Image of a human's head and the words 'Application for Brain Injury Fund Assistance' underneath.

Brain Injury Information
 

  • Facts
  • Financial Assistance
  • Q & A
  • TBI Information
  • Resources
  • Rehabilitation
  • Support Groups

Brain Injury Facts

Worldwide

Of all types of injury, those to the brain are among the most likely to result in death or permanent disability. (1)

Brain injury is the leading cause of death and disability worldwide.

Traumatic brain injury is the leading cause of seizure disorders.

The World Health Organization (WHO) adopted standards for the surveillance of central nervous system injury in 1993.

United States

Annually:

  • One million Americans are treated and released from hospital emergency departments as a result of traumatic brain injury (TBI). (2)
  • 230,000 people are hospitalized and survive (3)
  • 80,000 people are estimated to be discharged from the hospital with some TBI-related disability (4)
  • 50,000 people die (5)

An estimated 5.3 million Americans are living today with disability related to traumatic brain injury. (6)

Most studies indicate that males are far more likely to incur a TBI as females.

The highest rate of injury occurs in between the ages of 15-24 years. Persons under the age of 5 or over the age of 75 are also at higher risk.

Consequences of Brain Injury

Brain Injury can cause many different kinds of physical, cognitive, behavioral and emotional impairments that are sometimes temporary and sometimes permanent depending on the individual and the severity of the brain injury. Impairments can range from subtle to severe. Brain injury can also result in seizure disorders.

Brain Injury is a public health concern that demands ongoing epidemiological study, increased efforts to prevent injuries from occurring, and research to advance medical options and therapeutic interventions.

References
  1. Centers for Disease Control and Prevention
  2. Data from the National Hospital Ambulatory Medical Care Survey, 1995-1996, of the National Center for Health Statistics.
  3. Data from the National Hospital Discharge Survey , 1996, of the National Center for Health Statistics.
  4. Guerrero JL, Leadbetter S, Thurman DJ, Whiteneck G, and Sniezek JE. A method for estimating the prevalence of disability from traumatic brain injury. In preparation.
  5. Unpublished data from Multiple Cause of Death Public Use Data from the National Center for Health Statistics, 1996.
  6. Guerrero JL, Leadbetter S, Thurman DJ, Whiteneck G, and Sniezek JE. A method for estimating the prevalence of disability from traumatic brain injury. In preparation.”

Financial Assistance for Persons with Brain Injury

Are you looking for financial assistance for a brain injury survivor? Peruse the list of programs and services below that can help provide financial support for brain injury survivors. Eligibility varies from provider to provider so please contact the individual providers to see if you or your family member are eligible for their services. Don’t forget to ask physicians, hospital social workers, and other professionals about available financial assistance in Delaware.

Delaware Benefits & Programs
  • The Delaware Department of Health and Social Services website contains a wealth of information on the Delaware Prescription Assistance Program.
  • The Delaware Medicare Assistance Bureau (DMAB) provides free health insurance counseling for people with Medicare, including those under 65 years of age. Call DMAB at 800-336-9500 or (302) 674-7364 to set up a free counseling session with a trained volunteer at a convenient site near you. Learn more by viewing the Delaware Medicare Supplement Insurance Shopper’s Guide 2020.
  • MEDICAID: Medicaid provides health insurance for eligible low-income children and adults. Services are coordinated through Delaware Health and Social Services, Division of Medicaid and Medical Assistance (DMMA). In Delaware, call (800) 372-2022 or apply online through Delaware ASSIST.
  • Delaware Division of Vocational Rehabilitation: Provides services for disabled children and disabled adults. There is an application process involved. The disabled person must also be reasonably expected to become more employable as a result of some rehabilitation services. The purpose of these programs is to attempt to rehabilitate and to gain employment. Vocational rehabilitation services include medical and therapeutic services and physical and can include necessary surgeries, hospitalizations, prosthetic and assisted devices, eyeglasses, special services, such as transportation or dialysis, diagnosis and treatment for mental and emotional disorders, physical therapy, occupational therapy and speech or hearing therapy. They can also provide communication services, vocational training, financial support and transportation for those enrolled in the program.
  • Application for Brain Injury Fund Assistance - Funding assistance is limited to legal Delaware residents with a qualifying, medically documented traumatic brain injury (TBI) who would benefit from covered services which are otherwise not available to residents through other federal, state, or private healthcare programs.
Federal Benefits & Programs
  • SOCIAL SECURITY: Social Security provides a monthly income for eligible older persons and persons with disabilities. Call the Social Security Administration at (800) 772-1213.
  • SUPPLEMENTAL SECURITY INCOME (SSI): SSI supplements Social Security payments for individuals who have certain income and asset levels. SSI is administered by the Social Security Administration. Call (800) 772-1213. SSI helps people with disabilities who have little or no income. It provides cash to help pay for food, clothing and a place to live. It is a federal government program, and you can find out if you are eligible for SSI by completing an online screening tool in just a few minutes. To apply for SSI benefits, call the Social Security Administration (SSA) at (800) 772-1213 to make an appointment for help applying for benefits, either on the phone or at a local Social Security office. Without an appointment, you may have a long wait to be helped.
  • Social Security Disability Insurance (SSDI) pays benefits to people who worked and paid into Social Security before a disabling injury, or to the person's spouse or children. SSDI pays cash to those who meet the eligibility requirements and are unable to work for a year or longer because of a disability.
  • You can apply for online or call the Social Security Administration (SSA) at (800) 772-1213 to make an appointment for help applying for benefits, either on the phone or at a local Social Security office. Without an appointment, you may have a long wait to be helped. Be sure to get a list of the information you will need to complete the application, so you can do it in one visit.
  • The Government Benefits website offers a totally free, easy-to-use and completely confidential way to find out government benefit programs.
  • HILL-BURTON FUNDS are available when a hospital receives construction funds from the federal government. Any hospital that received Hill-Burton funds are required by law to provide some services to people who cannot afford to pay for their hospitalization. For more information on hospitals covered by the Hill-Burton Act, call (800) 638-0742.
  • VETERANS BENEFITS: Eligible veterans and their dependents may receive treatment at Delaware’s Veterans Affairs (VA) Medical Center. Treatment for non-service connected conditions may be available based on the veteran’s financial need. The VA also has a special brain injury program. Call (800) 827-1000.
  • MEDICARE is a federal health insurance program for individuals who receive Social Security benefits. Eligible individuals include older people, people with permanent kidney failure, and persons with disabilities under the age of 65 who meet requirements. To learn more call 1-800-MEDICARE.
  • PRESCRIPTION DRUGS: Prescription drug coverage is available through Medicare Part D.
Other Financial Assistance
  • The NeedyMeds website provides information on prescription assistance, free or low-cost sliding scale clinics, medical transportation, and additional resources to help lower costs.
  • Contacting a brain injury specialist at the National Brain Injury Information Center is a great place to find information. Call (800) 444-6443
  • PRIVATE HEALTH INSURANCE: If you have private health insurance, contact your insurance company to find out available services covered under your policy. Ask your doctor or other health care provider for help with advocating for your medical needs with your insurance company.
  • PRIVATE FUNDS: Don’t forget to check available private funds to help pay medical bills. There are many not-for-profit organizations, foundations, community groups, religious organizations, and even fundraising events that may help you obtain financial assistance after a brain injury. Help with medical costs, low-cost housing, bills, transportation, education, nutrition, and job training may also be available. Services vary widely and opportunities often have special eligibility requirements.
  • FUND RAISING SUPPORT: Some families choose to contact local newspaper, radio and television stations to request assistance with sharing information on their survivor’s situation. These types of requests usually request monetary donations toward medical or equipment costs. (E.g. Catholic Charities, Salvation Army and many others.
    • Help Hope Live provides support specifically for catastrophic injury campaigns.
    • Go Fund Me enables friends and family to set up a personal fundraising campaign to cover medical expenses

