- What is a TBI (Traumatic Brain Injury)?
“Brain injury” is the commonly accepted term implying that the damage is to the brain itself and not to the outside areas of the head.
There are several ways to describe brain injuries:
Closed Head Injury – the skull is intact and there is no penetration of the skull. Direct or indirect force to the head can cause this type of injury.
Open Head Injury – penetration of the skull with direct injury to the head.
Diffuse Axonal Injury – diffuse cellular injury to the brain from rapid rotational movement. This is often seen in motor vehicle accidents or shaking injuries.
Contusion – a bruise to a part of the brain that bleeds into the tissue.
Penetrating Trauma – any object that enters the brain, causes direct injury by impact and pushing skull fragments into the brain.
Secondary Injury – swelling and release of chemicals that promote inflammation and cell injury or death. Secondary injury includes:
- Intracranial hemorrhage (bleeding inside the skull)
- Brain swelling
- Increased intracranial pressure (pressure inside the skull)
- Brain damage associated with lack of oxygen
- Infection inside the skull, common with penetrating trauma
- Chemical changes leading to cell death
- Increased fluid inside the skull (hydrocephalus)
Acquired brain injury – injuries other than congenital, birth trauma, hereditary or degenerative. This includes traumatic brain injury. In the non-traumatic types of acquired brain injury, the brain is usually diffusely injured. Common causes are strokes, encephalitis, aneurysms, anoxia (lack of oxygen) and hypoxia (insufficient oxygen). Drugs and poisoning can also cause acquired traumatic brain injury. Carbon monoxide poisoning is an example of poisoning that may cause brain injury.
- How do I know if I have a brain injury? Or… What are the ‘symptoms’ of a brain injury?
Although the causes of brain injury differ, the effects of these injuries on a person’s life are quite similar. Whatever the cause, a brain injury can result in an impairment of cognitive abilities, physical, behavioral, and emotional functioning.
Behavioral
- Irritability/Frustration Tolerance
- Impulsivity
- Egocentricity
- Impatience
- Dependency
- Hyper/Hypo-sexuality
- Aggression
- Verbal Outbursts
- Silliness/jocularity
- Disinhibition
- Childishness/social immaturity
- Obsessiveness
- Confabulation
- Verbosity
Cognitive
- Attention and concentration
- Memory
- Problem solving deficits
- Inflexibility/rigidity
- Lack of Insight
- Perseveration
- Decreased abstraction
- Slowed information processing/cognitive speed
- Unawareness of deficits
- Problems with initiation, planning and organization
- Inability to effectively utilize feedback
- Distractibility
- Mental fatigue
- Problems with Communication
Emotional
- Anxiety
- Depression
- Anger
- Denial
- Lability
- Indifference/apathy/lack of motivation
- Fearfulness
- Suicidal ideation
- Guilt
- Distrustfulness
- Social isolation/withdrawal
- Defiance/oppositional attitude
Physical/Somatic
- Paralysis/paresis
- Spasticity
- Seizures
- Fine and gross motor deficits (visual, auditory, olfactory)
- Fatigue
- Headaches
- Dizziness
- Sleep Disturbances
- Photophobia
- Is a concussion a brain injury?
A concussion is a mild traumatic brain injury (MTBI), induced by mechanical forces that immediately disrupt the normal functioning of the brain.
- Concussion is the most common type of brain injury sustained in sports.
- An athlete does not have to lose consciousness to have sustained a concussion.
- Once an athlete has sustained a concussion, that athlete is at greater risk of sustaining additional concussions.
- How will my injury affect my life?
In therapy you will learn new strategies to handle the physical, cognitive and behavioral issues that you may be facing.
- What can I do to improve my level of function?
In therapy you will learn new strategies to handle the physical, cognitive and behavioral issues that you may be facing.
- When will I be able to go back to work/school?
This can only be answered on an individual basis depending on the type and extent of your injury, and what you might have been doing before the injury.
- How long will my rehabilitation take?
Your rehabilitation ends when you have reached all the goals that you have set for yourself, along with your team, your family and your funding source. There will come a time when it is clear to you that you wish to move beyond a structured program. At that point, everyone will make certain that you have a smooth transition to the next step of your life. Often discharge is a gradual process, and your level of involvement with us will lessen as you continue to improve and reach your goals.
- Can I see my records at any time?
Your records are always available to you. We ask that you look at them with your case coordinator so he/she can explain any items that you may question.
