Tag: Support

Provincial/Territorial disability benefits

Financial assistance programs differ across the provinces and territories in Canada. It can be overwhelming trying to figure out what you are eligible for and where to look for programs that may help you.

The Government of Canada has a great online tool that can help narrow down the federal and provincial/territorial financial assistance programs for which you may be eligible. Use this Benefits Finder to determine what federal or provincial/territorial benefits you may be eligible to receive. If you need some assistance, ask a caregiver, friend or family member to help you sort through the results.

In addition to the benefits finder, here is some additional information about financial assistance resources at the provincial/territorial levels.

Provincial and territorial disability services

Each province and territory has disability services. They can help you find out what financial assistance may be available to you.

More information about provincial and territorial disability benefits

Social/income assistance

Social assistance is a program designed by each province/territory to provide money to individuals/families who have explored all other means of financial support and are in financial need. The money is for basic needs such as food, rent, and utilities (heat, water and electricity).

The program requirements and eligibility is determined by each province and territory. You can learn more about your province or territory’s social/income assistance program in the list below.

Workers’ compensation

If your brain injury is a result of a workplace accident, the provincial/territorial Workers’ Compensation programs can help with financial assistance.

Please note: if you are a federal employee, your claims would go through the federal Labour Program.

 

Types of rehabilitation

Please note: not all of the therapies listed below are available publicly and may not be covered by insurance providers. This means that there may be out of pocket costs, depending on the type of therapy you do.

There are several types of rehabilitation that individuals with brain injuries may find helpful in their recovery. We have included the most common and recognized rehabilitation therapies. Different rehabilitation therapies will be recommended for different people. Not every rehabilitation therapy will be available in every area. Speak with your medical team about rehabilitations available to you, and ways you can access them. In some cases, there may be online rehabilitation services that can make getting support even easier.

You can also reach out to your local brain injury association about available public groups.

Occupational therapy
Occupational therapy (OT) assists with activities of daily living (ADLs) and creating a home environment that is designed for the person with a brain injury to be as independent as possible. This includes things like:

  • Cooking
  • Eating
  • Bathing
  • Cleaning
  • Getting dressed
  • Going to the bus stop

After a brain injury, these everyday activities can be more challenging. If you’re experiencing problems with your fine motor skills, having trouble with memory or processing instructions, or have issues with vision, hearing, or touch, occupational therapy will be a big help.

An occupational therapist will perform a functional assessment of you, your family, and your environment. They identify impairments and environmental barriers and create a treatment plan designed specifically for you. Part of the plan is developing specific goals you want to achieve, and using tools and strategies to help you do so. An occupational therapist helps you re-learn self-care, work, and leisure skills. This includes teaching you new ways to do things if your capabilities have changed. Their job is to help you with your ADLs, and help you reach a place where you can do them as independently as possible. They’ll do this using tools, new processes, and activities. They’ll even complete an assessment of your home environment so it can be set up in a way that works best for you. This includes making recommendations for furniture placement and how to remove tripping hazards and prevent further injuries.

Physiotherapy
Physiotherapy focuses on improving movement and mobility. This is done through carefully monitored stretching and exercises. This is one of the most common therapies – most people recovering from physical injuries need it. A physiotherapist is a rehabilitation professional who will perform an assessment of your physical capabilities and create a treatment plan to improve strength, muscle tone, or mobility. Exercises and activities can include range of motion exercises (ROM), strengthening exercises focused on building endurance and muscle, balance exercises which will target areas of deficit, and gait training to improve posture and walking.

Physiotherapy can be short or long-term. You may also be given activities or exercises that you have to do between appointments. As you meet physiotherapy goals, your abilities and needs will be reassessed, and your plan adapted to make sure you continue making positive progress.

Psychological therapy
Psychological therapy – which can also be called counselling – is an excellent way to take care of your mental health and understand more about your emotions, behaviours, and thoughts. It’s also a great way to unburden yourself and receive considerate, thoughtful feedback from a professional. Counselling can be done by either a psychiatrist or a psychologist – both are licensed mental health professionals. The main difference is that a psychiatrist has a medical degree and is able to prescribe medication.

The health professional providing the treatment will first complete an assessment to help identify what you need and what goals you would like to reach.

Speech and language therapy
Possible effects of brain injury include cognitive communication challenges. You may not be able to process your thoughts, have difficulty organizing your speech, or struggle with reading/writing. A speech language pathologist (SLP) can help with relearning communication skills and new adaptive techniques.

