“We need to re-think the service delivery in brain injury rehabilitation so that long after the rehabilitation has ended, persons with TBI will be able to maintain the gains they made during the in-patient rehabilitation. We must pay attention to providing the resources, support, services and preventing re-hospitalizations to meet the ultimate goal, which is improving the overall quality of life.” -Christine Weaver
More individuals survive severe brain injury due to the current medical advancements. At present time, there are 3.2 million to 5.3 million people in the United States who are living with a traumatic brain injury (TBI)-related disability. The symptoms of TBI vary from one person to another, and although some symptoms might resolve completely, others, especially as a result of moderate and severe TBIs, can result in symptoms that persist and become long-term problems. These symptoms can be disabling and dramatic and lead to complications, which include neurologic and behavioral health problems and re-hospitalizations.
Re-hospitalizations, which is currently at 36%, and post-traumatic symptoms have considerable negative impacts on the quality of life of individuals who sustained a traumatic brain injury (TBI). Other factors such as the emergence of health problems, problems with community access and housing, and social network problems are also likely to affect the lives of individuals with TBI from a broad section of the American society.
Although there are many life-changing impacts of TBI, evidence exists to support that persons with TBI can function positively post-injury. Surprisingly, only a handful of research has empirically examined the positive aspects of quality of life for persons with TBI (e.g., Kincaid, 1998; Steadman-Pare, Colantonio, Ratcliff, Chase, & Vernich, 2001).
Quality of life has been overlooked in most rehabilitation. Recognizing this gap in the continuum of care and the economic impact of TBI, the Center for Disease Control’s (CDC) report to congress calls for improving the quality of life of persons with TBI. Focused on filling critical research gaps, increasing access to care, and improving the effectiveness of rehabilitation services through improvement of the ability to perform daily tasks, socialization, and participation in their community.
Attaining the ultimate goal of improving quality of life can be challenging due to the complex nature of TBI. The injury creates its own set of unique problem that requires a dynamic rehabilitation process that is challenging and can be more costly than a traditional home rehabilitation model.
Rehabilitation has a role, especially at the home and community level but the current rehabilitation requires considerable progress. It requires a more proactive approach than a reactive approach to anticipating the needs that may arise especially after they are discharged from an in-patient rehabilitation setting.
Restoring the quality of life has been an elusive goal to attain for most individuals with TBI. Choosing the right program is very important to meet the changing needs of a person with TBI after in-patient rehabilitation, it is important to choose services that provide individualized treatment; and focused on rehabilitation, improving well-being, social participation and restoring quality of life.