Brain Injury Question & Answers

What are "acquired brain injuries" and "traumatic brain injuries" and how do they differ?

Traumatic brain injury (TBI) is defined as trauma resulting in an injury or damage to the brain caused by an external physical force such as from a blow to the head, striking the head on a hard surface, a fall, car accident, or a gunshot wound to the head. A TBI is not caused by something internal such as a stroke or tumor, and does not include Acquired Brain Injuries (ABIs) or damage to the brain due to prolonged lack of oxygen (anoxic brain injuries). A Traumatic brain injury includes any injury to the brain resulting from a direct blow to the head that is caused by trauma where the force is large enough to break through the skull and damage the soft brain, or to cause the brain to move within the skull including:

  • Concussions
  • Contusions
  • Coup-contrecoup Injuries
  • Second Impact Syndrome (Recurrent TBI); and
  • Penetration Injuries.

Traumatic Brain injuries are classified as closed or open. A closed traumatic brain injury is the result of trauma in which the brain is injured as a result of a blow to the head, or a sudden, violent motion that causes the brain to knock against the skull. Closed traumatic brain injuries can be diffuse, meaning that they affect cells and tissues throughout the brain; or focal, meaning that the damage occurs in one area. Closed traumatic brain injuries can range from mild to severe. These traumatic brain injuries can cause issues in many places like the occipital lobe or the parietal lobe.

About 50 to 70 percent of all traumatic brain injuries are the result of motorized vehicle accidents. Other causes include:

  • Slips and falls,
  • Violence, and
  • Sports-related accidents.

TBIs are included as part of the broader category of acquired brain injuries (ABIs).

Acquired brain injury (ABI) is an injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma. Essentially, this type of brain injury is one that has occurred after birth. The injury results in a change to the brain's neuronal activity, which affects the physical integrity, metabolic activity, or functional ability of nerve cells in the brain.

ABI is a broader category that includes two types of acquired brain injury: traumatic (such as those caused by accidents) and non-traumatic injuries caused by certain medical conditions. A non-traumatic brain injury is an alteration in brain function or pathology caused by an internal force (such as strokes).

How are brain injuries classified?

Traumatic Brain Injury

Concussion

Even a concussion can cause substantial difficulties or impairments that can last a lifetime. Whiplash can result in the same difficulties as head injury. Such impairments can be helped by rehabilitation, however many individuals are released from treatment without referrals to brain injury rehabilitation, or guidance of any sort.

  • A concussion can be caused by direct blows to the head, gunshot wounds, violent shaking of the head, or force from a whiplash type injury.
  • Both closed and open head injuries can produce a concussion. A concussion is the most common type of traumatic brain injury.
  • A concussion is caused when the brain receives trauma from an impact or a sudden momentum or movement change. The blood vessels in the brain may stretch and cranial nerves may be damaged.
  • A person may or may not experience a brief loss of consciousness.
  • A person may remain conscious, but feel dazed.
  • A concussion may or may not show up on a diagnostic imaging test, such as a CAT Scan.
  • Skull fracture, brain bleeding, or swelling may or may not be present. Therefore, concussion is sometimes defined by exclusion and is considered a complex neurobehavioral syndrome.
  • A concussion can cause diffuse axonal type injury resulting in temporary or permanent damage.
  • A blood clot in the brain can occur occasionally and be fatal.
  • It may take a few months to a few years for a concussion to heal.

Contusion

  • A contusion can be the result of a direct impact to the head.
  • A contusion is a bruise (bleeding) on the brain.
  • Large contusions may need to be surgically removed.

