Brain Injury: Helping Patients Achieve the Best Results
March is Brain Injury Awareness Month. Karina Foreman, Occupational Therapist II at Adventist HealthCare Rehabilitation in Takoma Park, has worked closely with patients with brain injury for the past three years. Explore her firsthand perspective of what it's like working for the CARF-accredited Brain Injury Program and helping patients return home healthy and as independent as possible.
When brain injury occurs, the patient and family want the very best medical specialists. They want the expertise that will ensure the best outcome -- so the patient can return home and be as independent as possible.
“There are so many physical, emotional and cognitive changes that occur with a traumatic brain injury. It’s really important as therapists and healthcare providers to address each of those aspects,” says Karina Foreman, Occupational Therapist II at Adventist HealthCare Rehabilitation in Takoma Park. There is also a similar unit in Rockville.
For the past three years, Foreman has been working closely and frequently with brain injury patients. She is a certified brain injury specialist and co-leader of the brain injury program in Takoma Park.
Several Adventist HealthCare Rehabilitation therapists and nurses are certified by the Brain Injury Association of America, which means they have pursued continuing education in this specialty. “We see individuals with traumatic brain injuries every day in our inpatient rehabilitation program, and our interventions have a big impact on their progress,” says Foreman.
Adventist HealthCare Rehabilitation’s Brain Injury Program is accredited by the Commission on Accreditation of Rehabilitation Facilities and The Joint Commission, the nation’s leading healthcare accrediting agency. These achievements reflect the team’s commitment to providing the safest and most effective care possible.
Patients in the Washington, D.C. region consistently choose Adventist HealthCare Rehabilitation, which provided high-quality inpatient therapy for 1,869 patients in 2018 including:
- 98 Non-traumatic brain injuries – Internal traumas, such as a tumor, blood clot, seizure or infection
- 126 Traumatic brain injuries (TBIs), including concussions
Concussions are “tricky” to diagnose because they don’t show up in imaging or MRI, so they often go under the radar, says Foreman. “We have speech therapists who are amazing at finding hidden cognitive deficits -- difficulty with problem-solving or memory.”
Personalized, customized, effective
To ensure the best outcomes, healthcare providers measure how much each patient has improved each day while in rehab. Adventist HealthCare Rehabilitation patients’ daily improvement is among the highest in the region. Those measurements include:
- Results-oriented: 27% of our patients have higher daily improvement than the average in the region.
- Successful: More than 72% of our patients returned to their homes after leaving our hospital.
- Compassionate: Our patients consistently report positive satisfaction ratings about our hospital and care to an independent auditor.
Rehabilitation inpatients have very intensive 3-hour daily therapy sessions. When they have met specific therapy goals, they are discharged to go home with follow-up by a home health therapist or to outpatient therapy. If family members are unable to provide 24-hour care, the patient will go to a skilled nursing facility until ready for independent living.
Adventist HealthCare teams work to get patients back home, where they have family support and can be comfortable in their own environment, Foreman explains. “For some patients, this isn’t possible if the family simply can’t handle 24-hour-a-day supervision, so they will spend time in a skilled nursing facility -- always with the goal to go home.”
With therapy, patients can achieve a greater quality of life, despite the traumatic experience. For some, this will involve learning to adapt and compensate for their injury. Some may improve cognitive skills through rehabilitation. Most will achieve greater independent living ability despite their injury.
“Many patients may not get back to the normalcy they once had,” she explains. “But they can still have a great quality of life despite this traumatic experience. We see it every day.”
Outreach to patients, families, community
Adventist HealthCare Rehabilitation provides support groups for patients and their families. Groups meet once per month via Zoom during the pandemic. Patients and family caregiver groups meet separately so participants can talk freely.
“Caregiver burdens are very real. We can share ideas on continuing to live a full life after the traumatic event,” says Foreman.
Community outreach extends to local first responders to educate them on traumatic brain injury. Symptoms like confusion, impulsivity, lack of empathy, easy frustration may occur immediately after the injury, or even 10 years later, Forman explains. Training helps first responders better understand these behaviors.
“We want to give first responders the tools they need, so they know what to expect,” she explains. “When they’re looking at someone with brain injury, it’s not always possible to tell. But if they know the indicators to watch for, they will also know how to manage that behavior safely.”
March is Brain Injury Awareness Month. If you know someone who is living with brain injury – or if you have one yourself – you know that brain injury is not an event or an outcome. It’s the start of a neurological disease. For more information about what you can do to help educate others about what it’s like to live with a brain injury learn more here.