What Kinds of Rehabilitation Does a TBI Survivor Need?
Rehabilitation is a vital part of the recovery process for a TBI survivor. Moderately to severely injured patients usually first receive treatment and care in an intensive care unit of a hospital. Once stable, the survivor can be transferred. At this point survivors follow many different paths toward recovery depending on their needs.
It is important for TBI survivors and their families to select the best 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 survivor, family, and rehabilitation team members should work together to find the best place for the survivor to recover.
Some patients may need medication for physical and emotional problems resulting from the TBI. Great care must be taken in prescribing medications because TBI patients are more prone to side effects and may react to some drugs. It is important for the family to provide social support for the survivor by being involved in the rehabilitation program. Family members may also benefit from counseling in order to cope with the demands and stress of helping to care for a TBI survivor.
Read about research into TBI treatment methods.
Individualized Treatment Programs
It is important that TBI survivors receive an individualized rehabilitation program based upon the person’s strengths and capacities. Rehabilitation services also need to be modified over time to adapt to the survivor’s changing needs. Moderately to severely injured patients require rehabilitation treatment that draws on the skills of many specialists. This involves individually tailored treatment programs in the areas of physical therapy, occupational therapy (learning skills for the activities of daily living), speech/language therapy, physiatry (specialists in rehabilitation medicine), psychology/psychiatry, and social support.
The overall goal of rehabilitation after a TBI is to improve the survivor’s ability to function at home and in society. Therapists help the individual adapt to disabilities or make modifications to the home to make everyday activities easier.
Learn about some of the things you can do to reduce your risk of suffering a TBI.
Experimental Treatment for Frontal Lobe Injuries
A frontal lobe is frequently involved in a traumatic brain injury (TBI). When the front of the head is struck, the frontal lobes will hit the inside of the skull. The impact can result in injury because the brain is soft (about the consistency of toothpaste). And even when the back of the head is struck, the brain may bounce off the back of the skull, ricochet forward and strike the front of the skull, injuring both the back and front of the brain.
The frontal lobes are responsible for “higher” brain functions, such as planning, decision making, and judgment (which are called “executive functions”). When the frontal lobes are injured, an individual may be indecisive or apathetic and have trouble initiating activity. The frontal lobes are also responsible for regulating, checking, and inhibiting emotions and actions. As a result, some TBI survivors with frontal lobe damage are impulsive, moody, agitated, easily irritable, explosive, or make poor decisions. These survivors are quite vulnerable to becoming substance abusers.
People with Attention Deficit and Hyperactivity Disorder (ADHD) experience symptoms similar to symptoms experienced by some TBI survivors with frontal lobe damage – difficulty focusing and concentrating, impulsiveness, and poor decision making. One form of treatment for ADHD is a class of medications that includes Ritalin. These drugs stimulate the brain. While giving a stimulant to someone who is hyperactive and impulsive might seem like pouring gasoline on a fire, it is believed that the drugs stimulate the frontal lobes and increase their ability to regulate and control impulsive and inappropriate behavior while enhancing the person’s planning and decision making.
Because some of the characteristics of ADHD are similar to the symptoms
of some TBI survivors with frontal lobe damage, studies have been performed
to determine if medications used to treat ADHD can be helpful in the treatment
of TBI. These studies have produced some evidence that Ritalin is helpful
with some TBI survivors in improving concentration and reducing impulsivity.
A study is currently underway at the University of Washington, one of the
model centers in the U.S. for treatment of traumatic brain injuries, to
determine if Ritalin improves short term memory (also called working memory)
in survivors who have memory impairment.
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Resources for TBI Survivors and Families
Experimental Treatment for Frontal Lobe Injuries