Coup-Contrecoup

  • Coup-Contrecoup Injury describes contusions that are both at the site of the impact and on the complete opposite side of the brain.
  • This occurs when the force impacting the head is not only great enough to cause a contusion at the site of impact, but also is able to move the brain and cause it to slam into the opposite side of the skull, which causes the additional contusion.

Diffuse Axonal

  • A Diffuse Axonal Injury can be caused by shaking or strong rotation of the head, as with Shaken Baby Syndrome, or by rotational forces, such as with a car accident.
  • Injury occurs because the unmoving brain lags behind the movement of the skull, causing brain structures to tear.
  • There is extensive tearing of nerve tissue throughout the brain. This can cause brain chemicals to be released, causing additional injury.
  • The tearing of the nerve tissue disrupts the brain’s regular communication and chemical processes.
  • This disturbance in the brain can produce temporary or permanent widespread brain damage, coma, or death.
  • A person with a diffuse axonal injury could present a variety of functional impairments depending on where the shearing (tears) occurred in the brain.

Penetration

Penetrating injury to the brain occurs from the impact of a bullet, knife or other sharp object that forces hair, skin, bones and fragments from the object into the brain.

  • Objects traveling at a low rate of speed through the skull and brain can ricochet within the skull, which widens the area of damage.
  • A “through-and-through” injury occurs if an object enters the skull, goes through the brain, and exits the skull. Through-and-through traumatic brain injuries include the effects of penetration injuries, plus additional shearing, stretching and rupture of brain tissue. (Brumback R. (1996). Oklahoma Notes: Neurology and Clinical Neuroscience. (2nd Ed.). New York: Springer.)
  • The devastating traumatic brain injuries caused by bullet wounds result in a 91% firearm-related death rate overall. (Center for Disease Control. [Online August 22, 2002: http://www.cdc.gov/ncipc/didop/tbi.htm#rate,]).
  • Firearms are the single largest cause of death from traumatic brain injury.
  • (Center for Disease Control. [Online August 22, 2002: http://www.cdc.gov/ncipc/didop/tbi.htm#rate,]).

Acquired Brain Injury

Acquired Brain Injury, (ABI), results from damage to the brain caused by strokes, tumors, anoxia, hypoxia, toxins, degenerative diseases, near drowning and/or other conditions not necessarily caused by an external force.

Anoxia

Anoxic Brain Injury occurs when the brain does not receive any oxygen. Cells in the brain need oxygen to survive and function.

Types of Anoxic Brain Injury:

  • Anoxic Anoxia- Brain injury from no oxygen supplied to the brain
  • Anemic Anoxia- Brain injury from blood that does not carry enough oxygen
  • Toxic Anoxia- Brain injury from toxins or metabolites that block oxygen in the blood from being used Zasler, N. Brain Injury Source, Volume 3, Issue 3, Ask the Doctor
Hypoxic

A Hypoxic Brain Injury results when the brain receives some, but not enough oxygen.

Types of Hypoxic Brain Injury:

  • Hypoxic Ischemic Brain Injury, also called Stagnant Hypoxia or Ischemic Insult- Brain injury occurs because of a lack of blood flow to the brain because of a critical reduction in blood flow or blood pressure.

Resources:

Brain Injury Association of America, Causes of Brain Injury. www.biausa.org

Zasler, N. Brain Injury Source, Volume 3, Issue 3, Ask the Doctor

What are the Levels of Brain Injuries?

Mild Traumatic Brain Injury (Glasgow Coma Scale score 13-15)

Mild traumatic brain injury occurs when:

  • Loss of consciousness is very brief, usually a few seconds or minutes
  • Loss of consciousness does not have to occur—the person may be dazed or confused
  • Testing or scans of the brain may appear normal
  • A mild traumatic brain injury is diagnosed only when there is a change in the mental status at the time of injury—the person is dazed, confused, or loses consciousness. The change in mental status indicates that the person’s brain functioning has been altered, this is called a concussion
Moderate Traumatic Brain Injury (Glasgow Coma Scale core 9-12)

Most brain injuries result from moderate and minor head injuries. Such injuries usually result from a non-penetrating blow to the head, and/or a violent shaking of the head. As luck would have it many individuals sustain such head injuries without any apparent consequences. However, for many others, such injuries result in lifelong disabling impairments.

A moderate traumatic brain injury occurs when:

  • A loss of consciousness lasts from a few minutes to a few hours
  • Confusion lasts from days to weeks
  • Physical, cognitive, and/or behavioral impairments last for months or are permanent.
  • Persons with moderate traumatic brain injury generally can make a good recovery with treatment or successfully learn to compensate for their deficits.
Severe Brain Injury

Severe head injuries usually result from crushing blows or penetrating wounds to the head. Such injuries crush, rip and shear delicate brain tissue. This is the most life threatening, and the most intractable type of brain injury.

Typically, heroic measures are required in treatment of such injuries. Frequently, severe head trauma results in an open head injury, one in which the skull has been crushed or seriously fractured. Treatment of open head injuries usually requires prolonged hospitalization and extensive rehabilitation. Typically, rehabilitation is incomplete and for most part there is no return to pre-injury status. Closed head injuries can also result in severe brain injury.

TBI can cause a wide range of functional short- or long-term changes affecting thinking, sensation, language, or emotions.

TBI can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age.1

Repeated mild TBIs occurring over an extended period of time (i.e., months, years) can result in cumulative neurological and cognitive deficits. Repeated mild TBIs occurring within a short period of time (i.e., hours, days, or weeks) can be catastrophic or fatal.

There is a kind of brain damage that results from genetics or birth trauma. It's called congenital brain damage. It is not included, though, within the standard definition of brain damage or traumatic brain injury.

Resources:

National Institute of Neurological Disorders and Stroke. Traumatic brain injury: hope through research. Bethesda (MD): National Institutes of Health; 2002 Feb. NIH Publication No.: 02-158.

Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. Report to Congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Atlanta (GA): Centers for Disease Control and Prevention; 2003.

Brain Injury Association of America, Causes of Brain Injury. www.biausa.org

What are the main causes of traumatic brain injury?
  • Vehicle-related collisions
  • Blows to the head
  • Sports injuries -- Collisions, blows and falls during sports
  • Falls, especially in and around the home
  • Bicycle Accidents
  • Motorcycle Accidents
  • Nursing Home Abuse
  • Construction Accidents
  • Work Accidents
  • Physical violence
  • Gunshots
  • Military combat, including explosive blasts and shrapnel injuries
  • Other penetrating wounds to the head
What are the main causes of acquired brain injury?
  • Poisoning or exposure to toxic substances
  • Infection
  • Strangulation, choking, or drowning
  • Stroke
  • Heart attacks
  • Tumors
  • Aneurysms
  • Neurological illnesses
  • Abuse of illegal drugs
How frequently do traumatic brain injuries occur?
  • In the U.S., every year, about 2.6 million people have some type of brain injury -- whether as a result of trauma, stroke, tumor, or other illnesses, according to the Brain Injury Association of America.
  • A quarter of a million people are hospitalized for traumatic brain injuries every year.
  • Half of a million ER visits for traumatic brain injuries are for children under 14.
  • People over the age of 75 have the highest rate of traumatic brain injuries.
  • Approximately 52,000 people die every year as a result of traumatic brain injury.
  • More than 5 million Americans who've suffered traumatic brain injury require assistance in performing daily activities.
  • Approximately 3 in 4 traumatic brain injuries are also classified as concussions.
  • Those most likely to receive a traumatic brain injury fall in the following age ranges: 0-4; 15-19; 65 and up.
When does rehabilitation begin after a traumatic brain injury?

Before you can start rehab, you must get care and treatment for the early effects of TBI. This might include:

  • Emergency treatment for head and any other injuries
  • Intensive care treatment
  • Surgery to repair brain or skull injuries
  • Recovery in the hospital
  • Transfer to a rehabilitation hospital

If you have had a TBI, rehabilitation (or rehab) is an important part of your recovery. Rehab takes many forms depending on your individual needs, and may include physical, occupational, and speech therapy, as well as psychiatric care and social support. All of these are designed to help you recover from the effects of your injury as much as possible.

Rehab can take place in various settings. You, your case coordinator, and your family should pick the setting that works best for you. How long your rehab lasts and how much follow-up care you will need afterwards depends on how severe your brain damage was and how well you respond to therapy. Some people may be able to return to the same level of ability they had before TBI. Others need lifetime care.

What is the Rancho Los Amigos Scale?

The Rancho Los Amigos Levels of Cognitive Functioning Scale is a renowned clinical tool used to rate how people with brain injury are recovering. The ten levels of recovery noted in the scale also help to decide when a patient is ready for rehabilitation. As patients "wake up" after a head injury, they go through different levels of recovery on the Rancho Scale. Each level describes a general pattern of recovery, with a focus on cognition and behavior. Check out the Levels of Cognitive Functioning on the CNS Centre for Neuro Skills education and resources webpage.

What happens after a traumatic brain injury patient is released from the hospital?

Nearly 23% of traumatic brain injury patients require additional treatment following discharge from the hospital. Your individual program may include any or all of these treatments:

  • Physical therapy
  • Physical medicine
  • Occupational therapy
  • Psychiatric care
  • Psychological care
  • Speech and language therapy
  • Social support

You have many options for rehabilitation therapy, and the type of therapy that you need is determined by your care team. For a list of the rehabilitation facilities in Delaware and surrounding areas visit the Brain Injury Rehabilitation page of this site.

What are the long-term effects of brain injury?

Long-term effects of brain injury can include:

Cognitive Effects
  • Memory loss either short or long term
  • Post-traumatic amnesia
  • Attention and concentration problems
    • Decreased concentration or attention span
    • Decreased speed of thinking
    • Difficulty understanding directions or instructions which may manifest as confusion
  • o Language and communication issues
    • Difficulty speaking and listening
  • Loss of vision lack of taste, smell and hearing.
 
Emotional Effects
  • Personality traits are sometimes affected in the long-term
  • Irritability
  • Emotional mood swings
  • Depression
  • Anxiety
  • Frustration and confusion
  • Unprovoked acts of violence
  • Inappropriate behavior such as laughing, impulsive decision making that is illogical, or a lack of self-control when quietness and subtly are needed.
Physical Effects
  • Headache
  • Fatigue and sleep disturbance
  • Nausea
  • Seizures and spasms
  • Locomotion, coordination and balance issues
  • Negotiating objects in the survivor’s path
  • Paralysis may affect certain areas of the body
 
Sensory Effects
  • Writing and drawing may prove difficult
  • Reading
  • Spatial relations
  • Depth perception
  • Difficulty with puzzles and building blocks
    • Forgetting how objects relate and fit with one another
What assistance is available for persons in Delaware with brain injury?

Brain injuries can be a major challenge for survivors, family members and caregivers.

Traumatic Brain Injury Information

The Delaware State Council for Persons with Disabilities, Traumatic Brain Injury Fund Committee is sharing the following Abstracts, Fast Facts, InfoSheets,, Problem Sheets and Reports about complications that may occur after incurring a Traumatic Brain Injury.

Visit Delaware’s Traumatic Brain Injury Fund webpage, our Brain Injury Resources webpage. Find a support group by visiting our Delaware Brain Injury Support Groups page.

