Shannon Janzen MSc, Jonathan Serrato MSc, Corbin Lippert BScN, Margaret Weiser PhD, Jo-Anne Aubut BA, Robert Teasell MD FRCPC
Community reintegration is the ultimate goal of acquired brain injury (ABI) rehabilitation. However, the evidence supporting many widely held beliefs about outcomes in this domain is limited. The evaluation of clinical work in this area may not lend itself well to the rigors of a randomized controlled trial (RCT), as the situations, circumstances, deficits, and supports are as complex and varied as the individuals themselves.
The transition back to the community from acute care or post-acute rehabilitation requires diverse supports in the community, often for extended periods of time. Returning to a full range of activities within the community can prove difficult for brain injury survivors and their families. Life encompasses work, love, and play, but rehabilitation efforts often focus primarily on vocational status. The impact of a brain injury on interpersonal relationships, parenting, friendships, and leisure roles may be equally challenging and disabling.
Given that a brain injury is a relatively significant disabler of an otherwise healthy, young, and productive segment of our population, the implications for return to productivity and “normalcy” becomes paramount. This is particularly poignant for those who were not yet able to live autonomously prior to the injury – in these cases, skill-focused rehabilitation must be founded on primary “habilitation”. Clients may need to be taught basic activities of daily living (ADL), how to make friends, and complete primary or secondary schooling before considering vocational options.
This chapter will review the evidence pertaining to community integration and is divided into five primary themes:
13.1 Independence and Social Integration. This section deals with the ability to manage personal needs following ABI and also looks at aspects of community reintegration, including sexuality, socialization and the role of community supports.
13.2 Caregiver Burden. This section deals with the issues of distress, depression, and burden that are experienced by caregivers of patients with an ABI.
13.3 Satisfaction with Life. This section includes those studies dealing with life satisfaction of individuals with ABI.
13.4 Productivity. This section looks at the educational and vocational activities and vocational rehabilitation following an ABI.
13.5 Return to Driving. This section specifically deals with the return to driving following an ABI.
Contact Information: ERABI; Parkwood Institutel; 550 Wellington Road, London ON; 519-685-4292 x44559