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What professionals are part of the rehabilitation care team and what are their roles?

The care team may vary according to: [1]

  • Where rehabilitation occurs: hospital, rehabilitation centre, internal or external services
  • The establishment’s priorities
  • The availability of resources

The care team may include:

  • Physical educator/kinesiologist
  • Special educator
  • Occupational therapist
  • Nurse
  • Physician
  • Remedial teacher
  • Speech language pathologist
  • Physiotherapist
  • Neuropsychologist/psychologist
  • Social worker
  • Career consultant
  • Dietician

Physical educator/kinesiologist

  • The physical educator or kinesiologist evaluates motor development as well as the condition and capacity of neuromotor, cardiopulmonary and neuromusculoskeletal (nerves, muscles, and bones) systems, taking into account different aspects of the individual (psychological, social, education, etc.).
  • They organize physical and sports activities aimed at improving and maintaining health, acquiring a healthy lifestyle and achieving social integration.
  • Interventions are carried out in both individual and group sessions.

Special educator

  • The special educator identifies skills and the ways that the individual has developed to cope with their new condition.
  • They help the individual practise what they have learned in rehabilitation, in their daily lives and at work.
  • They facilitate therapeutic activities aimed at supporting learning and social integration (group activities facilitated with other professionals, the use of an agenda, sport activities).
  • They guide and accompany the person in their dealings with different community resources.

Occupational therapist

  • The occupational therapist evaluates personal autonomy at home and in the community.
  • They intervene to resolve disability situations for brain-injured persons.
  • They teach various strategies (energy management, posture, etc.) and suggest ways to help (technical assistance, agenda, timing, etc.) while the individual progressively adopts their life plan.
  • They participate in the process of evaluating working ability by analyzing the person’s work station and documenting the skills, disabilities and environmental factors that influence their professional integration.
  • They participate as the person develops their ability to work (simulation exercises in a clinical setting, training in the work place, gradual return to work).

Nurse

  • The nursing care team usually consists of a head nurse, primary care nurses, nursing assistants and orderlies.
  • The head nurse is responsible for all the care activities and services undertaken in her unit. She coordinates and evaluates the care team and carries out tasks related to care and administrative tasks.
  • The primary care nurse evaluates, plans, and provides care following medical orders, promotes health, teaches and rehabilitates patients.
  • The nursing assistant collaborates closely with primary care nurses, participating in care and treatment delivery.
  • The orderly provides care related to daily living activities. Orderlies make sure that people are comfortable, and help them move around.

Physician

  • The physician treats medical problems and refers patients to the appropriate specialist as required (psychiatrist, neurologist, orthopaedist, physiatrist or others).
  • They make a comprehensive assessment of the person’s health.
  • They make diagnoses (state of health) and identify other health problems related to the medical prognosis (assessment of chances for recovery).
  • They are responsible for prescribing medication and manage requests for examinations and consultations.
  • They oversee medical care throughout the rehabilitation period and coordinate with the attending physician as required.

Retraining specialist

  • The retraining specialist works with brain-injured persons who wish to commence or resume studies.
  • They determine whether the person has lost prior academic learning (what they knew prior to the accident) and document the possibility of a return to school.
  • They prepare the individual for their return to school, develop a study plan, participate in their integration in the learning institution (school, CEGEP, university), and coordinate with the institution.

Speech language pathologist

  • The speech therapist evaluates all aspects of communication: verbal and non-verbal.
  • They measure the impact of cognitive faculties like memory, judgement and problem-solving on communication, particularly on the person’s ability to adjust to different situations, in a group, at work, etc.
  • They work on speech and language disorders (speaking and understanding), voice and stuttering.
  • They work on motor problems of neurological origin such as deglutition (difficulty swallowing) and elocution (difficulty pronouncing words).

Physiotherapist

  • The physiotherapist evaluates physical abilities and disabilities in neuromusculoskeletal, vestibular, cardiovascular, respiratory, central nervous and peripheral systems.
  • They analyze the nature and causes of the problems before establishing rehabilitation priorities and a personalized therapeutic plan.
  • Many different therapies are used: exercises, physical and mechanical tools, and specialized methods in an exercise room or in a pool.

Neuropsychologist/psychologist

  • The neuropsychologist or psychologist makes an assessment of the person’s cognitive problems (understanding, memory, judgment, problem solving) and their impact on the person’s daily life.
  • They propose strategies to brain-injured persons and to other caregivers aimed at partial recovery of cognitive functions or how to compensate for persistent problems.
  • They evaluate changes in personality and the nature of problems related to coping (depression, anxiety, aggressiveness, etc.),
  • They offer therapeutic support as required.
  • They make recommendations to help other team members adapt their care to the person’s abilities and psychological development.

Social worker

  • The social worker makes an assessment of the individual’s psychosocial behaviour after a TBI as compared to their behaviour prior to the injury.
  • They help the individual reintegrate into society by, for example, providing information on available resources.
  • They help the person’s loved ones in their own adjustment processes by offering individual or group support: supportive care, attention and information on TBI, rehabilitation, and their life experiences.
  • In some cases, they help in the process of creating a protection plan (a mechanism aimed at ensuring that an individual who is no longer autonomous will be protected – the plan can be managed by a loved one or the Quebec Public Curator).

Career consultant

  • The career consultant is specialized in identifying the person’s competencies.
  • They encourage the person to make academic and vocational choices by reaching a better understanding of their interests, personality and abilities, the labour market, and their environment.

Dietician

  • As required, a dietician can make an assessment of the person’s diet and monitor changes in their eating habits.
  • They address various problems such as excess weight and obesity, diabetes, hypertension, weight loss, malnutrition, etc.

[1] Two sources were used to develop the material in this section: the Client Program Directorate, Program for Bain-Injured Persons, Lucie-Bruneau Rehabilitation Centre, June 28, 2006, and the Web site of the Institut universitaire de gériatrie de Montréal.