ABI Discharge Planning

OT Dude Academy’s Free NBCOT® Exam Prep Course Neurology ABI Discharge Planning

Overview

Discharge planning for patients with acquired brain injury (ABI) is a crucial aspect of occupational therapy. It ensures a smooth transition from the inpatient setting to the community, addresses the multifaceted needs of the patient and involves collaboration with families and other healthcare professionals.

Key Areas of Focus

1. Family and Social Support, Preparation, and Education

Importance: Family and social support are essential for successful community reintegration. Proper preparation and education of family members can significantly impact the patient’s recovery and adaptation post-discharge.

  • Research Insight: Families often experience significant emotional strain during the transition from hospital to home. Effective discharge planning includes preparing and educating caregivers on what to expect and how to provide necessary support 1  2 .

2. Sociocultural Norms

Importance: Understanding and respecting sociocultural norms can influence discharge planning and outcomes. Tailoring interventions to the patient’s cultural background can enhance engagement and adherence.

  • Research Insight: There are racial and ethnic disparities in discharge to rehabilitation services following traumatic brain injury, highlighting the need for culturally sensitive discharge planning 3 .

3. Consultations and Referrals

Importance: Timely consultations and referrals to specialists, such as physical medicine and rehabilitation, are critical for addressing specific needs and improving functional outcomes.

  • Research Insight: Physical medicine and rehabilitation consultations are associated with better acute functional outcomes, shorter lengths of stay, and more effective discharge planning 4 .

4. Job/Vocational Skill Improvement

Importance: Enhancing vocational skills is vital for the patient’s long-term independence and quality of life.

  • Research Insight: Vocational services provided to traumatic brain injury patients within model systems of care show significant diversity and are critical in supporting patients’ return to work 5 .

5. Socialization

Importance: Facilitating socialization helps in preventing isolation and promoting mental health.

  • Research Insight: The pathways of care in the first year after moderate and severe traumatic brain injury often determine the patient’s socialization success and overall recovery 6 .

6. Durable Medical Equipment and Supplies

Importance: Providing appropriate medical equipment and supplies ensures safety and independence.

  • Research Insight: Long-term utilization and costs of medical care among traumatic brain injury survivors highlight the need for durable medical equipment and supplies as part of discharge planning 7 .

7. Driver Assessment and Training

Importance: Assessing and training patients for driving is critical for independence but must consider impairments.

  • Research Insight: Predictors such as PTA duration, physical/visual impairment, and slowed reaction time are important for assessing on-road driver performance post-TBI 8 .

8. Support for Health, Wellness, and Safety Concerns

Importance: Addressing health, wellness, and safety concerns is essential for the patient’s overall well-being.

    • Research Insight: Patients with moderate-to-severe traumatic brain injury and their family caregivers often face significant health, wellness, and safety concerns that need to be addressed during discharge planning 9 .
  1. Piccenna, L., Lannin, N. A., Gruen, R., Pattuwage, L., & Bragge, P. (2016). The experience of discharge for patients with an acquired brain injury from the inpatient to the community setting: A qualitative review. Brain Injury, 30(3), 241-251[↩]
  2. Turner, B., Fleming, J., Parry, J., Vromans, M., Cornwell, P., Gordon, C., & Ownsworth, T. (2010). Caregivers of adults with traumatic brain injury: The emotional impact of transition from hospital to home. Brain Impairment, 11(3), 281-292[↩]
  3. Meagher, A. D., Beadles, C. A., Doorey, J., & Charles, A. G. (2015). Racial and ethnic disparities in discharge to rehabilitation following traumatic brain injury. Journal of Neurosurgery, 122(3), 595-601[↩]
  4. Wagner, A. K., Fabio, T., Zafonte, R. D., Goldberg, G., Marion, D. W., & Peitzman, A. B. (2003). Physical medicine and rehabilitation consultation: relationships with acute functional outcome, length of stay, and discharge planning after traumatic brain injury. American Journal of Physical Medicine & Rehabilitation, 82(7), 526-536[↩]
  5. Hart, T., Dijkers, M., Fraser, R., Cicerone, K., Bogner, J. A., Whyte, J., … & Waldron, B. (2006). Vocational services for traumatic brain injury: treatment definition and diversity within model systems of care. The Journal of Head Trauma Rehabilitation, 21(6), 467-482[↩]
  6. de Koning, M. E., Spikman, J. M., Coers, A., Schönherr, M. C., & van der Naalt, J. (2015). Pathways of care the first year after moderate and severe traumatic brain injury—Discharge destinations and outpatient follow-up. Brain Injury, 29(4), 423-429[↩]
  7. Vangel Jr, S. J., Rapport, L. J., Hanks, R. A., & Black, K. L. (2005). Long-term medical care utilization and costs among traumatic brain injury survivors. American Journal of Physical Medicine & Rehabilitation, 84(3), 153-160[↩]
  8. Ross, P. E., Ponsford, J. L., Di Stefano, M., & Spitz, G. (2015). Predictors of on-road driver performance following traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 96(3), 440-446[↩]
  9. Oyesanya, T. O., Arulselvam, K., Thompson, N., Norelli, J., & Seel, R. T. (2021). Health, wellness, and safety concerns of persons with moderate-to-severe traumatic brain injury and their family caregivers: a qualitative content analysis. Disability and Rehabilitation, 43(5), 685-695[↩]
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