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Brain Injury Resources

This page contains a wealth of information in an easily accessible format that allows users to either scroll down the page or use the page menu to go directly to specific areas of interest.

Provided within this page are Delaware specific resources, additional resources, information for families and caregivers trying to understand and contact numbers if you need to talk to someone. Additional information on Delaware State Agencies & Services, Caregiver Resources, Delaware Legal Resources, Federal/National Resources, International Resources, Military Veteran Resources, links to Books, Exercises & Guides, and other available Resources.

Please bookmark this page and return frequently to obtain information needed.

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Books, Exercise & Guides

Acute Brain Injury: A Guide for Family and Friends
This booklet provides basic information about brain injury and its treatment to read 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 are difficult to predict. All information contained on uihc.org is copyrighted--©2022--and the property of the University of Iowa unless otherwise noted.

Brain Injury Professional
Is an official publication of the International Brain Injury Association and the North American Brain Injury Society that is published quarterly by HDI Publishers in PDF format. Try viewing their ebook selections on brain injury.

Pocket Guide
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.

Your Brain at Work: Recovering from Brain Injury
What you do everyday matters to your brain. Learn four factors that may predict maintenance of cognitive function.”

Brain Injury Symptoms

Cognitive |  Emotional |  Physical |  Sleep |  Vision

Thinking & Remembering Symptoms

People who sustain a brain injury experience problems with their ability to think, plan, concentrate, and remember. Some symptoms may appear right after an injury while some show up days, weeks, months or even years after the brain injury occurred. Sometimes brain injuries are disguised as something else, especially when there was no obvious wound, blood, or unconsciousness from the persons injury.

Common Symptoms
  • Attention and concentration.
  • Processing and understanding information.
  • Short or long-term memory problems and general forgetfulness.
  • Communication.
  • Planning, organizing, and assembling.
  • Reasoning, problem-solving, decision-making, and judgement.
  • Controlling impulses and desires.
  • Being patient.
  • Restlessness and being easily distracted.
  • Difficulty finishing something or working on more than one task at a time.
  • Problems carrying on long conversations or sitting still for long periods of time.
  • Trouble following televisions, movies, etc.
Uncommon Symptoms
  • Anxiety and Post-traumatic stress disorder (PTSD)

Mood Disruption/Emotional Symptoms

Mood issues are one of the most common symptoms suffered after a brain injury along with anxiety. It is very common for the personality of someone with a brain injury to change. Frequently frustration due to the individual’s other deficits caused by their brain injury cause anger and anxiety. Anti-depressants are sometimes administered and depending on the individual may help considerably. Psychiatric therapy is also beneficial to help deal with the person’s deficits.

Common Symptoms
  • Anxiety or nervousness;
  • Depression;
  • Anger and frustration;
  • Feelings of guilt, sadness, and confusion;
  • Sadness;
  • Irritability or easily angered;
  • Feeling more emotional;
  • Mood swings;
  • Changes in behavior;
  • Overwhelming flood of thoughts or emotions;
  • Trouble controlling behavior; and
  • More impulsive than usual.
Uncommon Symptoms
  • Emotional outbursts and spontaneity;
  • Manic Behavior (Switching between happy and depression.)
  • Impaired impulse control – inability to control feelings of aggression, anger, and irritability.
  • Loss of self or feeling like you are in a dream state or outside of yourself watching.
  • Spatial Distortion – Trouble sensing depth and geometry of objects.
  • Suicidal Thoughts;
  • Sudden development of new skills and abilities.
  • Complete Personality Shift; and
  • Loss of sense of humor.

Physical Symptoms

After a brain injury, the nerve cells in the brain may no longer send information to each other the way they normally do. This is why people with a brain injury may have changes in their physical abilities. Every person with a brain injury is unique and has their own recovery path. Some information may apply now, but not in the future.

Common Symptoms
  • Chronic Pain;
  • Delayed response;
  • Difficulty Walking;
  • Hearing problems;
  • Loss of coordination;
  • Loss of smell and/or taste;
  • Numbness and/or tingling;
  • Paralysis;
  • Persistent Headaches;
  • Problems managing bodily functions (e.g.:blood pressure, temperature regulation);
  • Problem swallowing;
  • Severe Nausea or vomiting;
  • Seizures;
  • Slurred Speech;
  • Spasticity;
  • Weakness on one of both sides of the body;
Uncommon Symptoms
  • An aching Jaw;
  • Aphasia (Inability to understand speech);
  • Bad taste in the mouth.
  • Cannot recognize people or places, gets confused, restless, or agitated
  • Inability to Speak (Dysarthria);
  • One pupil larger than the other;
  • Tinnitus (Ringing in the ears) & Hearing Loss;

Sleep Symptoms

People who have brain injuries frequently suffer from sleep disturbances. Not sleeping well can increase or worsen depression, anxiety, fatigue, irritability, and a person’s sense of well-being. It can lead to poor work performance and traffic or workplace accidents. Sleep disturbances are found in people with all severities of brain injuries from mild to severe.

