Successful Brain Injury Rehabilitation Through Immersive Community Living
Home-like center helps brain injury patients recover with more independence to return home
A brain injury (BI) is a life-altering event for patients and their loved ones.
Each year, Select Medical specialty hospitals serve over 33,000 patients with brain injury (BI). The care given in the days, weeks and months after such an event determines the fullness in living and hopefulness for those we serve.
Our Neuro Transitional Rehab Centers (NTCs) are the foundation for that hope and a new model in brain injury rehabilitation that’s delivering better patient outcomes.
The NTC model covers long-existing gaps in medical services – gaps that can leave patients struggling when they return home. This often results in BI patients being readmitted to the hospital after going home or being admitted to long-term nursing care if they aren’t independently capable of returning home.
Transitional services at the NTC bridge the gap between hospital and home. NTC rehabilitation provides the time and space that many BI patients need to make further strides in their recovery after a hospital stay and before returning home.
Our NTCs focus on real-life, clinical rehabilitative strategies. These are led by expert teams – delivered in a non-hospital, home-like setting – to achieve three goals:
- The patient’s successful re-entry to home and community, and re-engagement with people and activities
- Family and caregiver readiness in learning how to care for a loved one before they return home
- A higher rate in the percentage of patients who achieve lasting independence after discharge to home
This article will help you understand more about BI recovery and how our NTCs help patients with even the most complex brain injuries recover to their fullest potential.
Brain injury patients often struggle with transitioning to home after a hospital stay
For individuals who suffer a moderate to severe BI, their initial care is either critical illness recovery or inpatient rehabilitative care in post-acute hospitals like ours.
Yet even with highly skilled levels of inpatient care, BI patients have a long road ahead in recovery after discharge.
Going home too soon after a hospital stay may not be the right choice. This is often the case when an individual has moderate to severe difficulty thinking, speaking, socializing, or mobility during everyday tasks.
Patients with lingering physical, cognitive or behavioral limitations often struggle in their transition back to home life – what once was familiar, now feels different after suffering a BI.
Your loved one may have difficulty adjusting to their environment, managing responsibilities or coping with the changes in their life. This is the gap that exists between going from hospital to home.
Select Medical is expertly closing this gap.
“We recognize that what many BI patients need before returning home is more time —specialized focus to adjust to and relearn life after brain injury,” said Jane Boutte, clinical director of neuro transitional rehab for Select Medical. “This is the forward-thinking foundation of our neuro transitional centers.”
Boutte continued, “Other types of transitional services may offer short-term rehab programs on an outpatient basis, or maybe a 30-day inpatient period. Our model of transitional care is unique in that our patients stay with us an average of 100 days and receive 24/7 intensive rehabilitation, which includes family and caregiver participation.”
Bringing in family during therapy sessions gives them the chance to talk with therapists and see the patient’s progress. It also lessens any fear factor by observing and learning how to care for and help their loved one at home.
It’s a unique approach to transitional services that boosts our patients’ capabilities in returning to independence when they go home.”
As example, Baylor Scott & White shared the success of their approach with 2022 data. Discharge rates shows more patients progressing to living independently 30 days after going home:
- 16% of patients discharged as independent rose to 22% at 30-day follow up
- 1% of patients discharged as needing just overnight check-ins rose to 17%
Boutte explained these improvement measures show NTCs help patients gain greater independence with fewer limitations in their daily living. There’s a progression in patients moving from low independence to fully independent by the time of discharge.
What neuro transitional life looks like
- Patient population: 9-15 individuals
- Patient mix: 67% male; 33% female
- Age level: 16 and up
- Accommodations: oversized private suites
- Amenities: kitchens, laundry, gym, quiet rooms
- Staffing ratio: 1:3
- Activities: weekly external exploratory & learning outings
- Accepts: commercial health insurance or Workers Compensation
- *Medicare and Medicaid do no cover NTC services
The NTC model is a 9- to 15-bed residential center with comforts of home. The small number of beds reflects the focus on individualized patient care. Each patient has a private suite and access to:
- Multiple kitchens for learning tasks like cooking
- Laundry rooms for cleaning their clothes
- Computer study and quiet room
- Therapy gym and outdoor space
Patients arrive at the center after completing their inpatient stay at a hospital. Unlike typical skilled nursing facilities, NTC life includes round-the-clock, intensive short-term rehabilitation.
The average 100-day stay allows our staff to concentrate their time and attention on retraining patients in activities related to home, work and community.
Staffing ratios are 1:3 – 3 patients to one staff – for dedicated care. Rehab disciplines include:
- Physical and occupational therapy
- Speech and recreational therapy
- Behavior analysis
- Neuro rehab coaching
- Physiatry (physical medicine and rehabilitation)
Our NTC team members are skilled in more than one area of rehab. So you may hear the term transdisciplinary team. This means, for example, that a nurse will be able to provide feedback and recommendations for physical therapy or a behavior analyst may also do rehabilitation coaching.
The benefit of teams being skilled in several areas is that everyone on the team takes part in each of the rehab disciplines. It’s effective because it brings stronger collaboration and understanding among the team, which means a unified focus on patient progress.
Neuro Transition is an effective model for helping brain injury patients and caregivers cope with the transition home
We help patients and families cope with the transition home by providing education and support for what to expect during recovery.
This can be an especially important time for BI patients, who may still be recovering from their condition after discharge from the hospital.
There may be physical limitations or changes in personality that need to be understood and managed. This is part of the work we do at the NTC so that patient and family are ready to return home safely.
The goal is not only for patients to return safely but also to live independently in their own homes.
“As leaders in BI rehabilitation, we’re making the hope of those we serve a reality,” said Boutte. “At the NTC, we restore and nurture life.”
What life can look like after coming home
Please watch this video highlighting the remarkable progress of patient Lori Sellers in the NTC program. Lori suffered four strokes, causing non-traumatic brain injury.
Take a virtual tour of one of our NTC locations to see the accommodations.
For more information on Select Medical, its joint ventures and expansion plans for Neuro Transitional Centers, email Jane Boutte, clinical director, Neuro Transitional Rehab.