Brain Injury Resources

American Association of Neurological Surgeons (AANS)
The AANS provides information on prevalence of TBIs, Incidence and Demographics, TBI Symptoms, Surgical Lesions, Diffuse Injuries, Skull Fractures, Radiological Tests, Surgical Treatment, Medical Treatment, Outcome, Glasgow Coma Scale, Rehabilitation, General Head Injury Prevention Tips, Sports and Recreation Head Injury Prevention Tips, a Glossary of Terms and Traumatic Brain Injury Resources.

Brain Injury Association of America (BIAA)
The leading national organization serving and representing individuals, families and professionals who are touched by a life-altering, often devastating, traumatic brain injury (TBI). Together with its network of more than 40 chartered state affiliates, as well as hundreds of local chapters and support groups across the country, the BIAA provides information, education and support to assist the 5.3 million Americans currently living with traumatic brain injury and their families. The Brain Injury Association of America’s guiding principles are:

  1. Being the voice of brain injury.
  2. Serving the entire field.
  3. Benefiting from strong leadership.
  4. Committing to increasing their resources; and
  5. Valuing strategic decisions and action.

Contact
Brain Injury Association of America at:
1608 Spring Hill Road, Suite 110
Vienna, VA 22182
Phone: 703-761-0750 Departmental Contact Information
CapTel: 703-761-0755 Email: info@biausa.org

Brain Injury Association of Delaware (BIAD)
The Brain Injury Association of Delaware is a not-for-profit affiliate of the Brain Injury Association of America. BIAD focuses on providing support, education and advocacy to traumatic brain injury survivors, their families and caregivers throughout the State of Delaware and Salisbury, MD.

Mailing: P.O. Box 1897,Dover, DE 19904
Office: 872-C Walker Rd., Dover, DE 19904
Phone: 302-346-2083

BrainLine
BrainLine is a national multimedia project offering authoritative information and support to anyone whose life has been affected by brain injury or PTSD: people with brain injuries, their family and friends, and the professionals who work with them. BrainLine also provides military-specific information and resources on traumatic brain injury and post-traumatic stress disorder (PTSD) to veterans, service members, and their families.

Contact
BrainLine, WETA-TV
3939 Campbell Avenue
Arlington, VA 22206
Phone: 703-998-2020
Email: info@BrainLine.org

Brainline Military
Provides military-specific information and resources on traumatic brain injury to veterans, service members in the Army, Navy, Air Force, Marines, National Guard, Reserve, and their families. Through video, webcasts, articles, personal stories, research briefs, and current news, those whose lives have been affected by TBI can learn more about brain injury symptoms and treatment, rehabilitation, and family issues associated with TBI care and recovery. BrainLineMilitary.org is part of BrainLine.org, a national multimedia project offering information and resources about preventing, treating, and living with TBI.

Centers for Disease Control and Prevention (CDC) -- Traumatic Brain Injury & Concussion
The CDC defines a traumatic brain injury (TBI) as a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury. Everyone is at risk for a TBI, especially children and older adults.

Visit this website to learn basic information, view data and statistics, find publications, reports, fact sheets, find news and announcements relating to brain injuries and so much more.

Crisis Intervention
Phone: 1-800-652-2929 in Northern Delaware and 1-800-345-6785 in Southern Delaware.

DANA Foundation
The Dana Foundation is a private philanthropic organization dedicated to advancing understanding about the brain in health and disease through research grants and public outreach. Their website provides fact sheets, truth vs. myths, Q & As about the brain , how the brain works, how exercise affects the brain and so much more information.

Delaware Aging and Disability Resource Center (ADRC) Visit the ADRC website for additional information or assistance for brain injury survivors and caregivers. The ADRC staff are available to assist you Monday through Friday from 8:00 a.m. to 4:30 p.m. The ADRC is a one-stop access point for information and services to help adults with physical disabilities and caregivers and acts as a single point of entry to public long-term support services. Foreign language services available.

Phone: 1-800-223-9074;
Telecommunications Device for the Deaf (TDD) only:
302-391-3505 or 302-424-7141
Email: DelawareADRC@delaware.gov

Delaware Commission of Veterans Affairs (DCVA)
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Provides aged or disabled veterans with rehabilitative, residential and medical care and services. The VA also helps veterans and their families to present claims for veterans' benefits to the federal government and offers veterans low-cost loans to acquire farms and homes.

Phone: (800) 344-9900 (Within Delaware)
(302) 739-2792 (Outside Delaware)
Caregiver Eligibility: Family members of a veteran
Care Recipient Eligibility: Veterans who are residents of Delaware

Delaware Division of Medicaid and Medical Assistance (DMMA) website lets you apply for Medicaid and Delaware’s Prescription Assistance Program in addition to offering medical assistance and support services for dental resources and so much more! DMMA provides a variety of home and community-based long term care services. Please visit the DMMA website for further information.

DMMA
DHSS Herman Holloway Campus, Lewis Building
1901 N. DuPont Highway
New Castle, DE 19720
Phone: 302-255-9500 or 1-800-372-2022
Phone Numbers and Service Hotlines:
Customer Relations: 866-843-7212
Provider Relations: 800-999-3371; and
Health Benefits Manager: 800-996-9969

Delaware Joining Forces (DJF) is a network of state agencies, and external service providers who proactively work together to provide solutions for Delawarean military members, veterans and families. The DJF network may be called upon to address and provide solutions to critical issues and needs, including financial and legal assistance, job training and employment, homelessness and housing, education, behavioral health and wellness. Be sure to visit this site to search for Delaware services by type of service offered, by keywords, or by service index.

Delaware’s Traumatic Brain Injury Fund provides funding assistance for service(s), treatment(s), therapy (ies), or equipment not covered by an applicant’s healthcare insurance or another state agency or organization. Click on the link to learn more about the fund and to complete an Application for Traumatic Brain Injury Fund Assistance. Download a copy of the Traumatic Brain Injury Fund Brochure.

Point of Hope
Brain Injury/Neurological Impairment Program – Work-centered program that helps people develop their own goals within a daily schedule of activities.