Common Symptoms
  • Insomnia – Difficulty falling asleep or staying asleep; or sleep that doesn’t leave you rested.
  • Excessive Daytime Sleepiness – Extreme drowsiness.
  • Delayed Sleep Phase Syndrome (Mixed-up sleep patterns.)
  • Extreme fatigue or drowsiness.
  • Problems with sleep or sleep patterns (e.g., trouble falling asleep, sleeping more or less than usual.).
  • Feeling drowsy no matter how much you sleep.
  • Waking frequently during the night.
Uncommon Symptoms
  • Hormonal imbalances;
  • Vivid Dreaming and Insomnia;
  • Sleep apnea;
  • Narcolepsy – Falling asleep suddenly and uncontrollably during the day.
  • Periodic limb movement disorder – Involuntarily moving limbs during sleep.
  • Parasomnias, a catch-all term for unusual behaviors experienced prior to falling asleep, or between sleep and wakefulness. (e.g.: Mental confusion or confused behavior in bed; Sleepwalking, Night Terrors, Sleep-related sexual abnormal behaviors, and sleep eating disorders)

Vision & Balance Symptoms

Visual problems are often overlooked during initial treatment of a brain injury and in some cases; symptoms may not be present until sometime following the injury. If you notice any changes in your vision following a brain injury or head trauma, don’t ignore them: Immediately contact your eye care professional.

It is important to determine the cause of the vision change. Early diagnosis leads to appropriate treatment and/or referral to a specialist. Dizziness and balance problems are quite common with brain injuries resulting in an equilibrium problem that makes it hard for people with brain injuries to keep their balance. Balance and dizziness are a real problem for people who sustain a brain injury. The risk of suffering an additional brain injury becomes very high when balance problems can cause one to fall very easily.

Common Symptoms
  • Dilation of pupils
  • Vision disturbances (e.g., double vision)
  • Eye Focusing – blurred vision or ability to shift focus
  • Eye Teaming – Eyes not working together properly
  • Eye Movements – Difficulty trying to follow a moving object.
  • Motion sensitivity
  • Continual sense of disequilibrium
  • Visual Field Loss – Partial or total
  • Eye pain
  • Dizziness, unsteadiness or imbalance
  • Light and/or noise sensitivity
  • Increased Clumsiness or Coordination Problems
  • Slow movements or inability to move
  • Inappropriate gait or trouble walking in a straight line
  • Incorrect weight distribution and posture
Uncommon Symptoms
  • Post-traumatic Vertigo or sense of spinning;
  • Transient Blindness;
  • Benign Paroxysmal Positional Vertigo (Immediate but brief sense of dizziness when the head changes position.

    Direct Vision Problems

    • Double vision
    • Eye turns
    • Blurry vision

    Behavioral Changes

    • Fatigue during reading or computer use
    • Intolerance to crowded places or loud noises
    • Bumping into objects
    • Walking only on one-side of a hallway

    Incapacities

    • Reduced reading comprehension
    • Decreased memory and attention
    • Loss of place when reading
    • Poor balance or posture
    • Loss of side vision
    • Reduced coordination

    Sensitivities

    • Sensitivity to light
    • Frequent nausea and dizziness
    • Frequent headaches
    • Inclination to motion sickness
    • Sore or irritated eyes during reading or computer use
    • Dry or watery eyes

Caregiver Resources

Adults: What to Expect at Home
Returning home following brain injury - regardless of severity - can be complex. It is often emotional, exciting, overwhelming, and exhausting for both the individual and their family.

After the Injury
Immediately following a brain injury, two things occur!

Caregiver 101
Helpful information for caregivers including an emotional first aid kit, finding good homecare, caring for the caregiver and ten ways to maintain a positive attitude.

Caregiver Action Network
This resource ill help you assist your loved ones with the day-to-day activities of life. This website has a Family Caregiver Toolbox, and 10 Tips for Family Caregivers.

Caregiver Resource Centers Network
The Division of Services for Aging and Adults with Physical Disabilities (DSAAPD) 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.

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.

Family Caregiver Alliance (FCA)
Services by State Tool helps family caregivers locate public, nonprofit, and private programs and services nearest their loved one—whether they are living at home or in a residential facility.

Family Caregiver Alliance (FCA), Events & Classes
Find a list of upcoming classes, webinars, support groups and workshops.

Health Conditions
Obtain information and related resources focused on your family or friend’s condition or disease including Brain Tumor, Dementia, Depression, Hypoxic-Anoxic Brain Injury & more.

Smart Patients Caregivers Community
An online community for patients and caregivers to share, interact, and learn from each other in a safe, supportive environment.

Well Spouse
Organization focusing exclusively on the needs of all spouses caring for a chronically ill and/or disabled husband, wife, or partner.

Delaware Community Support

Delaware Resource Directory

Brain Injury Association of Delaware (BIADE)
The state’s leading nonprofit organization supporting people who have been impacted by a brain injury. Through brain injury prevention, advocacy, education, and resources, they make a significant difference in our community.

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.


Need 2 Talk?


Trying to Understand?

Lost & Found:
What Brain Injury Survivors Want You to Know.

9 Things NOT to Say to Someone with a Brain Injury
Brain injury is confusing to people who don’t have one. It’s natural to want to say something, to voice an opinion or offer advice, even when we don’t understand. Here are a few things you might find yourself saying that are probably not helpful.

10 Things People with a Brain Injury Would Like to Hear...
Every individual’s experience with traumatic brain injury is unique, but there are many common symptoms and emotions. Learn about he things they would most like to hear from their friends and family.


Delaware Financial Resources

Stand By Me
Free Financial Coaching

Delaware Score
Free, confidential, face to face advice with a certified mentor

America Saves
Motivates, encourages, and supports low- to moderate-income households to save money, reduce debt, and build wealth.