A person may also experience difficulty speaking or trouble swallowing. These challenges are connected to the throat and mouth muscles. Not only can it be difficult to talk, but it can be challenging to eat or drink, causing further problems with nutrition and safe eating. An SLP will perform tests in the early (acute care) stages of recovery if a person is experiencing any of these issues. It may be recommended that the person continue to work with a speech language pathologist to improve speaking and swallowing abilities. This can be a long process that requires patience, and treatment will be updated on an ongoing basis.

Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy is rehabilitation that focuses on creating programs and activities that will help you engage in positive and productive behaviour. Cognitive behavioural therapy covers a lot of symptoms of brain injury, including neural feedback, appropriate behaviour, memory, and information processing. Since no two brain injuries are the same, cognitive behavioural therapy doesn’t have a set program of exercises and activities. Your therapist will perform an initial assessment and set goals with you that you will then work towards. Once those goals are met, new goals will be set, and the treatment plan will evolve to include activities that will help you reach those goals.

Cognitive behavioural therapy is becoming more and more common, but it is still a growing part of rehabilitation for brain injury and is not as widely available as other types of rehabilitation.

Vocational rehabilitation therapy
It can be challenging after a brain injury to go back to a job. Depending on your injury, you might not be able to return to your former workplace or you may have to come up with new strategies to help you complete work-related tasks. Vocational rehabilitation therapy focuses on helping you prepare to re-enter the workforce. They give you the tools and skills needed to find a part-time or full-time position. In partnership with the Vocational Rehabilitation Association of Canada, we have developed a guidebook to help you understand the return to work process.

Art therapy
Art therapy is a more experimental therapy. Patients complete art projects in a personalized program. When someone is working on a creative art project, it can stimulate multiple parts of the brain at the same time and encourage neural pathways to form. Art therapy can also improve fine motor skills, help with other cognitive challenges such as memory and attention, and improve mental health and moods. Art therapy is conducted by licensed art therapists and is normally an out-of-pocket expense.
Mindful meditation and yoga
Mindful meditation and yoga have become popular forms of therapy after brain injury. Both focus on the concept of quieting the mind, limiting outside distractions, and focusing on deep breathing and relaxing. Meditation can reduce stress and anxiety and allows for emotional self-check-ins and is a great technique for calming down.

Yoga also reduces stress and anxiety but adds an element of physical movement. Yoga moves are designed to be adapted and taken at the person’s pace. There are special classes and movements designed specifically for people who need adaptations.

Music therapy
Music therapy uses music to help people with functional goals, improve mental health and cognition, and promote self-awareness and reflection. Music can be used to help with speech problems through musical vocals, motor skills through instruments, and cognition through composing. Music therapists are licensed professionals who undergo several years of training. Music therapy is an out-of-pocket rehabilitation expense.

More information on music therapy

Recreational therapy
Recreational therapy uses leisure activities that a person would normally do to meet rehabilitation goals. The goal of this therapy is to help the person become as independent as possible when doing those activities. This could include walking, outdoor activities, arts and crafts, dancing – anything someone would normally do in their leisure time. Certified recreational therapists will use these activities to help with cognition, mental health, and even physical health if the activities are exercise-based.

Additional rehabilitation specialists

Depending on your rehabilitation needs, you may work with additional rehabilitation specialists who will help you with recovery. Please note: you may not need to work with every kind of rehabilitation specialist. Doctors will make recommendations and referrals based on your needs.

Audiologist
An audiologist is a healthcare professional with a focus in hearing loss related to the inner ear and vestibular system. They can diagnose and recommend treatment for people with brain injury who are experiencing hearing loss.
Behaviour therapist
A behavioural therapist is a professional that uses professional training to help people with behaviour challenges understand good vs. bad behaviour. The therapist will identify the problem behaviours, then outline a treatment plan based on what the person wants to achieve. While there are many different types of behavioural therapy, the therapist will help reinforce positive behaviours.
Case manager
A case manager is someone who can help you coordinate appointments and other daily activities after your brain injury, particularly if you are experiencing cognitive challenges that make planning and going to appointments difficult. They can also help you by going to appointments with you and assisting you with post-appointment activities.

Case managers are not available everywhere in Canada and may be an out-of-pocket expense. You should speak with your physician about available rehabilitation specialists in your area and what would be right for you.

Chiropractor
Chiropractors focus on treating neuromuscular (nerve and muscle) conditions by physically working on the person’s spine. Their focus is on improving muscle and skeletal structure and reducing pain in the back and related joints. Chiropractor services can be helpful for people with lingering pain from physical injuries.
Dietitian
A dietitian is a medical professional with a degree in nutrition science. They are able to understand how food impacts health and well-being, and work with individuals to create comprehensive diet plans that treat nutritional problems. Treating nutritional problems can aid in treating other conditions, such as brain injury.

