to more complex skills such as judgment. During cognitive rehab, you may also have to learn shapes and colors again as well as writing or reading skills.
Physical Rehabilitation after Brain Injury
Once you have had some success in cognitive rehabilitation, your health care team will move forward with more vigorous physical rehabilitation. The attention and focus skills that you would have regained during cognitive therapy play a key role in your physical rehabilitation. The physical therapists will emphasize improving movement, strength and endurance; range of motion exercises and other varied activities are parts of the treatment plan working up to the final goal of walking. As with cognitive rehab, you would begin with simple physical tasks like sitting and advance to more complex skills such as bathing or eating. You will also learn ways to compensate for the physical skills that you may be no longer able to perform.
Specialists in Brain Injury Rehabilitation
Your brain injury rehabilitation team consists of a variety of specialists. Neurologists are physicians who diagnosis the extent of the brain injury; other health care specialists called physiatrists combine physical therapy and orthopedics. Neuropsychologists evaluate the brain to determine what functions were lost after the injury. The team also includes physical, occupational, cognitive and speech therapists who all work to help you regain the specific skills that were lost or diminished by the brain injury. The social worker --- while not a health care provider --- is another vital part of the team because of the coordination services provided between the family, medical staff and insurance providers. All of these people work closely together to help you become as independent as possible.
Types of Rehabilitation Sites
Rehabilitation after an acute brain injury can take place in a variety of settings. The initial rehabilitation typically begins in the hospital immediately after the injury, but the rehabilitation continues during the inpatient stay. After your release from the hospital, you can receive services through a day program where the services are typically offered from 8 a.m. to 5 p.m.; another option is residential care where you check into a facility for a specified amount of time and undergo a rigorous program. Some facilities offer specific rehabilitation services like speech or physical therapy as outpatient services. Other facilities may offer supported care housing, which is like an assisted living facility when the rehab services have been completed, but you still need some support.
