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Rehabilitation & Ongoing
The definition of rehabilitate is "restore to a good
condition; make over in a new form" (Gage Canadian Dictionary, 1983).
Many people think of rehabilitation as what
happens while the brain injury survivor is in the hospital with a team of
professionals. The understanding of rehabilitation can be expanded to
include not only the ongoing support that is needed for the survivor, but also
the supports for his or her natural support system.
That is, support needs to be in place for
family, friends, and others in the community whom interact with the survivor on
a regular basis. These people can be considered as part of the
rehabilitation team as they are often the ones dealing with the day-to-day
issues after the patient comes home and over his or her lifetime.
The medical model consists of the professional working
with the brain injury survivor while he or she is still in hospital. The
rehabilitation team may consist of the following members:
Professional who evaluates the patient's hearing.
Dietician: Professional who
seeks to meet the nutritional needs of the patient through proper diet.
Careful consideration is taken of pre-trauma weight and eating habits.
Neurologist: Physician who
specializes in disorders of the brain. He diagnoses the type of injury and
makes recommendations for surgery and medications.
doctor who specializes in the relationship between the neurological system and
psychiatric or psychological disorders. He may provide individual and/or
Psychologist with a Ph.D. who specializes in the relationship between the brain
and behavior. He performs tests to determine levels of functioning in the
areas of cognition, intelligence, and personality. He may also provide
individual and/or family therapy on an individual or group basis.
Nurse: Professional who
provides daily care.
Professional who focuses on the patient's physical, cognitive, and perceptual
disabilities. He helps the patient regain function of arms, hands, and
fingers and return to the activities of daily living. He works on fine
motor skills, hand-eye coordination, and self-care skills. He may also
provide any necessary special equipment.
Professional who assists the patient return to the highest level of motor
functioning as possible. He helps the patient regain function of the body
movements needed for basic actions such as standing, walking, and sitting.
He evaluates the need for special equipment and constructs a program of
exercise and movements.
Professional who evaluates the patient's leisure interests and skills, his
ability to initiate leisure activities, group skills and interaction, and skills
in the community. Therapy often takes place in a group setting.
Therapist: Professional who helps with problems breathing when
the patient is in the early stages of hospital care. He is responsible for
maintaining the ventilation system and assisting the patient who is unable to
cough up secretions.
Professional who assists the patient to meet his social and psychological needs
with planning and counselling. He acts as a liaison between the professional
team and all other parties concerned, including family, funding sources, and
past or future facilities. He also completes various assessments.
Pathologist or Speech Therapist: Professional who helps the
patient regain communication skills, including speech, language, memory, thought
processing, reading, and writing. He evaluates the patient's cognitive
functioning and social interaction skills.
The aspect of rehabilitation
that many people tend to overlook is the ongoing support that is needed over the
lifetime of the affected individual. This involves the issues that arise
from time to time after the survivor has left the hospital and adjusts to daily
life in the community.
Ongoing concerns may include issues with:
Problems may occur in
the areas of problem solving, memory, communication (which includes listening
skills, social skills, and reading and writing skills), attention, organization,
decision-making, and planning. Other issues which may or may not have
already been addressed in the hospital but which become apparent upon returning
home include dealing with household tasks, transportation, money, and leisure
- Anger management
- Conflict management
- Meaningful activity
- Sense of community
If these issues arise shortly after the
injury (typically within a couple years), the survivor may be allowed to return
to a rehabilitation facility on an outpatient basis. Very often, however,
these issues do not become apparent until many years later. In that instance,
community resources must be accessed. Unfortunately, there is a serious
lack of these resources and very often there are none available in small
communities. Your local support group may be aware of what is available in
Returning to work may also lead to
difficulties that had not yet become evident. Vocational Rehabilitation is
another area in which an individual may have an interest in exploring job
retraining, skills assessments, interest inventories, vocational counselling,
volunteer work trials, education, and vocational support.
The family plays a very important role
throughout the recovery process. They provide useful and insightful
information, such as the survivor's pre-trauma personality and learning style.
They provide psychological support for the patient. They also act as an
advocate for him or her. Support for the family is important and may be
offered to the family in the form of counselling, caregiver support groups, or
Brine, N. 1998.
(September). Community Integration for Persons with Brain Injury. Presentation
given at Brain Attack - What's New in Stroke Care? Symposium. Edmonton, AB.
Cera, R.M., Vulanich, N.N. & Brady, W.A. (1995). Patients with Brain
Injury. Austin: Pro-Ed.
Hawley, L.A. (1989). The Family Guide to the
Rehabilitation of the Severely Head-Injured Patient. Austin: Health Care
here to find out more about:
479-1757 or toll free 1-800-425-5552
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