MyMoney.gov
Locate federal brochures, publications, websites and videos. Resources provide background information, helpful guidance, hints and tips to assist with financial decisions

Delaware.Money
A web-based portal to local agencies that provide financial education, resources, and assistance free of charge.

Delaware Able Plan
Low cost 529(a) savings plan that allows individuals with disabilities and their families to save for a broad range of expenses on a tax-advantaged basis without jeopardizing their benefits from supplemental security income (SSI), Medicaid and other federal programs.

Disability Resource Community
A platform designed for people with disabilities, their family members and caregivers to ask questions, share resources and build community around the things that matter most.

Personal Finance for Diabled People
A resource guide for people with disabilities to help them manage their finances and meet their financial goals.

Social Security Offices in Delaware
This page provides a list of cities that have Delaware Social Security office locations. They can assist you with any questions or issues you might have with your social security benefits, or if you need to obtain a social security card.

Delaware Division of Medicalciad and Medical Assistance (DMMA)
Apply for benefits!

Delaware State Agencies & Services

Adult Day Services
provides activities and assistance for people with physical and/or mental impairments, designed for people who cannot be left alone for long periods of time. Phone: (800) 223-9074

Delaware Aging and Disability Resource Center (ADRC)
A one-stop access point for information and services to help adults with physical disabilities and caregivers that acts as a single point of entry to public long-term support services. Foreign language services available. Phone: (800) 223-9074; Telecommunications Device for the Deaf (TDD) only: (302) 391-3505 or (302) 424-7141; Email: DelawareADRC@delaware.gov

Delaware Coalition for Injury Prevention – TBI
Provides collaborative leadership and data to reduce injury-related morbidity and mortality through statewide injury prevention initiatives to include traumatic brain injuries (TBI) in Delaware.

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.

Division of Developmental Disabilities Services (DDDS)
Supports individuals with intellectual and developmental disabilities to thrive by accessing services they need in their community. DDDS works to identify and support the unique needs of eligible service recipients by offering access to an extensive network of providers including: employment services and vocational training; support coordination and community navigation; assistive technologies; respite; a variety of day and residential programs; and, options for supported living.

Applicant Services
Division of Developmental Disabilities Services eligibility – page. Download and begin an application.

Family Support Services
Provides information on Olmstead Court Decision (ADA), report abuse, self-advocacy, your voice matters, training videos, testimonials, information, and links to service providers and regulations, policies and guidance.

Respite Services
Respite is a service designed to give caregivers a break from the stress of taking care of an individual with special needs.

Some respite options include:

  • a private provider/person of your choice
  • a DDDS Shared Living Provider Home
  • a DDDS Residential Program

Waiver Services
Information on the Division of Developmental Disabilities (DDDS) Home and Community-Based 1915(c) Lifespan Waiver; DDDS HCBS 1915(i) SPA Pathways waiver; DDDS Waiver Fee-for-Service Selective Contracting Program 1915(b)(4) waiver; Division of Developmental Disabilities (DDDS) Home and Community-Based 1915(c) Lifespan Waiver Renewal; and general information.

Delaware Division of Medicaid and Medical Assistance (DMMA)
Provides information to apply for Medicaid and Delaware’s Prescription Assistance Program. Offers medical and support services for dental resources and a variety of home and community-based long-term care services.

Division of Services for Aging and Adults with Physical Disabilities
Guide to Services for Older Delawareans and Persons with Disabilities.

Caregiver Information
Useful links and Caregiver Information.

Delaware Aging and Disability Resource Center (ADRC)
The ADRC is a one-stop access point for information and services for older persons and adults with physical disabilities throughout the State. The Delaware ADRC can help you learn more about available resources, decide what services would be best for you, and find the services that you need.

Long Term Care Information
Useful links for Long Term Care Information.

Division of Social Services
Provides assistance services including the Supplemental Nutrition Assistance Program (SNAP), General Assistance, Temporary Assistance, Child Care, Refugee Cash Assistance, Medicaid, Health Insurance, Eligibility for Social Service Programs and applications, Community Partner Support Unit, and Delaware’s P-EBT Program providing food assistance to families with children who lost access to free or reduced-price school meals when Delaware schools closed as a result of the COVID-19 pandemic.

Delaware Assist
An online application for Delawareans to apply for health and social service programs. (Apply for benefits online) or call (866) 843-7212 so we may serve you by phone. To access our Online ASSIST Portal, please click the ASSIST Icon to the left.

Division of Substance Abuse and Mental Health (DSAMH)
Provides services and programs for crisis intervention services (CIS), Prevention Services, Treatment Access Centers, and substance abuse help.

Delaware Psychiatric Center (DPC)
DPC acts as a member of the Delaware community of caregivers providing integrated services to adults suffering from severe and persistent mental illness.

Help Is Here – Prevent, Treat, Recover!
Information on Understanding Addiction, Overdose Prevention, Mental Health, and Health Care Providers. Learn how to start the conversation, obtain counseling and attend support groups.

Division for the Visually Impaired
DVI provides educational, vocational, and technical support to empower and foster independence for Delawareans with visual impairments provided in the environment(s) that meet the participant’s needs to include work, homes, schools, and in the community.

Division of 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

Department of Health and Social Services
Provides assistance to families facing economic challenges in today’s world from birth to retirement. Serves individuals with disabilities and their families. Provides services promoting the health, well-being and protection of Delaware’s seniors and so much more!

