TRAUMATIC BRAIN INJURY REHAB TEAM
Welcome to the Traumatic Brain
Injury manual -- TBI for short. This manual is designed to provide
you with the rehabilitation treatment you need to help you reach your physical,
cognitive, psychological, social, and vocational potential. Your TBI Rehab
Team will be working with you and your family to help you become independent
and understand the effects of your injury. Prior to your admission, you had
a thorough pre-admission evaluation and screening to make sure you are an
appropriate candidate for rehab and to help your TBI Rehab Team determine
the best possible individualized plan of care for you.
You are the most important member of the TBI Rehab
Team. If you have any questions or problems, do not hesitate to talk with
the other members of your team. They exist for one reason- to help you succeed
and reach your optimum level of wellness and independence.
- The Physiatrist is a physician who is a specialist in physical medicine
and rehabilitation. The physiatrist is the Team Leader who directs your care.
- Your Nurse is also a very important person. She/he will:
Assess you physically and obtain pertinent information necessary to design
your personal care plan
Take care of you and instruct you and your family so that you will be as
independent as possible. The concept of independence is very important for
you and your family to understand, as nursing care is based on this goal.
Your nurse will encourage you to do as much for yourself as possible - and
Follow through with your other therapists' recommendations for your care.
After the first few days, you will be given a daily therapy schedule.
You will be expected to keep your therapy appointments on your own whenever
possible. If you are unable to get to your therapy appointments independently,
a transporter will assist you.
- The Occupational Therapist will help you:
Improve your well being and prepare to return to a meaningful "occupation"
or routine of day-to-day activities. These activities can include work, leisure,
school, and social responsibilities. Daily activities, such as getting dressed,
eating, preparing a meal, and bathing or using the toilet are often difficult
to manage following a brain injury. The occupational therapist will help
you relearn the skills necessary to perform these activities of daily living
(ADLs) as independently as possible
Learn to function with changes in your thinking and physical abilities by
teaching you other techniques and the use of adaptive equipment. For patients
in a coma, the occupational therapist works with other members of the Rehab
team to provide a structured program of multi-sensory stimulation
Increase your overall endurance and the strength and function of your upper
body and arms, with splints or positioning aids when necessary
Evaluate changes in your visual and perceptual skills and the impact of these
changes on your functioning at school, work, and in the community, including
driving, thinking, managing money, memory, etc.
Design a treatment plan based on your injury and needs. The primary goal
is for you to improve and relearn the skills necessary for living as
independently as possible.
Physical Therapist is often thought of as a specialist in walking. However,
for patients with a brain injury, physical therapy encompasses many aspects
of function. Although walking is often a realistic goal, the physical therapist
Help you meet other goals as well, such as:
Increasing the structure of your day
Increasing your upper and lower body strength
Improving function in all activities
Increasing your balance
Obtaining maximum endurance and independence in mobility
Instruct you in a variety of activities that you can perform to help you
reach your goals, such as range of motion, strength, coordination, balance,
mobility, and safety activities, and design a treatment plan to suit your
rehabilitative needs, which may include a brace, orthotic device, or walker
Review any precautions your physician may have ordered, such as cardiac,
safety, or orthopedic precautions, and instruct you how to incorporate them
into your daily functional activities, such as using a cardiac monitor
Instruct you and a family member in a home exercise program or other activities
that let you continue your strengthening program, and may recommend home
therapy, day treatment, outpatient therapy, special equipment, or community
resources following your discharge from the hospital
Speech/Language Pathologist addresses a variety of issues in brain injury
rehabilitation, including speech quality (articulation), understanding and
expressing the spoken and written (language/communication), thinking (cognitive
skills), and swallowing problems. The speech therapist will:
Thoroughly evaluate changes in communication and cognitive skills due to
the brain injuryand the impact of these changes on day-to-day activities.
For some problems, the therapist may recommend evaluation by a hearing specialist
(audiologist) or an ear, nose, and throat doctor (otolaryngologist)
Emphasize the relearning of cognitive skills which are affected by the brain
injury, such as attention, memory, sequencing, planning,
reasoning/problem-solving, judgment, and self-monitoring of thoughts and
behaviors, and the ability to use the relearned skills in other settings
and situations. The therapist works with other members of the Rehab Team
to help the patient address cognitive skills in all daily activities
Evaluate the skills necessary for effective school, work, and community
functioning and focus on relearning those tasks that are specific to the
individual's previous work or school responsibilities when possible. The
therapist may consult with a vocational counselor for optimal assistance
and may evaluate additional (augmentative) communication needs for patients
who may require an alternative system to help them communicate needs and
thoughts, such as a letter or word board or an electronic or computer system
Evaluate and manage swallowing (dysphagia) problems
Recreational Therapist will focus on leisure activities, hobbies, and
crafts that integrate goals and functional tasks begun in other therapies.
An integral part of therapeutic recreation is the community re-entry program,
which consists of outings into the community, movies, shopping malls, etc.
These outings provide an opportunity for you to apply techniques learned
during therapy sessions and reach your maximum level of independence in the
"real world." Family members are invited and encouraged to participate in
the community re-entry program.
Psychology Department provides assessment and therapeutic services to
you and members of your family who are learning to cope with the effects
of your disability, whether temporary or long term. When illness or trauma
causes changes in levels of function and lifestyles, support and positive
motivation are crucial to a successful adjustment by you and your family.
You may meet with a member of the psychology department several times a week,
in individual or group sessions. Services provided by the psychology department
Initial cognitive and emotional evaluation, as well as neuropsychological
Individual and/or group psychotherapy to facilitate your involvement in the
rehabilitationprocess, your adjustment to your injury or disability, and
the alteration in your physical, cognitive, and emotional functioning.
Marital and family therapy that focuses on changes in family dynamics caused
by illness, trauma, and/or disability, as well as sexual counseling
Biofeedback and relaxation techniques
Case Manager is a vital member of your rehabilitation team. She/he will
assist you with many aspects of your care, such as preparing and implementing
your discharge plan, arranging meetings with you and your family, arranging
a schedule for family observation and training days, working with other
interdisciplinary team members, and working with your insurance carrier to
communicate the rehab team's short and long term goals. Your case manager
will also arrange any equipment and/or home modifications that may be necessary.
TEAM AND FAMILY CONFERENCES
The Rehab Team will meet routinely to discuss your treatment
plan and progress. In addition, the Team will meet with you and your family
after your admission to report on your progress and answer any questions.