Everything that I have read about injuries to the brain emphatically underscores the need for rehabilitation to commence as soon as the patient is able. Neither the patient nor the doctor has any idea of the extent of injury until rehabilitation is started.
We were lucky. Harold woke up from his brain surgery the very next day and after 5 days in ICU, he was cleared to be transferred to a rehabilitation facility. But Harold still couldn’t walk without complete assistance.
At the rehab center Harold would slowly, and with much assistance, regain his ability to brush his teeth, get dressed, shave, work the TV remote, walk and eat. Initially, he had to call for assistance for everything. To walk to the bathroom, which was just a few feet from the bed, the staff would come in and wrap a thick and wide band of material around his waist, assist him to his walker (inches from the bed) and continue to help Harold to the bathroom, and in the bathroom and then back to his bed. Very, very slowly.
His day was completely scheduled with physical therapy, occupational therapy, speech therapy, etc. . . One exercise Harold had to do was bolting and unbolting a selection of screws and bolts. It seemed easy enough; however, the board that the bolts and screws were attached to was located directly over Harold’s head. Yes, OVER his head. So he had to gingerly tilt his head back far enough to see what he was doing but not so much that he would lose his balance. Then, he had to unscrew the screws and place them on a table directly in front of him at waist level. Once all the screws were off and lined up neatly on the table, he then had to take them and put them back on the bolts located overhead. Tedious but he seemed to enjoy the challenge and even more so when he could successfully complete the task.
Although Harold was determined to make progress and constantly worked to make progress, at times he was frustrated and angry. I was told to expect this.
That Harold’s mood and psychological state would fluctuate and that he would have good days and not-so-good days. And while it’s critically important to maintain a positive and encouraging disposition for your loved one, it’s also important for you to take care of yourself. It’s difficult when someone you love has such strong personality swings but remember they are scared and have no idea what the future holds for them. Difficult for them. Difficult for you. Another aspect of rehabilitation is making sure that you know the names and phone numbers of everyone involved in your loved one’s care. This is important.
There are different stages of a patient’s rehabilitation process: inpatient, outpatient, group therapy, and/or individual therapy. After Harold’s inpatient therapy at the rehabilitation center, he was cleared to come home but still required therapy. As he was on Dilantin to prevent seizures, I drove him to his various individual therapy appointments. He did not require group therapy but I know that had I known about any group therapy sessions I would have strongly encouraged him to participate. Brain injury rehabilitation is a long, lonely road and knowing someone else who had gone through it or was going through it would have been immensely helpful to him and to our family.
There are essentially two components to brain injury rehabilitation: the restoration of functions that can be restored and the learning of how to compensate for functions that cannot be restored to pre-injury condition. Every brain injury is different. Every rehabilitation process is different. However, there is complete agreement in the medical community that rehabilitation is critical/vital to begin as soon as the patient is able and that while the patient is making progress their rehabilitation should continue. Unfortunately, many health insurances have strict limits on what they will and will not cover for brain injury rehabilitation. If you’ll look under the Insurance tab you’ll find information on insurance as well as other options.
In my next blog I’ll share information on selecting a rehabilitation facility and things to look for in a rehabilitation facility. See you soon!