Rehabilitation after brain injury

Question 1

What problems can patients face post brain injury?

Answer 1

-Physical
Cognitive
emotional
behavioural
social

Question 2

What are the early physical issues?

Answer 2

Mobility (
muscle tone
nutrition
Pressure areas (need to prevent pressure sores)
continence (needs catheter)
Communication (Very upsetting for family if can’t communicate)

Question 3

Non-physical issues that impact on early rehab?

Answer 3

impaired cognition 
(disorientation, short attention span, poor short term memory, impaired executive function & insight)

emotional lability

behavioural probs

Question 4

What is rehabilitation?

• carried out by who?
• explain the biology of rehab? (4)

Answer 4

based on principles of adult education
an active process that must involves the patient
goal orientated
aimed at minimising disability and handicap, maximising activity and participation

-multi-professional team

-stop further damage and stabilise
recovery and repair of damaged cells, circuits
activation of redundant pathways
stem cell differentiation and activation
promote experience dependent plasticity through focussed practice

Question 5

what meds to be considered in younger adult patient group? (5)

Answer 5

job or career
dependent children
financial commitments 
sporting interests 
self image- denial

Question 6

What should the process of rehabilitation involve? (4)

Answer 6

multi-professional assessment of needs
agree goals with patient +/- family
Work to achieve the goals
review process regularly 
plan discharge and long term follow up

Question 7

Setting goals

-what model is used and what does it stand for?

Answer 7

SMART
S- specific
M- motivating
A- achievable
R- rational and relevant to patient
T- time defined

Question 8

Long term support:

• what needs to be considered in terms of home and family? (4)
• employment?(2)
• Structure and leisure (4)

Answer 8

-length of hospital stay
suitability of houses: access, safety
relationships: supporting fam & friends
risk of social isolation

-financial probs, benefits, role in family
vocational rehab and support

-need daily structure
planning this becomes key treatment goal
some interests easier to resume than others
involve social work

Question 9

What 4 things are needed for effective rehab?

Answer 9

early identification of patients and problems
multi professional team
good comms between acute/rehab/community teams
joined up plan for transference of care