Without brain injury rehab the brain has an amazing ability to adapt to and overcome trauma
Monday, March 2nd, 2009Conventional methods of brain injury rehabilitation result in certain mainstay methods and steps.
For us transitioning from ICU to a sub-acute facility was painful and difficult. Fully not understanding what brain trauma and brain damage really encompasses we stumbled our way through. I can honestly say that many of the accepted establishments were far from acceptable as they were unsanitary and often smelled of urine. We were left with the challenge of finding a facility that could care for our son, who had experienced a severe head injury ,the way that we would. The search for brain injury rehab would begin. After the must needed visit to over 10 so-called high ranked establishments we finally decided on a hospital based home for our son. They had extensive experience with cognitive rehabilitation and brain tbi.
Entering the 5th floor and exiting to your right you come upon two hallways, each with a two patient room on either side, right or left. The nurses station can be found central to all the patients rooms so that they can monitor the patients who have experienced extensive and severe brain injury. You see, no one really knows what it is like until they’ve experienced it for themselves. Hopefully they never will.
Brain injury rehab comes in many forms and this form is, believe me, not by choice. It’s what they call sub-acute where you bring your family or friend after they have been severely injured and had neurological damage until they are ready for acute rehabilitation. Most never are.
The age of patients is dominated by men ranging from 18+ mostly due to younger men reckless behavior/risk taking and elderly male stroke.
There certainly is a difference between sub-acute and acute brain rehab. Sub-acute patients rarely are able to participate in the standard 4 hour day of acute therapy. Many are in coma. They are warehoused with a routine of being turned in bed every two hours to prevent bed sores to being placed in a chair for up to four hours.D Very few of the patients have much family support and my guess is that it’s just easier. They just kind of exist especially after they past the “one year” of possible spontaneous recovery.
(unless they meet Tom Wisenbaker who has been a very successful strength trainer for brain injury.)
Range of motion to prevent more contractions is a common daily practice on each patient. There are the constant room changes due to infection control and in most cases the isolation rooms far out number the non-isolation rooms. The patients with the germs are grouped with the patients with the germs. And once you get the germs it is really tough to get rid of them. Yellow gowns worn by the nurses and family members are seen everywhere.
Spasticity is common place in the sub acute unit. It is a condition where various muscles are in a continuous state of contraction. This condition results in constant stiffness or tightness of the muscles. It results when there is damage to the portion of the brain that controls voluntary movement. Symptoms of spasticity can include:
Spasticity can vary from mild muscle stiffness to severe painful spasms. Stretching can greatly enhance the brain injury rehab process until muscle is developed.
You can walk up and down the hall and know that each room has a story of it’s own.
On the other hand the acute facilities are geared more for intensive therapy. There are routines set in motion for the brain injured (if they are capable) such as breakfast, lunch and dinner at certain times during the day. In between these activities there are main therapy’s that focus on the patients deficits.
The intent is to return them to society after brain injury rehab.
Insurance plays a huge role in the brain injury rehab process as most insurance companies don’t believe that there is much benefit to the acute rehabilitation phase so they grant a two to six week stay for most patients. You are then released to either a skilled nursing facility which is ranked below sub-acute or to home with your family. Our son went from sub-acute to home bypassing the acute rehabilitation process for the above reasons. How much progress can be made in that much time? Especially since he had been among the fortunate to have had intensive rehabilitation in the sub-acute facility where he stayed.
There has been a gap in recovery services for survivors. They would be given immediate acute care followed by short term rehabilitation. If they did not improve within a year, they were not expected to. This is no longer deemed to be true.
