Introduction

This information was written for health service planners, other professional bodies and clinicians.

Brain injury specialist rehabilitation

Brain injury specialist rehabilitation is a specialty discipline within rehabilitation that is most relevant to a subset of people who have experienced a brain injury. It is particularly relevant when the impacts of the brain injury produce acute, complex and functionally significant abnormality across multiple domains of cerebral function.

Most commonly brain injury specialist rehabilitation is for people with severe traumatic brain injury (TBI). Some non-traumatic brain injuries, often referred to as acquired brain injury (ABI), for example some hypoxic brain injuries and some strokes, have similar characteristics, effects and impacts to severe TBI. The nature of these brain injuries and subsequent impairments and impacts are described in Part A: Brain injury and specialist rehabilitation.

From injury to living in the community

The brain injury specialist rehabilitation pathway goes from the point of injury to the client being back in the community. Recovery and rehabilitation from severe brain injury is typically most rapid in the first three to six months but may continue for several years. The pathway includes acute hospital care and rehabilitation, in-patient rehabilitation, transitioning to community living and living in the community.

This pathway is unique for each person, it includes health and community services and has multiple sources of funding including health, community services, disability, motor vehicle and other insurance.

Brain injury specialist rehabilitation includes values, principles, pathways, wrap around services and special environments. Brain Injury Rehabilitation Programs (BIRPs) are located within NSW local health districts (LHDs) and the BIRPs are networked through the Agency for Clinical Innovation (ACI). The network is called the Brain Injury Rehabilitation Directorate (BIRD). The essence of brain injury specialist rehabilitation is described in Part B: Values, principles, pathways and core activities.

Integrated rehabilitation, care and support

The pathway of recovery following severe brain injury is often complex. A range of different health and non-health services are needed across the continuum of recovery, rehabilitation and community resettlement. A whole-of-person approach provides the framework for integrating person-centred health and non-health goals to achieve maximum recovery, adjustment to the impact on the hopes, dreams and aspirations of the individual.

There are a variety of health service settings and pathways that may be needed by the person before beginning the acute hospital setting phase, or being back in the community. Health services and pathways become integrated with other government and non-government services and pathways to meet the complex needs of people with a new brain injury causing disability. Services needed can include housing, income and decision-making supports and services that could be provided by the National Disability Insurance Scheme (NDIS), national government funded aged care services, NSW icare and Lifetime care, and private insurance.

Parts C, D, E and F describe the NSW services, settings, pathways and funding.