COMMUNITY REENTRY OF LONG-TERM INSTITUTIONALIZED BRAIN-INJURED PERSONS

Although evidence exists for delayed recovery after traumatic brain in jury, patients who do not receive rehabilitation early after their inj uries often remain permanently in long-term care facilities. Case repo rts of five severely brain-injured persons who were discharged into lo ng-term nursing care facilities for at least 1 year before initial reh abilitation admission are discussed. After prescreening for evidence o f functional improvement, these patients were admitted to a rehabilita tion unit with the goal of community discharge. Functional improvement was evaluated using the Functional Independence Measure (FIM) and add itional categories of function. Community discharge was successfully a chieved in all five patients, who demonstrated particular improvement in bathing, transfers, memory, bowel management, problem solving and i ndependence during waking hours. Further efforts should be made to ide ntify patients in long-term care facilities who might benefit from reh abilitation services, and to identify those factors which contribute t o successful community discharge.