- Can I live at home and still receive neuro rehabilitation services?
About 50% of our clients live in their homes and go to our Outpatient Center for rehabilitation services. We also provide an “outreach” program where our staff members can come directly to your home and community to provide services. In addition, we have group residences in Northern N.J. and can set up apartments wherever it is practical.
- If I live at one of the group residences or apartments, can my family visit me?
Generally, our family and friends are encouraged to visit whenever they want. We ask you not to arrange visits when you are scheduled for therapy.
- How will you make sure that I will be safe where I live?
Each client is assessed for safety by our staff at the time of admission. An appropriate amount of staffing is assigned to you at that time. As you progress, your plan is reassessed and revised as necessary.
- What happens in a typical day at the rehab center?
Everyone’s program is designed specifically for them. Our treatment is offered individually and in groups, and takes place in an outpatient center, in the community, or in the home. Sessions consist of a variety of therapies. The focus is to return you to work, school, and all activities related to daily living.
- In an emergency, is there a hospital nearby?
Rehabilitation Specialists is located 10 minutes from two local hospitals and medical centers.
- Will my insurance plan cover my rehabilitation?
In many cases, insurance will cover the cost of rehabilitation, depending on how your injury occurred. We accept many different funding sources, and will work with you to find out what is available to you. We are also sensitive to helping you conserve your funds in case you need coverage in the future for some related disability.
- Is the program accredited by the Committee on Accreditation of Rehabilitation Facilities (CARF)?
CARF accreditation is sought every three years. Rehabilitation Specialists is CARF certified.
- What is ABS?
Addictive Behaviors Services (ABS) program provides comprehensive assessment, monitoring, and treatment of alcohol or other substance abuse and related problems in persons who have suffered neurologic illness or injury. A significant percentage of the brain injury population has at one time experienced an alcohol or other substance abuse problem in his or her life. Further, the increase in stressors and related changes in life circumstances following brain injury can put a person at risk of developing ineffective coping strategies. Thus, the foundation of ABS is based upon sensitivity to the individualized needs of the person with a brain injury. ABS acknowledges specific neuropsychological impairments that may interfere with coping strategies post-injury. The ABS team further ensures ongoing monitoring of treatment effectiveness by use of measurable outcomes.
- What is the ABS procedure?
Upon admission to Rehabilitation Specialists, all clients are screened to determine candidacy for Addictive Behaviors Services. When at-risk clients are identified, they are referred to the ABS clinical team for additional assessment. Individualized treatment protocols are then developed and implemented based upon review of available records, clinical interview, and formalized testing.
- Who makes up the ABS team?
Assessment and treatment of clients are provided by a team of professionals, led by the staff neuropsychologist. The client, clients’ family members, internal case coordinators, as well as other staff, play pertinent roles in the coordination of ongoing clinical care.
- How are treatment sessions structured?
A client’s treatment plan consists of a combination of individual and group psychotherapy sessions. The frequency and type of sessions are based upon the individual needs of the client.
- Where do the sessions take place?
Therapy sessions take place in our Rehabilitation Center. Other resources within the community are incorporated when appropriate.
- What are treatment objectives and goals?
Session objectives are focused on reducing substance seeking behavior, determining more effective methods of coping, and recognizing cues that may trigger future abuse or maladaptive behaviors. The ultimate goal of ABS is to maintain abstinence and to provide clients with effective coping behaviors.
- What happens if relapse occurs?
Relapse results in immediate intervention, which can consist of, for example, increasing the intensity of the client’s existing treatment protocol, increased monitoring of behaviors, and/or referral to a detoxification facility.
- What happens in a typical day at the rehab center?
Everyone’s program is designed specifically for them. Our treatment is offered individually and in groups, and takes place in an outpatient center, in the community, or in the home. Sessions consist of a variety of therapies. The focus is to return you to work, school, and all activities related to daily living.
- In an emergency, is there a hospital nearby?
Rehabilitation Specialists is located 10 minutes from two local hospitals and medical centers.
- Will my insurance plan cover my rehabilitation?
In many cases, insurance will cover the cost of rehabilitation, depending on how your injury occurred. We accept many different funding sources, and will work with you to find out what is available to you. We are also sensitive to helping you conserve your funds in case you need coverage in the future for some related disability.
- Is the program accredited by the Committee on Accreditation of Rehabilitation Facilities (CARF)?
CARF accreditation is sought every three years. Rehabilitation Specialists is CARF certified.