 

New Castle Location
34 Blevins Drive Suite 5
New Castle, DE 19720
Phone: (302) 731-7676
Fax: (302) 731-7477

Smyrna Location
4877 Wheatleys Pond Road
Smyrna, DE 19977
Phone: (302) 514-5042
Fax: (302) 514-9554

 

Website: http://www.point-of-hope.com
To Apply for the program complete the application form online (PDF Form) print, sign and mail or fax it to Point of Hope.

SHARE Military Initiative at Shepherd Center
The SHARE Military Initiative at Shepherd Center is a comprehensive rehabilitation program that focuses on assessment and treatment for active duty or separated service members who have served in the U.S. military since September 11, 2001 and who are experiencing symptoms of or have a diagnosis of mild to moderate brain injury, or concussions and any co-occurring psychological or behavioral health concerns, including post-traumatic stress.

SHARE Military Initiative provides hope, assistance, support and education to service members and their families during their recovery treatment and beyond.

Shepherd Center
2020 Peachtree Road NW
Atlanta, GA 30309-1465
Phone: 404-603-4314
Phone: 404-352-2020

The Delaware Department of Health and Social Services maintains a Brain Injury and Coma Information that contains excellent resources.

National Resource Center for Traumatic Brain Injury
The mission of the National Resource Center for Traumatic Brain Injury (NRCTBI) is to provide relevant, practical information for professionals, persons with brain injury, and family members. Their FAQ page contains a wealth of information on basic aspects of brain injuries, problems following brain injuries, and information on special issues relating to brain injuries.

The National Resource Directory
Find information by category. Resources are consistently vetted, reviewed and maintained. To get started, select a category or view all categories.

The National Resource Directory (NRD) and the Office of Warrior Care Policy engage with programs for Service members and Veterans across the Department of Defense, Department of Veterans Affairs, other U. S. Government agencies, and associated organizations.


State of Delaware Agencies
Federal Agencies
  • Social Security Administration - The official website of the Social Security Administration.
    • Medicare Information – The official U. S. Government website for Medicare information. Get free and secure access to your Medicare information, find care, compare procedure costs, and find out what’s covered.
    • The Red Book - A guide to work incentives. The Red Book serves as a general reference source about the employment-related provisions of the Social Security Disability Insurance (SSDI) Programs for educators, advocates, rehabilitation professionals, and counselors who serve people with disabilities.
    • Supplemental Security Income (SSI)
International
  • International Brain Injury Association (IBIA) -- The IBIA works to develop positive relations and interactions between individuals, families, groups, organizations, institutions, diverse cultures and nations. The IBIA strives to provide international leadership for creative solutions to the issues associated with brain injury. Visit this site to view Brain Injury Facts.
Legal Assistance

Delaware Volunteer Legal Services (DVLS)
DVLS serves indigent residents throughout the State of Delaware by providing quality, pro bono legal services. They try to ensure that those individuals without financial resources receive the same access to justice in civil matters as other litigants.

To find out if you are eligible for free legal assistance visit the Delaware Legal Help Link or call DVLS at 302-478-8680 in Wilmington, DE or 888-225-0582 in Kent or Sussex County.

Community Legal Aid Society, Inc., Disabilities Law Program
The Disabilities Law Program (“DLP”) is a special project of Community Legal Aid Society, Inc., which is designated by the Governor as the Protection and Advocacy agency in Delaware.

The DLP provides advocacy services to Delaware residents with physical or mental disabilities prioritizing their services based on federal agency guidance and needs identified by consumer and community groups.

 

New Castle County:
100 W. Tenth St.,
Suite 801
Wilmington, DE 19801
Phone: 302-575-0690
TTY/TDD: 302-575-0696
Toll Free: 800-292-7980

Kent County:
840 Walker Road
Dover, DE 19904
Phone: 302-674-8503 (TTY/TDD Also)
Toll Free: 800-537-8383

Sussex County:
Georgetown Professional Park
20151 Office Circle
Georgetown, DE 19947
Phone: 302-856-3742 (TTY/TDD Also)
Toll Free: 800-462-7070

Legal Services Corporation of Delaware
A private, non-profit law firm whose mission is to use the practice of law to help low-income families in Delaware.

  • LSCD is a non-profit organization that offers legal advice and assistance to people who cannot afford a private attorney.
  • LSCD works to give low-income individuals an opportunity to exercise the rights they have been granted by law. They are not a political or religious organization.
  • LSCD handles only civil cases. They do not handle any criminal matters.
 

Dover Office
24A Hiawatha Lane
Dover, Delaware 19904
Phone: 302-734-8820
Fax: 302-734-8826

Wilmington Office
100 West 10th Street, Suite 203
Wilmington, DE 19801
Phone: 302-575-0408
Fax: 302-575-0478

UAB-TBIMS Home-Based Cognitive Stimulation Activities
The University of Alabama at Birmingham’s (UAB) Traumatic Brain Injury Model System (TBIMS) Home Stimulation Program provides activities for use with individuals following their brain injury. These activities are designed to assist the individual in the recovery of their thinking skill. Each activity provides a group of tasks listed by their level of difficulty.

The tasks range from the least challenging, Level 1 to higher levels that are progressively more challenging. Select activities that you feel might be appropriate and follow the directions, increasing the level of difficulty as the progress warrants. Work on several tasks each day and shift tasks after a few days to provide variety. These tasks are not meant to substitute for professional therapy and use of the tasks does not guarantee recovery. The tasks are offered to provide some guidance and structure to people with brain disorders and their families. https://www.uab.edu/medicine/tbi/uab-tbi-information-network/uab-tbims-home-based-cognitive-stimulation-activities

This booklet is free to print and disseminate for educational purposes.

