Rehabilitation tips

People with a brain injury often say rehabilitation is the biggest challenge of their lives. While life may never return to ‘normal’, people can influence their recovery through hard work and persistence. A steady and consistent approach to rehabilitation makes a big difference, as it is important to avoid fatigue.

Read more about managing fatigue

The ways people react to hardship can have a significant impact on recovery and wellbeing after brain injury. Resilience is an important quality for individuals and families managing brain injury. People react to a catastrophe differently. Some people may find it impossible to see beyond their challenges while others notice positive factors, like how hard they have worked, or how strong the family has been. Research has shown that many people experience positive psychological growth following brain injury (Evans, 2011). This is not to say people are happy about the injury, but report experiences like pride in themselves, and a new appreciation for life (Collicut, McGrath and Linley, 2006).

Many families use humour to sustain them through difficult times. Finding reasons to smile each day is a factor in health and staying positive. Research shows that our attitudes and beliefs have a strong influence on our wellbeing. Some of the qualities associated with resilience are:

• having hope for the future
• the ability to be independent, proactive and get things done
• having close relationships
• the ability to solve problems
• the ability to enjoy laughter and respond to humour despite tragic situations (Rees, 2012)

A good rehabilitation program will enhance resilience by identifying individual and family strengths.

For many, it is important to work through the grief and shock about how brain injury has changed their lives. It is common to feel bitter, resentful, or as if it is punishment. In some cases, finding a ‘reason’ for the brain injury can help during rehabilitation. For example, a person may never work again but discovers happiness in volunteer work that is helping others. Others become involved in brain injury support groups and make sense of their injury by seeing how they can help others in a similar situation.

We all need structure in our lives, such as when to eat, rest, sleep and work. After a brain injury, this need for structure and routine is extremely important to allows the brain to rest and save its energy for rehabilitation. Having meals at regular times and maintaining a healthy diet is vital. Having a weekly timetable for meal times, rest periods, rehabilitation tasks and exercise on a big poster or whiteboard will provide gentle memory prompts and encouragement if memory or motivation problems exist.

Read more about Steps to a Healthier brain

Research has shown improved outcomes for people with a brain injury when their families engage in the rehabilitation process (Braga et al., 2005). Although the focus of rehabilitation is usually on the injured person, a good rehabilitation team understands the importance of family (McIntyre and Kendall, 2013). It is during this formal rehabilitation stage that knowledge can be passed on to family members about how to provide support beyond the formal period of therapy. If behavioural problems emerge, family members can ask for a plan to use at home in order to respond appropriately. It is important to have a realistic discharge plan before leaving rehabilitation. Once home, it is necessary to establish a routine and consistently apply the discharge plan. It is important that the family member being cared for has control over aspects of their life they can safely manage.

Read more about Rehab

Support groups can play a vital role for the person with a brain injury, their carers and family. It is a chance to identify with others who have similar problems, to feel understood, and to discuss ways of managing new challenges. Online support groups are an option for connecting people who live in remote areas or are unable to travel.

It is beneficial to stay in touch with friends during the rehabilitation and recovery stage. This can be scheduled and might be as simple as a quick phone call or email. It might be necessary to let friends know what kind of support is needed. For example, allow time for the person with the brain injury to answer and understand that they will tire quickly.

The brain is particularly vulnerable after injury, so an important aspect of rehabilitation is minimising the chances of a second brain injury. Rehabilitation specialists will usually recommend a person does not drink alcohol for at least a year after a brain injury, and often say it is best to permanently refrain from drinking alcohol. For the elderly, it is important to minimise falling risks around the house. For children, helmets must always be worn for risky activities such as cycling.