Brain Injury and Coma Information
Information to assist persons with brain injury and their caregivers. Brain Injury Questions and answers, regional coma and brain injury rehabilitation programs, resources for persons with brain injury in Delaware, financial assistance for persons with brain injury, Useful publications related to brain injury, and internet links related to brain injury.

Department of Insurance
Maintains information and helpful links related to consumer services, investigations, fraud prevention, Delaware Medicare, Guides & Publications, disaster preparedness, and flood insurance. You can also find information, and helpful links related to legal arbitration, bulletins, insurance laws and regulations, service of process, and proposed and adopted regulations on their website.

Office of the Attorney General, Victims' Compensation Assistance Program (VCAP)
The Victims’ Compensation Assistance Program (VCAP) can provide financial assistance to help cover the costs of a variety of services that help victims, and their families begin to rebuild their lives, including lost wages, medical expenses, payment for mental health counseling, and funeral expenses.

Financial Assistance for Persons with Brain Injury
A list of programs and services which can provide financial support to persons with a brain injury. Program eligibility varies. Please contact individual providers to determine eligibility for you or your family member. Consider getting help from physicians, hospital social workers, and other professionals in exploring financial assistance options.

Regional Coma and Brain Injury Rehabilitation Programs
View a list of major coma and brain injury rehabilitation programs in and around Delaware.

Resources for Persons with Brain Injury in Delaware
View a list of various resources for persons with brain injury and their families.

Additional Brain Injury Resources
Information on brain injury behavior, resources and treatments, articles on caring for someone with a brain injury and news.

Federal Resources

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.

Social Security Administration
The official website of the Social Security Administration where you can obtain inform on Disability, Social Security Income, Medicare, and sign up for online services.

Supplemental Security Income (SSI)
Supplemental Security Income (SSI) is a Federal income supplement program funded by general tax revenues (not Social Security taxes) that is designed to help aged, blind, and disabled people, who have little or no income; and provides cash to meet basic needs for food, clothing, and shelter./p>

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.


Financial Assistance, Suggestions & Resources

Financial Assistance

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.

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

Suggestions

  • Tell your doctors you’re having financial problems. They may give you a break on their fees.
  • Surf the Web for federal, state, and local government assistance programs. Try www.GovBenefits.gov.
  • Apply for assistance from charitable and civic organizations.
  • Follow the example of many brain injury families who have had raffles, yard sales, car washes, bake sales, road races, and concerts to raise funds for their survivor’s medical expenses.
  • Finally, don’t forget that your medical expenses may be tax deductible.

Resources

America Saves - motivates, encourages, and supports low to moderate-income households to save money, reduce debt, and build wealth.

Delaware ABLE Plan - a low cost 529(a) savings plan that allows individuals with disabilities and their families to save for a broad range of expenses on a tax-advantaged basis without jeopardizing their benefits from supplemental security income (SSI), Medicaid and other federal programs.

Delaware Division of Medicaid and Medical Assistance (DMMA) – Apply for benefits!

Delaware.Money - a web-based portal to local agencies that provide financial education, resources, and assistance free of charge.

Delaware Score – Free, confidential, face to face advice with a certified mentor.

Delaware Social Security Offices - Find office.

Disability Resource Community - is a platform designed for people with disabilities, their family members and caregivers to ask questions, share resources and build community around the things that matter most.

MyMoney.gov - Locate federal brochures, publications, websites and videos. Resources provide background information, helpful guidance, hints and tips to assist with financial decisions.

Personal Finance for Disabled People - a resource guide for people with disabilities to help them manage their finances and meet their financial goals.

Stand By Me - free financial coaching.

Frequently Asked Questions

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).

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, (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

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

  • 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
  • Poisoning or exposure to toxic substances
  • Infection
  • Strangulation, choking, or drowning
  • Stroke
  • Heart attacks
  • Tumors
  • Aneurysms
  • Neurological illnesses
  • Abuse of illegal drugs
  • 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.

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.

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.

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.

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
  • Language and communication issues
    • Difficulty speaking and listening
  • Loss of vision lack of taste, smell and hearing.

Emotional Effect

  • 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

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

Info Sheets

5 Facts About PseudoBulbar Affect (PBA)
by the Brain Injury Association of America

A Head For The Future: Baseball/Football Helmet Fact Sheet
This fact sheet from the Defense and Veterans Brain Injury Center provides tips for choosing the right helmet for the right sport, with information about different safety features in helmets for baseball and football.

A Head For The Future Bicycle Safety FS
This safety fact sheet from the Defense and Veterans Brain Injury Center provides tips to protect your head and help prevent traumatic brain injury (TBI) while riding a bike.

A Head For The Future Car Safety Fact Sheet
This fact sheet from the Defense and Veterans Brain Injury Center provides tips to help prevent TBI while driving a motor vehicle and safety measures to take to keep passengers safe.

A Head For The Future: Cycling Helmets Fact Sheet
This fact sheet from the Defense and Veterans Brain Injury Center provides tips for choosing the right helmet for the right ride, with information about different safety features in helmets for bicycling and riding motorcycles.

A Head For The Future Sports Safety FS
This safety fact sheet from the Defense and Veterans Brain Injury Center provides sports safety tips to prevent or minimize sports-related traumatic brain injury (TBI).

A Parent’s Guide to Returning Your Child to School After a Concussion
This booklet from the Defense and Veterans Brain Injury Center offers practical advice to parents on how to recognize the signs and symptoms of a concussion, information on treatment and recovery, and what a parent can do to support a child’s recovery and successful return to school.

