Community-integrated brain injury rehabilitation: Treatment models and challenges for civilian, military, and veteran populations.
Traumatic brain injury (TBI) is a major health problem in civilian, military, and veteran populations. Individuals experiencing moderate to severe TBI require a continuum of care involving acute hospitalization and postacute rehabilitation, including community reintegration and, one would hope, a return home to function as a productive member of the community. In the military, the goal is to help individuals with TBI return to active duty or make an optimal return to civilian life if the extent of their injuries necessitates a "medical board" discharge. Whether civilian, military, or veteran with TBI, individuals who move beyond the need to live in a facility must be reintegrated back into the community. This article discusses four treatment models for community reintegration, reviews treatment standardization and outcome issues, and describes a manualized rehabilitation pilot program designed to provide community reintegration and return to duty/work for civilians, veterans, and military personnel with TBI.
Trudel
Tina M
TM
Defense and Veterans Brain Injury Center at Virginia NeuroCare, Lakeview Healthcare Systems, University of Virginia Medical School, Charlottesville, VA 22902, USA. ttrudel@lakeview.ws
Nidiffer
F Don
FD
Barth
Jeffrey T
JT
D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation*; D002985:Clinical Protocols; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000592:standards; D003159:Community-Institutional Relations; D019317:Evidence-Based Medicine; D006801:Humans; D008889:Military Personnel; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care; D010346:Patient Care Management / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D012720:Severity of Illness Index; D014481:United States; D014728:Veterans