Outcomes

• Highlights

Adult Programs

• Coma Stimulation
• Slow to Recover
• Complex Care
• Dual Diagnosis
• Outreach and Clinic Rehabilitation Services
• Clinic Services
• Community Based Programs
• Independent Living Services
• Residential Rehabilitation
• Adult Groups

Children, Youth, and
Family Programs

• Paediatric Programs
• School Re-entry
• College/University Supports
• Kids On the Go Camp
• Family Services

Program Locations

• Etobicoke
• Mississauga
• Hamilton
• Toronto
• Outreach

External Links

• NRI
• Brookhaven Hospital

Programs Overview

• Coma Stimulation


• Slow to Recover


• Complex Care


• Dual Diagnosis


• Clinic, Outreach and Community Based Rehabilitation Services


• Clinic Services


• Community Based Programs


• Supported Living Services


• Residential Rehabilitation


• Adult Groups


• Program Locations
  

Coma Stimulation Program

NRIO offers a comprehensive Coma Stimulation program within community hospitals for individuals with a severe brain injury who need a program to assist them with a return of cognitive and physical functions. By working with the hospital staff, we develop and provide a successful program that introduces sensory and environmental stimulation to those individuals who are experiencing a diminished state of awareness. Movement of large muscle groups and massage are implemented to prevent atrophy and improve circulation. NRIO also provides passive range of motion to stimulate movement and increase awareness to surroundings exercises.

Individualized goals are determined upon intake to the program and reassessed throughout treatment.

• Increase arousal level
• Decrease muscle atrophy, improve level of conditioning
• Increase awareness of environment
• Increase response and participation in environment
• Increase ability to communicate with care givers

Slow to Recover

NRIO ’ s Slow to Recover program begins with coma stimulation and continues rehabilitation services for those individuals identified as "slow to recover." The program begins with tactile, sound, olefactory and environmental stimulation to those clients who are at a low level of consciousness or emerging from a coma and progresses to a rehabilitation program which is designed to enhance functioning. Movement of large muscle groups and massage are implemented to prevent atrophy, to improve circulation and to increase sensory integration. A program integrating rehabilitation to maximize therapeutic gain is offered to individuals as they make and sustain progress from coma or minimally conscious states throughout recovery.

Individualized goals are determined upon intake to the program and reassessed throughout treatment.

• Increase arousal and response levels
• Decrease muscle atrophy, improve level of conditioning
• Increase awareness of environment
• Increase participation in environment
• Increase ability to communicate with care givers

Complex Care

NRIO ’ s Complex Care program, located in the Hamilton residence, offers a complete program of rehabilitation, nursing and community re-entry services to clients suffering with a severe brain injury. These clients have continuing medical care issues, in addition to intensive rehabilitation needs. The program provides a twenty four hour care environment offering services such as:

• Physiotherapy/Neuromotor Therapy
• Occupational Therapy
• Cognitive Therapy
• Speech and Language Therapy
• Neuropsychology
• Social Work
• Avocational and Leisure Therapies
• Nursing and Personal Attendant Care

The Complex Care program is designed to enhance the functional skills and independence of individuals who traditionally were not served in community programs. The Complex Care program offers a unique opportunity for a full rehabilitation program for the individual with ongoing medical care needs. Clients may elect to live in NRIO ’ s residential setting or in their home to receive the extensive rehabilitation services.

Treatment is delivered by rehabilitation therapists under the supervision and direction of a rehabilitation specialist. The Complex Care program allows for the higher level of treatment intensity, duration and frequency required for meaningful and lasting change. The program also focuses on community reintegration and participation as a key aspect to return to independence.

Individual client programs are routinely evaluated and modifications are made as needed to ensure consisten progress. The client and their family are a vital member of the rehabilitation team and are encouraged to participate in goal setting and program development.

Individualized goals are determined upon intake to the program and reassessed throughout treatment.

• Increase levels of independence
• Community reintegration
• Improve health status
• Improve cognitive functioning
• Increase functional mobility
• Increase level of alertness, attention and concentration
• Improve communication skills

Dual Diagnosis

NRIO has developed a program for those clients who have an acquired brain injury, as well as psychiatric, behavioural health, or addictive problems. Our Dual Diagnosis program offers a complete multi-disciplinary program of rehabilitation, counselling and community re-entry services. Program design may include utilizing individual and established support programs, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), to assist the client in managing their addiction. Attendance in these programs will be supported by NRIO staff. Neuropsychological counseling is also offered where needed. Each program is set up to address the specific behavioural health and rehabilitation issues.

NRIO has programs for clients with:

• Pre- and post-injury psychiatric problems exacerbated by brain injury
• Substance abuse / addictive problems
• Post-traumatic stress disorder
• Post-concussive syndrome with the cognitive, psychological and behavioural components of brain injury along with pre- or post-injury psychiatric / psychological problems

Individualized goals are determined upon intake to the program and reassessed throughout treatment.