A Parent’s/Guardian’s Guide to Concussions
Prepared by the National Federation of State High School Associations (NFHS) Sports Medicine Advisory Committee (SMAC) Revised and Approved April 2019.

An Educator’s Guide to Concussions in the Classroom 3rd Edition
Proper management of a concussed student in the classroom by his or her educators can allow the student to continue making academic progress through accommodations designed to help prevent permanent damage to the student’s academic record. An educator’s involvement is vital.

Brain Basics: Know Your Brain
This fact sheet is a basic introduction to the human brain. It may help you understand how the healthy brain works, how to keep it healthy, and what happens when the brain is diseased or dysfunctional.

Brain Injury and Coma Information
Brain Injury and Coma Information from the Delaware Division of Services for Aging and Adults with Physical Disabilities.

Brain Injury Facts & Statistics Info Sheet
Brain Injury Facts & Statistics Info Sheet by the Brain Injury Association of America

Concussion Info Sheet
Learn more about Concussion Recognition, Management and Prevention, Observed Signs, and Symptoms Reported by an Athlete.

Concussion Fast Facts
Visit this site to test your knowledge, Know the facts, and learn who is most affected by concussions. Learn about Second Impact Syndrome (SIS), concussion symptoms, and prevention tips.

Concussion Safety Protocol Checklist
A checklist that will help an athletic director ensure that an athletic department is compliant with the concussion management plan

Cruise with Control Fact Sheet
Six tips for preventing Brain Injuries from Motor Vehicle, motorcycle, and bicycle accidents.

Delaware Brain Injury Study
This info sheet provides an introduction, objectives, methodology, and results of the State Council for Persons with Disabilities, Brain Injury Committee’s Research Study using the Delaware Health Information Network data on Traumatic Brain Injuries in Delaware and the prevalence of follow-up care for Delaware’s brain injury survivors. All graphics shown contain Delaware Specific data.

Heads Up CDC Know Your Concussion ABCs Poster
This poster is provided by the CDC and the National Association of School Nurses (NASN). Learn more and download free concussion resources at the CDC.

Head Check: Know Your Helmet for Bicycles and Motorcycles
Helmets worn when playing sports or riding bikes and motorcycles do not make you concussion-proof but they can help protect you from a serious head or brain injury.

Know the Facts About Mild Traumatic Brain Injuries/Concussions to Protect Your Child
Concussions are traumatic brain injuries (TBI) that should be taken seriously. Recent studies show that these types of injuries are becoming more common, particularly among children who participate in sports. If your child is in gymnastics, tumbling, martial arts, or is playing a sport outside of school, you should make sure the organization is following established safety protocols. This fact sheet offers information that can help you protect your child from an injury that could result in a life-altering disability.

Living with Traumatic Brain Injury (TBI)
Evidence-based materials in a variety of formats including printable PDF documents, videos, and slideshows from the Model Systems Knowledge Translation Center (MSKTC).

Making The Most of Lived Experiencea
Making The Most of Lived Experience by Carole Starr, Kelly Lang, and Eric Washington for the National Center on Advancing Person Centered Practices and Systems (NCAAPS).

Mild TBI Symptom Management Fact Sheet: Ways to Improve Your Memory
This fact sheet from the Defense and Veterans Brain Injury Center can be used by health care providers to educate patients with concussion/mild traumatic brain injury on how to manage memory problems related to their injury

Report to Congress – The Management of Traumatic Brain Injury in Children:
Opportunities for Action by the Center for Disease Control and Prevention

Traumatic Brain Injury Fast Facts
Visit this site to test your knowledge, know the facts, learn prevention tips, and understand how teens are affected. Who is most likely to incur a TBI? What are the costs? What are some potential consequences? What can you do?

Traumatic Brain Injury Factsheets
The MSKTC works closely with researchers to develop resources for people living with traumatic brain injuries and their supporters. These evidence-based materials are available in printable PDF Fact Sheets, videos, and slideshows.

VA Research on Traumatic Brain Injury
VA Research on Traumatic Brain Injury by the U. S. Department of Veterans Affairs, Office of Research and Development.


International Resources

Brain Injury HOPE
This website contains some of the best brain injury resources available today including a state-by-state guide to local brain injury associations and alliances.

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.

Mayo Clinic – Traumatic Brain Injury
Visit this site to learn about traumatic brain injury symptoms and causes and diagnosis and treatment.

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.”


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 individuals without financial resources receive the same access to justice in civil matters as other litigants.

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

Delaware State Bar Lawyer Referral Service
(LRS) services are made available to the community through a telephone interview with the LRS and a payment of a $35.00 consultation fee.

Community Legal Aid Society, Inc., Disabilities Law Program (DLP)
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: (302) 575-0690; Kent County: (302) 674-8503 (TTY/TDD Also); Sussex County: (302) 856-3742 (TTY/TDD Also).

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 handles only civil cases. Dover Office: (302) 734-8820 or Wilmington Office: (302) 575-0408.

National Brain Injury Trial Lawyers Association
An invitation-only professional organization composed of and limited to the Top 25 attorneys from each state or region who serve individuals and families who need attorneys to represent them in the American legal system regarding Brain Injury claims.

Severe Brain Injury and Coma
Learn more about Coma Injuries, Subtle Brain Injury and Coma, Seizures, Child Brain Injury, and Acquired Brain Injury from Neurotrauma Law Nexus.

