Case Study: Importance of Cognitive Rehabilitation In Returning to Competitive Employment
I.G. had just accepted a job in Human Resources and was excited to begin her new position. Then, in September of 2005, this 28-year old woman’s world as she knew it changed. I.G. was injured in a motor vehicle accident. In addition to a pelvic fracture, liver laceration, and cervical injuries, I.G. also had a traumatic brain injury. Her brain injury left her with moderate cognitive difficulties in the areas of memory, attention, concentration, speed of information processing, initiation, and word finding. Although, I.G.’s physical injuries were debilitating, her difficulty with cognitive tasks were the most concerning to I.G. because they were preventing her from being the independent woman that she was prior to her injury.
After becoming medically stable and making some improvements in her activities of daily living skills, I.G. progressed from Baylor Institute for Rehabilitation to Centre for Neuro Skills ® in Irving, TX to begin post-acute brain injury rehabilitation. While at CNS, I.G. engaged in therapy up to four hours per day in the areas of physical, occupational, and speech therapies, as well as, counseling. Physical and occupational therapies focused on independent mobility, activities of daily living and returning to driving. Cognitive-speech therapy focused on attention and memory skills, organization, planning, problem solving, word finding, and speed of processing. Counseling focused on coping with brain injury and adjustment to disability. I.G. had graduated from college with a degree in Communications and had worked hard in this field to earn her new position in Human Resources. Now, she was unable to work, drive or live independently. When asked what her main goal for rehabilitation was, she replied, "to return to work as soon as possible."
After receiving comprehensive and and intensive treatment (up to 15 hours per day) for one month at CNS-Irving, I.G. returned home to live independently, was able to drive again, and even met her ultimate goal of returning to her job in Human Resources. If I.G. had not received cognitive rehabilitation, she probably would have been able to ambulate independently, but she would not have been able to be independent in other areas such as driving, living, or being competitively employed. For instance, the impulsivity and slowed reaction time that I.G. demonstrated would have not allowed her to safely return to driving a vehicle. Untreated difficulties in problem solving, memory and attention would have compromised her ability to live safely by herself. For instance, if there was a gas leak in her house, would I.G. be able to problem solve to figure out what she needed to do and then remember to carry out those plans to safely deal with the situation? Would she have been able to carry out her duties in the Human Resource department of her company if she had memory and attention issues and could not find the proper words to express herself? Probably not. If I.G.’s cognitive problems had not been addressed, it is likely that she would have developed frustration, anger and depression because of unemployment and dependence on others. Intensive cognitive rehabilitation allowed I.G. to achieve both independence and competitive employment, both of which were important to her.
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