Rehabilitation Tips - Fact Sheet

Many rehabilitation professionals expect recovery to plateau or taper off at some point in their treatment programme. This belief usually terminates the formal rehabilitation programme and ignores what we know about human development: growth ceases only with death.
While there is no cure for brain injuries, the brain does have some capacity to repair itself and rehabilitation is crucial to recovery from a head injury—it uses both your body’s natural healing abilities and your brain’s ability to relearn to aid recovery. Rehabilitation also means learning new ways to compensate for abilities that have permanently changed due to brain injury.

Even when survivors are very motivated, there can be periods of apparent lack of progress. These may be times of consolidation, where the individual is gaining sufficient practice with the new skills to make them become habits. In other cases there may be other issues the person is dealing with. When learning skills are impaired, it is unreasonable to expect the individual to learn new information and behaviours every day.

After decades of experience many rehabilitation professionals have found the common keys to making the most of the rehabilitation process.

Those who make the most of their recoveries tend to have an optimistic outlook, are usually more giving and selfless than most people, and don’t tend to give up easily. Even if this isn’t your natural personality, this is the perfect time to develop these traits! Those who do the best usually look upon negative experiences as a chance to grow and develop themselves further.

People with a brain injury often say rehabilitation is the biggest challenge of their lives. While you may never get back to ‘normal’, the good news is there is no limit to the extent of your rehabilitation. How far you get depends on how much you put in, and even if improvement is painfully slow remember progress is better than staying where you are.

Rehabilitation may the hardest thing you’ve ever done but look at it positively. As Ronald E. Osborn said, “Undertake something that is difficult; it will do you good. Unless you try to do something beyond what you have already mastered - you never grow.”

Most of us lead highly structured lives: we awake, sleep and work at the same times each day. This kind of structure allows us to put most of our lives on automatic pilot and reserve creativity, memory, and novelty for more important areas. After a brain injury individuals often have no structure. They nap throughout the day and then can’t sleep at night, eat meals at varying times and therefore can’t recall if they have eaten at all, they leave things wherever they please and then can’t find them. Tight structure reduces the need to continually make decisions, vastly increases capabilities and significantly reduces the demands placed upon the caregiver.

Upon discharge, try to develop a schedule that includes as much activity as your loved one can handle without becoming too tired. Remember that fatigue, initiation and motivation are often big problems after an injury, so make gentle encouragement the theme to home rehabilitation.

Hand in hand with structure are memory prompts. If the individual is constantly faced with situations in which they have no recall and those around are constantly mentioning this lack of memory, it may eventually cause an erosion of self-esteem. Create some strategies for compensating for this problem by developing lists, post-it notes, cue cards or any other strategies that help the person feel more independent and less likely to make mistakes and be nagged or scolded.

A brain injury often creates difficulty learning new information and generalising new skills from one environment to another. The most effective rehabilitation occurs in the home setting where old learning is maximised. When injured individuals are transported to another city or state, much of what they learn cannot be applied when they return home. The familiar cues which facilitated recall in the treatment setting disappear and the new behaviour cannot be elicited.

Individuals with a brain injury have enough problems without increasing their burden by accepting any and all behaviour. If family members tolerate behaviour which drives others away, the injured individual becomes increasingly isolated from human contact and the burden on the caregiver can become immense. Provide accurate and realistic feedback on their behaviour and its consequences.

Support groups play a vital role in the lives of people with brain injuries and their families, and never more so than when the individual completes rehabilitation and finds that life is changed in ways that the individual and the family find puzzling or difficult to manage. Groups enable the individual to identify with others with similar problems, and together solutions are often found. Additionally, as a result of group interaction, the individual feels less alone and a sense of “belonging” is very important to those whose lives have been dramatically changed.

During the rehabilitation process, be as involved as possible, ask questions, attend family conferences and learn all you can while your family member is in a structured setting. You know your needs best. Your team needs to hear your opinions and concerns. If you have trouble with communication find someone you trust to speak for you.

Make sure you are provided with a sound and realistic discharge plan. Once home, don’t sit back and assume everything will automatically fall into place. Establish a routine (structured environment), consistently enforce the discharge plan, and make sure that your family member has control over those aspects of their life that are safely manageable.As difficult as it may sound, troubleshooting as you go can ease any burden you may assume in guiding your family member to the optimal level of functioning possible.

Whether you have memory problems or a legal case coming up, record everything in writing. Keep copies of all your letters. Record and date your phone calls. Ask people for permission to record phone calls if you think this is required.

One brain injury makes you much more susceptible to further ones. Some of these added traumas occur because of the Cognitive and behavioural deficits following the original injury: The impulsive person who has poor judgment may repeatedly place himself in dangerous situations and then be unable to cope. Apart from supervision another useful tip is to avoid:
Exposure to toxic materials
Alcohol, nicotine, stimulants and other recreational drugs
Exposure to megavitamin therapy.

Hopefully this information has been useful to you and you will begin to think about rehabilitation in terms of cognition and behaviour rather than medical and physical problems. People who have sustained head injuries have a great deal to offer to family, friends, and society if they are given a chance.

Information, education and support are the three most important aspects of rebuilding life after brain injury. Add to that an equal measure of love, and it can be a win-win situation.

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