Our last article detailed some of the members of the traumatic brain injury treatment team. This article provides you with some of the most important questions and concerns you should be raising with any treatment facility you are considering.
Treatment of TBI varies from person to person. Educating the TBI patient and his/her family about the symptoms that may be experienced, and the treatment available, as a result of such an injury is critical. Referral to specialists in neurology, neuropsychology, or rehabilitation may be appropriate.
Anyone with signs of TBI should receive medical attention as soon as possible. Because little can be done to reverse the initial brain damage caused by trauma, medical personnel try to stabilize an individual with TBI and focus on preventing further injury. Primary concerns include insuring proper oxygen supply to the brain and body, maintaining adequate blood flow, and controlling blood pressure. Imaging tests help in determining the diagnosis and prognosis of a TBI patient. Patients may receive skull and neck X-rays to check for bone fractures or spinal instability.
Many TBI patients will undergo an imaging test known as a computed tomography (CT) scan. is a noninvasive, painless medical test that helps physicians diagnose and treat medical conditions. A CT uses special x-ray equipment to produce multiple images or pictures of the inside of the body and a computer to join them together in cross-sectional views of the area being studied [A CT is sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. When the image slices are reassembled by computer software, the result is a very detailed multidimensional view of the body's interior.]. CT scans of internal organs, bone, soft tissue and blood vessels provide greater clarity than conventional x-ray exams. CT scans of the body enable a physician to more easily diagnose brain injuries but also problems such as cancers, cardiovascular disease, infectious disease, trauma and musculoskeletal disorders.
Moderately to severely injured patients receive rehabilitation that involves individually tailored treatment programs in the areas of physical therapy, occupational therapy, speech/language therapy, physiatry (physical medicine), psychology/ psychiatry, and social support. Looking at the list of questions below should help you get started in deciding which medical facility is most appropriate for TBI treatment. Please note that this list is not meant to be exhaustive but is meant to help you get started on your way towards finding the best treatment for you or a loved one with TBI.
Here are the questions I believe are important for you to ask any treatment facility and these can be easily tailored for any medical provider:
1. Are programs custom-tailored to meet your needs or is there a cookie-cutter approach that applies to everyone with a brain injury? Will evaluators spend time with you and your family/support group to truly understand your needs, and rehab goals? Will progress reports be individualized, with objective quantifiable goals in all disciplines?
2. Is the program accredited by the Commission of Accreditation of Rehab Facilities (CARF) and/or the Joint commission on Accreditation of Healthcare Organizations (JCAHO)?
3. What is your program's greatest strength and greatest weakness?
4. Will the program accept your health, auto or private pay? What is the daily cost of the program and what does this include (room & board, medications, physician services, therapy, transportation, etc.)? Are there billed extras (i.e., special diet, telephone, internet laundry, bed hold fees)?
5. How many of your patients realize their rehab goals? What is the average outcome?
6. What is the average length of treatment? Will you put in writing how long you anticipate my treatment will be?
7. What type of follow up programs and services do you offer? Are family members and friends involved? What kind of family training, support groups and therapy is offered? Is there a charge for participation?
8. What is your staff to patient ratio? Is the majority of therapy conducted on a one-to-one basis?
9. Does your Rehab Team include licensed/certified: Neuropsychologists; Clinical Psychologists; Vocational Rehabilitation Counselors; Registered/Licensed Vocational staff; Practical Nurses; Recreational Therapists; Physical Therapists; Occupational Therapists; Speech/Language Pathologists; Educational Therapists; Social Services staff; case management staff? [Note: the licensures/certifications should be available for your review.]
10. Do you have an out-patient program? Do you provide follow up services in the home, the school and the job?
11. Upon discharge, will I receive a written plan that addresses issues, such as housing, job coach, vocational rehab and counseling, recreational, social services, nursing home, parent's home?
NOTE: These are just some of the important questions that you, or a family member, should be asking of any facility you are considering for treatment of TBI. We do not presume to tell you where to get treatment but we want to give you the power to ask the right questions, raise the right issues, address the right concerns before engaging in any treatment.
About the Author
David A. Bressman is a personal injury trial lawyer practicing in Columbus, Ohio. He limits his practice to representing those seriously injured in car wrecks, animal attacks and falls. More information can be found at: http://www.auto-accident-lawyer-ohio.com