Traumatic Brain Injury
Learn about the brain, brain map, brain injury, minor traumatic brain injury (TBI), causes and consequences, costs and prevention, facts, demographics, and risk factors, and morbidity and mortality.


Local Brain Injury Resouces

Brain Injury Association of Delaware (BIADE)
The Brain Injury Association of Delaware is a not-for-profit affiliate of the Brain Injury Association of America. BIADE focuses on providing support, education and advocacy to traumatic brain injury survivors, their families and caregivers throughout Delaware. Phone: (302) 346-2083

Crisis Intervention
9-8-8 Nationwide Crisis Hotline
Northern Delaware: (800) 652-2929 and Southern Delaware: (800) 345-6785
DSAMH Consumer Issue Resolution Hotline: (855) 649-7944
Military Crisis Line: (800) 273-8255 (TALK) or 9-8-8 and press 1
Veteran Crisis Line: (800) 273-8255 (TALK), Press 1

Point of Hope
Brain Injury/Neurological Impairment Program – Work-centered program that helps people develop their own goals within a daily schedule of activities. Contact at their New Castle location at: (302) 731-7676 or Smyrna location at: (302) 514-5042.


Military Veterans Resouces

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.

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.

Delaware Joining Forces (DJF)
A network of state agencies, and external service providers who proactively work together to provide solutions for Delaware 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.

Military Health System
Patient and Family Resources, Outreach Network, TBI Fact Sheets, Family and Caregiver Guides, and TBI Patient Resources and so much more are available from this website.

The National Resource Directory (NRD)
A resource website that connects wounded warriors, Service Members, Veterans, their families, and caregivers to programs and services that support them. Find information by category. Resources are consistently vetted, reviewed and maintained. To get started, select a category or view all categories

Office of Veterans Services (OVS)
Provides veterans and their families with information on veteran’s employment, Delaware Veteran’s Cemeteries, community services, benefits, and eligibility. Contact information

Operation We Are Here: TBI Resources for Military Veterans
Provides TBI resources for military veterans.

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. Phone: (404) 603-4314 or (404) 352-2020.

Understanding Traumatic Brain Injuries: For Veterans And Their Families
20,250 of the 1.7 million Americans that experienced a Traumatic Brain Injury (TBI) in 2013 served in the U.S. Military. If you or a loved one has experienced a TBI while serving, there are some basic things you need to understand.

Uniformed Services University, Center for Neuroscience and Regenerative Medicine (USU/CNRM)
Individuals with symptoms of traumatic brain injury (TBI, also known as concussion) and posttraumatic stress (PTS) can contact this website to participate in TBI/Concussion and PTS Research..


National Organizations

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 touched by a life-altering, often devastating, Acquired brain injury (ABI) or traumatic brain injury (TBI). The BIAA provides information, education and support to assist the 5.3 million Americans currently living with a brain injury. Contact: (703) 761-0750, Departmental Contact Information, CapTel: 703-761-0755 Email: info@biausa.org

BrainLine
A national multimedia project offering authoritative information and support to anyone whose life is affected by brain injury or PTSD. For people with brain injuries, their family, friends, and the professionals who work with them this site provides military-specific information and resources on traumatic brain injury and post-traumatic stress disorder (PTSD) for veterans, service members, and their families. Contact: (703) 998-2020 or Email: info@BrainLine.org

Concussion Unpacked by Brain Trauma Foundation (BTF)
Concussions are the most underreported, under diagnosed and underestimated brain trauma by far. Concussions account for 90% of TBIs with millions of trauma cases every year. Through field research, outreach, and education, BTF is leading the charge to better prevent, diagnose, and manage concussion.

Centers for Disease Control and Prevention (CDC) -- Traumatic Brain Injury & Concussion
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.

Brain Injury Resources
Helpful Info About TBI Treatment & Recovery from Constant Therapy Health – Find the best information on prognosis, brain injury treatment, research, therapy options, clinical trials, and caregiver tips.

Brain Basics
Get the answers to some of the most common questions about the brain. Learn how the brain learns language, understanding sleep, and moods.

Johns Hopkins Medicine: Traumatic Brain Injury
Visit this site to learn more about traumatic brain injuries (TBI). What is a traumatic brain injury? What are the different types of TBI? Can the brain heal after an injury? And so much more!

Mayo Clinic – Traumatic Brain Injury
Visit this site to learn about traumatic brain injury symptoms and causes and diagnosis and treatment.

Living with Traumatic Brain Injury TBI
Learn more about Acute Inpatient Rehabilitation, Alcohol and TBI, Balance Problems, Changes in Memory, Chronic Pain, Cognitive Problems, Concussion Recovery, Driving, Emotional Problems, Fatigue, Headaches, Irritability, Anger, Aggression, Loss of Smell or Taste, Relationships, Returning to School, Seizures, Sever TBIs, Sexuality, Sleep, Social Skills, Spasticity, Staying Healthy, Stress Management, Depression, Understanding Behavior Changes, Understanding TBI, Vegetative States, Vision Problems, and Voting Tips After a TBI.

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 information on basic aspects of brain injuries, problems following brain injuries, and information on special issues relating to brain injuries. Be sure to visit their VCU BrainLine Video Series.

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.

Traumatic Brain Injury
A 50 State Guide to Traumatic Brain Injury for those seeking information about local resources.

