Living With TBI

Ninety percent of traumatic brain injuries (TBIs) are mild. Most individuals with mild TBI (mTBI)/concussion are able to resume their normal lives. However, some individuals with mTBI and those with more moderate or severe TBI may have longer-lasting symptoms or even life-long symptoms that interfere with daily life.

Living with TBI requires knowledge and work:

• The first thing to know is that rehabilitation helps – seek out professionals who understand and are experienced with TBI rehabilitation.
• The second thing to know as you begin your journey living with TBI is that getting better takes time – don't give up.
• The third thing to know is that family is important – involve family in your rehabilitation.

Living with TBI requires setting priorities. This means setting goals that you can achieve in the short-term and the longer-term. Trying to do everything at one time is counterproductive to succeeding in your goals. Many research studies of outcome following a TBI suggest that good social support from families, friends and other resources is critical in how well individuals recover.

TBI COMMUNITY REINTEGRATION

Most common models of community reintegration following TBI (such as DVBIC-Johnstown, Virginia NeuroCare, and those being developed by the Department of Veterans Affairs) focus on individuals with moderate to severe TBIs, especially those with significant persistent symptoms which make returning to the community challenging.

Individuals who complete it have high rates of success in achieving their goals in returning to daily life. These goals might be to continue active or reserve military service, start or continue technical training or college, start or return to a civilian job, or simply resume normal life with family and friends.

Community integration brings services members and veterans together with others who have had similar experiences through military service. Patients live in a home-like setting while they gain the real-life experiences and skills necessary to return to their military or civilian homes. Importantly, community reintegration also helps individuals return to having fun in their lives through a wide range of activities that are interesting and enjoyable.

During community reintegration, individuals with TBI receive comprehensive rehabilitation therapies including rehabilitation psychology evaluation and treatment, physical therapy, occupational therapy, speech-language pathology therapy, physician evaluation and treatment, neuropsychology evaluation and treatment, nurse case management, and family treatment.

The work of service members or veterans during community reintegration is to practice activities of daily living — and these activities are treated very much like a job with the responsibility of acquiring the skills and abilities necessary to achieve each individual’s goals. In this, community reintegration staff work as coaches: encouraging and teaching. Each day is individualized to a person’s particular needs. For example, someone with significant physical weakness and fatigue issues might start with a half-day of therapy at the beginning of the program.  The goal would be to improve strength and stamina over several months, eventually working up to a full day.

What does a person do in TBI community reintegration? It is like real life. Service members and veterans wake up and start their morning routine as if they were going to work or school. Usually, they take care of their personal hygiene, make their breakfast, and are transported to the community reintegration clinic. At the clinic, they begin work with individual therapies and small group therapies and these typically last until noon. At noon, individuals usually prepare a meal together. Then, it is off to the community where individuals may exercise at the gym, swim in the pool, volunteer in a community vocational setting, or go into the community to do something that they enjoy. In the evening, individuals have their own time. On weekends, individuals can participate in scheduled recreational activities or have time on their own.

In the last month of community reintegration, individuals try out their skills and abilities in independent living situations. They arrange their own transportation, they independently buy and prepare their own food, they manage their own medications, they plan their week, and they work full days at a volunteer job setting. Active military personnel who have the goal of remaining on active service typically spend a month working in a local military unit with military duties. This is in preparation for returning to their home unit or next duty station. Veterans and those individuals who will not be returning to active service choose their volunteer placement that best meets their needs.

Additional Resources

Afterdeployment
A mental wellness resource for service members, veterans, and military families. If you’ve deployed, or know someone who has, you know that spending time in a war zone means being changed in some way. Some of these changes are good. But some of these changes may be causing problems for you or for someone you know. Having problems after a deployment is normal. Unfortunately, less than half of the service members having difficulty after a deployment seek services.

America's Heroes at Work (AHAW)
An initiative from the US Department of Labor (DOL) focusing on the employment challenges of returning service members living with traumatic brain injury (TBI) and/or Post-Traumatic Stress Disorder (PTSD). Watch a 5 min. 41 sec. video about America’s Heroes at Work featuring BG Loree Sutton and Col Michael Jaffee.

BrainLine.org
BrainLine.org is a new national multimedia project offering information and resources about preventing, treating, and living with TBI. BrainLine.org is a service of WETA, the public TV and radio station in Washington, DC and is funded by the Defense and Veterans Brain Injury Center through a contract with the Henry M. Jackson Foundation.

DVBIC-Johnstown
DVBIC-Johnstown is the combination of multiple sites in Johnstown, PA. These sites include a community re-entry program, an outpatient clinic, and an assisted living pilot project. We are committed to improving the lives of military personnel, veterans, and their beneficiaries with traumatic brain injuries by maximizing independence and facilitating re-entry into family and community life. Our treatment programs are client-centered and family-centered, transdisciplinary, and innovative.

Virginia NeuroCare
Virginia NeuroCare, Inc. in Charlottesville, VA provides a community integrated brain injury rehabilitation program, comprehensive evaluation, outpatient therapy clinic, vocational training and innovative community re-entry services for military and civilians with brain injury. Virginia NeuroCare is a national leader in developing treatment modules for community reintegration and evolving use of technology aids. The experienced rehabilitation team and scientific agenda promote optimal treatment.