bi post rehabilitation

post rehabilitation

The Post Rehabilitation Stage: Home Sweet Home

Brain injury survivors have been through a lot with prolonged hospital stays and lengthy rehab programs. However, this is only the beginning of the recovery journey as the survivor and family must take what was taught in the rehabilitation facility and apply it in the real world. The post rehabilitation phase is a time of adjustment as the brain injury survivor reintegrates.

It is often stated life is where real rehab takes place. Since head injured individuals frequently have difficulty learning new information and generalizing new skills from one environment to another, the most effective rehabilitation often occurs in the familiar home setting where previous learning is maximized. Be patient, keep perspective of the limitations these types of injuries can present and understand there will be hurdles along the way. And, recognize precautionary steps can be taken to prevent many issues.

“Okay, these words are comforting, but what ‘precautionary steps’ should we take?”

By now, the severity of the brain injury should be understood, either by the survivor or the family, and decisions need to be made so everyone is aware of what to do in the event of an emergency. Having a back-up plan is something every family needs, regardless of whether or not a catastrophic injury has affected their lives. It assures not only the survivor’s safety, but also provides everyone with peace of mind.

Suggestions to consider:

Speak with local emergency services. Whether it is the EMS, fire department or the local hospital, let them know what your situation is and they will develop a plan of action in accordance with your needs in the event of an emergency. This reduces the time spent explaining an extensive medical history and ensures your loved one receives fast and efficient attention. The personnel will be prepared with potentially necessary equipment and will already have knowledge of your condition. Just give them a call and ask to speak with a director. These people are here to help and are dedicated the well being of the communities they serve.

Keep an up-to-date medical history notebook with logs of all current meds, all doctor’s names and phone numbers, a medical history, and any medical needs should there be a need for hospitalization (i.e. mattress, turning, bladder care, skin care, etc.) It will allow for peace of mind and can be extremely helpful in an emergency or at various doctor’s appointments.

If you or your loved one requires the use of home medical equipment, such as a wheelchair or ventilator, contact your medical equipment provider and make sure they have a backup readily available in case the original malfunctions. Don’t get caught up in long UPS waits for parts or equipment. A delay is not in your best interest.

It may also be a good idea to consider hiring a Home Health Care Agency or Personal Care Assistant (PCA), at least for the first few months after a brain injury survivor returns home. Having an experienced PCA will help in everyday life and also in times of emergency. It is also nice to have the extra help as not only the survivor, but the family must become acclimated to not having around the clock care like in the hospital. There are several relief programs that can provide financial assistance for Home Health Care or a PCA, which are listed for your reference on our Benefits page.

For more information and options on hiring a PCA, please visit our SCI Post Rehab section. Also, if planning to advertise for a PCA, consider using our Printable PDF Example of PCA ad and Interview Questions

“What types of medication may be prescribed once at home?”

Medications for persons with brain injury are carefully selected, prescribed, and monitored by a physician on an individual basis. The physician or pharmacist can explain a medication’s purpose, side effects and precautions to you. A general explanation of medication groups is described below:

• • Analgesics may be used for pain relief and pain management
• • Anti-Anxiety Agents may lesson feelings of uncertainty, nervousness, and fear
• • Anti-Coagulants may be used to prevent blood clots
• • Anti-Convulsants may be used to prevent seizures
• • Anti-Depressants may be used to treat symptoms of depression
• • Anti-Psychotics may be used to target psychotic symptoms of combativeness, hostility, hallucinations, and sleep disorders
• • Muscle Relaxants may be used to reduce muscle spasms or spasticity
• • Sedative-Hypnotic Agents may be used to induce sleep or depress the central nervous system in areas of mental and physical response, awareness, sleep, and pain
• • Stimulants may be used to increase levels of alertness and attention
  
  

“How can we continue to develop skills at home once released from rehab?”

There are many different types of programs that can continue providing the stimulation needed for individuals recovering from traumatic brain injury, as we mentioned in the Brain Injury Rehab section.

However, not all states have such programs. In many instances, this comes down to what third-party payors will support. Regardless of what options are available, it is imperative to create a plan to continue to develop the skills that fall under the brain injury survivor’s strengths at home.

Tips that Can Be Utilized at Home:

• • Implement a daily schedule
  A common side effect of a brain injury is decreased performance speed. It may take a recent TBI survivor an hour to get ready in the morning. Implement a daily schedule and watch his or her actions to see if there is something that can be done to speed up this process. Remember, with brain injury survivors repetition is key. The more times an action is repeated the more ingrained it becomes in the mind, lessening the effects of a traumatic brain injury.
  
