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11 - Neuropsychological rehabilitation in the community
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- By Pamela Klonoff, Barrow Neurological Institute, Phoenix, Arizona, David Lamb, Barrow Neurological Institute, Phoenix, Arizona, Steven Henderson, Barrow Neurological Institute, Phoenix, Arizona, Lauren Dawson, Barrow Neurological Institute, Phoenix, Arizona, Jennifer Lutton, Barrow Neurological Institute, Phoenix, Arizona, Jessica Grady, Barrow Neurological Institute, Phoenix, Arizona, Harold Bialsky, Barrow Neurological Institute, Phoenix, Arizona
- Michael P. Barnes, University of Newcastle upon Tyne, Harriet Radermacher, University of Newcastle upon Tyne
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- Book:
- Community Rehabilitation in Neurology
- Published online:
- 11 August 2009
- Print publication:
- 04 September 2003, pp 212-236
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- Chapter
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Summary
Introduction
Recovery from brain injury is an extended and arduous process. It is estimated that a full 18 months or more are required to obtain the maximum benefit of natural recovery following a traumatic brain injury (TBI) (Dikmen et al., 1995), while recovering from a stroke can continue for many years (Speach and Dombovy, 1995). Acute rehabilitative efforts for those who have suffered neurological insult typically begin once a patient is judged to be medically stable and transferred to an inpatient rehabilitation unit. Multidisciplinary programmes provide ongoing medical care and seek to address deficits in basic activities of daily living such as orientation, mobility, feeding and communication. Also, an initial assessment of gross cognitive skills is typically conducted. Depending upon progress and perceived need, patients are either discharged home or transferred to a postacute rehabilitation programme. Malec and Basford (1996) provide a hierarchy of the types of brain injury-rehabilitation programmes, with a basic division into subacute and postacute categories. The subacute rehabilitation setting provides long-term residential care for those with such severe deficits that they cannot meaningfully participate in further rehabilitative efforts. These types of people typically include those who require coma management or whose severe behavioural problems preclude ongoing rehabilitation and demand a very intensive level of management.
Malec and Basford (1996) further stratify postacute rehabilitation programmes, with the most restrictive being neurobehavioural programmes.