Rehabilitation is an important part of the recovery process for a Traumatic Brain Injury (TBI) patient. During the acute stage, moderately to severely injured patients may receive treatment and care in an intensive care unit of a hospital. Once stable, the patient may be transferred to a subacute unit of the medical center or to an independent rehabilitation hospital. At this point, patients follow many diverse paths toward recovery because there are a wide variety of options for rehabilitation.
Testing by a trained neuropsychologist can assess the individual's cognitive, language, behavioral, motor, and executive functions and provide information regarding the need for rehabilitative services.
The overall goal of rehabilitation after a TBI is to improve the patient's ability to function at home and in society. Therapists help the patient adapt to disabilities or change the patient's living space, called environmental modification, to make everyday activities easier.
Some patients may need medication for psychiatric and physical problems resulting from the TBI. Great care must be taken in prescribing medications because TBI patients are more susceptible to side effects and may react adversely to some pharmacological agents. It is important for the family to provide social support for the patient by being involved in the rehabilitation program. Family members may also benefit from psychotherapy.
It is important for TBI patients and their families to select the most appropriate setting for rehabilitation. There are several options, including home-based rehabilitation, hospital outpatient rehabilitation, inpatient rehabilitation centers, comprehensive day programs at rehabilitation centers, supportive living programs, independent living centers, club-house programs, school based programs for children, and others. The TBI patient, the family, and the rehabilitation team members should work together to find the best place for the patient to recover.
The VA’s Polytrauma System of Care provides a full range of rehabilitation services for all enrolled Veterans and for Service Members covered by TRICARE authorization, who have sustained TBI or other acquired brain injury and:
- Have physical, cognitive, or emotional impairments and disability due to trauma,
- Are medically stable enough to allow safe transport to and management by the PSC program,
- Have potential to benefit from rehabilitation services provided by the program
If you believe that you or somebody you know has TBI and may benefit from rehabilitation, contact your local VA and ask for the Polytrauma/TBI Point of Contact. TBI care in the VA is available throughout the entire Polytrauma System of Care, which is made up of:
- Polytrauma Rehabilitation Centers -Polytrauma Rehabilitation Centers provide acute, comprehensive, inpatient rehabilitation. They maintain a full team of dedicated rehabilitation professionals and consultants from other specialties related to polytrauma. The Centers serve as consultants to other facilities in the Polytrauma System of Care.
- Residential Transitional Rehabilitation Program - A structured residential program in a therapeutic, "real-world" setting with a focus on progressive return to independent living. Treatment is individual and group-based.
- Network Sites - Acute rehabilitation care provided as the first step in the journey toward recovery for the most severely injured. The next step is often one of the Polytrauma Network Sites (PNS), which are located in VA hospitals. Currently there are 23 specialized rehabilitation programs located throughout the United States. These programs offer continued medical care and rehabilitation services for Veterans and Servicemembers who are transitioning closer to home following discharge from a Polytrauma Rehabilitation Center. These programs are also the entry point for rehabilitation services for those who have experienced a mild-moderate TBI. Depending on need, these services may be provided on an inpatient or outpatient basis.
- Support Clinic Teams - Currently there are 87 Polytrauma Support Clinic Teams (PSCT) located in VA hospitals across the country. The PSCTs provide specialized outpatient care. PSCTs offer continued medical and rehabilitation care and support closer to your home community. PSCT programs may also be the entry point for outpatient rehabilitation services for those who have experienced a mild-moderate TBI or polytraumatic injury.
- Points of Contact -VA Polytrauma Points of Contact are available at 39 VA hospitals without specialized rehabilitation teams. These Points of Contact, established in 2007, are knowledgeable about the VA Polytrauma/TBI System of care and coordinate case management and referrals throughout the system and may provide a more limited range of rehabilitation services.