Long-term health implications of individuals with TBI: a rehabilitation perspective

Individuals with acquired brain injuries often present with lifelong health challenges. Trauma to the body directly related to the injury, physical and medical sequelae resulting from the brain injury itself, and an increase in the observed onset of physical aging are among the problems which require consideration throughout their lives. For many rehabilitation professionals, issues related to medical stability and health maintenance are unfamiliar and intimidating. As both hospital stays shorten and an existing population of individuals with brain injuries' survival and life expectancy rates increase, rehabilitation professionals have been increasingly challenged by medical issues. Rehabilitation nurses are positioned to best navigate these issues and facilitate needed care coordination, early intervention, and ongoing education for individuals, their families, and other caregivers. This article describes common medical complications related to the initial and related disability and aging in individuals with brain injury including chronic and late emerging complications involving all body systems including spasticity and changing mobility, aspiration and dysphagia, incontinence, diabetes, and acute and chronic pain. Strategies for successful management of these issues in a home or community setting are also discussed. Special attention is paid to falls and fall prevention, issues specific to aging women, and nutrition and weight control. Ways to promote positive health behaviors to preserve function are also explored. Additionally, patient and family education as part of a lifetime management plan is discussed.