The first step which occurs to receive service is that a referral must be made. Depending on the type of service you are accessing, you may be able to “self-refer”, that is request services for yourself, or you may need a professional or doctor to make the referral on your behalf. The referral itself usually contains a brief summary of your injury and the challenges you may be facing as a result. There is also often room for the person making the referral to indicate what type of help they are hoping to receive as a result of the referral. This information is shared with the organization with your permission in order to begin the process.
Unless your brain injury has led to you requiring a substitute decision maker, any contact between different organizations require your consent or permission for this to occur. Typically this requires that you sign a form authorizing this sharing of information and in some occasions verbally agreeing to this is sufficient. If you would like a loved one who is not your formal substitute decision maker to be able to discuss your services with professionals, it is advisable to provide consent for this person also. In the case where someone has a substitute decision maker, it is this person who authorizes consent on the survivor’s behalf.
When a referral form is received, the organization will contact you to conduct an intake interview. This is sometimes done by phone and at other times it is done in person. You may find it helpful to have a family member with you during the intake, and notes about your medical history, to help you remember important details. The intake staff will ask you about yourself: your history, your current abilities and challenges, and what type of services you hope to receive. It’s important to be as forthcoming as you can with this information.
After the intake is completed you will be advised whether you meet the service criteria and are eligible for services from that particular organization. At times you may be deemed eligible, but be placed on a waitlist until staff are available to work with you. If this occurs you should ask what a typical waiting period is, as this varies from one organization to the next. If you are deemed ineligible, you can ask for an explanation of why this is, and request reconsideration if you disagree. If you feel you are being treated unfairly due to your ABI, you can contact System Navigation to advocate on your behalf.
Once you have been confirmed eligible, you will be able to begin receiving services from the organization. Often the first step in this is establishing goals. These will be dependent on the type of service you are receiving. For instance, in an exercise program you might identify you want to increase the strength of your legs, while in brain injury services you may identify that developing memory strategies would be helpful. While the staff may suggest different goals, it is important for you to agree that these are important for you. If you find that you are not comfortable with the goals identified, you should communicate this and offer suggestions of the types of things you would like to work towards. Ultimately these services are intended to help you, and you must feel that what you are working towards is important if you are to succeed.
For some services, the period of time staff can work with you is limited, for others it may be more open ended. Discharge typically occurs when the the goals you have been working toward have been met, or time has run out. Before leaving, it is good to find out if you can return to services at a later date if the need arises. Often this time is difficult, particularly if you have developed a close relationship with staff. It is important to recognize this is a necessary part of the process and not take discharge as a personal rejection. If you are having particular difficulty saying good-bye, you may find it helpful to think of a way to show your appreciation, such as a card or letter that lets the staff know the impact they have made. Many people find this is a helpful step to moving on. You will also want to consider how you will fill your time instead now that the service is over, and what new opportunities you might have the time to engage in.