Traumatic Brain Injury in Adults – American Speech-Language-Hearing Association
Information on Traumatic Brain Injury in Adults. This site provides information on an Overview, Incidence and Prevalence, Signs and Symptoms, Causes, Roles and Responsibilities, Assessment, Treatment, Resources, and References.

UAB-TBIMS In-Home Cognitive Stimulation Guidebook
The University of Alabama at Birmingham’s (UAB) Traumatic Brain Injury Model System (TBIMS) In-home Guidebook offers activities to stimulate thinking skills of people with brain disorders. Each activity provides a group of tasks listed by their level of difficulty. This booklet is free to print and disseminate for educational purposes.


Other Resources

Educational Grants and Scholarships
National, Federal, Local, Private, State and Local Government grants for people who are disabled.

Grants for Students with Disabilities

What Happens to Family After Brain Injury (Video)

This video explains what happens to the family after a brain injury.


Recovery

The 10 Stages of Traumatic Brain Injury Recovery

Based on the Rancho Los Amigos Scale.

Early Stages of Brain Injury Recovery

Stage 1. Coma (No Response, Total Assistance)

Stage 2. Vegetative State (Generalized Response, Total Assistance)

Stage 3. Minimally Conscious State (Localized Response, Total Assistance)

Stage 4. Post-Traumatic Amnesia (Confused/Agitated, Maximal Assistance)

Later Stages of Brain Injury Recovery

Stage 5. Confused/Inappropriate, Non-agitated (Maximal Assistance)

Stage 6. Confused/Appropriate (Moderate Assistance)

Stage 7. Automatic/Appropriate (Minimal Assistance)

Stage 8. Purposeful/Appropriate (Standby Assistance)

Stage 9. Purposeful/Appropriate (Standby Assistance on Request)

Stage 10. Purposeful/Appropriate (Modified Independent)

Rehabilitation

Medical Professionals

Behavioral Analysts are experts on the science of behavior and how it is applied to problems of individual and social significance. Behavior Analysts work with people across their lifespan.

Cognitive Therapists help people identify their thoughts and behaviors, specifically regarding their relationships, surroundings, and life, so that they can influence those thoughts and behaviors for the better.

Neurologists and Neurosurgeons are experts on how the nervous system functions following brain injury. Neurosurgeons correct trauma-related nervous system injuries.

Neuropsychiatrists conduct evaluations to characterize behavioral and cognitive changes resulting from central nervous system disease or injury, including brain injuries, Parkinson's disease or another movement disorder.

Neuropsychiatrists Treat Brain Injuries -- Many mental disorders can stem from brain injuries. The brain is powerful but quite sensitive. Any injury to the brain can change how it functions and how you see the world. The idea of becoming something else just because you injured your brain is quite scary, and there are many types of brain injuries one can experience. As there are many types of brain injuries, and everyone handles them differently, this means that you aren't going to have two brain injuries that are alike. Sometimes, your brain injury can heal over time. Other times, it may not heal, or it can be treated but never cured. Neuropsychiatrists help by looking at the situations you have and seeing what they can do for you. A person who has a brain injury may feel more anxious or have poorer concentration and it's up to neuropsychiatrists to help the person who is suffering from it. They can do this through medicine, therapy, and by stimulating the brain.

Neuropsychologists provide services to reduce the impact of setbacks and help individuals return to a full, productive life. Neuropsychologists’ evaluations provide valuable information to assist with rehabilitative planning and school, community, or employment re-entry.

Occupational Therapists (OT) treat injured, ill, or disabled patients through the therapeutic use of everyday activities. They help patients develop, recover, and improve, as well as maintain the skills needed for daily living and working.

Physiatrists are medical doctors who have completed medical school and training in the specialty field of physical medicine and rehabilitation. Physiatrists diagnose illnesses, design treatment protocols and can prescribe medications.

Physical Therapists (PT) are health specialist who evaluate and treat human body disorders and can help manage illnesses or injuries to your bones, brain, heart, lungs and skin.

Recreational Therapists (RT)) help people reduce depression, stress, and anxiety; recover basic physical and mental abilities; build confidence; and socialize effectively. They use interventions, such as arts and crafts, dance, or sports, to help patients.

Speech/Language Pathologists (SLP) work to prevent, assess, diagnose, and treat speech, language, social communication, cognitive-communication, and swallowing disorders in children and adults.


Rehabilitation Options

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/.


Rehabilitation Facilities Nearby

Delaware

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

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

Ivy Rehab for Kids (Formerly Theraplay)
118 Sandhill Drive, Ste 101-102
Middletown, DE 19709
Phone: 302-744-7095

Newark Kids / Ivy Rehab for Kids
630 Churchmans Rd, Ste 100a,
Newark, DE 19702
Phone: 302-544-4361

PAM Health Rehabilitation Hospital of Georgetown
22303 Dupont Boulevard
Georgetown, DE 19947
Main Phone: 302-440-4866
Referral Phone: 302-551-3117

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

Outpatient Services
Phone: 302-672-5854

University of Delaware Physical Therapy Clinic
540 South College Avenue, Suite 160
Newark, DE 19713
Phone: 302-831-8893

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

Self-Care

Alternative Medicine

Hyperbaric Oxygen Therapy (HBOT) is a treatment involving breathing pure oxygen in a pressurized environment.

