Traumatic brain injury commonly affects people of younger age and can cause life-long disability in physical, cognitive, behavioural, and social function. Even more so than physical deficits, behaviour and personality deficits may be even more disabling. Recovery from TBI can take up to several years from the time of the initial injury.

As with rehabilitation from any illness or injury, the goal of rehabilitation following TBI is to return the patient to the maximum degree of function possible. There are two phases of rehabilitation: inpatient rehabilitation and community management.

Inpatient Rehabilitation

Rehabilitation should begin as soon after injury as possible, and should have a multidisciplinary focus. The rehabilitation team may consist of the patient and the patient’s family, the family doctor, a rehabilitation physician and nurse, a physiotherapist, an occupational therapist, a speech therapist, a social worker, a nutritionist, and a psychologist or psychiatrist.

Patients with mild TBI may be cared for on an outpatient basis, but those with moderate to severe TBI will require inpatient management. Focus is on:

• Retraining the patient in activities of daily living
• Management of pain
• Behavioural and cognitive therapies
• Medication management
• Assisting the patient to access aids to daily living
• Readying the patient’s home for discharge
• Family education
• Patient and family counselling

Patients must be physically stable and may require rehabilitation for other injuries suffered as a result of the trauma, such as fractures. Patients who have had a catastrophic injury may need major modifications made to their home before discharge, such as installation of patient lifts, installation of ramps for wheelchairs, or modifications to vehicles. Patients may also require extensive retraining before they will be able to function at home.

Community Rehabilitation

Community rehabilitation follows discharge from an inpatient rehabilitation unit. Helping the patient in regaining maximum pre-injury independence and functioning can be a monumental task. Families and patients must be supported through education and counselling.

Quality and availability of community services may be less than what is desired, depending on the patient’s geographic location.

Financially, moderate to severe TBI can have a devastating impact on patients and family. Insurance issues, costs of hospitalization, the loss of the patient’s income (or a family member’s if a family member must quit working to care for them), and rehabilitation costs can be overwhelming. Patients and families will need support and education on financial options to help them cope with the high cost of rehabilitation. The Brain Injury Resource Foundation can provide information and support to patients and their families.