title: Back home after an acquired brain injury: building a "low-cost" team to provide theory-driven cognitive rehabilitation after routine interventions.
abstract: BACKGROUND
  Individuals with Acquired Brain Injury (ABI) could benefit from further cognitive rehabilitation, after they have returned home. However, a lack of specialist services to provide such rehabilitation often prevents this. This leads to reduced reintegration of patients, increased social disadvantages and ultimately, higher economic costs.
  
  
  METHODS
  10 months post-stroke, a 69 year-old woman was discharged from an inpatient rehabilitation program and returned home with severe cognitive impairments. We describe a pilot project which provided an individualised, low cost rehabilitation program, supervised and trained by a neuropsychologist. Progress was monitored every 3 months in order to decide on continuation of the program, based on the achieved results and predicted costs.
  
  
  RESULTS
  Post intervention, despite severe initial impairment, cognitive and most notably daily functioning had improved. Although the financial investment was moderately high for the family, the intervention was still considered cost-effective when compared with the required costs of care in a local non-specialist care home. Moreover, the pilot experience was used to build a "local expert team" available for other individuals requiring rehabilitation.
  
  
  CONCLUSIONS
  These results encourage the development of similar local "low cost" teams in the community, to provide scientifically-grounded cognitive rehabilitation for ABI patients returning home.
authors.affiliation: Keiron & Montreal Neurofeedback Center, Montreal, QC, Canada.
authors.forename: Davide
authors.initials: D
authors.lastname: Pierini
authors.affiliation: Institute of Psychiatry, King's College London, Denmark Hill, London, UK.
authors.forename: Doreen
authors.initials: D
authors.lastname: Hoerold
mesh_terms: D000368:Aged; D001930:Brain Injuries / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy; D005260:Female; D006699:Home Care Services; D006801:Humans; D010865:Pilot Projects; D011581:Psychological Tests
keywords: Acquired brain injury; cognitive rehabilitation; home-based rehabilitation; post-acute recovery; post-acute rehabilitation; rehabilitation team