An acquired brain injury happens when a mechanism damages your brain. These types of injuries include:

• Traumatic brain injuries: When something hits the head from the outside or the brain is shaken within the skull; examples include car or bike accidents, falls, sports injuries or assault
• Non-traumatic brain injuries: When the brain doesn’t get enough oxygen or if there are medical issues that affect how the brain works; examples include stroke, brain aneurysm, brain tumor, heart attack or infection

Acquired brain injuries don’t include congenital brain changes that you’re born with or degenerative brain diseases that get worse over time, such as Alzheimer’s disease.

A brain injury can change your brain function, preventing the brain from sending or receiving messages with the body.

Symptoms can be different for everyone, but often include:

• Confusion
• Convulsions, or shaking
• Dizziness
• Headaches
• Loss of coordination
• Memory problems
• Personality changes
• Poor concentration
• Slurred speech
• Weakness in muscles

It’s important to find the right rehabilitation setting for your needs after a brain injury. Try to think through what you expect, your health coverage, services you need and any possible future needs.

Options may include:

• Home health agency: Services for patients who can’t leave home
• Inpatient rehabilitation facility (IRF): Intensive 24-hour rehabilitation care with supervision from a rehabilitation and medical care team; includes a minimum of 3 hours of therapy, 5 days a week
• Long-term acute care facility: Hospital-level care for patients with complex chronic medical needs
• Nursing home: Care for patients who can’t live by themselves
• Outpatient clinic: Care for patients who can leave home for therapy
• Skilled nursing facility (SNF): Daily skilled nursing or rehabilitation care

If you’ve had a brain injury, rehabilitation is an important part of your recovery. The brain has a special ability called neuroplasticity, meaning it can change, adapt, rebuild and reorganize itself after brain injury. Participating in rehabilitation helps the brain heal.

Rehabilitation can take many forms depending on your needs. All services are designed to help you recover from the effects of your injury as much as possible. For example:

• Organized exercises focusing on attention, memory and higher thinking help promote brain reorganization
• Speech and language therapy retrain the part of your brain that control language
• Task-specific training develops and strengthens brain pathways for motor skills

Your care team includes different specialists based on your specific needs. Your physiatrist leads the team and manages your care.

You may also work with:

• Discharge planners
• Nurses
• Occupational therapists
• Pharmacists
• Physical therapists
• Recreational therapists
• Registered dietitians
• Respiratory therapists
• Social workers
• Speech-language pathologists
• Spiritual care providers

The first step of inpatient rehabilitation is being admitted to our Acute Inpatient Rehabilitation Unit.

Shortly after admission, you meet with your care team for a personal evaluation to assess your recovery needs and develop a rehabilitation program designed just for you. We also involve families as much as possible. Throughout recovery, we encourage loved ones to observe, participate in your care and attend educational sessions about your therapy.

During your care, we focus on early movement, sensory stimulation and improving thinking and language skills. You may receive supportive treatments to prevent infection, malnutrition and other complications.

We use the Rancho Los Amigos scale to measure thinking and behavior changes throughout recovery – from initial injury until you leave the unit.

The Rancho Los Amigos scale is a way for us to measure the level of brain injury, so that we can provide appropriate treatments.

The scale has 10 levels:

• Level 1: No response to all stimulus
• Level 2: Generalized response, not always directly to stimulus, with inconsistent reaction
• Level 3: Localized response directly to stimuli with inconsistent reaction
• Level 4: Confused and agitated
• Level 5: Confused and inappropriate, not as agitated
• Level 6: Confused and appropriate, responds accurately to commands
• Level 7: Automatic and appropriate, goes through daily routine with little confusion
• Level 8: Purposeful and appropriate, has functioning memory and responsive to environment
• Level 9: Purposeful and appropriate, standby assistance on request
• Level 10: Purposeful and appropriate, modified independent

The length of your rehabilitation and the amount of follow-up care that you need depends on how severe your brain injury is and how well you respond to therapy. Some people may be able to return to their same level of ability. Others need lifetime care.

We can’t always tell how someone will recover right away. It may take months or even years to know. Every brain injury is different, and progress doesn't always follow a straight path.

Your time at the hospital is one step in your brain injury recovery. We want to help you go home and continue to heal.

Before you leave, we’ll recommend support services, such as outpatient therapies, home health therapies or nursing and personal care assistant (PCA) services.

We can also help determine if you need an extended care facility, assisted living facility or skilled nursing facility.

Your case manager helps you schedule required follow-up appointments. We also make sure you understand any medications you need to take.

There are many organizations that support Alaskans and their loved ones with brain injury recovery.

Some examples include:

• Access Alaska: Offers grant funding for related brain injury services that Medicaid or other sources don’t cover, such as medical, dental, behavioral health, housing, adaptive equipment and other needs
• Alaska Brain Bus: A project of the Alaska Brain Injury Consortium, creating systems of support and improving the lives of community members and their families impacted by traumatic brain injury
• Alaska TBI Resource Locator: Lists brain injury resources in Alaska
• ALTA: Provides language and cultural solutions that may be helpful after brain injury
• Brain Injury Association of America: Provides information and resources related to brain injuries, treatment and education
• Brain Injury State Partnership Program: Increases the capacity to provide complete, continuous care for people with brain injury and their families in Alaska
• Challenge Alaska: Helps improve the lives of people with disabilities, their families and the community with adaptive sports, therapeutic recreation and education
• Daybreak: Helps adults find and use resources to live a complete and mostly self-sufficient lifestyle in Mat-Su Valley
• Maniilaq Association: Provides health, tribal and social services to people who live in Northwest Alaska
• Southeast Alaska Independent Living, Inc. (SAIL): Empowers older adults and people with disabilities by helping with independence and productivity
• Turnagain Social Club: Serves as an adult day center with therapeutic activities, personal care, supervision, nursing services and more for those who have disabilities or are age 55 or older