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Community Neurorehab Services (CNS) provides community oriented services to persons with brain injury, stroke or cognitive dysfunction secondary to another medical condition. Fees are calculated on an hourly basis with the exception of certain programs operating on a flat monthly rate. Duration of programs range from six weeks to six months with opportunity for extension depending on individual needs. However, it is important to note that CNS offers a full day program. Regular office hours are from 8:30 A.M. to 4:30 P.M., Monday to Friday; evening and Saturday coverage is available on a case-by case basis. Structured sessions, occurring daily, provide the opportunity to develop skills (e.g. organizing) and abilities (e.g. getting along with others). These skills and abilities are then implemented within the community at large. Thus, while clients are not physically at CNS for a full day, they attend therapy sessions where programming needs are developed and then implemented at various community locations (i.e. fitness program would be implemented at a local health club, the assessment of work skills would take place at a work experience, adaptive psychosocial behavior is practiced in social situations, developing leisure skills takes place in a corresponding community run program).
Support is provided by professionals, as needed, in order to achieve success across settings (i.e. in a classroom, on the job, at home, at the health club). This model of rehabilitation provides both flexibility and responsiveness to meeting individual needs as only those settings creating concern are targeted.
Individualized programs to achieve community reintegration include some or all of the following services:
Comprehensive assessment services
Partial or complete assessment services are available:
- Medical Status Examination
- Neuropsychological Assessment
- Functional Occupational Therapy Assessment
- Psychosocial Assessment
- Ergonomic Assessment
- Functional Work-site Assessment
- Community Integration Assessment
- Functional Capacity Evaluation
- Learning Deficit Assessment
- Attention Deficit / Hyperactivity Disorder (AD-HD)
- Physiotherapy Assessment / Fitness Evaluation
- Nutritional Assessment
- Speech Language Assessment
- Quality of Life Assessment
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Vocational rehabilitation
This program will help the individual consolidate and generalize learned strategies in the work place. This is facilitated by intensive and timely therapeutic intervention in the work setting. Without such intervention, many individuals who suffer from even mild brain injury can unnecessarily lose their competitiveness for employment.
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Community living skills retraining
Independence in community living is important to one’s self-esteem and quality of life.
Training is provided in areas such as:
- Community mobility
- Money and time management
- Meal planning and preparation
- Household responsibilities
- Self-care
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Social and leisure skills development
Maladaptive social skills resulting from even minor brain injuries can cause social isolation, job loss and interpersonal difficulties.
Modeling, group interaction and persistent practice in a variety of settings are the keys to developing long-standing acceptable social skills. Training of skills involves intensive participation in interactive activities in groups and in the community with consistent therapeutic intervention.
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Cognitive therapy
Utilizing both process specific and metacognitive approaches, the therapist prescribes hierarchically graded treatment tasks to facilitate cognitive recovery. The treatment aims to improve attention, memory, visual processing and all aspects of executive functioning. Group activities and community work experiences are used to provide opportunities for the generalization of skills.
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Individual, family and group counseling
Emotional changes and psychosocial maladjustment following brain injury or cognitive dysfunction resulting from another medical condition, are often major barriers to successful reintegration. Individuals receive counseling services, group and family therapy as needed to promote positive coping styles and improve quality of life. Counseling interventions frequently focus on developing insight into areas of need and developing strategies to overcome these difficulties. Prospects for achieving long term positive gains are thereby enhanced.
Many research findings promote the group process as one of the most effective ways to overcome psychosocial barriers. Group millieu allows peer feedback and facilitates motivation for behavioural change.
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Physical conditioning
Physiotherapy and fitness addresses physical injuries and challenges over the recovery process.
- Enhances stamina and endurance
- Physical conditioning for work
- General physical fitness
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Community integration
Social isolation can be a significant challenge. CNS provides education and support to acquire meaningful life roles.
Assistance is provided in accessing :
- Productive activity
- Leisure pursuits
- Recreational opportunities
- Education
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Physical Therapy Assessment
A physical therapy assessment may be required to determine the need for medical intervention, as a follow-up to a medical referral, or to determine any physical contraindications to either assessment procedures such as the functional capacity evaluation or to rehabilitation exercises. This assessment is conducted by the physical therapist either in the client’s home, in a local fitness facility, or in a clinic.
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Case management and communication with all parties involved
Employers, insurers and other service providers can access clinical consultation on an as needed basis. Case consultation may involve file review with subsequent recommendations for further lines of treatment/investigation. Presentations, workshops, referral services, and case management are additional services offered by an interdisciplinary team of seasoned professionals.
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Medical Status Examination
A Medical Status Exam performed by the physician confirms diagnosis and outlines needs for further investigation, treatments and/or rehabilitation. The results of this assessment are shared with the treating general physician and the CNS team to ensure comprehensive medical management of the claim.
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