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Physical, Occupational & Cognitive Therapy for TBI

In her excellent article, 'Living With Brain Injury: Post-Rehabilitation Recovery," Judith Falconer, Ph.D., explains, 'Two of the most common reasons for problems after a head injury are (a) overestimating or underestimating the cognitive and behavioral abilities and limitations of the injured individual and (b) failure to understand the practical implications of these deficits. Expecting too much ‚?¶causes significant behavioral problems; expecting too little‚?¶limits recovery and the acquisition of new skills. At either extreme, the stress experienced by family members is exacerbated and increases over time."

Rehabilitation for TBI can be a long, slow and difficult journey for the person and his or her family. The healing of any physical injury takes time but when the brain has been damaged, recovery involves far more than just rebuilding tissue. TBI survivors frequently have to relearn simple physical skills like brushing their teeth, dressing themselves, bathing, etc. Occupational therapy is often a key component of a person's recovery plan and has the best effect when reinforced by supportive family members.

But as Falconer observes, '‚?¶physical and medical limitations are relatively easy to understand and work around. It is cognitive and behavioral deficits which prevent return to a normal life for the injured individual and it is these deficits which cause stress for family members on a daily basis."

Wherever the person is treated ' at home, in a nursing home, through a hospital out-patient rehabilitation clinic, or in an independent living center ' he or she will do best with the support of a team consisting of healthcare professionals and family members. Working together, they can find the best living arrangement for the TBI survivor and provide ongoing healthcare, and perhaps an appropriate mentoring program. In addition to day to day caregivers, this team will likely include:

Physiatrist ' a physician who specializes in physical medicine and rehabilitation

Physical Therapist ' a professionalwho evaluates the person's physical capabilities and develops a program to help them walk, improve their balance, and increase their mobility skills.

Occupational Therapist ' a professional who accesses and works on a patient's visual, cognitive, and perceptual skills. Through OT exercises, basic yet essential skills such as dressing, eating, housework, etc. can be relearned and mastered to help the person recover some of their independence.

Speech and Language Pathologist ' a professional who evaluates the patient's ability to understand the speech of others and express themselves verbally. Enhancing a TBI survivor's communication skills can have a huge impact on their rate of recovery and family dynamics.

Neuropsychologist ' a professional who analyzes and tracks the injured person's ability toproblem solve, put things in sequence, and make rational choices. Based on their findings a course of action is developed to help the TBI survivor overcome or cope with any disabilities.

Social Worker ' a professional who often works with everyone in the family on how to handle the stress and financial burdens they may be facing during this crisis. A social worker also suggests community agencies that could help the family with these challenges.

Merln Hurd PhD; BCN, QEEGT

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