About Traumatic Brain Injury

In the United States, 1.4 million people sustain a Traumatic Brain Injury each year. Of those, 50,000 die; 235,000 are hospitalized; and 1.1 million are treated and released from an emergency department.

So what is a traumatic brain injury (TBI)? A TBI is defined as a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. Not all blows or jolts to the head result in a TBI. The severity of such an injury may range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury. A TBI can result in short or long-term problems with independent function.

The leading causes of TBI are: falls (28%); motor vehicle crashes (20%); struck by/against events (19%); and assaults (11%). Service members injured in Operation Iraqi Freedom and Operation Enduring Freedom are bringing increased attention to the issue of TBIs. In prior conflicts, TBIs accounted for 14-20% of surviving combat causalities. Unfortunately, preliminary information from the current conflicts suggests that number is now higher. The increased use of improved explosive devices (IEDs) in current warfare has led to higher numbers of blast injuries in our soldiers. Blast injuries are a rapidly growing cause of TBI in current combat. Additionally, certain military assignments carry an increased risk for exposure to TBI. These include, among others, airborne operations and policing in combat areas.

At Walter Reed Hospital, more than 4500 patients with TBI were treated between January 2003 and February2005. All admitted patients who have been exposed to a blast are routinely evaluated for brain injury; 59 percent of them have been given a diagnosis of TBI. Of these injuries, 56 percent are considered moderate or severe, and 44 percent are mild. The Centers for Disease Control and Prevention estimates that at least 5.3 million Americans currently have a long-term or lifelong need for help to perform activities of daily living as a result of a TBI. According to one study, about 40% of those hospitalized with a TBI had at least one unmet need for services one year after their injury. The most frequent unmet needs were:

• Improving memory and problem solving;
• Managing stress and emotional upsets;
• Controlling one’s temper; and
• Improving one’s job skills

TBI can cause a wide range of functional changes affecting thinking, language, learning, emotions, behavior, and/or sensation. It can also cause epilepsy and increase the risk for conditions such as Alzheimer’s

According to the Vermont Department of Health, there are over 4,600 Vermonters living with a brain injury. In 1991, the Vermont Department of Aging and Disabilities and the Department of Social Welfare started a three-year pilot project that offered community based rehabilitative services to Vermonter’s with traumatic brain injuries. The goal of the program was to divert Vermonters with a moderate to severe traumatic brain injury from hospitals and facilities and/or return them to a community based setting. The program is intended to support Vermonters achieve independence and help them return to work.

Funded by State and Federal agencies since October 1994, the short-term community-based TBI Waiver Rehabilitation Program serves individuals under the administration of VocRehab Vermont. Services available through the TBI Waiver Rehabilitation Program include case management, rehabilitation services, community supports, respite, employment supports and environmental/assistive supports.

To be eligible for the Traumatic Brain Injury Waiver Program, a person must:

• Be a Vermont Resident
• Be age 16 or older and diagnosed with a moderate-to-severe brain injury
• Be a recipient of traditional and/or long term Vermont Medicaid
• Have a documented, recent moderate-to-severe brain injury resulting in residual deficits and disability
• Demonstrate the ability to benefit from rehabilitation and a potential for independent living
• Require one-to-one instruction focusing on independent living
• Demonstrate a possibility for returning to vocational activities

For more information on the Vermont Traumatic Brain Injury Waiver Program, call (802) 241-1456 or visit:http://www.ddas.vermont.gov/ddas-programs/programs-tbi-default-page