Cognitive dependence in physically independent patients at discharge from acute traumatic brain injury rehabilitation

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J90131

Journal:

Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

2022 , 103, 9, 1866-1869

Publication Website:

Abstract:

Study examined the incidence of cognitive dependence in 226 adult inpatients with moderate-to-severe traumatic brain injury (TBI) who were physically independent at discharge from acute rehabilitation. Cognitive and physical independence were assessed using the Functional Independence Measure (FIM). Patient sex, age, race and ethnicity, discharge destination, care plan (i.e., discharge to living with family, friends, alone, attendant, or other), and FIM Motor and Cognitive scores at discharge were extracted from hospital records. Approximately 69 percent of the physically independent inpatients were cognitively dependent at discharge from acute rehabilitation, with the highest proportions of dependence found in the domains of problem solving and memory. Most (82.6 percent) of these physically independent, yet cognitively dependent, patients were discharged home. Of those discharged home, 82 percent were discharged to the care of family members, and 11 percent were discharged home alone. Patients from racial and ethnic minority backgrounds were significantly more likely than White patients to be discharged while cognitively dependent. The findings indicate that most physically independent patients with TBI were cognitively dependent at the time of discharge from acute inpatient rehabilitation. Further research is needed to understand the effect of cognitive dependence on caregiver stress and strain and the disproportionate burden on racial and ethnic minority patients and families. Given the potential functional and safety limitations imposed by cognitive deficits, health care policy and practice should facilitate delivery of cognitive rehabilitation services in acute TBI rehabilitation.

Author(s):