Links
Additional Website Resources
Caregiver Resources
  • Adult Day Services

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    Adult Day Services provides activities and assistance for people with physical and/or mental impairments. This service is for people who cannot be left alone for long periods of time. For example, a person may use adult day services while his or her primary caregiver (such as a family member) is at work.

    Phone: (800) 223-9074

    Caregiver Eligibility: Anyone

    Care Recipient Eligibility:

    • Functionally-impaired adults aged 60+ or persons under age 60 with dementia (OAA)
    • TANF and SSI recipients or low-income eligible aged 18 to 59 (SSBG)
    • Persons aged 18 and over who meet financial and medical eligibility requirements (Medicaid Waivers)

  • Care-giver.com
  • Caregiver Resource Centers Network serves as an access point for issues related to caregiving. Coordinators at each center understand the challenges that caregivers face. They provide information, assistance and support that can be helpful in a caregiver's individual situation. They help caregivers navigate services systems, find solutions to individualized concerns and make appropriate referrals.
  • Easterseals Respite Program -- Provides funding to help caregivers take a break from being a caregiver. Respite funding is available for Delaware residents not receiving respite funding from any other source and include the Child and Adolescent Caregiver Respite, the Relative Respite Program, and the Lifespan Respite Program.
  • Empowering Caregivers - organization whose mission is to provide assistance; education, support, referrals and respite for informal family caregivers, as well as to promote public awareness about the realities of those who care for loved ones.
  • Family Caregiver Alliance - a public voice for caregivers, illuminating the daily challenges they face, offering them the assistance they so desperately need and deserve, and championing their cause through education, services, research and advocacy.
  • Family Caregiver Learning Center -- An online learning community offering information, training, classes and more on your schedule.
  • National Family Caregivers Association - educates, supports, empowers and speaks up for the more than 50 million Americans who care for loved ones with a chronic illness or disability or the frailties of old age.
  • National Fathers Network - organization whose mission is to celebrate and support fathers and families raising children with special health care needs and developmental disabilities.
  • Smart Patients created this new Caregivers Community so that caregivers and other loved ones can join the community for free to share, interact, and learn from each other in a safe, supportive environment.
  • TBIhelp.org
  • Today's Caregiver Magazine - Caregiver Media Group is a leading provider of information, support and guidance for family and professional caregivers.
  • Well Spouse Foundation - organization focusing exclusively on the needs of all spouses caring for a chronically ill and/or disabled husband, wife, or partner.
Discussion, Chat, and Listserve Sites
  • Epilepsy Support Group -- New Castle County, DE
  • Quadriplegic (Tetraplegic) Discussion Group - provides a forum for quadriplegics (tetraplegics) to communicate with others who share the same condition.
  • TBI Help Now -- This is a service portal providing links to those healthcare providers (HCP) who have completed additional specialty training with the Millennium Health Centers, Inc, in the area of Traumatic Brain Injury.
  • Traumatic Brain Injury by bjscloset - This site is dedicated to survivors and all who wish to learn more about traumatic brain injury (TBI). Spread your wings.......open your minds.....and learn.
  • Vent Users Mailing List - provides a forum for people who require a ventilator (respirator) to breathe to communicate with others who share the same condition.
Organizations
  • Brain Injury HOPE – Most people do not completely recover from a brain injury. Fortunately, we live in an age where the number of brain injury resources increases daily.
  • Brain Trauma Foundation - dedicated to improving the outcome of Traumatic Brain Injury (TBI) patients by developing best practice guidelines, conducting clinical research and educating medical personnel. Visit this page to learn about concussions, coma guidelines, research news and improving outcomes.
  • Brain Injury Resource Center / Head Injury Hotline - offers consultations, research assistance, case management services, legal services, and in-service training. Their clientele include individuals with brain injuries and their families, government officials, agency heads, educators, medical and legal professionals, and social workers.
  • North American Brain Injury Society (NABIS) - society comprised of professional members involved in the care or issues surrounding brain injury. The principal mission of the organization is moving brain injury science into practice. Be sure to check out their Brain Injury Facts under “Resources.”
  • Traumatic Brain Injury Information Page – by the National Institute of Neurological Disorders and Stroke.
  • TBI.org – The primary focus of TBI.org is positive communication between persons with brain injury, family members/ caregivers/friends of persons with brain injury, those many professionals who treat persons with brain injury and community members in order to create positive changes and enhance public awareness and knowledge of acquired/traumatic brain injury.
Books, Exercises & Guides

Acute Brain Injury: A Guide for Family and Friends
“This booklet provides basic information about brain injury and its treatment. Please read it at your own pace. As you learn more about the brain, you will have many questions. Members of your health care team will do their best to answer your questions. Definite answers may not be known because the long term effects of brain injury can be difficult to predict. All information contained on uihc.org is copyrighted--©2019--and the property of the University of Iowa unless otherwise noted.”

Brain Injury Professional
Following the affiliation between the North American Brain Injury Society (NABIS) and the International Brain Injury Association (IBIA) in 2017, BIP became an official publication of both organizations, with an expanded international focus and reach.

Pocket Guide (also available as app)
Mild Traumatic Brain Injury Pocket Guide
Pocket Guide | Mobile App.

The Mild TBI Pocket Guide is a quick reference, all-encompassing resource for primary care and other TBI health care providers on the assessment, treatment and management of patients with mild TBI and related symptoms in the continental United States. The clinical guidance and tools in the guide include:

  • TBI basics
  • Summaries of the VA/DoD Clinical Practice Guideline for the Management of Concussion/Mild TBI(2009) and Updated DoD Mild TBI Clinical Guidance (2008)
  • ICD-9 coding guidance for TBI
  • Cognitive rehabilitation for mild TBI
  • Clinical recommendations on driving assessment after TBI
  • Patient education tools
  • Other clinical tools and resources

Survivor Acceptance: Moving Forward After Trauma -- Step-by-Step Exercises to Help You Reintegrate into Social Life, Accept Your Limitations, Discover and Capitalize on Your Strengths, and Live Life to the Fullest Possible.