Please note: There is a difference between a dietitian and nutritionist. Dietitian is a protected term in Canada, which means they need to have professional certification. Nutritionist is only a protected term in Alberta, Quebec and Nova Scotia. This means that someone may be a nutritionist in British Columbia but not have the same credentials as someone in Alberta. Dietitians of Canada has an explanation and a chart of protected titles by province/territory that can help you identify what kind of health professional to consult for dietary needs.

Ear, nose and throat doctor (ENT)
An ear, nose and throat doctor (ENT) – officially called an otolaryngologist – is a doctor that specializes in the connected systems in the head. An ENT can diagnose and provide treatment recommendations for conditions such as hearing loss, tinnitus, sinus issues, balance problems, and swallowing difficulties.
Life care planner
A certified life care planner is someone who can help you create a plan after a life-altering event such as a brain injury. This plan can include services, supports, and costs necessary from that point on. A life care planner will perform an in-person assessment and develop a plan that will help map out future needs. This is incredibly helpful, especially if a person’s abilities to plan are compromised, or their family is worried about care, finances, and emergency planning for the future.
Life skills planner
A life skills planner is someone who is trained to teach other people how to develop and improve life skills. Life skills is a broad term used to describe any skills that are helpful in activities of daily living (ADLs). Examples of life skills include communication skills, interpersonal skills, decision-making, and taking care of a home.
Personal support worker
A personal support worker is someone who helps you with your activities of daily living (ADLs) and self-care, and is either with you full or part-time in your home or at a treatment centre. Their role is to help make your day-to-day routine more manageable.
Neurologist
A neurologist is a medical health professional that specializes in treating the nervous system, which includes the brain. A neurologist is one of the physicians that would be able to make a diagnosis of brain injury and address symptoms. They also help with management of brain injury and its symptoms through treatment and referrals to other treatment options.
Neuropsychologist
A neuropsychologist specializes in understanding how the brain and behaviours are linked. For someone with an acquired brain injury, a neuropsychologist can help determine how the injury will affect their cognitive abilities and behaviours and make recommendations for what rehabilitations could be helpful in your recovery.
Physiatrist
A physiatrist is someone who specializes in physical medicine and rehabilitation. They can help a person with a brain injury by evaluating physical needs and making rehabilitation/treatment plans. The physiatrist can identify and make recommendations for treatment in relation to physical, cognitive or behaviours problems that can result from brain injury.
Recreational therapist
A recreational therapist is a professional that uses leisure and recreational activities as rehabilitation to build skills. The treatments are assessment-based and can be useful for people with social, cognitive, and behavioural challenges in developing independence and improving quality of life.
Respiratory therapist
A respiratory therapist is a professional that can assist with breathing difficulties. They work alongside doctors at hospitals to provide emergency respiratory care, or they can work in rehabilitation centres or at home to help people with ongoing breathing difficulties. Doctors will provide a recommendation if they think you need to see a respiratory therapist during rehabilitation.
Social worker
A social worker is a healthcare professional that provides ongoing support to the patient and the family by serving as an advocate and assisting with accessing services. They can also provide some levels of counselling. Their primary focus is improving overall well-being. A social worker can be a huge help for someone who is not sure where to find information or resources or needs someone to help support them while they look for services.

Talking to family and friends about your brain injury

One of the most frustrating aspects of living with the effects of brain injury is trying to get other people to understand how you are feeling and how much you are impacted by cognitive, physical, emotional and behavioural effects.

Your friends and families may not be familiar with brain injury in any way. Therefore, they may make some comments that make you feel hurt or upset. They mean well, but they don’t know what you’re experiencing. The only way they will know is if you tell them. You can do this by creating an atmosphere of open communication and dialogue. Take the opportunity to educate them about your injury and how you are impacted. Knowledge leads to understanding and even though it can be frustrating and take patience, it is important to keep those connections with friends and family.

Some examples of comments/questions you may hear from family or friends. Remember, your friends or family members mean well and want to know how to talk with you.

