Whatever it takes: a model for community-based services

The Whatever It Takes model is presented as an extension of the medical/rehabilitation model. It is not presented as an alternative to the rehabilitation model, although it does represent an opposition to the manner in which the model is typically implemented in community-based programmes for individuals with acquired brain injury. After brain injury, medical complications persist and a strictly anti-medical model in a community-based programme is unwise. On the other hand, community-based programmes that attempt to treat the individual, or provide rehabilitation services, in the absence of careful consideration of environmental barriers or the need for natural supports, are not likely to meet the long-term community reintegration needs of the individual, and may be unjustly using up finite resources. There are numerous complications associated with living with the effects of acquired brain injury. There also is considerable complexity associated with a health-care system and reimbursement system that emphasize acute care. Given these complexities, and the strong probability that a cure for brain injury is not likely to be found within the next decade, even the most learned professionals in brain injury are likely to say that practical solutions are needed for the present. Most notable is the late Dr Sheldon Berroll, who provided so much leadership to the field, but when asked about solving the day-to-day problems for an individual, would often respond: 'Do whatever it takes'. This advice was not presented in desperation, but rather as practical guidance. We have attempted to describe the whatever it takes approach, and to provide some guidelines for its implementation in community integration programmes.