NOTE: This toolkit is meant for educational purposes only. The information within it should not be used to diagnose or treat brain injury in your clients

Photo: Where to Refer

Where to Refer

In addition to a family doctor or general practitioner, there are several types of health professionals that can support survivors in recovering from brain injury and adjusting to their new normal. Based on feedback from survivors and frontline workers, here are some examples of what kinds of service providers might be helpful, what they do, and what survivors might expect from a first appointment.

NOTE: All services may not be available in all areas, provinces, or territories.

Speech-Language Pathologists

What is a speech-language pathologist (SLP)?

Speech-language pathologists (SLPs) are regulated health care professionals who work to prevent, assess, diagnose, and treat speech, language, social communication, cognitive-communication, and swallowing disorders in children and adults.

What does an SLP do?

An SLP can help individuals identify their communication challenges and how they impact their daily life. Then the SLP would work with the person to establish some goals that are meaningful and practical. Finally, the SLP will develop and teach the person strategies to support successful communication as well as working to improve overall communication abilities. SLP's sometimes work with communication partners so that they can also better understand the types of challenges and use strategies to support their loved one.

How does an SLP support someone with a brain injury?

SLPs are actively involved in the care and support of people with TBI who may have challenges with understanding, following, and remembering conversations, finding words, expressing themselves clearly, and being able to say the right thing at the right time. People with TBI may also have difficulty with slower thinking as well as difficulty understanding where the other person is coming from. For example, is the person teasing or serious, are they being sarcastic, are they being truthful?

Occupational Therapists

What is an occupational therapist (OT)?

Occupational therapists are client-centred professionals who are concerned with promoting the health and well-being of people through occupation. Their primary goal is to enable people to participate in the activities of everyday life.

What does an OT do?

Occupational therapists work with people and communities to enhance their ability to engage in the occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment to better support their occupational engagement (WFOT, 2012). An OT can help individuals return to work, school, and other meaningful activities. Examples of these activities include:

  • Self-care – getting dressed, eating, moving around the house
  • Being productive – going to work or school, participating in the community
  • Leisure activities – sports, gardening, social activities

How does an OT support someone with a brain injury?

An occupational therapist will initially conduct a comprehensive assessment to understand your unique circumstances, including barriers and challenges related to your brain injury. An occupational therapist may problem solve to minimize or prevent your barriers/challenges, analyze tasks to help you return to pre-injury roles and/or provide you with strategies that will better enable you to perform the task unaided or with accommodations. OTs can help you:

  • Learn new ways of doing things
  • Regain skills and develop new ones
  • Use materials or equipment that makes life easier, or
  • Adapt your environment to work better for you

Physical Therapists

What is a physical therapist (PT)?

Physical therapists are trained to help strengthen a patient’s physical abilities. They help relieve pain through the use of therapeutic exercise, heat, cold, and electric stimulation. Their primary goal is to help a patient recover from physical injuries and impairments.

What does a PT do?

PTs are specialists in evaluating and treating disorders of the human body by using physical means rather than drugs. Physical therapy treatment often includes exercise, especially for patients who have been immobilized or who lack flexibility, strength or endurance. PTs encourage patients to use their muscles to increase their flexibility and range of motion. More advanced exercises focus on improving strength, balance, coordination and endurance. This often includes instructing patients and their families and supervising physical therapist assistants, students, and other health care workers in carrying out the program or selected parts of it. PTs work in a variety of settings including:

  • Hospitals, rehabilitation centres, outpatient clinics
  • Schools, athletic facilities, research centres
  • In a patient’s home

How does a PT support someone with a brain injury?

The traumatic brain injury (TBI) population is one of the most challenging that a physical therapist may encounter. PTs work on soft tissue mobilization and range of motion exercises early on after the injury to maintain joint integrity and mobility and prevent contractures. They also coordinate with family and caregivers for long-term management. As a part of a multidisciplinary team, a PT performs evaluations, makes recommendations for individual and group therapy, formulates and implements treatment plans, provides staff and family education and training, makes possible community access and mobility, assesses assistive devices, and collaborates with other medical personnel to obtain the necessary items.

Social Workers

What is a social worker (SW)?

Social workers are regulated health professionals who work with individuals, families, groups and communities to enhance their individual and collective well-being. SWs advocate for social justice, human rights, and equitable access to health and social services. They provide counselling, therapy and problem-solving interventions and help individuals gain access to information and resources (e.g., community support programs). In addition, they address broader social issues such as oppression, discrimination, domestic violence, unemployment and poverty.

What does a SW do?

SWs help people deal with their relationships with others. They work with clients to solve their personal, family, and community problems. SWs also help clients grow and develop as they learn to cope with or shape the social and environmental forces affecting daily life. They are often employed in hospitals, community health centres, mental health clinics, schools, advocacy organizations, government departments, social services agencies, child-welfare settings, family services agencies, correctional facilities, social housing organizations, family courts, employee assistance and private counselling programs, school boards, and consultation agencies.

How does a SW support someone with a brain injury?

The SW will provide you and your family with information about community resources and help plan for your hospital discharge and return to the community. They will offer individual, group, and family counselling to help you adapt to life with a brain injury. They come from a ‘client centred’ perspective and will work with you to achieve your identified goals. SWs are also strong advocates and can help you navigate systems such as justice, child welfare, and family law. Some offer services from within a hospital or rehabilitation centre, others have private practices in community office spaces, and some will visit you in your home.

Brain Injury Coordinator/Navigator

What is a Brain Injury Coordinator or Navigator?

A Brain Injury Coordinator or Navigator is someone who usually has extensive experience in a variety of contexts and has good working knowledge of services available. Brain injury is a complex condition that can impact a survivor in many different ways. It is important for the coordinator/navigator to have a basic knowledge of how to support and speak with individuals with varying backgrounds and experiences in order to best serve them. This role is based in advocacy, diverse knowledge, and a flexible approach to client-directed support. They are usually found through your local brain injury associations.

How do they support someone with a brain injury?

Brain Injury Coordinators/Navigators guide survivors and their caregivers through many individual and complicated systems of care. They provide individuals with brain injury with client-directed, agile, barrier free assistance with service navigation and connect individuals with other community agencies to create wrap around supports. They often also provide support through advocacy to ensure individuals receive proper and adequate support from service providers. Clients generally do not require a formal diagnosis in order to access services and they are often provided free of charge. They can help individuals with a variety of systems and contexts such as:

  • Medical: Connection to doctors and other specialists that can further long-term wellness for individuals affected by brain injury.
  • Housing: subsidized housing applications, housing search, landlord engagement, support with LTB
  • Legal: Advocacy within family court, criminal court, referral and connection with legal aid
  • Support for victims of violent crime through victim services, advocacy with the social justice tribunals
  • Financial stabilization and connection with disability supports, CPP/CPP-D, taxes,
  • Working collaborations with mental health providers to ensure individuals with brain injury who are also affected by mental health issues are having their needs met by both supporting agencies.

A coordinator/navigator can support a client’s goal in a variety of ways, for example:

A client says they are not getting proper mental health care. They identify memory impairment as a cause for this as they keep forgetting and missing their appointments. The coordinator/navigator might work to build a plan to utilize memory aids to assist in attending appointments regularly, offer to attend appointments with the client, provide reminders, or assist in planning transportation to and from the appointment.