Brain Injury Rehabilitation Options

People who sustain a brain injury frequently need to relearn different processes in order to recover and compensate for abilities that they have lost or that permanently changed because of their brain injury. Rehabilitation focuses on helping individuals to safely and as independently as possible, perform normal activities of daily living (ADLs).

Rehabilitation following a brain injury can be divided into three main parts: early, intermediate, and late. Early-stage rehabilitation typically occurs in the hospital, while intermediate and late-stage rehabilitation often occurs in outpatient settings. The type and duration of rehabilitation will vary depending on the individual’s needs.

This page shares information on the different rehabilitation options available to someone with a brain injury.

Acute Rehabilitation

As early as possible in the recovery process, individuals who sustain brain injuries will begin acute rehabilitation. The treatment is provided in a special unit of a trauma hospital, a rehabilitation hospital, or another inpatient setting. During acute rehabilitation, a team of health professionals with experience and training in brain injury work with the patient to regain as many activities of daily living as possible. Activities of daily living include dressing, eating, using the bathroom, walking, and speaking.

Cognitive Rehabilitation Therapy (CRT)

Refers to a group of therapies that aim to restore cognitive function after a brain injury. There are many different types of CRT. In individual therapy sessions, cognitive rehabilitation therapists work with you to improve your thinking (cognitive) skills and maximize your success in personal and occupational roles. Some examples of compensatory CRT include using:

• assistive speech devices for a person with a speech impairment.
• calendars and memory tools for people who struggle with executive functioning.
• alarms to regain a person’s attention in certain contexts.
• Neurofeedback uses scans of brain waves to offer real-time brain feedback.
• Attention Processing Training (APT) uses tasks to help improve attentiveness in the areas of focused, selective, sustained, alternating, and divided.
• Computer Assisted Learning may help a person regain attention and memory.

Day Rehabilitation (Day Rehab or Day Hospital)

Day treatment provides rehabilitation in a structured group setting during the day and allows the person with a brain injury to return home at night. Some people may transition to a day program following their discharge from an inpatient post-acute rehabilitation facility, while others may proceed directly to sub-acute rehabilitation after discharge from the hospital.

Neuromuscular Brain Rehabilitation

Physical and occupational therapists trained in brain rehabilitation use state-of-the-art approaches to treat mobility and motor control limitations and to maximize reintegration into independent living. Rehabilitation sessions are focused to improve the brain and muscle coordination. A team of occupational therapists and physical therapists help the individual to ease the process of reintegration into independent life or to expand the boundaries of their limitations caused by severe impairments.

Outpatient Rehabilitation

Following acute, post-acute, and/or sub-acute rehabilitation, a person with a brain injury may continue to receive outpatient therapies to maintain and enhance his or her recovery. Individuals whose injuries were not severe enough to require hospitalization or who were not initially diagnosed with a brain injury when the incident occurred may attend outpatient therapies to address problem areas as a result of their brain injury.

Post-Acute Rehabilitation

When patients are well enough to participate in more intensive therapy, they may be transferred to a post-acute rehabilitation setting, such as a transitional rehabilitation facility. Transitional rehabilitation facilities are sometimes called residential rehabilitation or transitional living facilities. The goal of post-acute rehabilitation is to help the person become as independent as possible. Patients undergo at least six hours of therapy per day. This type of comprehensive rehabilitation in a post-acute facility is considered the gold standard for care and treatment following brain injury.

Speech and language rehabilitation

In individual therapy sessions, speech-language pathologists work with you to reduce any language-based or other limitations to effective communication you may experience. This rehabilitation therapy works to rebuild the ability to build words, grammatical structures, and other communication skills, including the use of personal communication devices, if required. Speech rehabilitation therapy can also involve evaluation and treatment of swallowing disorders (dysphagia). Speech-language rehabilitation can be helpful for individuals who experience new or longstanding difficulties with communication, cognition, voice, speech, and swallowing as a result of changes in the brain, such as brain cancer, brain injury, stroke, and/or degenerative conditions (Parkinson Disease, Dementia, ALS, Primary Progressive Aphasia).

Sub-Acute Rehabilitation

Patients who cannot tolerate intensive therapies may be transferred to a sub-acute rehabilitation facility. Sub-acute rehabilitation programs are designed for persons with brain injury who need less-intensive rehabilitation services over a longer period of time. Sub-acute programs may also be designed for those who have made progress in an acute rehabilitation setting (and are still progressing) but are not making rapid functional gains. Sub-acute rehabilitation may be provided in a variety of settings, such as a skilled nursing facility or nursing home.

Vocational Rehabilitation (Voc. Rehab)

Staff help people to develop a plan to resume work in their previous job field, help people develop new career goals or find ways to best resume other productive activities. Vocational Rehabilitation provides individualized services to employers and people with disabilities, developing career pathways that link qualified employees to jobs, resulting in greater independence and a more inclusive workplace. View the steps to the Rehab Process in Delaware here: https://labor.delaware.gov/divisions/dvr/rehab-process/.