Meditation/Mindfulness – is a mental training practice that teaches you to slow down racing thoughts, let go of negativity, and calm both your mind and body. It combines meditation with the practice of mindfulness, which can be defined as a mental state that involves being fully focused on "the now" so you can acknowledge and accept your thoughts, feelings, and sensations without judgment.

Neurotherapy - non-invasive therapy that works to help you retrain your mind to help improve concentration, focus, attention, moods, and sleeping habits.

Social Skills Training - A broad term that includes understanding what is expected of you in different social interactions.

Yoga - A mind and body practice. There are many styles of yoga that combine poses, breathing techniques, and sometimes meditation.


Basic Self-Care

Individuals with a brain injury need to learn to:

  1. Ask for help,
  2. Accept less than perfect,
  3. Say no and set boundaries,
  4. Simplify,
  5. Re-prioritize,
  6. Get enough sleep,
  7. Eat well and healthy,
  1. Exercise,
  2. Let go of any guilt,
  3. Practice gratitude,
  4. Connect with friends,
  5. Remember that things will change,
  6. Rest and de-stress frequently,
  7. When you are able to return to work, Set up a supportive work environment.

Follow the links on this page to learn more about the different types of self-care and complementary and alternative medicine.

Basic Self Care – Eating well, Drinking Water, Exercise, Aerobic Activity, Strength training, and practicing good sleep habits.

Fundamentals for Living – Survivors often have a hard time knowing how to manage new challenges, managing stress, setting goals, being patient and knowing when to ask for help.

Importance of Sleep - Many people who have brain injuries suffer from sleep loss, making it harder for them to concentrate. There are several types of sleep issues that may affect you.

Nutrition - A healthy diet and regulated eating during the recovery from a brain injury is essential.


Types of Self-Care

Mental and Emotional care - Mental health is just as important as your physical health. This can be as simple as journaling, spending time outside, attending a religious service, or calling a loved one. Healthy coping skills take practice, particularly when emotional regulation is affected by brain injury. The LoveYourBrain website includes research and exercises.

Physical Care – eating properly and staying hydrated. Continue some form of daily exercise program based on your abilities that includes something aerobic and some strength training.

Social Self-Care - Staying connected to your friends is important to your overall well-being. Relationships work best when they are cared for and maintained. Healthy boundaries are also an important component of social self-care. Everyone has different social needs so you will have to find the right balance and level of social engagement that works best for you.

Spiritual - Growing research shows that spirituality or religion as a part of your lifestyle improves your wellbeing. Spiritual self-care does not necessarily mean practicing religion. Spirituality can include anything that connects you to the universe or deepens your sense of meaning.

Therapy & Testing

Cognitive Therapy (CT) Cognitive therapy focuses on present thinking, behavior, and communication rather than on past experiences and is oriented toward problem solving.

Neurobehavioral Therapy a set of assessment and treatment procedures addressing biological mechanisms of underlying behavioral disorders and psychological conditions.

Neuropsychological Testing a test to measure how well a person's brain is working. The abilities tested include reading, language usage, attention, learning, processing speed, reasoning, remembering, problem-solving, mood and personality and more.

Occupational Therapy (OT) This therapy involves treating injured, ill, or disabled patients through the therapeutic use of everyday activities. They help these patients develop, recover, improve, as well as maintain the skills needed for daily living and working.

Physical Therapy (PT) the treatment of disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise rather than by drugs or surgery.

Psychological Counseling helps individuals learn coping skills, work on interpersonal relationships, and improve general emotional well-being.

Speech/Language Therapy (SLT) is a treatment that can help improve communication skills. The specialists who do this type of therapy start by identifying what kind of speech or language problem an individual has, determine what’s causing it and decide on the best treatment. This type of therapy can target problems with: Receptive language (understanding language), Expressive language (using language), Social Communication (using language in socially appropriate ways), and Reading and spelling (including dyslexia).

Vision Therapy (VT) called neuro-optometric rehabilitation in case of brain injury, helps treat the effects of brain injury and teaches the injured brain new ways to compensate for vision problems.

Vocational Rehabilitation (VR) is defined as a process that a disabled individual goes through in order to gain, maintain, or return to employment. Several professionals work together to help you through this process.

Types of Therapy

Anti-anxiety medication to lessen feelings of nervousness and fear;

Anticoagulants to prevent blood clots and improve blood flow;

Anticonvulsants to prevent seizures;

Antidepressants to treat symptoms of depression and mood instability, also called mood swings;

Computerized Tomography Scan or CT scan to look for signs of a brain injury;

Complete Rest and slow return to normal activities;

Diuretics to help remove fluid that can increase pressure inside the brain;

Glasgow Coma Scale (GCS) measures the level of consciousness based on eye-opening to appropriate stimuli, motor responsiveness, and verbal performance;

Magnetic Resonance Imaging or MRI to obtain a detailed image of the brain;

Muscle relaxants to reduce muscle spasms and to relax constricted muscles;

Neurological Exam to test for motor and sensory skills, hearing and speech, coordination and balance, and mood and behavior;

Repairing skull fractures; For most skull fractures, treatment consists of close observation in the hospital and medication to relieve pain during the healing process. However, some skull fractures require surgery.

Repetitious Exercise; A type of physical activity that involves planned, structured, and repetitive bodily movement done to maintain or improve one or more components of physical fitness.

Relieving pressure inside the skull;

Stimulants to increase alertness and attention;

Surgical removal of blood clots or pools;

Vision Therapy to help treat the effects of brain injury and teach the injured brain new ways to compensate for vision problems;





 

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