The Center for Brain Injuries at the JFK Johnson Rehabilitation Institute is recognized nationally and internationally as a pioneer in brain trauma evaluation and treatment. Through a comprehensive continuum of care, from acute inpatient rehabilitation, subacute extended recovery, to outpatient rehabilitation, the Center for Brain Injuries restores real-life skills to those with brain injuries, enabling a return to a more healthy and satisfying lifestyle with families, friends and communities.
We are one of the only brain injury programs in the nation that meets the needs of all levels of brain injury recovery. We have assembled a multi-disciplinary and highly collaborative team to provide the most effective, state-of-the-art treatment options in three comprehensive and innovative care settings:
Brain Trauma Unit
Extended Recovery Unit
Cognitive Rehabilitation Care
The Brain Trauma Unit
The Brain Trauma Unit (BTU) is the acute inpatient rehabilitation component of the Center for Brain Injuries, located within the JFK Johnson Rehabilitation Institute at JFK Medical Center. The program is accredited by the Joint Commission and Commission on Accreditation of Rehabilitation Facilities.
The BTU team utilizes an integrated, interdisciplinary approach to provide rehabilitation to adults who have sustained acquired brain injuries. This is the first phase As the first phase of brain injury rehabilitation following medical stabilization, we serve patients with various levels of disability and impairment—from those emerging from a coma with significant medical, physical and cognitive problems, to individuals who are ambulatory, but have difficulties with self-care activities, community mobility, behavior, cognition and communication.
Comprehensive Brain Trauma Services
Medical management by a Board Certified physician in Brain Injury Medicine
Twenty-four hour specialized rehabilitation nursing care
One-on-One physical, occupational and speech therapy
Neuropsychological evaluation and consultation
Twenty-four hour access to intensive medical services and consultation from JFK Medical Center
Availability of experts consultations from multiple clinical disciplines, including Behavior Management, Disorders of Consciousness, Medical Management, Spasticity Management, Assisted Technology, and Cognitive Disorders
Social Work services for patients and families to provide counseling and assistance with discharge planning and returning to home
Family education, observation, support, and training
Frequently Asked Questions
WHAT SERVICES ARE USUALLY PROVIDED?
The Brain Trauma Unit provides medical, nursing and therapy services (including physical therapy, occupational therapy, speech therapy, recreational therapy), as well as social work and psychology services, based on an individual patient needs. In addition, group leisure activities, books, and movies are available.
WHAT ARE THE MOST TYPICAL PATIENT TYPES AT THE REHABILITATION INSTITUTE?
Brain Injury 227 patients/55% overall
Stroke (and other neurological diseases) 188 patients/45% overall
The average age of our patient is 61 years old. These patients sustained traumatic and non-traumatic brain injuries.
The program does not provide services to patients who require a ventilator or for patients actively receiving chemotherapy.
(based on 2016 data)
HOW LONG CAN YOU EXPECT TO STAY AT THE REHABILITATION INSTITUTE? HOW MUCH THERAPY WILL I RECEIVE WHILE AT THE REHABILITATION INSTITUTE?
The average stay (in 2016) for all patients was 19 days. All patients are scheduled for three (3) hours of therapy five days out of seven.
WHAT CAN I EXPECT TO BE ABLE TO DO FOR MYSELF WHEN I LEAVE THE REHABILITATION INSTITUTE?
All patients are evaluated to see how much help they need to do functional activities (like walking, moving from lying down to sitting up, getting dressed, etc.) when they arrive and leave the Rehabilitation Institute. These are the basis of your predicted outcomes, or your individual rehabilitation goals. Based on this evaluation of our patients discharged in 2016, a majority of patients were able to do the following at discharge. Please keep in mind, this data represents an average.
Self Care (bathing, dressing, and eating): At admission, most patients required about 75-100% help from a staff member, and at discharge required 50-75% or less physical help.
Mobility (walking, going up/ staff member to walk or go up/down stairs, and at discharge down stairs): At admission, most patients required about 75-100% help from a required only 50-75% or less help.
Transfers (moving from bed to chair, member and at discharge required 50-75% or less physical help. into the bathtub, etc.): At admission, most patients required 75-100% help from a staff
Cognitive areas: At admission, our patients had significant issues in memory, expression, and problem solving and on discharge these areas were considered moderately impaired.
WHERE CAN I EXPECT TO GO WHEN I AM READY TO LEAVE THE REHABILITATION INSTITUTE?
