Brain Injury Rehabilitation Program
Brain Injury Rehabilitation Program Description
The mission of Burke’s Brain Injury Rehabilitation Program is to provide the most comprehensive and effective rehabilitation to maximize your recovery from physical, cognitive and psychological impairments caused by traumatic brain injury (TBI) and acquired brain injuries. Led by a neurologist, the interdisciplinary team works collaboratively with you and your family and/or caregiver to facilitate achievement of the best possible physical and mental recovery. Intensive rehabilitation is provided in a safe, secure and structured environment to allow you to reach your full potential and return to an active, productive lifestyle.
Your rehabilitation team consists of the you and your family and/or caregivers, as well as medical, nursing and other rehabilitation personnel who, by virtue of their education and experience, are qualified to work with brain-injured individuals. The medical and rehabilitation professionals on the team are responsible for assessing your medical, behavioral and rehabilitation needs, establishing individualized goals in consultation with you and/or your family/caregiver, designing and implementing a treatment program, assessing its outcome, communicating with the team and preparing you and your family/caregiver for the next phase in the brain injury rehabilitation process.
Scope of Services
The Brain Injury Team is committed to ensuring that each individual’s needs are addressed by:
- Providing rehabilitation through an interdisciplinary approach that emphasizes communication, collaboration and cooperation
- Lessening limitations of activities by focusing on the individual’s capabilities and utilizing compensatory strategies and devices
- Providing the highest quality, patient focused rehabilitation
- Removing or lessening restrictions to participation in life situations to the extent possible
- Providing counseling to the individual and family and/or caregiver on alternative possibilities for life participation when necessary
- Preparing the individual, family and/or caregiver to make the transition to the next stage of the rehabilitation process
Cultural and religious needs are respected for each patient by the entire team. Accommodations to the patient’s schedule, dietary needs and requests, and the provision of appropriate equipment are provided to enhance the patient’s experience and support full participation in the rehabilitation program. All staff members participate in annual cultural diversity and sensitivity training. Patients’ preferences are shared throughout the team to ensure that patients receive individualized care.
The Brain Injury Program serves patient populations from adolescence through geriatric. Over the past year, the ages for the persons served has ranged from 18 to 94. Some diagnoses of patients served include subarachnoid hemorrhage, subdural hematoma, epidural hematoma, diffuse axonal injury, skull fracture, cerebral contusion, intracerebral hemorrhage, anoxic encephalopathy, brain tumor, meningitis, hydrocephalus, encephalitis, brain abscess and stroke.
Beginning on the day of admission and continuing throughout your stay, the Brain Injury Team works collaboratively to identify and address your unique needs. An assessment is conducted by the medical and rehabilitation professionals on your interdisciplinary team, including the physician, nurses, social worker/case manager, clinical neuropsychologist, occupational therapist, physical therapist, speech-language therapist, recreation therapist and dietitian. Other professionals, such as an orthotist, may become part of the team as warranted. These professionals share the information obtained from the assessment via verbal communication and chart documentation so that each team member can understand your strengths, impairments, and limitations to activity, restrictions in participation, and the environmental and personal contextual factors that may influence treatment outcomes and plans for discharge.
Based on the results of the assessment, your goals are determined and a treatment plan is implemented. Throughout the treatment program, team consultation and collaboration occur, and your progress is discussed formally once per week at a team meeting.
Within a safe, secure and structured environment, Burke offers intensive therapy seven days a week. Your schedule will be determined by your individual needs and goals. As a patient in any of Burke's inpatient programs, you will receive a minimum of 3 hours of therapy a day, 5 days per week, generally Monday through Friday, and additional therapy on Saturday and/or Sunday for at least 1.5-2 hours. Skilled therapy will be provided in a combination of physical therapy and occupational therapy and/or speech therapy as needed. Rehabilitation nursing and access to a physician are available 24 hours a day, seven days a week.
In 2017, the Brain Injury Program:
- Had 452 discharges
- Discharged patients went to the following environments:
- 34% of the patients returned home to the community
- 39% of the patients continued therapy at a subacute rehabilitation facility
- 26% of the patients returned to the acute care hospital
- 0% of the patients entered a long term care facility
Within the scope of the Brain Injury Program, patient evaluation and care planning are designed around the World Health Organization definitions. The model assesses levels of dysfunction which stem from the patients’ admitting diagnosis regarding impairments, activity limitations and participation restrictions.
