Rehab is treatment to help the person work on the thinking and moving skills that were affected by the injury. Rehab itself is very different from acute hospital care. Even though it may start in the hospital, it often continues after discharge.
The fastest changes are usually seen within the first 3 to 6 months. People will continue to make gains beyond this time and even for years after the injury, but these changes will happen more slowly.
Rehab is hard work. It’s done with the person, not to the person.
He must be willing and able to work with rehab services during active treatment and, later with caregivers or by himself when he’s discharged.
Important points to remember about rehab
- The goal of rehab is to help patients be able to do as much as they can on their own (reach their functional goals).
- Most rehab services last days to weeks; some can last months.
- Rehab can happen at home and in-between therapies. Doing everyday tasks, even when not in active treatment is still rehab.
Factors that affect rehab progress
As we have said, rehab is hard work. Along with how alert the person is, his medical status, where he is in his recovery, and how well he can tolerate and take part in therapy can affect progress:
How much he is willing to work at rehab (motivation): People differ when it comes to motivation. A brain injury may also affect the person’s insight, awareness, and motivation. The person’s personality is also a factor. Family can also help by talking with the healthcare providers about how he has dealt with other life challenges. Also, helping to identify what he enjoys doing or was important to him will help to create goals that have meaning.
Relationship with therapists: The person will likely work with many healthcare providers. Of course, each has his or her own style. Let each healthcare provider know what style you’ve noticed works best and write this into the treatment plan.
Expectations: One of the hardest parts of rehab is being realistic about how much function a person can get back. Some people make a full recovery and function as they did before the injury. Other people will improve just a little. This mostly depends on how bad the injury was. He may need to learn new ways of doing everyday tasks, while staying hopeful that things will keep getting better.
Feelings: People can have a lot of feelings during rehab. These can be feelings about the injury itself, how much their rehab is going to help them, or how much they expect to recover. Feeling tired, angry, discouraged, or overwhelmed is normal and part of the rehab process.
A brain injury can make these feelings even stronger. Talk with the healthcare team if you think these feelings are so strong that they may affect his rehab progress. As a family caregiver who is watching or being part of the rehab process, you will also have many strong feelings. It may help to talk with the social worker, or ask the team who can help you.
As family and other support people know what the treatment goals and activities are, they become partners with the person with the injury and the rehab team to help him get back as many skills as he can and become as independent as possible.
If you have questions, even years after the brain injury, you are welcome to speak to the brain rehabilitation team.
It’s hard to know how a person’s thinking will be affected by a brain injury. However, we do know that there is a usually a pattern to recovery that starts soon after a serious brain injury. One scale that is often used to describe cognitive disability and recovery is the Rancho Los Amigo Scale.