It is our goal to return all patients back to their own homes with follow up services, whenever possible. In 2016, 41% of our patients were discharged home with additional services and 50% were discharged to a subacute program. In 2016, our patients had 9% unplanned transfers to an acute medical facility during their stay which was lower than the region and the nation. The JFK/JRI system has many opportunities for continued care which includes subacute and long term care, outpatient services, and adult day care.
HOW SATISFIED ARE FORMER PATIENTS WITH THE SERVICES THEY RECEIVED AT THE REHABILITATION INSTITUTE?
When a patient is discharged from the Rehabilitation Institute, they receive a Patient Satisfaction Questionnaire. The highest rating is a score of 100%. Our scores in 2016 were:
Overall Satisfaction: 93% higher than the region and nation
Recommendation of facility: 95% higher than the region and nation
Extended Recovery Unit
The Extended Recovery Unit (ERU) is a specialized subacute setting designed to treat patients who have improved medically, yet continue to require a high-level of rehabilitative care. This program is located at the nearby JFK Hartwyck at Oak Tree facility in Edison, a short drive from the Institute and Medical Center. Our interdisciplinary team of specialists work together with patients and families to establish a treatment plan that is specifically designed to meet the unique and special needs of every individual. This program can also offer dedicated brain injury rehabilitation for an extended period of time.
Comprehensive Extended Recovery Services
Medical management by a Board Certified physician in Brain Injury Medicine
Twenty-four hour subacute nursing care
Individual therapy sessions by licensed therapists
Dedicated neuropsychological evaluation and consultation
Easy access to clinical services at JFK Medical Center and the JFK Johnson Rehabilitation Institute
Coordinated access to expert Recovery Sub-Specialists, including: Behavior Management, Disorders of Consciousness, Medical Management, Spasticity Management, Assisted Technology, and Cognitive Disorders
Counseling and Assistance with Discharge Planning for patients and families by our Social Work team
Family education, observation, support, and training
State of the art therapies, modalities, and equipment
Outpatient Cognitive Rehabilitation Program
The primary function of the brain is to process information, acquire knowledge and understand our experience. This is accomplished through a variety of cognitive processes. Cognition includes our ability to focus our attention, store and recall information, communicate our thoughts and feelings, make decisions, and solve problems. Cognitive disability is often the most prominent consequence of brain injuries or neurologic illness and the major cause of difficulties in everyday functioning. Difficulties with cognition can also lead to other common symptoms of brain injury, such as mental fatigue and frustration.
The Outpatient Cognitive Rehabilitation program provides specialized services for outpatient treatment of individuals who have sustained traumatic brain injuries or other acquired neurological injuries, such as stroke or anoxia. The highly trained interdisciplinary teams provide treatment targeting cognitive functioning, physical abilities, emotional adjustment and social functioning.
The Outpatient Cognitive Rehabilitation Programoffers a variety of specialized services, from in-depth Neuropsychological Evaluations, integrative team-based care, cognitive rehabilitation therapy programming, to tailored individualized therapies through our clinic.
Our neuropsychologists provide comprehensive assessments of attention, memory and thinking skills. Tests are administered, scored and interpreted by doctorate level neuropsychologists specially trained in the field of brain injury. Evaluation results assist in:
Identifying the level and degree of neurological injury and potential impact on everyday life
Developing a treatment plan
Making recommendations for modifications and accommodations to be used in the home and the community, including tailored recommendations for work and school
Comprehensive Outpatient Neurorehabilitation
Cognitive Rehabilitation is defined as the systematic application of therapeutic activities based on brain-and-behavioral relationships to improve attention, memory, thinking and other functional abilities. The Comprehensive Outpatient Program provides a full-range of multidisciplinary evidence based therapeutic services including:
Neuropsychology – trains cognitive skills such as attention, memory, problem solving, and executive functioning skills; symptom management training for residual concerns such as cognitive fatigue, emotional changes, sleep issues and headaches
Speech Therapy – remediation and compensation in: cognitive-linguistic skills, speech intelligibility, word finding, verbal organization, listening skills and comprehension, reading and writing, swallowing and voice
Occupational Therapy – maximizes functional daily living skills (ADL’s), provides vision training, adaptation to vision changes, cognitive skill development, and fine motor skill training
Physical Therapy – retrains mobility skills, vestibular training, management of residual dizziness, strengthening and endurance training, adaptation to changes in cognitive and physical function in order to return to community involvement