“When will you get better?”
This can be hard to hear. No one wants to live with memory loss, fatigue, pain, or any of the other effects of brain injury. Unfortunately, brain injury requires a lot of time, patience and commitment to rehabilitation. You will never be the same as you were before the injury. This is something that both you and your friends/families need to talk about. Brain injury recovery does not happen overnight. You are continually recovering and adapting. Let them know how they can help and support you. Tell them what you need from them and keep them updated as it your needs change over time.
“Glad to see you back to your normal self”
Bran injury is called the invisible disability because many symptoms of brain injury aren’t immediately obvious to others. What your friend or family member doesn’t know is that to prepare to see them, you have slept for hours and will then need to sleep again to recover. Or that you spend most of your time isolated from the world to cope with your symptoms. So, while to them you look ‘normal’, you’re far from it. You may feel hurt and frustrated by the comment: but they won’t know what you’re experiencing if you don’t tell them. Let them know how much physical and cognitive fatigue impacts your daily life.  Ask them to listen and ask questions about what you are experiencing and what “normal” looks like to you.
“You never come out or hang out with us anymore”
Bright lights, loud or multiple sounds and other stimuli may be hard for you after your brain injury. Traditional environments for socializing can cause you to experience symptoms of your injury or make those symptoms worse. You may be experiencing increased social isolation, and it’s frustrating when someone says something like this. But if they don’t understand what you’re going through or how to help them. Let your friends or family members know what types of environments don’t work for you at the moment. Socialize in smaller groups or one on one at your home or a place you are comfortable. If you can control your environment, you can control your symptoms and get more enjoyment from being with your family and friends.
“I feel like you are different, and our relationship has changed”
You are dealing with a whole new set of circumstances than before your brain injury. You may be different, and that’s okay. But it can be hurtful to hear someone say something like this. It can cause you both to dwell on the past when you should be focusing on the future of your relationship. Inform your friend or family member about how you’re feeling.  Through communication and continued engagement, you can forge a new relationship path forward.  “
“Weren’t you listening? I already told you that”
You were listening, but you may be experiencing memory loss or trouble focusing after brain injury. It’s a common challenge and one that can be so frustrating for both of you.  While you can use all sorts of tips and strategies to help you assist with memory loss, you need friends and family to be patient and not critical. There is no quick fix to memory impairments, so making sure family and friends are aware and understanding of your challenges will reduce frustration on both parts.
“I don’t want to upset you. I feel like I am always walking on eggshells”
This can be hurtful and comes from a lack of knowledge about the impairments caused by brain injury.  You may be experiencing multiple symptoms of brain injury that could impact how you interact with others. For example, you might have emotional lability (which is extreme emotional reactions such as laughing or crying excessively and sometimes in inappropriate situations), chronic pain, behavioural challenges, and frustration over the changes you have gone through and that people don’t understand them. All of this is common for brain injury survivors, and it’s important to communicate this with your friend or family member. There may be times when you both get upset. By being open and honest about what’s happening, you will both be able to communicate with more consideration and thought.

These are just a small sample of what you may hear from your family and friends as everyone adjusts and adapts. They are not trying to be offensive: they are trying to be supportive. Explain to them why comments like these are hurtful and help them understand how to communicate with you in a more positive way.

Other ways to educate family and friends

Ask them to visit the Family/Caregiver section of this site and ask them to spend some time looking through the information so they can become better educated about the complexity that is living with a brain injury.

Helplines & crisis support

If you’re in an emergency, you should always call 9-1-1.

For crisis centres and supports in your area, refer to the list below.

Canada
Canada Suicide Prevention Services is a national crisis and suicide line offering live call and text support. Toll-free, 24 hours a day: (1-833) 456-4566 or Text 45645 from 4 pm – 12 am

The Hope for Wellness Helpline is available for Indigenous peoples across Canada. Call toll-free at (1-855) 242-3310 24 hours a day, 7 days a week, or use the chat box link.

Alberta
Distress Centre Calgary

Distress Line of Southwestern Alberta

Doctor Margaret Savage Crisis Centre
Lakeland

Salvation Army Hope Line
Greater Edmonton

Distress Line
Edmonton

Wheatland Crisis Society Helpline
Strathmore

British Columbia
Crisis Centre
Provincial

BC 211
Provincial

Burnaby Mental Health and Addictions Centre
Burnaby

Canadian Mental Health Association Crisis Line
Kootenay, Vernon, Kelowna, Williams Lake

Crisis Prevention, Intervention, and Information Centre
Northern British Columbia

S.A.F.E.R. (Suicide Attempt Follow-up, Education, & Research)
Vancouver

Vancouver Island Crisis Society
Vancouver Island

KUU-US Crisis Line Society
Provincial – Indigenous

Telecare Crisis and Caring Line>
Provincial

Fraser Health Crisis Line
Fraser Health region, including Abbotsford, Agassiz, Burnaby, Chilliwack, Coquitlam, Delta, Hope, Langley, Maple Ridge, Mission, New Westminster, Pitt Meadows, Surrey, and White Rock.