  
• • Continue to find new ways to stimulate the brain
  Play games that require appropriate thinking skills that will develop a part of the brain that may be only partially functional. The brain is like a muscle; if exercised, it will mature and grow.



• • Use technology
  Technology has come a long way in making some things easier with the creation of smart phones and tablets. These items may be used as communication devices, daily schedules, checklists and provide the option of setting alarms to remind the TBI survivor to take meds or eat. There are also numerous apps available that provide brain training games/exercises.
  
  

“What is the importance of exercise and nutrition for the brain injury survivor?”

Staying healthy is imperative to brain and bodily functions, regardless of injury. Appropriate quantities of well balanced meals can make a huge difference in the post rehabilitation phase. Proteins, good fats and vitamins nourish the body and mind. The necessity of good food boils down all the way to cell function and ATP production.

Nutrition Tips

• • Eat small meals every three to four hours.
• • Keep small baggies of healthy snacks with you during the day to boost energy, such as nuts, trail mix, apples, cheese, hard-boiled eggs, and energy bars. If you are unable to, ask a member of your family or support group to make these for you and put them in a small cooler to take with you when away from home.
• • Balance small meals with a combination of protein, healthy fats and oils, and carbohydrates. Proteins include fish, lean meats, nuts, and eggs. Healthy fats and oils can be found in avocados, seeds, and nuts. Carbohydrates are found in vegetables, fresh fruits, and grains. Avoid eating carbohydrates by themselves if you have blood sugar concerns. Many individuals report sugar and chocolate increase headaches, so eat sweets sparingly.
• • Eat moderately. Do not overeat as it can cause you to feel sleepy.
• • Eat by the clock. If your brain/body signals are not working well, set a timer, watch alarm or a mobile phone to alert you that it’s time to eat.
• • Since weight gain is common following brain injury, this is another reason to stick to a healthy diet.
• • Try to eat around the same time every day. The body does best when it is on a routine schedule.
  
  

Foods to Avoid

Try to avoid the following foods:

• • Alcohol
• • Caffeine
• • Salty foods
• • Excessive sweets and candy

Along with a healthy diet, exercise is crucial to the recovery process after a TBI. Researchers are finding that exercise increases blood flow to your brain. More blood to the brain means more nutrition for your brain. Just like good nutrition makes your muscles and your body work better, good nutrition also makes your brain work better.

Note:It is always important to consult your physician before beginning any new exercise regimen.

Exercise Tips

• • Exercise that involves movement is better than static exercise.
• • An exercise that challenges you is good. Things that make you focus on what you are doing or require learning something new are better than things you can do without thinking.
• • Exercise is best when it is regular. Several times a week is best. It needs to become a habit.
• • Exercise that includes changes in scenery is good. Workouts that involve interacting with other people are also good. For example, an exercise class might be better than working out alone. Running or biking outside beats running on a treadmill or riding a stationary bike. The less "boring" or automatic the exercise is, the better it probably is for stimulating the brain.
• • The exercise may not need to be exhausting or push you to the limit. If you’re completely fatigued, you won't function well.
• • So, GET MOVING and Stay Healthy!
  
  
  

“Can a person who has sustained a brain injury drink alcohol?”

Alcohol consumption is not recommended following a brain injury. Please consult your physician prior to drinking any amount of alcohol after a brain injury.

Additional information about the risks associated with drinking, how to get help with problems with alcohol and other drug use and abuse may be found in The Brain Injury Association of America Substance Abuse and Brain Injury Booklet.

“How is sexuality affected by a brain injury?”

Sexuality is a concept that deals with more than sexual activity. It also includes how someone feels about themselves as a man or woman and his or her ability to form and maintain intimate relationships. People with TBI want to work productively, live independently and feel a part of their family and community. Sexuality is an important aspect of these goals.

When a person has a TBI, the concept of sexuality is often brushed aside, in part because healthcare providers themselves may be uncomfortable addressing sexuality issues. Caregivers are often providing care that involves intimate activities such as bathing, and the patient has little or no privacy.

Individuals with TBI may have impaired judgment and may be impulsive. It is common that in an environment with impaired cognition, inappropriate sexual comments or behavior occurs. Caregivers should recognize that these actions are an expression of a basic need and should not take these comments personally.

After a person with a TBI leaves the rehabilitation facility, it is important to establish leisure time and social time. Social problems are at the top of the list of problems for individuals with TBI five years after the injury. Friends and family may have drifted away after the injury and through the hospitalizations. It is important for the person with the TBI to re-establish relationships or form a new circle of friends. Relationships are easier to establish in leisure settings.