Rehabilitation team and family assessment of the initial home pass.

Brain-injured individuals may have neurologic damage resulting in physical, cognitive and personality sequelae. Rehabilitation promotes recovery for these patients by restoring cognitive and social functions and focusing attention on medical-physical and cognitive-social intervention. A major component in rehabilitation is to teach family members to understand the process of recovery and their role in teaching and reinforcing desired behaviors at home. To investigate the utility of the family's role, we studied the effects of allowing patients to return to the home/family environment for short stays (therapeutic pass). By comparing functional ratings obtained from family and rehabilitation team members, we found families rated brain-injured patients higher in medical-physical areas and more equally in cognitive-social areas. Although we do not control for the family's frame of reference regarding the patient's premorbid status, we conclude that impaired cognitive functioning has a profound impact on family members who, like the patient, must make adjustments because of the disability. We recommend therapeutic passes as a meaningful tool in the process of educating families about the disability, its scope and impact, as well as its accompanying effects on cognitive and social functioning.