Brain Injury Rehabilitation Programs

Listed below are major brain injury and coma rehabilitation programs in and around Delaware.

Delaware

Bayhealth Rehabilitation
560 S. Governors Avenue
Dover, DE
Phone: 302-744-7095

100 Wellness Way
Milford, DE 19963
Phone: 302-430-5706

ChristianaCare Center for Rehabilitation
Throughout Delaware
Phone: 302-320-6600

 

Encompass Health Rehabilitation Hospital of Middletown
250 East Hampden Road
Middletown, DE 19709
Phone: 302-464-3400

Post-Acute Medical Rehabilitation Hospital of Dover
1240 McKee Road
Dover, DE 19904
Phone: 302-672-5800

Pennsylvania

Bryn Mawr Rehab Hospital
414 Paoli Pike
Malvern, PA 19355
Phone: 484-596-5400

Good Shepard Rehabilitation
1800 Lombard St.
Penn Medicine
Philadelphia, PA 19146
Phone: 1-888-447-3422

Jefferson Hospital for Neuroscience
900 Walnut Street
Philadelphia, PA 19107
Phone: 215-955-6000

 

Magee Rehabilitation Hospital
1513 Race Street
Philadelphia, PA 19102
Phone: 1-800-966-2433

MossRehab
Einstein Healthcare Network
12 South 23rd Street
Philadelphia, PA 19103
Phone: 215-523-7800 or 215-523-6982
Main Campus
60 Township Line Road
Elkins Park, PA 19027
Phone: 215-663-6000 or 215-663-8891

Maryland

Sinai Rehabilitation Center -- Brain Injury Program
A LifeBridge Health Center
2401 W. Belvedere Avenue
Baltimore, MD 21215
Phone: 410-601-9000

University of Maryland Rehabilitation & Orthopaedic Institute
200 Kernan Drive
Baltimore, MD 21207

 

The Sandra and Malcolm Berman Brain & Spine Institute
LifeBridge Health SurgiCenter
23 Crossroads Drive, Suite 100
Owings Mills, MD 21117
Phone: 410-601-9515 for a neurologist
410-601-4417 for neurosurgeon appointments
410-601-7375 for neuropsychological assessments
410-601-5597 for rehabilitation appointments

New Jersey

Bancroft NeuroRehab
Multiple locations in NJ

Kessler Institute for Rehabilitation
Marlton, NJ

 

Magee Rehabilitation – Cherry Hill
2211 Chapel Avenue, Suite 101, First Floor
Cherry Hill, NJ 08002
Phone: 856-922-5090

Brain Injury Support Groups

Delaware Support Groups

New Castle County, Delaware

Wilmington
3rd Thursday of each month at 6:30 p.m.
Facilitators: Sharon Lyons and Maggie McCormick
Location: Alfred I. DuPont Hospital for Children, Room # 1,
Bluebird Blvd.,
1600 Rockland Rd.,
Wilmington, DE
Call: 302-737-4506

 

Kent County, Delaware

Smyrna
3rd Tuesday of each month at 12:00 p.m.
Facilitator: Tiffany Stewart
Location: Point of Hope,
4877 Wheatleys Pond Rd.,
Smyrna, DE
Call: 302-731-7676 x200

 

Dover
1st Thursday of each month at 4:00 p.m.
Facilitator: Sharon Lyons
Location: Post-Acute Medical Rehabilitation Hospital,
1240 McKee Rd.,
Dover, DE
Call: 302-346-2083

 

Sussex County, Delaware

Georgetown
2nd Tuesday of each month at 7:00 p.m.
Facilitator: Brenna Meixner
Location: Easterseals facility, Rt. 113, Georgetown, DE
Call: 1-800-411-0505

 

Lewes
2nd Thursday of each month at 6:30 p.m.
Facilitator: Amy Kratz
Location: Lewes Senior Center, 32083 Janice Rd., Lewes, DE
Call: 302-542-4991

Millville
1ST & 3RD Tuesdays of each month from 1:00 to 3:00 p.m.
Facilitators: Beverly and Ed Bell
Location: Millville Volunteer Fire Company, Route 26, Millville, DE
Call: 302-537-9016

 

Maryland - Eastern Shore

Salisbury, Maryland
1ST & 3RD Tuesday of each month from 1:00 to 3:00 p.m. ** No meetings in December **
Facilitator: Dr. Glenn Brooks
Location: Chesapeake Rehabilitation (Health South),
Employees’ Dining Room,
Route 50 and Tilghman Road,
Salisbury, MD
Call: 410-546-4600 or 800-938-4600
Open To: Survivors, caregivers, families, friends, and healthcare professionals.

** NOTE: Please call to confirm meeting times and locations, as they occasionally change. **
 


While Traumatic brain injuries (TBI) affect individuals with varying levels or degrees of symptoms, TBI survivors experience similar emotions. Both the survivor and their family find that dealing with the effects of a TBI are challenging; however, sharing your experiences with people who have had similar experiences can help. TBI support groups provide the opportunity to make friends, learn more about TBI and to share available resources.

Different support groups focus on different aspects. Some TBI support groups emphasize learning about TBI, some have separate meetings for TBI survivors and family members, some are open to anyone, while others offer adaptive recreational opportunities for TBI survivors. We recommend visiting several in order to find the one that best meets your needs.

While we tried to make the list above as complete as possible; support groups may change or disband without warning. Please call the number listed before traveling to a group’s meeting location for the first time. If you cannot find a group in your area, you may wish to start one. You can obtain information about starting your own TBI support group from the Brain Injury Association of Delaware.