S.U.C.C.E.S.S. Chinese Helplines
Richmond and area

CHIMO Services Crisis Intervention Program
Richmond, South Delta, Ladner & Tsawwassen

Manitoba
Crisis Stabilization Unit
Winnipeg

Interlake Regional Health Authority
View the area served here

Klinic Community Health Centre
Winnipeg

MB Farm, Rural & Northern Support Services

Reason to Live Suicide Line
Provincial

First Nations and Inuit Hope for Wellness Help Line
Counselling available in English and French – upon request, in Cree, Ojibway, and Inuktut

Northern Health Region

Prairie Mountain Health
Brandon, Assiniboine, Parkland

Southern Health-Santé Sud

New Brunswick
Chimo Helpline
Provincial, bilingual

Tele-care: 8-1-1

Newfoundland & Labrador
Mental Health Crisis Line
Provincial

Northwest Territories
NWT Helpline
Territory-wide

Nova Scotia
Mental Health Crisis Line
Provincial

Nunavut
Nunavut Kamatsiaqtut Help Line
Provincial, available in English, French, and Inuktitut

Ontario
Connex Ontario
Providing information on mental health and addiction services

Good 2 Talk – for post-secondary students
Provincial

Crisis Response Services
Kenora Rainy River District

Cambridge Distress Line

Distress Centre Durham

Hamilton Crisis Line

Telephone Aid Line Kingston (T.A.L.K)

Kitchener Waterloo Distress Line

Distress Centre
Lanark, Leeds, and Grenville

Support Line
London and Middlesex

Distress Centre Niagara

Mental Health and Addictions Access Line
Niagara

Distress Centre Halton

Distress Centre of Ottawa and Region

Crisis lines

Peel Crisis Capacity Network
Brampton, Mississauga, Caledon

Spectra Helpline
Peel region – multiple languages available

Distress Line – Sarnia Lambton

Six Nations Crisis Services
Ohsweken

Distress Centres of Greater Toronto

Torchlight Distress Line
Guelph, Dufferin

The Distress Centre of the Downtown Mission
Windsor

  • 12 pm – 12 am: (1-519) 256-5000
  • Text 2 pm – 2 am: 258258
  • Online chat from 2 pm – 2 am

York Support Services Network

Prince Edward Island
The Island Helpline
Provincial, bilingual

Québec
Centre de prévention du suicide de Québec
Provincial, bilingual

KRTB the Suicide Prevention Centre

Centre de prévention du suicide et d’intervention de crise du Bas-Saint-Laurent
Saguenay/Lac St. Jean

Service Point Baie-Saint-Paul
Baie-St-Paul

Suicide prevention centre Portneuf – Arc-en-ciel

Charlevoix Suicide Prevention Centre
La Malbaie

Suicide Prevention Centre of Quebec
Quebec City

Suicide Prevention Centre Les Deux Rives
Trois-Rivières (Quebec)

JEVI Centre de prévention du suicide – Estrie
Sherbrooke, (Quebec)

Suicide Action Montreal
Montreal, (Quebec)

Suicide Detour
Maniwaki

Amos Suicide Prevention Centre
Amos

Abitibi-Ouest Suicide Prevention Centre
La Serre

Suicide Prevention Centre of Malartic
Malartic

Suicide Prevention Centre of Rouyn-Noranda
Rouyn-Noranda

Témiscamingue Suicide Prevention Centre
Ville-Marie

Suicide Prevention Centre and Crisis Intervention Bas-St-Laurent (for Gaspésie-Îles)
Rimouski

Chaudiere-Appalaches Regional Telephone Service

Suicide Prevention Beauce-Etchemin
St-Georges-de-Beauce

Ilot-Laval Crisis Regional Service
Laval

Lanaudière Suicide Prevention Centre – Joliette

Centre prevention suicide Faubourg
St-Jérôme

Crisis and suicide prevention centre La Maison Sous les Arbres
Châteauguay

Centre de prévention du suicide de la Haute-Yamaska
Granby

Centre de crise L’Accès
Montérégie-Est

Centre de crise et de prévention du suicide La Traversée
Sorel-Tracy

Contact Richelieu-Yamaska

Centre de crise et de prévention du suicide du Haut-Richelieu Rouville
St-Jean-Sur-Richelieu

Le Tournant
Salaberry -de-Valleyfield

Le Centre d’écoute et de prévention suicide Drummond
Drummondville, (Quebec)

Le Centre de prévention suicide Arthabaska-Érable
Victoriaville

Saskatchewan
Five Hills Mental Health & Addictions Services
Moose Jaw

Saskatoon Crisis Intervention Service

North East Outreach and Support Services
Melfort

Prince Albert Mobile Crisis Unit

Mobile Crisis Services
Regina

Southwest Crisis Services
Swift Current

West Central Crisis & Family Support Centre
Kindersley

Yukon
Distress and Support Line

Mental health resources

Support group & Network changing routine

If you have been attending a support group, or if you belong to a support network – over time you may be feeling like you might like to make a change to the routine.

