McMordie et al. ( 1991) observed that families of TBI patients had questions about prognosis, care, and referral resources after initial hospitalization. Their main concerns were focused on expectation and outcome. The authors concluded that educational programs should be implemented for families of TBI patients.
Experience tells us that it is almost impossible to rehabilitate a TBI patient without the family. It is the family that provides physical and moral support, cares for the patient in the long run, and facilitates his or her reintegration into society. Therefore, it is mandatory that families be involved in the rehabilitation process from the very beginning, that any and all available information be shared with them, and that they be aided in adjusting their expectations on a realistic level. Only in this manner can the best possible psychosocial outcome of patients be achieved.
To help the TBI patient achieve optimal psychosocial functioning through the rehabilitation process, objective, integrative, and measurable criteria for success must be established. I chose the patient's ultimate return to employment on the open market or his or her return to school as my index for successful outcome. My choice was supported by results of the RNSS, which revealed that the patient's subjective evaluation of the quality of his or her life is highly correlated with his or her vocational status. I concluded that the psychosocial functioning of TBI patients can be determined on the basis of their employment status in a real-life situation after discharge from the rehabilitation program.
I suggest that age alone is not an independent factor in determining the psychosocial outcome of TBI patients, and that outcome is influenced by the presence and severity of deficits in motor control, communication, cognition, and behavior.
Family involvement in the rehabilitation process is crucial, and family members must be given emotional support and information starting from the very early phases after trauma. This eases anxiety, decreases uncertainty, and provides them with resources for the care and support of patients within the family and for facilitating their reintegration into society.
Avizur M. ( 1992). Injuries from road accidents -- circurnstances of accident, evacuation and Outcome. Jerusalem: Hebrew University and Hadassa Medical Organization.