The process of recovery from a traumatic brain injury varies from person to person depending on the exact nature of the injury and the specific needs of the affected individual. The ultimate outcome and how long rehabilitation will take can be hard to predict at the outset, but by following the right steps, significant improvement can often be achieved.
In this article we will address some of the most common questions asked by people who have suffered traumatic brain injuries and their loved ones about the rehabilitation and recovery process.
There is no set timeline for recovering from a brain injury as each case is unique. In the initial period after the injury occurs, it is very hard to make an accurate prediction about how long rehabilitation will take. This can obviously be very frustrating for those affected, but is unfortunately unavoidable.
After around six months, the prognosis will usually start to become clearer. At this point a brain specialist should be able to give a more meaningful idea of what level of recovery the patient is likely to achieve and how long this will take. After a year, it should be relatively certain what the final outcome is likely to be and how much longer this will take to achieve.
A common belief is that any improvements usually tail off after the first two years, but, in fact, many patients continue to improve for years after a brain injury. However, it is worth bearing in mind that the most significant recovery normally happens within the first six months and after this any improvement is likely to be smaller in scale.
Accessing brain injury rehabilitation services
Rehabilitation services for traumatic brain injuries are run by both the NHS and various private firms across the UK. Which service a patient is referred to will be decided by the clinical team, the patient and their family.
After a referral has been made, the patient will normally need to undergo an initial assessment at the rehabilitation centre to determine whether the service is appropriate and what type of support the patient will need.
The number of spaces available at any given service and the level of funding available varies, but most units (including private ones) accept NHS referrals, so will be funded by the NHS. If you would prefer to be treated privately, medical insurance and compensation claims for traumatic brain injuries can sometimes cover the costs.
Where does rehabilitation take place?
Traumatic brain injury rehabilitation services are normally offered in a number of ways. Where treatment is offered will depend on the severity of the injury and what stage of recovery the patient is at.
Initially, the patient is likely to be treated as an inpatient, especially in the most serious cases. This will normally involve intensive rehabilitation care in a hospital or specialist neurological rehabilitation centre. Inpatient treatment for brain injuries normally follows a highly structured program, which can be critical during the early stages of recovery.
For less serious injuries, and those who are already some way into the recovery process, it may be possible to be treated as an outpatient. This means the patient can return home and only come to a hospital or specialist treatment unit as and when they need to for treatment.
The final stage of rehabilitation will usually involve patients returning to their home, or moving into a specialist residential unit, where they can receive rehabilitation support in their own home. This stage is usually focused around helping brain injury sufferers to learn to live independently again and is generally delivered by a community rehabilitation or outreach team.
What does the recovery process involve?
There are likely to be various stages in the recovery process and not all patients will need the same types of treatment. Exactly what kinds of care a patient needs will depend on the unique nature of their brain injury.
Some of the most common treatments include:
Neurosurgery – Brain surgery may be required for a number of reasons, including repairing serious wounds, removing blood clots and/or dealing with a build up of blood or other fluid in the brain. This is likely to happen early in the recovery process, but further surgeries may be required in some cases.
Intensive care – After neurosurgery, or in other cases where the patient remains in a serious condition, they are likely to be placed in an intensive care unit. Alternatively they may be placed in a specialist neurological high dependency unit (HDU). This means they can receive 24-hour monitoring by trained specialists with access to all the appropriate equipment for their care.
General ward care – Non-emergency patients may spend some time in a general ward where they can be monitored and supported by trained staff. Patients at this stage of their recovery may still need help with issues such as eating and general self-care.
Physical rehabilitation – The amount of physical rehabilitation care a patient needs will depend on the severity of their brain injury. This is likely to involve steps such as getting used to sitting up, standing and beginning to walk again, often with the help of a mobile frame or other support equipment. Patients may also need to work on issues such as balance, posture and spacial awareness, as well as general control of their movements.
Mental rehabilitation – Many sufferers of traumatic brain injury have issues with their memory and concentration. Particularly common are problems with remembering the recent past and dealing with new situations can often be confusing and stressful for the patient.
Managing fatigue – A major issue with traumatic brain injury patients is fatigue. Patients become tired quickly in the early stages of recovery and should rest immediately if they begin to become fatigued during rehabilitation exercises. Although this can be frustrating, it is not helpful to overtire a rehabilitation patient as this can in fact slow down their recovery process.
Outcomes for traumatic brain injury patients
As stated above, the long-term outcome for traumatic brain injury patients varies from patient to patient depending on the exact nature of their injury. However, with the right rehabilitation treatment, significant recovery can often be achieved.
Patients will generally benefit from a strong support network, so for the best results it is essential to involve family and friends in the recovery process wherever possible, helping patients to work towards leading a fulfilling, independent life once more.