Pediatric and adult patients benefit from Nexus’ brain injury neurocontinuum for many reasons. As rehabilitation progress and needs change, our care settings – ranging from ICU to community-based living – afford patients the opportunity to receive care, rehab, and live in environments that are least restrictive. Following patients from admission to discharge or transition to life care, our interdisciplinary team develops evolving treatment plans and cultivates long-lasting relationships with patients.
Nexus Neurocontinuum Patient Case Study
In the spring of 2017, a 17-year-old female patient admitted to Nexus Children’s Hospital – Houston from a local acute care facility. The patient suffered a diffuse axonal injury, a type of traumatic brain injury, as a result of a motor vehicle accident.
Upon admission to Nexus Children’s Hospital – Houston, the patient was in a marked coma, with profound cognitive-communication deficits and was aphonic due to a trach and fed through a gastrointestinal tube. She also had increased tone and contractures and could only tolerate sitting up for a maximum of 10 minutes with assistance of two persons.
This patient was admitted into the Nexus Children’s Hospital Brain Injury Program, managed by a PM&R physician, with the rehabilitation team, including a neuropsychologist. She received intense mobility, cognitive, and self-care training through physical and occupational therapy and speech-language pathology services. The patient began to make significant functional gains including increased participation, as she came out of post-traumatic amnesia (PTA).
As rehabilitation continued, the patient showed signs of more appropriate comprehension, expression, social interaction, problem solving, reasoning, organization, and functional recall. She required supervision to minimal assistance with activities of daily living (ADLs), including upper and lower body dressing, grooming, toileting, and bathing, and her bowel and bladder control improved to greater than 50%. Also, the patient was able to transfer objects between her hands independently and complete bed mobility with stand by assistance. In addition, she was able ambulate with a rolling walker and without the use of braces or splints.
After eight months at Nexus Children’s Hospital, the patient transitioned to Nexus Neurorecovery Center where she participated in physical, occupational, and recreational therapy, speech-language pathology, and cognitive groups. Through programming, the patient redeveloped long- and short-term memory and communication. By discharge, she was able to recognize faces, recall places, remember details prior to the accident, and carry on conversations.
After 73 days of inpatient rehabilitation at Nexus Neurorecovery Center, the patient was discharged to a personal care home. Nexus staff arranged necessary medical services and coordinated her discharge.
