Rehab Insights is a weekly blog written by Burke Rehabilitation professionals to offer practical information for patients, families and the community. Its goal is to educate the reader on relevant topics in rehabilitation, general health and wellness.

What to Ask Your Therapist After a Brain Injury

March 14, 2018

Did you know that, every year, about 1.7 million people in the U.S. experience a traumatic brain injury? That’s according to the CDC, which also cites that falls are the most common cause of traumatic brain injuries, (TBIs), followed by car accidents.     

While 80 percent of people who wind up with a TBI will be sent home from the emergency room, about 275,000 will have a hospital stay, says the CDC. Many of those patients will require rehabilitation.

When you or a loved one is admitted to an acute rehabilitation hospital program—like Burke’s Brain Injury Program—it can be overwhelming. You’ve likely never been through the experience before, and you’re not sure where to begin. To help, we talked with Rachel Feld-Glazman, OT, Director of Burke’s Brain Injury Program, to find out some common questions she and her team receive—and what you should know. 

What will my recovery be?

“This is a challenging question because everyone really is different,” says Feld-Glazman. Some patients might not recover as well as previously thought, while others might totally exceed expectations. “But we’re going to put everything into the recovery process and hope that we see that positive outcome,” she says.

Different factors can determine the extent of recovery, including the type and severity of the injury, what area of the brain has been affected, comorbidities, age and even cognitive reserves.

One of the most important things to remember is that recovery won’t happen overnight. “I think that’s a shock for people,” says Feld-Glazman. The injury won’t go away as quickly as it came—especially when it was an injury that was the result of something sudden like a fall or car accident. Her advice? Don’t compare yourself to others, and, most importantly, even though it’s hard, have patience for the process.

What if, as a symptom of the injury, there is a lack of awareness of deficits?

If the patient is experiencing cognitive or behavioral impairments, he or she might not even realize it’s happening—it’s the brain’s lack of awareness. “That’s challenging for loved ones because they want to defer to the patient. For instance, [the patient] might say that he’s fine to be alone all day, but he’s not. It can be invisible,” says Feld-Glazman. 

During rehab, therapists will put safeguards in place if necessary—such as wearing a seatbelt in a wheelchair—even if it might be hard for the patient to understand why. Things such as video feedback or providing opportunities for “safe mistakes” can also be helpful.

Can I drive again?

The question of whether a patient can drive again often comes up, says Feld-Glazman, but it’s important to remember that it takes time for the brain to heal. 

When the patient is ready, a driver evaluation is necessary before getting behind the wheel. Burke offers an outpatient Driver Evaluation Program, where patients can be evaluated post-TBI. First, an occupational therapist gives tests that measure skills required for driving, and then, if that’s successful, there’s an in-car evaluation. (For more info on the program, click here.)

But driving isn’t the only thing that patients might wonder when they can resume—things like walking, swallowing or eating are common questions, all of which can be determined with the help of the rehab team.

What if I’m not ready to leave?

Patients and their families often feel that their stay at Burke hasn’t been long enough, says Feld-Glazman. And in recent years, inpatient stays have become shorter. But that doesn’t mean that recovery stops just because a patient is discharged.

“Life is therapy,” says Feld-Glazman. The recovery process will continue, whether it’s at a sub-acute facility, outpatient clinic, or, eventually, at home. The Burke team can help secure additional services, if possible, and there are community resources, as well as psychotherapy groups specifically for brain injury patients or caregivers, such as those offered through Burke’s neuropsychology department, available.

How do we support our loved one?

Having a support system can be a huge help when it comes to recovery. The key is finding a balance: it could be between watching over your loved one—such as when there’s a deficit they’re not aware of—and allowing them to do things on their own. Or the balance between rest and being engaged in therapy activities, says Feld-Glazman.    

Another important thing to remember is try to avoid caregiver burnout. It’s important to take care of yourself, too. “This is a long recovery process,” says Feld-Glazman, “It’s a marathon, not a sprint.”

--Marisa Iallonardo

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Burke's Rehab Insights blog is intended to provide general information about rehabilitation and other health care topics. It should not take the place of medical care. Burke staff cannot comment on individual medical cases or give medical advice.

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