Obtaining support through others is an important aspect of brain injury recovery, and can take shape in many ways.  At the same time, it provides social contact as well as an opportunity for you to encourage others.

Regardless of what your situation is, just as it is important to carefully consider your reasons for wanting to join a support group – it is also important to consider your reasons for wanting to change this routine.

It may be helpful to develop a pros and cons list, and to think about some of the factors that may be leading you to want this change.  Some of these factors may include for example:

  • Why did you join this group initially?
  • Have any of the original conditions changed for you?
  • Do you believe you have talked as much as you are able to about your situation at this stage?
  • Does it seem that you are repeating yourself?
  • Do you need some time away from the group to process what you are learning?
  • Are you finding the schedule is too demanding?
  • Are you learning new things?
  • Are you hearing new information?
  • Are you finding that you are leaving feeling drained and/or down?
  • Are you wondering if your energy/effort might be re-directed elsewhere at the moment?
  • Are you beginning to feel that you do not want or need to attend any longer?
  • Have you reached a point where you are talking about goals and hope for the future, versus having the time and energy to practice and apply what you have been learning?
  • Has attending become a habit?
  • Perhaps someone else can benefit from your spot.
  • The social contact is positive for you.
  • It’s valuable for you to have a routine and a reason to get up and out to attend
  • Do you feel you are genuinely offering support and encouragement to others?
  • Have you been connecting with others who are sharing similar experiences?
  • Some in the group have moved on, others have remained
  • Overall, are you receiving positive messages that are moving you forward?
  • Is there an opportunity to apply any new strategies you are learning, and bring this information and awareness back to the group to debrief and/or discuss?
  • Are there other options available for you to obtain support that you might like to explore?
  • Are the people leading your group/network trusted sources?
  • If applicable, have you discussed this decision with your medical/other team?

If you are thinking about changing your routine:

  • How might you approach this?
  • Must it be all in or nothing?
  • Can your attendance, and/or time invested be modified to better suit your situation or schedule?
  • Who should you talk to about this?
  • Can you take some time to carefully consider your options before making a decision?
  • Can you test out/have a trial period to implement a modified schedule?
  • If you stop attending, should you find you are missing and needing the contact and support, can you re-join or reach out to someone?

There are a range of considerations involved in joining a support group and eventually in deciding whether to change up your routine.

Be sure to take the time necessary to consider your options carefully.  Talk to the right people, and on balance decide if attending this group brings you positive reinforcement.

When nothing seems to be working

You feel like you have tried everything. You doctor says you are doing all the right things, but you are still experiencing debilitating symptoms with no relief in sight. This can be frustrating and make you feel a sense of hopelessness.

While there is no magic spell that will make you feel better, there are a few options to explore.

Seek a second opinion

It is within your right to seek medical care from a variety of professionals. Some may have different training or more up to date knowledge on brain injury (or brain injury-related medical topics).

Allied health professionals

Allied health professionals are healthcare and health service providers that are not specifically medical-focused Allied health professionals include: dental hygienists; laboratory and medical technicians; optometrists; pharmacists; physio and occupational therapists; psychologists; speech language pathologists and audiologists . They can provide a range of diagnostic, therapeutic, and support services to aid in your treatment and recovery.

Ask your physician about the benefits of other therapy options.  Some of these services do not require a physician referral, so be sure to do your homework. Please read the next section on Private Clinics for additional information.

Private clinics

The public health care system can be limited and not cover all treatments and services.  You may need to seek the assistance of private providers or clinics. Be mindful that some of these clinics are not regulated in the same way that publicly funded hospitals are, so there is no guarantee the quality of the treatment or whether it will work.  In fact, it they state the treatment will absolutely work, that is a sign you should look elsewhere, as this is an extreme claim.  Brain injury is so individualized and complex, there is no “one size fits all” treatment for everyone and no guarantee that a treatment will work for you.

Private clinics are not always covered by insurance and you may have to pay out of pocket. This is something to keep in mind

When looking at private clinics, make sure you ask a few important questions:

  • Is the treatment evidence-based and could they share the research with you?
  • What is the benefit of the treatment related to the cost?
  • What is the wait time for treatment?

