REHABILITATION [ back to Glossary Index ]
Rehabilitation is a broad term covering all forms of assistance to promote, speed up or extend the natural processes of regaining function following a TBI. Rehab is customized to acute, early post-acute and long term needs. Rehab may start as early as the third day of hospitalization and as late as 10 years post-injury. Common goals are maximizing capacity for self-care, independent living, return to work and social re-integration into the community. A severely injured patient will need help with such basic things as relearning how to swallow or relearning who his wife and children are. Patients with more mild injuries will benefit from learning how to improve self-monitoring of their behavior to avoid overloading and how to use notebooks to organize their activities and make information retrieval more efficient. Typical modalities may include physical therapy, balance therapy, speech therapy, visual therapy, occupational therapy, psychotherapy, behavioral therapy, vocational retraining and others.
 
Rehab professionals are a dedicated group, but they must have a reciprocal commitment to get better from the patient. Gains in rehab depend to a significant extent on how strongly the patient wants to get better and how hard he struggles with to overcome motor weakness, cognitive slowness and fatigue. The many obstacles to effective rehabilitation of a brain injury include organic or psychological denial of deficits; depression; apathy; violent or aggressive behavior; perservative behavior (getting stuck); lack of insurance coverage; lack of transportation; and living in an underserved, rural community. Although the medical profession is correct in saying that early, aggressive rehab is beneficial, it is not true that rehab is wasted on TBI people who are 5, 10 or 15 years post-injury. The process of recovering from a TBI is a lifelong project.