Counseling – assists with adjustment to changes resulting from injury, provides brain injury education, connects with outside agencies, family liaison, facilitates monthly client support group and provides monthly education and support meetings for family members
Vocational Therapy – assesses and trains vocational skills, provides therapeutic work trials, résumé changes and interview skills for preparing to return to work, work/community reintegration
Cognitive Educational Therapy – provides cognitive academic skills evaluation, assist with understanding and compensating for any learning changes, study skills training, support school re-entry process including exploring assistive technology and developing an accommodation plan
Case Management – processes client’s goals, strategies and performance each week to help integrate and make connections about skills and progress from one therapy to another, assists with scheduling and transportation
The Comprehensive Cognitive Rehabilitation Program provides a team based approach to meet each individual’s unique needs with:
Coordinated treatment goals and strategies developed and utilized across multiple clinical disciplines
Learning and practicing skills in each sessions. Therapists support clients to connect their goals and strategies to tasks outside of sessions to encourage generalization of strategies at home and in the community
Emphasis on cognition and how it impacts function
Monthly (or regular) meetings coordinated by neuropsychologists to ensure consistency and progression of cross-disciplinary goals
Family education, support and involvement based on individual patient needs
Assistance with transition to back to work, school and/or community activities
Neuropsychology Clinic Service
Neuropsychology Clinic Service provides the same individualized care, but for clients who would benefit from targeted therapy in one or two disciplines. The Clinic is:
Tailored for individuals who have sustained a concussion or mild brain injury who would benefit from select therapies but who do not require full treatment program.
A transitional step for clients after completing the Comprehensive Neurorehabilitation program, addressing specific residual needs to facilitate community re-entry.
Frequently Asked Questions
WHAT SERVICES ARE USUALLY PROVIDED?
The Cognitive Rehabilitation Department provides comprehensive, integrated, inter-disciplinary treatment for adults 18 years and older with acquired brain-injury through outpatient clinic and day treatment programs. Therapies include neuropsychology, speech-language therapy, physical therapy, occupational therapy, counseling and psychotherapy, educational services, pre-vocational services, and recreational therapy. Treatments are provided both individually and through group intervention. All therapies are individually tailored to client’s needs and goals based on a comprehensive initial evaluation.
A Neuropsychological evaluation may be conducted prior to starting treatment, in order to identify the most pressing areas of need and to refer appropriate therapies.
WHAT ARE THE MOST TYPICAL PATIENT CONDITIONS AT COGNITIVE REHABILITATION?
Traumatic Brain Injury – 133 clients/ 55% overall
Stroke – 70 clients / 29% overall
Other neurological illness – 41 clients/ 16% overall
Average age of our patient is 47.
Clients have a wide range of needs and abilities, ranging from people with higher-level cognitive deficits, such as planning and prioritizing, following a cerebral concussion, to people with more significant cognitive and physical limitations following severe brain injury or neurologic illness.
HOW LONG CAN YOU EXPECT TO RECEIVE COGNITIVE REHABILITATION?
The average length of treatment in 2016 for all clients was 3 months. The length of treatment ranged based on individual needs and spanned from a month to over 12 months. The amount of treatment can range from 1 hour per week to 25 hours per week, with most clients receiving between 3 and 10 hours of weekly treatment. Treatment is provided Monday through Friday between 8:00 am and 5:00 pm.
WHAT CAN I EXPECT TO BE ABLE TO DO FOR MYSELF WHEN I LEAVE THE COGNITIVE REHABILITATION PROGRAM?
All clients receive a comprehensive evaluation of their physical, functional and cognitive abilities. Treatment goals are developed on an individual basis and are addressed by all of the therapists with the client’s cooperation. All therapies are adapted to reflect the individual’s level of abilities and personal goals. Improvements are tracked over the entire course of treatment.
Our evaluations suggest significant improvements in most areas of functioning.
Please keep in mind, this information represents an average based on clients own reported outcomes.
Basic Mobility: Over 75% of clients made significant improvement in their physical abilities. On admission, most clients were able to move around indoors where they were familiar with the environment. Many people had some difficulty moving about outdoors and in the community.
After completing treatment, most clients could walk inside their home and other buildings without any difficulty. Most clients were also able to move about outdoors without any limitations. Vigorous activities such as playing sports or walking several miles may still be difficult to complete.
