Family Involvement in Traumatic Brain Injury Rehabilitation
“If you have a loved one who has a traumatic brain injury, your investment in getting that person back to a quality of life is going to involve helping them access something they are most passionate about,” says Dr. Jeff Snell, neuropsychologist and director of psychology and neuropsychology services at QLI.
QLI (Quality Living, Inc.) is a rehabilitation center that specializes in helping individuals with brain and spinal cord injuries. Dr. Kim Hoogeveen, the founder and founding CEO of the organization, was inspired to create this post-acute care rehabilitation center by a parent group. Involvement of families in the rehabilitation and care of patients, therefore, remains one of QLI’s fundamental principles.
In recognition of Brain Injury Awareness Month, Right at Home spoke with Dr. Snell from QLI to learn more about traumatic brain injury care.
How to Care for Someone With Traumatic Brain Injury
Traumatic brain injury (TBI) in the context of older adults often means falls or strokes; a majority of elderly TBI patients also had other medical conditions prior to TBI. But when it comes to restoring or returning someone of age to activities after TBI, Dr. Snell says the recovery profile and general procedure are not dramatically different from any other age group.
“We do what we can to re-integrate individuals with TBI and the things they are most passionate about,” says Dr. Snell. “With an emphasis on quality of life and a sense of purpose, we look at an individual’s life path to identify things that are most motivating. We then integrate those aspects within a functional, real-world application and skillset.”
Going one step further from the traditional rehabilitation approach that focuses on the medical and physical care of patients, QLI adds a holistic dimension to rebuild lives post-injury. “Because no two people’s passions, motivations and lives are the same, there aren’t two programs that look the same here at QLI,” Dr. Snell adds.
Dr. Snell also stresses that the success of rehabilitation is highly correlated with the degree of family support following rehab — which is why family members are not only often involved in the design of QLI’s rehabilitation programs, but are also involved in the implementation of them. “When a person transitions away from rehabilitation, the family members become the primary drivers for recovery until the individual becomes the driver of his/her own recovery.”
As for individuals who may not have the physical or cognitive capacity to engage in activities they are passionate about, Dr. Snell suggests to look into adaptations. “If there are other aspects to that endeavor in which the individuals can be involved, they can continue to gain a sense of meaning and purpose,” says Dr. Snell. “When it’s something that they are going to do often, there will be a lot of practice and repetitions that can improve functional ability eventually.”
Successful Rehabilitation and Recovery From Traumatic Brain Injury
Located in Omaha, Nebraska, QLI aids patients referred by hospitals, case managers, national organizations and accident insurance carriers. In 2017, the campus served individuals from 23 states. While QLI primarily helps younger adults, Dr. Snell remarks that they also serve a small number of patients who are age 65 or older; these patients haven’t retired yet and rehab their work-related injuries at QLI with the intention to return to work.
“With age, certainly there’s an increase in risks,” says Dr. Snell. “You have to pay attention to medication side effects or set up an environment in order for the person to be as successful as possible. Generally, that involves returning an individual to an independent level of functioning as they can possibly achieve. It has to be done in a very graded-step process, with support along the way.”
Another way to motivate patients and maximize their rehabilitation success is to set concrete, incremental goals. As patients manage to do a little bit more and feel a little better every day, they can feel the progress, and that’s powerful in pushing patients toward their big goals.