• Increase levels of independence
• Community reintegration
• Enhance ability to self-regulate interfering behaviours, addiction and substance abuse
• Enhance ability to address further rehabilitation goals

Clinic, Outreach and Community Based
Rehabilitation Services

NRIO ’ s Community Based Rehabilitation programs are designed to meet the unique needs of each individual and consist of services to assist our clients in regaining independence in all aspects of daily living. These unique programs can provide specialized services for community re-integration as discharge approaches and to enable the individual to receive services in their home and within the context of family living.

Services include direct care by a licensed rehabilitation therapist and prescriptive treatment by a rehabilitation specialist. Training in rehabilitation strategies will be provided to the client, their family members or significant other and personal care attendants. This approach increases the frequency, duration and intensity of rehabilitation services and supports the development of lasting and positive rehabilitation outcomes.

An interdisciplinary team made up of the client, their family, case manager, insurance representative, legal representative and/or any other involved party work together to develop and implement the appropriate rehabilitation program. All team members participate in setting treatment goals and are encouraged to provide ongoing feedback regarding the direction treatment is going.

The focus of Community Based Rehabilitation is functional skills (re) acquisition; development of adaptive strategies, the identification of equipment, orthotics or other devices to enhance independence; social role re-entry and supported access to community living opportunities.

Program services can include but are not limited to:

• Neuropsychology
• Physiotherapy / Neuromotor Rehabilitation
• Occupational Therapy
• Cognitive
• Education Therapy
• Speech and Language Therapy
• Behaviour Therapy
• Social Work
• Nursing / Health Education
• Personal Attendant Care

Individualized goals are determined upon intake to the program and reassessed throughout treatment to:

• Increase levels of independence
• Promote community reintegration
• Increase ability to participate in treatment and community activities
• Return to modified lifestyle and activity level

Services may be delivered in various locations, including the home, in the community and workplace, and, in the school.

Clinic Services

The Comprehensive Day Rehabilitation program offered within the clinic settings of Etobicoke and Waterloo integrates rehabilitation, community re-entry and social role return, as well as avocational and recreation activities, to enhance each person ’ s capacity to function in the community. An interdisciplinary team made up of the client, their family, case manager, insurance representative, legal representative and/or any other involved party work together to develop and implement the appropriate rehabilitation program. All team members participate in setting treatment goals and are encouraged to provide ongoing feedback regarding the direction treatment is going.

Programs offered during Comprehensive Day Rehabilitation are:

• Neuropsychology
• Physiotherapy
• Occupational Therapy
• Speech-Language Therapy
• Cognitive Therapy
• Behavioural Therapy
• Counseling
• Fitness
• Life Skills Retraining
• Vocational Re-Entry
• Community Reintegration

Individualized goals are determined upon intake to the program and reassessed throughout treatment.

• Increase levels of independence
• Promote community reintegration
• Increase ability to participate in treatment and community activities
• Return to modified lifestyle and activity level

Community Based Programs

The Community Based Rehabilitation program is designed to bring services to the client in their home or the community. It provides the support necessary to allow individuals to participate in the rehabilitation process in the real life setting of home and the community.

The focus of Community Based Rehabilitation is to re-learn or re-build functional skills; develop adaptive strategies, identify equipment, orthotics or other devices to enhance independence; social role re-entry and supported access to the community. Client are consistently invited to engage in meaningful and supported activities within the community

Program services can include but are not limited to:

• Physiotherapy / Neuromotor Rehabilitation
• Occupational Therapy
• Cognitive / Education Therapy
• Speech and Language Therapy
• Behaviour Therapy
• Social Work
• Neuropsychology
• Nursing / Health Education
• Personal Attendant Care

An interdisciplinary team made up of the client, their family, case manager, insurance representative, legal representative and/or any other involved party work together to develop and implement the appropriate rehabilitation program. All team members participate in setting treatment goals and are encouraged to provide ongoing feedback regarding the direction treatment is going.

Services include direct care by a licensed rehabilitation therapist and prescriptive treatment by a rehabilitation specialist. Training in rehabilitation strategies will be provided to the client, their family members or significant other and personal care attendants. This approach increases the frequency, duration and intensity of rehabilitation services and supports the development of lasting and positive rehabilitation outcomes.

Supported Living Services

The NRIO Supported Living Services are designed to provide community based rehabilitation programs to adult individuals (over the age of 16) requiring less than 24 hour care. Individuals who are ready for a return to independence are given the opportunity to gain skills in a supported staff living program. The level of supervision decreases as the ability of the individual to safely manage independence is demonstrated. Clients in the Supported Living Services program may live in their own apartment or home in the community or in an NRIO residence.

