Headway North London

Rehabilitation

Part of the text is reproduced by kind permission of Trevor Powell from his book Head Injury: A Practical Guide

Headway has had its own statement regarding rehabilitation since the late 1980's:

Rehabilitation is a process of change through which a brain injured person goes, seeking to regain former skills and to compensate for skills lost. Its aim is always to achieve the optimum levels of physical, cognitive and social competence followed by integration into the most suitable environment.

Note!

1. Rehabilitation is not achieved by doing something to somebody. It involves a process of change in which the person concerned participates.
2. It does not seek to achieve the highest levels of competence.
3. Rehabilitation is not complete without concern for placement. This, like the rest of the process, is never complete.

The greatest visible progress occurs in the first 6 months, after which improvement is often more subtle and less obvious. But it is important to bear in mind that progress does not stop after 2 years, as has been suggested in the past. Rather people continue to improve even 5, 10 or more years after a head injury. Rehabilitation has two stages, the first being the formal intervention to improve the individual, and the second stage is when the family and carers work to maintain that improvement. Research suggests that patients who make the best recovery are those whose family is actively involved, and can maintain this informal rehabilitation at home.

Who's Who on the Rehabilitation team

Nurses

Nurses are trained in all aspects of general health care and will help with dressing, washing, feeding and toileting. A ward will be run by a sister or charge nurse, accompanied by a staff nurse and nursing assistants.

Doctors

A consultant will co-ordinate the day-to-day medical care, carrying out examinations and prescribing medication while the patient is in hospital. The consultant is head of a medical team and will be assisted by junior medical staff such as registrars and house officers, who will spend more time on the ward than the consultant.

Physiotherapists

The physiotherapist aims to help patients recover the ability to use their muscles and joints so they can sit or stand without losing balance, co-ordinate movements, walk and use fine hand movements. The physiotherapist will set exercises and activities for improving physical ability, and help with learning techniques for lifting and transferring from a wheelchair.

Occupational Therapists

The occupational therapist (OT) is concerned with helping to develop independence in carrying out everyday tasks such as dressing, cooking, and housework. They will also help the individual develop skills which underlie these activities such as budgeting, planning, improving thinking and finding ways around problems. They may also provide special equipment and adaptations around the home.

Clinical Psychologist

The clinical psychologist will help in assessing the patient's mental skills and weaknesses, such as memory and concentration (a cognitive problem), using specially designed tests. They may also advise on management and rehabilitation and cognitive retraining programmes, both in hospital and in the community. They may also provide counselling and advice on dealing with the emotional problems involved in adjustment and coping.

Social Worker

Social workers are skilled in helping families receive the practical help that is needed. They can provide information about benefits, accommodation and transport. The social worker is also an experienced counsellor, and is there to talk to about emotions and feelings. If there has been no contact with a social worker in hospital, ask for an appointment to see one.

Speech and Language Therapist

Speech and language therapists aim to help patients communicate more effectively using both the spoken and written word. They may provide structured exercises and activities aimed at improving speech and language skills, or may work with other staff and relatives to improve all-round communication. The speech therapist will also have experience of communication aids.

Rehabilitation Centres

Headway's Communications Department has information on private and NHS rehabilitation units throughout the UK. Please contact them by telephone on +44 (0)115 924 0800 or by E-mail at information@headway.org.uk.