Regaining Independence after a Brain Injury

His helmet saved his life, but the impact jarred his brain—Tom Ficarro, 30, flew head first into a curb during a serious motorcycle accident that left him paralyzed from the waist down and affected by a traumatic brain injury (TBI).

After a long hospitalization, including inpatient rehabilitation, Tom was well enough to go home, but not able to live on his own. He moved in with his sister in New Hope, PA, and, with the support of his family and help from Doylestown Health’s Neurological Impaired Rehabilitation Program, his journey to independence is well underway.

About TBIs

At least 5.3 million Americans are living with a TBI-related disability, according to the Brain Injury Association of America. Caused by a blow to or shaking of the head, nearly half of all TBIs result from falls. Other causes include motor vehicle accidents and head injuries acquired during sports or other activities. Concussions are a mild form of TBI.

Brain injuries can lead to problems with:

• Speech
• Working memory
• Short-term memory
• Reasoning
• Problem solving
• Processing speed
• Organization
• Language/word retrieval problems
• Swallowing problems
• Balance
• Vision
• Seizures

Often, people who have a TBI cannot bathe, dress or walk without assistance, so family members become 24-hour caregivers.

Helping Patients Achieve Maximum Function

Doylestown Health’s neuro-rehab experts focus on mobility, thinking and communication skills, and activities of daily living after brain injury,” says Mona Dunlap, PT, MSPT, CLT-LANA, outpatient rehab clinical manager.

“We work for improvement in all areas, while targeting the patient’s specific challenges and helping them achieve their goals,” says Jean Schoener, MA, CCC-SLP, a speech pathologist and neuro rehab specialist.

Tom’s goal is to move into his own apartment. He follows a personalized treatment plan, including exercises and strategies to improve attention, concentration and memory. He works on building arm strength, learning how to transfer in and out of his wheelchair and modifications for managing daily tasks.

Celebrating Progress

“The greatest reward comes from seeing a patient regain independence, whether that means dressing and bathing without assistance, improving memory, getting back to driving or returning to work,” says Jean.

“I’m very optimistic about the future,” says Tom. “When I first started outpatient rehab, my Mom was helping me in and out of the car, but now I do most of the transfer myself,” says Tom, who has also mastered strategies for cooking while using his wheelchair. “I appreciate everything the team has done. They’re even helping me look for an apartment as part of my rehab,” adds Tom, a landscaper who is already looking ahead to his next goal of becoming a welder.

Our Personalized, Team Approach

“We utilize a highly collaborative, multi-therapy approach focused on understanding and accommodating the specific needs, progress and goals of each patient,” says Donna Seif, RN, certified registered rehab nurse and case manager.

Doylestown Health’s neuro rehab team offers decades of experience helping patients with brain injuries to recover physically, mentally and emotionally, achieving the highest level of function possible with a combination including:

• Physical Therapy (PT): Helps with gait, balance and strength, to improve movement and function. Vestibular rehabilitation (VT) is a subspecialty focused on balance and body orientation to overcome dizziness, blurred vision and motion sensitivity.
• Occupational Therapy (OT): Gets patients back to activities of daily living such as dressing, meal prep, money management, returning to work and help with visual-perceptual issues. A driving skills assessment can gauge when a patient is ready to move forward with driving.
• Speech Therapy (ST): Works on speech, language and voice; swallowing assessment and training, and cognitive deficits including attention, memory, executive function, and reasoning.
• The Nurse/Case Manager: Gets new patients established, helps with resources and psychosocial issues for patients and families as well as assisting with medical management.

Innovations that help

The Neurological Impaired Rehabilitation Program’s new location in the Clark Outpatient Rehabilitation Center on the Main Doylestown Health campus combines convenience with a bright, healing atmosphere and state-of-the-art technology including:

• BioSway—An interactive, computerized balance and assessment training tool to make therapy more effective and fun while tracking progress
• Vestibular infrared goggles—An illuminating optical device that records eye movements to identify the source of dizziness or vertigo
• Dynavision—Brain training technology designed to improve movement, hand-eye coordination, memory, concentration and information processing

Convenient Scheduling

Many TBI patients see multiple therapists, so the team schedules appointments back to back whenever possible to make it easier for patients and family members.

To schedule an appointment or for more information call 215.345.2894.