Impairments: Weakening, damage, or deterioration of function within a specific component of the neurological system, as a result of injury or disease.
Examples: Decreases in strength, active range of motion, passive range of motion, cognition, impulse control, balance, and/or activity tolerance along with increases in pain.
Activity Limitations: The inability to perform a specific task as a consequence of the impairments mentioned above.
Examples: Difficulty with ambulation, stair negotiation, reading, eating or self-care.
Participation Restrictions: The cumulative effect of impairments and activity limitations on the ability of a person to participate in life roles.
Examples: Inability to perform duties as a parent, caregiver, employee or participant in social and leisure activities.
The interdisciplinary Brain Injury Team is lead by Justin Hill, M.D., a neurologist who has experience caring for brain-injured patients. As the leader of the team, Dr. Hill is responsible for directing the medical care of the individual and monitoring the overall team process and outcome. Medical consultations (Podiatry, Urology, Plastics, ENT, Dermatology, etc.) are available to address all patient needs while at Burke.
The philosophy of the Brain Injury Program is that the program’s mission can best be accomplished by providing rehabilitative care through an interdisciplinary team approach. The team consists of the following:
- Individual with the brain injury
- Individual’s family and/or caregiver(s)
- Rehabilitation Nursing
- Social Work/Case Management
- Physical Therapy
- Speech and Language Therapy
- Occupational Therapy
- Recreation Therapy
- Respiratory Therapy
Additional services available to meet the needs of each individual patient may include:
- Medical consultations (Optometry, Psychiatry, Podiatry, Urology, Plastics, ENT, Dermatology, etc.)
- Pastoral Care
- Orthotic Services
- Laboratory Services
- Complimentary Therapy
- Brain injury support groups for patients and families
From admission through the discharge planning process, team members work collaboratively with each other, the individual with the brain injury and the family and/or caregiver(s) to ensure that the specific needs of each individual are addressed. Patient and family and/or caregiver involvement and participation is strongly encouraged throughout the entire rehabilitation process.
Patient and Family/Caregiver Education
Ongoing education of the individual with a brain injury and the family and/or caregiver is essential in order to maximize recovery from the physical, cognitive and psychological impairments and effectively prepare for the transition to the next stage in the rehabilitation process.
Patients in the Brain Injury Program will receive ongoing education from each discipline throughout their stay in order to maximize achievement of their goals. Family members and/or caregivers are encouraged to attend and participate in treatment sessions and patient care activities as appropriate. Providing education and training for the family and/or caregivers is an essential component of the patient’s rehabilitation stay and provides an opportunity to successfully transition the patient to the next phase of rehabilitation.
A series of educational lectures and discussions for families and other caregivers on various topics related to brain injury is provided by team members every Tuesday at 4 p.m. In addition, a monthly support group meets on the Burke campus for Traumatic Brain Injury survivors and caregivers.
Candidates for admission include patients who have suffered a brain injury, are medically stable and able to participate in 3 hours of therapy per day.
- Patients who are in a coma or vegetative state.
- Patients who require ventilator support.
The discharge planning process begins when the patient is first admitted to the program. The social worker/case manager leads the planning process, coordinating information from all members of the interdisciplinary team and acting as the primary liaison between the team and the patient and family. Based on the individual’s functional status for self-care, mobility and other daily life skills, family/caregiver support, medical needs, pre-morbid living situation and level of function, and available health insurance, the team, in collaboration with the patient and family, makes recommendations for the most appropriate and suitable discharge plan for the patient. At the team or family’s request, a meeting with the team and patient/family is scheduled to discuss available discharge options. The patient’s and family’s preferences are of primary concern and the team will make recommendations for a safe discharge when options for continued care and rehabilitation are considered.
Recommendations may include, but are not limited to:
- Home with home care services
- Home with outpatient services
- Sub-acute rehabilitation services
- Long term care services
- Hospice services
Located in White Plains, New York, Burke Rehabilitation Hospital's Brain Injury Rehabilitation Program attracts brain-injury patients from Westchester County, New York City, Long Island, Northern New Jersey, and Connecticut. Burke also welcomes brain-injury patients from across the country and around the world.
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