Post-Acute Traumatic Brain Injury Care: What to Expect for Ongoing Care and Service

An overview of the long-term TBI treatment and rehabilitation process

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Upon discharge from a hospital, including all extended stay and intensive care immediately following a traumatic brain injury, the post-acute phase of TBI care begins. To obtain the best possible long-term outcome, it is important that a person with TBI (as able) comply with the medical team’s post-acute treatment plan.

Therapy Programs and Services Typically Included in Post-Acute Traumatic Brain Injury Care Treatment Plans

Rehabilitation/Therapies: Specialized TBI rehabilitation (inpatient and/or outpatient) including physical therapy (PT), occupational therapy (OT), and speech language therapy (SLT).
Follow-Up Visits: Regular check-ups with neurologists, neurosurgeons, and other Specialists.
Prescription Drugs: A variety of medications to manage symptoms or secondary conditions.
Psychological Support: Access to counselors, social workers, psychologists, or psychiatrists for mental health support.
Counseling: Individual and group therapy sessions to help the patient and family members cope with the changes and challenges.
Long-Term Home Health Care: In-home nursing care or assistance with daily activities.
Skilled Nursing Facilities: Long-term care in a specialized facility.
Mobility Aids: Wheelchairs, walkers, or other mobility devices.
Communication Devices: Assistance for those who have lost the ability to speak or write.
Case Management: Services to coordinate various aspects of care.
Neuropsychological Testing: Assessments to determine cognitive and behavioral changes.

Sources:

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In some cases, patients recover from TBI and return to their normal level of health and activity. In other instances, however, there can be lifelong effects and limitations from TBI, which should be evaluated by the medical team and addressed on a case-by-case basis.

Potential Long-Term Effects and Limitations

Cognitive Impairments: Problems may linger with memory, attention, and executive function.
Behavioral Changes: The patient may exhibit long-term increased irritability, impulsivity, or emotional instability that affect their personal and social relationships.
Physical Challenges: A variety of chronic ailments can include motor deficits, coordination issues, and pain.
Educational Impact: Younger patients may also have difficulty with school performance and need special educational programs and services.

According to one survey, average recovery rates for patients at the two year anniversary after a moderate or severe brain injury are as follows:

Most people can move around, bathe, and dress without help, but approximately 30 percent need some level of assistance from another person during the day, at night, or both.
Trouble with thinking, processing speed, and forming new memories is common — although the severity of these issues varies.
About 25 percent of patients have major depression caused directly by the brain injury itself; depression may also be caused by major life changes resulting from the trauma, including changes in employment, driving, and living circumstances.
Just over 90 percent live in a private home. Of those who were living alone when they were injured, almost half continue to do so.
About 50 percent of people can drive again, but there may be changes in how often or when they drive.

About 30 percent of people are employed, but it may not be at the same job they had before the injury. Many people get help from vocational rehabilitation counselors who assist people with TBI and other disabilities.

Source: “Understanding TBI: Part 3 — The Recovery Process,” Brain Injury Alliance of Kentucky, last accessed September 30, 2024

Supporting Children Through Academic and Legal Protections

Children with TBI face unique challenges in their education and require specialized support, accommodation, and understanding to facilitate their learning and well-being. Special education is necessary for children with TBI. Fortunately, there is support for a child’s academic success through legal protections, educational strategies, and advocacy efforts aimed at inclusivity.

Traumatic brain injuries can have a significant impact on a child’s cognitive functions, memory, attention, executive skills, social interactions, and emotional regulation. This leads to challenges in education, including in learning, behavior, and academic performance.

Difficulties Faced by Some Students With TBI

Processing information
Retaining information
Concentrating, staying organized, and completing tasks
Communicating effectively with peers and teachers
Managing emotions, coping with stress, and regulating behavior
Participating in physical activities
Balancing sensory input
Navigating the school environment

Several laws and educational regulations aim to safeguard the rights, dignity, and educational opportunities of children with traumatic brain injuries.

For a full discussion of these subjects, request our free book About Traumatic Brain Injury and read Early Intervention Programs for Infants and Toddlers with a Traumatic Brain Injury and Educational Benefits Beyond Early Intervention for Children With Traumatic Brain Injuries.

Social, Economic, and Legal Support Systems for Adults and Senior Citizens

TBI can have lifelong effects on adults and seniors, affecting their independence, quality of life, and well-being. In the US, there are support systems in place to assist our adults and seniors with TBI, including access to health care, legal protections, financial assistance, and social services.

Support Services for Adults and Seniors With Traumatic Brain Injuries

Health Care Coverage and Rehabilitation Services: Access to health care coverage, including private insurance, Medicare, and Medicaid, is essential to receive comprehensive medical care, rehabilitation services, therapy, and ongoing support for their recovery and well-being.
Vocational Rehabilitation Programs: Vocational rehabilitation programs provide training, job placement services, career counseling, and accommodations for individuals with TBI seeking to reenter the workforce, acquire new skills, or engage in meaningful employment opportunities.
Disability Benefits and Social Security: Adults and senior citizens with TBI may be eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits if their condition meets the criteria for disability and affects their ability to work or maintain financial stability.
Housing Assistance and Accommodations: Housing assistance programs, such as Section 8 housing vouchers, group housing, and disability accommodations, can help individuals secure living arrangements that meet their physical and cognitive needs.
Caregiver Support Services: Caregiver support services offer resources, respite care, counseling, and educational programs for family members, friends, or professional caregivers assisting adults and senior citizens with TBI in their daily activities, personal care, and medical needs.

Legislation That Provides Protection

The following laws support adults and senior citizens with traumatic brain injuries:

Americans with Disabilities Act: The ADA prohibits discrimination based on disability and requires reasonable accommodations in employment, public services, transportation, and telecommunications to ensure equal access, participation, and inclusion in society.
Rehabilitation Act of 1973: The Rehabilitation Act mandates reasonable accommodation, accessibility, and affirmative action to promote employment, education, and community integration for adults and seniors with TBI in all programs that receive federal funding.
Older Americans Act: The Older Americans Act provides funding, services, and programs to support the health, independence, and well-being of senior citizens, including those with a TBI, through home and community-based services, nutrition programs, caregiver support, and long-term care options.
Guardianship and Legal Advocacy: Legal guardianship, power of attorney, advance directives, and legal advocacy services can help protect the rights, interests, and decision-making autonomy of people with TBI who may require assistance in managing their affairs, health care decisions, litigation, and financial matters.

Need help investigating your legal rights related to a traumatic brain injury?

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June 3, 2025