Level of Care Options For the Low Functioning Brain Injury Survivor
William Walker, M.D., Jeffrey Kreutzer, Ph.D., Adrienne D. Witol, Psy.D.
Abstract
During the early stages of recovery from severe brain injury many patients are comatose or minimally responsive. Rehabilitation for these low functioning survivors traditionally includes acute medical care and transfer to a skilled nursing facility or acute
rehabilitation. Concerns have been expressed that customary treatment options are ineffective, costly, or both. In response, "intermediate" level programs designed to provide effective, cost-efficient rehabilitation have emerged. The purpose of this manuscript
is to provide information regarding outcome of severe brain injury and the early rehabilitation needs of survivors. Common characteristics, advantages, and disadvantages of various intermediate programs, including "subacute" and "transitional"
rehabilitation are discussed and contrasted.
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