Disclaimer: There is no shortage of web-based online medical diagnostic tools, self-help or support groups, or sites that make unsubstantiated claims around diagnosis, treatment and recovery. Please note these sources may not be evidence-based, regulated or moderated properly and it is encouraged individuals seek advice and recommendations regarding diagnosis, treatment and symptom management from a regulated healthcare professional such as a physician or nurse practitioner. Individuals should be cautioned about sites that make any of the following statements or claims that:

  • The product or service promises a quick fix
  • Sound too good to be true
  • Are dramatic or sweeping and are not supported by reputable medical and scientific organizations.
  • Use of terminology such as “research is currently underway” or “preliminary research results” which indicate there is no current research.
  • The results or recommendations of product or treatment are based on a single or small number of case studies and has not been peer-reviewed by external experts
  • Use of testimonials from celebrities or previous clients/patients that are anecdotal and not evidence-based 

Always proceed with caution and with the advice of your medical team. 

Support groups

Seek the support from other people who have been in a similar position as you and have found success with other therapies, treatments or recovery methods.  Brain injury associations across Canada offer groups online and in-person for individuals living brain injury. Some are geared towards targeted groups such as women, men, youth. Find your closest brain injury association to see what they have to offer.

Nutrition

We are what we eat, which means that our diet has a big impact on our brain’s health and well-being. Visit the section on nutrition to see how to optimize your diet for brain health.

Sleep

No matter what stage you are at in your recovery, you need as much restful sleep as possible.  Both cognitive and physical fatigue can affect so many aspects of daily living, including mood, memory, concentration, communication, and your general ability to deal with issues or situations.

Take a step back

Take a step back and slow down. Sometimes we need to pause and listen to our bodies. Look at what may be triggering your symptoms. You may be juggling too many things at once.  It could be something in your environment, such as the lighting in your home or office. It is important to remember that recovery can take time, so you need to be patient and look at the whole picture.

Do something you enjoy

When you are not feeling well, it is hard to focus on the positives. Do something you enjoy or that brings you happiness and relaxation. Try to build this into every day. Doing activities that make you feel fulfilled can help you in your recovery process.

Become educated on your health

Individuals as much as possible need to become their own health advocates.  Becoming as educated as possible on the topics and treatments for brain injury will help you better communicate with your health team and bring new information that might be helpful in recovery.

Here are some helpful tips to help you advocate for your health:

  • Write down some talking point or notes so you don’t forget anything and can speak clearly with the healthcare provider
  • If you have articles or research papers about brain injury you want to share with your clinician, bring copies to your appointment. Try to limit the resources you bring to three or less
  • Ensure your sources of information are reputable, credible and based on evidence.
  • University and medical research centres are examples of reputable sources
  • Be open to their perspective and knowledge of the topic. Take notes (or have someone take notes for you)
  • Ask for more links or resources so you can be more informed

Use your voice

You have a powerful voice as a person with lived experience. You can use this power to advocate in your community. Reach out to your local brain injury association to see how you can share your experience and challenges and contribute to advocacy efforts.

Should you get a second medical opinion?

Sometime people feel awkward about seeking a second opinion about their medical diagnosis or treatment, as there is a perception that some physicians will get insulted or see it as lack of respect from patients or caregivers. In most cases, clinicians understand you want the best care and advice for yourself or your friend/family member.

It is within your right to seek medical care from a variety of professionals. Some may have different training or more up to date knowledge on a topic, particularly in the field of brain injury.

Reasons you or your friend/family member may wish to get a second medical opinion include:

  • You are unsure or have reason to question a diagnosis
  • You are trying to decide about a new treatment or a surgery that may have a high risk and/or high cost out of pocket
  • You are not clear about if or how well a test or treatment may work
  • You need more information about all options available[1]

Another situation which could lead to the desire for a second opinion is if you have talked to someone who had a wonderful experience with another clinician and saw improved health outcomes. While it is certainly helpful to learn more details, you must also keep in mind that each brain injury is different (as are the circumstances leading to the brain injury) so the outcomes for yourself or a friend/family member may not be the same.

Finding a second opinion

There are a variety of ways to find a possible second opinion.

