Making a Difference #6: Needs & Interventions
The continuum of care of aTBI starts at the moment of injury and can last a lifetime. Learn how to avoid barriers for care.
Module 6: Needs and Interventions The continuum of care for a person with a traumatic brain injury starts at the time of their injury and goes on through until the day that they go home. The initial point of entry for a person who has suffered a traumatic brain injury is usually the first responders. The first responders will mobilize the patient and then transfer them into an acute medical trauma center. After they leave the trauma center, they will enter into an acute rehabilitation facility in which they are inpatient and being cared for for the medical needs and being provided with services that range from cognitive rehabilitation to occupational therapy, speech therapy, and physical therapy. Services that are provided are covered by many of the insurances, and they're afforded a certain amount of time to be able to accomplish these goals of trying to learn how to speak, learn how to walk and talk again, and learning how to do the basic self daily skills of life. Some of the barriers that are encountered in the acute rehabilitation phase may be that at times their length of stay may be very limited. And at times, when a patient is discharged home, there is a lack of information with respect to public services and proper community reintegration into schools and workplace. The next step upon leaving the hospital is the post-acute rehabilitation phase. One of the resources is publicly-funded programs that are available for the post-acute rehabilitation phase in which it allows for an individual to continue with the comprehensive physical therapies and cognitive therapies in order to return to school and work. Unfortunately, there are also barriers for these types of services which, once again, there is limited length of service. There may be some limits with regard to the eligibility requirements for some public funding for comprehensive post-acute, and there also may be limited access to supports and services, especially in those rural areas in which a person may not have access to outpatient cognitive rehabilitation treatment. One other barrier of the post-acute rehabilitation phase is a lack of coordination between the inpatient hospital case coordinators and outpatient case management coordination of public funding. Many patients, unfortunately, may not be aware of the public-funded programs to continue the phase of rehabilitation. The process of recovering from an injury is a long, lengthy process for the survivor and their families, and it encompasses a long course of rehabilitation services. It would require the continued funding of healthcare. Many individuals will need to be funded under some type of state or federal program. In the state of Texas, young survivors may be eligible for Medicaid and eventually, possibly, for Medicare health benefits. Some individuals who sustain their injury as a result of being a victim or being a part of an accident may also be eligible for crime victim's funding from the attorney general. Other types of medical types of services would entail possible county health funding from their local county in which they may be able to draw from county funds for continued medical costs. There may be types of local indigent funding based on the community they reside in, and children may also be eligible under funding for children with special healthcare needs. Social services are also a very important part of helping a survivor and their families to return back to their homes and transition into their communities and workplace. One program is a community-based assistance program in which a survivor may be eligible for continued assistance at home. Other types of programs would include possible housing. Childcare services may also be an area in which a survivor and their family may need assistance or with having to take care of their children during the course of rehabilitation. Other services that are important to families and survivors are human services that fall under the Department of Aging & Disability Services, which include TANF or other types of funding in which it assists a person to manage their household as their continuing to rebuild their life and return back to work It is important for survivors to be informed about the Texas Workforce Commission and the opportunities for assistance with retraining to go back to work. Local community services would include traumatic brain injury support groups, independent living centers, GED programs, job coaching, job employer and education programs, license renewal, and some local leisure and recreational groups. During the course of rehabilitation, a survivor and their family may have mental health services needs. It is very difficult and challenging to try to rebuild your life. An individual may need counseling and may need to be referred to the local counseling services. They may also have chemical dependency needs in which they may need to receive rehabilitation for drug and alcohol abuse. Transportation is also an important service that needs to be addressed with survivors and families. The lack of transportation may not allow them to have access to continued rehabilitation. Patients with Medicaid may be eligible for transportation services. In addition, local community transportation services may be available for individuals to continue with outpatient rehab services. In summary, services for survivors and their families is essential for them to continue with the process of rehabilitation. It is important to know that not everyone with a TBI needs every service. [End of Module 6]
Posted on BrainLine April 8, 2011.
Produced by Texas Department of State Health Services and the Texas Traumatic Brain Injury Advisory Council.