Living with traumatic brain injury in a rural setting: supports and barriers across the continuum of care.
Anne L Harrison, Elizabeth G Hunter, Heather Thomas and 3 others
PMID 27549899WHAT IT FOUND
Rural survivors and caregivers said returning home was hardest: local TBI expertise, transportation, financial help, and community ties often fell short.
Urban rehab staff and family advocates helped, but few used available state supports.
Key findings
01Returning to rural home after rehabilitation was the hardest transition, with fear, lost structure, and inadequate local services.
02Caregivers faced long travel, missed work, and inadequate education about memory and daily care during rehabilitation.
03State financial and vocational supports were rarely known or used, while participants had ongoing function, activity, and social barriers.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only 13 people with TBI and six caregivers from ten counties were interviewed, so the findings describe a small group in one rural state. Two people with TBI could not communicate during interviews, so their own words were not heard. Caregiver interviews sometimes happened with the person with TBI or another family member present, which may have changed what was said. Participants were recruited from rehabilitation hospital records and had to respond to flyers, so those with very severe injuries, no caregiver, or less motivation may not be represented. The study reports experiences and barriers. It does not test whether case management, community health workers, or any therapy improves outcomes.
Declared interests
The paper is tagged as supported by NIH extramural research. No author conflict statement is reported.
The easy way to misread this
Do not read this as evidence that case management or community health workers improve outcomes. The study only described experiences and proposed service models; it did not test an intervention.