An acquired brain injury (ABI) is defined as brain damage caused by events after birth and not related to a congenital disorder or a developmental disability. There are two types of ABI: traumatic brain injury (TBI) and non-traumatic brain injury (nTBI). Traumatic brain injury results from physical trauma, such as that arising from an accident, an assault, brain surgery or other kinds of head injuries. Non-traumatic brain injury can be caused by either an internal or external source [e.g., a stroke, a brain tumour, infection, poisoning, hypoxia (lack of oxygen), ischemia (insufficient blood flow), encephalopathy (brain disease), or substance abuse]. ABI can result in cognitive, physical, emotional or behavioural impairments that lead to permanent or temporary changes in functioning.
About four years ago, due to the need in the health care system and as a trial, The Salvation Army Toronto Grace Health Centre (TGHC) began to admit patients with ABI for rehabilitation. During this time, the TGHC’s health care team has gained experience in providing optimal patient care for ABI patients. Consequently, the TGHC expanded its Complex Continuing Care (CCC) program to include ABI patients, who because of their physical state require the slower-paced approach of a low tolerance, long duration (LTLD) rehabilitation program.
After their stay in acute care, ABI patients, including those with only moderate impairment, normally do not perform well physically, functionally or cognitively in the first year after their injury. Generally, they are considered non-functional. These ABI patients, who are now medically stable, frequently cannot be easily restored to their previous functioning state. They may not have the cognitive capacity, motivation, stamina and endurance required to actively participate in intensive daily therapies. They are considered unsuitable for what is commonly known as a high tolerance, low duration rehabilitation program. These ABI patients often remain in an acute care setting receiving minimal rehabilitation. Essentially, ABI patients need to be discharged when medically stable to a more appropriate setting for a slower paced rehabilitation.
The TGHC’s LTLD rehab program delivers the slower paced rehabilitation therapy needed initially by ABI patients because of their level of disability. This delivery of slower paced, more appropriate rehabilitation to ABI patients by TGHC enables them, in the end, to move faster and more efficiently through the health care system and to ultimately transition to a high tolerance, low duration rehabilitation centre.
It is worth noting that in the past few years the TGHC has showcased some of their ABI patient’s stories in its different media platforms. Most recently, the TGHC’s website featured “Melinda: A Mother’s Hope,” a story about a former ABI patient at TGHC, who has now reconnected with TGHC to share her successful rehabilitation journey.
Currently there are eight ABI patients in the TGHC’s CCC program. The TGHC continues to meet the needs of the community, remaining a relevant partner in the health care continuum by providing excellent care for all individuals.
BY Gerry Condotta