The high-level tetraplegic: psychological survival and adjustment

From the date of injury tetraplegics with spinal cord lesions of C4 and above are faced with unparalleled social and psychological adjustment. The individual will be involved in a process of re-establishing his identity by learning to develop and adapt his only remaining resources, his mind and his ability to communicate. This patient population is absolutely dependent in all aspects of meeting basic needs during the initial stages of the injury. If we attempt to return the patient to an active role in society, the rehabilitation team must be aware of the dynamics by which the patient achieves control of both himself and his environment. He will undergo a marked regression of his physical and emotional being and will face the turmoil of realigning ego parameters. The focal point of patient, family and staff interaction is the months of rehabilitation, where the team deals with the problem of social reintegration. Family involvement is essential from the beginning and reaches a high point at discharge and home planning. The scope of the paper will be to trace the psycho-social development of the patient with cervical lesion of C4 and above through the initial, rehabilitation and discharge phases of the injury. Our aim is to develop sufficient insight to the problems facing our patient population that we may aid in their search for meaningful lives.