This blog is taken from our guide ‘Important information after a family member has sustained a Traumatic Brain Injury’. Download the full guide here >
After going through the initial treatment and care following a Traumatic Brain Injury, your family member will be ready to leave the hospital. At the point of discharge, depending on their physical status and needs, there are a number of different possible scenarios you and your family member are likely to face.
In this blog, we will look at the immediate options after your family member is discharged from the hospital, as well as what to expect in the first few months as they continue their recovery.
Preparing for discharge from the hospital
When your family member is ready to leave the hospital, there are a number of potential scenarios to consider. Some of these can include:
- Transfer to an inpatient rehabilitation centre
- Back home
- Back home with a package of care
- Residential home
- Nursing home
All these different options for discharge should be discussed with you and your family member, and a discharge plan should be put in place. It can often be a stressful time for everyone involved, so if you have any worries or concerns, you should speak to the medical team who will be able to answer any questions you may have. You will be supported in making the most appropriate decision by the medical team.
You and your family member should be involved in the decision-making process when developing the discharge plan.
Here are a few things you should consider before making any decisions:
- Gathering information about the plan, including any assistance your family member will need upon discharge.
- If your family member is being discharged home, what aids and equipment they will need and where these can be sourced.
- If your family member requires any adaptations to their home and how these will be funded and arranged.
- If they are being discharged to an inpatient rehabilitation centre, where is this located and what specialist care do they provide.
- If there are complex care needs either in an inpatient rehabilitation centre or at home, who will provide this care and how will it be paid for.
- You should also ask about what activities your family member can do and what they should avoid.
- What medication is your family member taking and how this is going to be managed.
- Any follow up appointments that have been arranged for your family member and who they are with and where.
- What the plan is for your family member’s ongoing treatment and therapy.
When speaking to your family member’s medical team, you should take notes about the discharge process and also write down any questions you may have.
Often, your family member will return home. If this is the case, they may return home for one or two visits on a trial run basis, to help understand whether the environment is right for them and if any other support and adaptations are needed.
Inpatient brain injury rehabilitation
If your family member is ready to leave the hospital but is not ready to come home, they may be discharged to a specialist centre for brain injury rehabilitation. These specialist centres provide intensive rehabilitation through structured programmes. There will usually be a multidisciplinary team providing brain injury care and therapy, including:
- A Physiotherapist will be involved in improving your family member’s balance and mobility and will put together a specific treatment plan for them to achieve as much independent function as they can.
- An Occupational Therapist will help your family member with everyday problems and find solutions to help. This can include things such as dressing, cooking, and returning to hobbies. Their aim is to help your family member return to being as independent as possible.
- A Speech and Language Therapist will help with any problems in relation to communication, including understanding language, verbal problems, reading and writing. They will also help with any eating and drinking problems.
- A Neuropsychologist will treat any cognitive, emotional and behavioural symptoms your family member may be struggling with.
A Dietician will assess your family member’s nutritional needs and will work alongside the Speech and Language Therapist to address any problems with eating and drinking.
- Doctors and Nurses will provide for your family members medical needs. Doctors will oversee the treatment and therapy of your family member. Nurses will provide the 24-hour care your family member needs, including managing medication, personal care and transfers.
Continuing Health Care
If your loved one has complex or specific care needs following a TBI, they may require continuing health care. Paying for care when somebody is discharged from hospital after a brain injury can be confusing. In some cases, ongoing care needs are partly funded by social services, but there are also a variety of other options available too.
If a person has complex care needs following a brain injury, they may be eligible for NHS Continuing Healthcare (CHC). Although most care outside of a hospital setting is funded through social care, CHC is paid for by the NHS through Clinical Commissioning Groups (CCGs).
NHS Continuing Healthcare (CHC) is designed for people with complex continuing care needs. To be eligible for CHC, a person must be over 18 years of age and have substantial ongoing care requirements. CHC can be provided in either the injured person’s own home or a care home setting and can fund home therapy following a brain injury, or provide other support including help with bathing, dressing, laundry and shopping. You can find out more about CHC and the assessment process in our blog ‘How much care can the NHS provide’.
Social services can provide care following a brain injury, but the amount of support and funding an injured person receives depends on their care needs and how much money they have to contribute to the cost of care.
There is a wide range of services included in social care, such as social work, personal care, protection, and social support. Social services’ support can help people with disabilities live a more independent and fulfilling life. It can include helping people with washing and dressing, getting in and out of bed, taking medication and helping with housework. You can find out more about what type of social care is available after a brain injury and who will provide this care in our blog ‘Do social services provide care following a brain injury’.
A case manager can help you and your family member after a brain injury. They can provide advice on how to access services and care providers, as well as source any aids, equipment or adaptations for your specific needs.
The case manager will look at you and your family member’s needs and will create full plans around these needs, working alongside other healthcare professionals and care providers to ensure your family member’s whole wellbeing is considered.
They will also be actively involved in assessing any rehabilitation needs your family member has and be instrumental in setting up full rehabilitation plans, as well as sourcing suitable therapists (including Occupational Therapists, Physiotherapists, Speech and Language Therapists and Neuropsychologists).
A case manager should be proactive in their approach and assess the real needs of your family member following a brain injury. Their roles can involve:
- Evaluating the needs of the injured person and the resources available to them.
- Finding the most efficient and cost-effective ways of meeting these needs.
- Assistance with any discharge plans and providing recommendations for discharge (e.g. whether back home, an inpatient rehabilitation centre or other accommodation).
- Liaising with the whole treating team including clinicians, care providers and social care, for example, resulting in joint care plans.
- Facilitating self-care to improve independence.
Having a case manager helping you can greatly improve your family member’s recovery and wellbeing, while also supporting and helping the whole family. Their role is about coordinating all of your family member’s needs and ensuring you and your family have access to a comprehensive care and support package.
For more information on what to do after a family member has suffered a Traumatic Brain Injury, download our guide for helpful advice on symptoms, rehabilitation and brain injury care. <Download the guide>