Once the need for intensive or acute rehabilitation services is reduced, NRIO provides access to the following with a focus on community reintegration and maximum independence:

• Outpatient Physiotherapy
• Intensive Neuromotor Therapy
• Cognitive Therapy
• Occupational Therapy
• Avocational Therapy
• Speech-Language Pathology
• Behaviour Therapy
• Attendant Care
• Social Work (family and individual)
• Psychological Support (family and individual)

Individualized goals are determined upon intake to the program and reassessed throughout treatment.

• Increase levels of independence
• Community reintegration
• Increase level of participation in life activities
• Social reintegration
• Avocational and volunteer activities

Individuals with ongoing physical, cognitive and behavioural issues secondary to their brain injury, as well as those with a dual diagnosis, may be considered for the program. This program may also be offered to clients who participate in other services in their community.

An interdisciplinary team made up of the client, their family, case manager, insurance representative, legal representative and/or any other involved party work together to develop and implement the appropriate rehabilitation program. All team members participate in setting treatment goals and are encouraged to provide ongoing feedback regarding the direction treatment is going.

Services include direct care by a licensed rehabilitation therapist and prescriptive treatment by a rehabilitation specialist. Training in rehabilitation strategies will be provided to the client, their family members or significant other and personal care attendants. This approach increases the frequency, duration and intensity of rehabilitation services and supports the development of lasting and positive rehabilitation outcomes.

Residential Rehabilitation

A total rehabilitation environment is offered to those individuals who require extensive physical, functional, cognitive and behavioural supports. NRIO operates residential prgorams in Mississauga and Hamilton for individuals that require more complex rehabilitation and care in long term supported living programs. Etobicoke also offers a residential for individuals who are preparing a return to independence and are learning to manage behavioral substance abuse and/or psychiatric problems related to their brain injury. Waterloo does not have a residence but can offer services in a supported living environment in the client’s home.

The residential site in Mississauga also houses an independent apartment that can be used in determining the level of functioning and support a client will need upon discharge to their own home. This offers the client the independence of their own space while having 24 hour support available when needed.

The three residential sites are located in lovely residential neigborhoods close to community services, including medical facilities, shopping, and libraries. They also offer cultural and recreational opportunities to engage the client in a full range of community activities. Residences are well equipped facilities for rehabilitation, while creating the comforts of home important to successful programming and community reintegration.

Each residence is staffed 24 hours a day by trained rehabilitation therapists. Due to our comprehesive staff training programs and dedicated employee base, NRIO sets a standard for achieving an unparalleled level of daily care, quality of life and rehabilitation programming.

The client and their family member(s) are actively involved in goal setting and it is encouraged they participate in evaluating and revising any programming needs as their loved one experiences progress in their rehabilitation program. Families are welcome and encouraged to come and visit the client at the residential site during rehabilitation session, on weekends or in the evening.

Program services offered in a residential site can include but are not limited to:

• Physiotherapy / Neuromotor Rehabilitation
• Occupational Therapy
• Cognitive / Education Therapy
• Speech and Language Therapy
• Behaviour Therapy
• Social Work
• Neuropsychology
• Nursing / Health Education
• Personal Attendant Care

Individualized goals are determined upon intake to the program and reassessed throughout treatment.

• Increase levels of independence
• Community reintegration
• Increase level of participation in life activities
• Social reintegration
• Avocational and volunteer activities

Adult Groups

NRIO offers group programs to adult residential and outreach clients at various times throughout the week to create opportunities for meaningful social and recreational activities. The Adult Group Programs assist individuals living with traumatic brain injury in reaching and maintaining their goals through involvement in high-value community-based activities with peers. Continuous consultation with our Discipline Specialists (Physiotherapy, Occupational Therapy, Speech and Language Pathology) ensures that the structure and quality for each participant is maintained within the programs.

Various Adult Groups are:

• Horticulture Group: offers outings, crafts, planting and addresses all therapeutic disciplines
• Communication Groups: address speech and cognitive deficits in a positive peer group
• Hydrotherapy Group: applies physiotherapy strategies to enhance physical functions
• Social Groups: occupational therapy strategies use recreational activities to enhance functional skill development
• Men ’ s Group: focuses on issues male clients are dealing with in the course of recovery and rehabilitation

Individualized goals are determined upon intake to the program and reassessed throughout treatment.

• Increase levels of self-confidence
• Exploration of individual interests through social interaction and community based activities
• Increase level of participation in life activities
• Community reintegration
• Social reintegration

Locations

Etobicoke – Coma Stimulation, Slow to Recover, Dual Diagnosis, Adult Groups, Clinic and Outreach Services, Residential

Hamilton - Slow to Recover, Complex Care, Residential

Mississauga - Coma Stimulation, Slow to Recover, Adult Groups, Clinic and Outreach Services, In the Workplace, Complex Care, Residential

Waterloo – Clinic and Outreach Services