Daily Activities: About 75% of clients made significant improvements in their ability to carry out daily activities on their own. At admission, many clients experienced significant struggles with performing most daily tasks. After completing treatment, most clients were able to complete most daily activities independently without much difficulty. Some clients still require assistance with more complex daily tasks (such as housekeeping or laundry).
Cognitive Abilities: About 67% of clients show significant improvement in their cognitive abilities. On admission, many clients had challenges carrying on a conversation in a crowded restaurant, reading and remembering information, carrying out complicated tasks such as preparing a meal or managing a checkbook. After finishing treatment, most clients were able to complete complex tasks such as reading a newspaper, managing money, and having a conversation with another person without difficulty. Some clients might still have some difficulty in completing multi-step activities such as following a complex recipe or completing an insurance form.
CAN I EXPECT TO GO BACK TO WORK OR SCHOOL AFTER REHABILITATION?
The process of returning to work or school varies greatly from person to person. For some clients return may be a graduated process moving from part time to full time. For a few, they may return directly back to their position with or without support. Other clients do volunteering at a work site or auditing a course as their next step after therapy. In 2016, of the clients who received Pre-Vocational services, 36% of the clients returned to part time or full time employment, 18% went into a volunteer role. Of those clients participating in Education Therapy, 67% returned to school part time or full time.
HOW SATISFIED ARE CLIENTS WITH THE SERVICES THEY RECEIVE AT THE JFK/JRI CENTER FOR BRAIN INJURIES, COGNITIVE REHABILITATION DEPARTMENT?
Clients receive a patient satisfaction survey while enrolled in the comprehensive treatment program and at discharge. The highest rating is a score of 100.
We received an overall Satisfaction score of 95 for 2016 for clients enrolled in our comprehensive program.
Connecting with Our Patients and Community
Every day, the JFK Johnson Rehabilitation Institute is finding new ways to engage and serve our patients. We build innovative partnerships with patients and community members through a wide variety of interactions and initiatives. As a result, the majority of our brain trauma patients and their families have lifelong relationships with us based on our ability to provide extensive services and support for this very special population.
We are proud of our many ties to patients and the community, including:
Our participation in the Brain Injury Alliance of New Jersey– serving on the Board of Trustees, Professional and Consumer Committees, and Camp TREK, a week long camp for brain injury survivors.
Our physicians serve as the faculty of the Physical Medicine & Rehabilitation Department of the Rutgers Robert Wood Johnson Medical School
Our staff members are Accredited Brain Injury Specialists (ABIS) by the National Brain Injury Association
Our prestigious accreditation for the Brain Injury Program by CARF
Our Annual 5K Miles for Minds Run, in support of brain injury patients and services
Leading the Way in Research & Development
Development of JFK Coma Recovery Scale to diagnose and treat the multiple levels of consciousness
Development of the Neurobehavioral Symptom Inventory (NSI) to evaluate mild traumatic brain injury and post concussive disorder
Development of Practice Guidelines for Cognitive Rehabilitation
An investigation into whether there is a correlation between length of stay and functional outcomes.
Pilot investigation of the utility of Activity Measure for Post-Acute Care (AM-PAC) to assess and track longitudinal changes in activity limitations in individuals with traumatic brain injury receiving specialized outpatient brain injury rehabilitation.
Objective examination of cognitive fatigue in individuals with stroke.
Development of symptom, psychiatric, and cognitive profiles of individuals with Post-Concussive Syndrome and applying it to the development/refinement of diagnostic criteria, assessment and treatment tools.
Development of caregiver education/preparation program for patient return to the community following inpatient rehabilitation discharge.
Pragmatic health delivery clinical trial of metacognitive strategy training and emotional regulation as active ingredients in treatment of individuals with moderate-severe traumatic brain injury.
Development and pilot of a flexible treatment manual of holistic cognitive rehabilitation of individuals with mild traumatic brain injury based on integration of currently available evidence.
“The BTU department has raised the bar very high …thank you to everyone that helped take care of my mother. Please keep up the good work.”
“Not every family has the time to write a thank you, but we all appreciate what you do for us. It’s not easy having a loved one in the hospital… but because you care make a difference in your patient’s lives, you make a hard time so much easier.”
Thanks to my “dream team”. You instilled my complete trust in you. If you told me I could do something, I knew I could. And if I failed, you caught me both literally and figuratively. I wish you all the best in life; you are very special people.
“The entire staff was wonderful. We heard this is the best place …and we agree whole heartedly.”