  • Ask the physician for a recommendation of someone else who works in the field but is not closely associated or a direct colleague
  • Use word of mouth. Perhaps there is someone that has been recommended by a friend or acquaintance, or you read about a physician in an article
  • Contact your provincial/territorial College of Physicians and Surgeons
Alberta
College of Physicians and Surgeons of Alberta
2700 Telus Plaza South
10020 — 100 Street NW
Edmonton AB T5J 0N3
Telephone:(780) 423-4764; public inquiries:1 (800) 561-3899
Find a physician in Alberta
British Columbia
College of Physicians and Surgeons of British Columbia
300-669 Howe Street
Vancouver, BC V6C 0B4
Telephone:(604) 733-7758 or 1 (800) 461-3008
Find a physician in British Columbia
Manitoba
College of Physicians and Surgeons of Manitoba
1000 – 1661 Portage Avenue
Winnipeg MB R3J 3T7
Telephone:(204) 774-4344
Find a family doctor in Manitoba
New Brunswick
College of Physicians and Surgeons of New Brunswick
1 Hampton Road, Suite 300
Rothesay NB E2E 5K8
Telephone:(506) 849-5050 or 1 (800) 667-4641
Find a physician in New Brunswick
Newfoundland and Labrador
College of Physicians and Surgeons of Newfoundland & Labrador
139 Water St, Suite 603
Saint John’s NL A1C 1B2
Telephone:(709) 726-8546
Find a physician in Newfoundland and Labrador
Find a physician specialist in Newfoundland and Labrador
Northwest Territories
Health and Social Services
Government of the Northwest Territories
PO Box 1320
Yellowknife NT X1A 2L9
Telephone:(867) 920-8058
Government of Northwest Territories Health and Social Services 
Nova Scotia
College of Physicians and Surgeons of Nova Scotia
7071 Bayers Road, Suite 5005
Halifax NS B3L 2C2
Telephone:(902) 422-5823 or 1 (877) 282-7767
Find a physician in Nova Scotia 
Nunavut
Department of Health and Social Services – Government of Nunavut
P.O. Box 1000 Station 200
Iqaluit, Nunavut
X0A 0H0
Telephone:1 (877) 212-64382
Government of Nunavut Department of Health 
Ontario
College of Physicians and Surgeons of Ontario
80 College Street
Toronto ON M5G 2E2
Telephone:(416) 967-2603 or 1 (800) 268-7096
Find a doctor in Ontario
Prince Edward Island
College of Physicians and Surgeons of Prince Edward Island
14 Paramount Drive
Charlottetown, PEI C1E 0C7
Telephone:(902) 566-3861
Find a physician in Prince Edward Island
Quebec
Collège des médecins du Québec
1250 boulevard René-Lévesque Ouest, Suite 3500
Montréal (Québec) H3B 0G2
Telephone:(514) 933-4441 ou 1 (888) 633-3246
Find a physician in Québec
Saskatchewan
College of Physicians and Surgeons of Saskatchewan
500-321A-21st Street East
Saskatoon SK S7K 0C1
Telephone:(306) 244-7355 or 1 (800) 667-1668
Find a doctor in Saskatchewan
Yukon
Yukon Medical Council
c/o Registrar of Medical Practitioners
Box 2703 C-18
Whitehorse YT Y1A 2C6
Telephone:(867) 667-3774
Find a physician in Yukon

Preparing for a second opinion

Becoming as educated as possible on the topics and treatments will help you become a better health advocate.  You will be better able to converse with clinicians and provide information that might be helpful in recovery.

As clinician visits are usually short, you will need to be prepared before and during the appointment. Here are some helpful tips:

  • Write down some talking point or notes so you don’t forget any questions you may have. You can also ask a friend or family member at the appointment to keep notes
  • If you have articles or research papers about brain injury you want to share with the clinician, bring copies to the appointment. Try to keep it to under three as a clinician is less likely to read a stack of articles
  • Ensure your sources of information are reputable, credible and based on evidence.   University and medical research centres are examples of reputable sources
  • Be open to the clinician’s perspective and knowledge of the topic. Take notes so you don’t forget what they have said
  • Ask for more links or resources so you can be more informed

There are some barriers to seeking a second opinion. Their may be limitations due to the number of clinicians in your area, or waitlists that could be anywhere from a few weeks to months. You will also have to ensure you have proper up-to-date medical records. It’s helpful as recovery progresses to request copies of their medical records. This will alleviate the wait time associated with getting a copy made or the possible transfer of care that could happen if the doctors requests the records on the person’s behalf.

What to do with the results

Sometimes the physician will come to the same conclusion for the diagnosis or pathway of care as the first clinician. This should help alleviate any uncertainty from a medical perspective.

In other cases, they will have different opinions. Both options may be good, but what is the best way to make such an important decision?

It is suggested that you take the results from the second opinion back to the initial physician for review.  There will be other factors to consider in the decision-making process.

  • Is one clinician suggesting a surgery that will have long recovery times? What are the benefits?
  • Is there a cost associated with the treatment, and if so, will it be covered by insurance or will there be out-of-pocket expenses?

Take the time to discuss the results. Ultimately it is up to the person receiving treatment, and they need to make the best decision for them and their recovery. Caregivers, friends and family members can help with the decision-making process, offer advice or any support the person with the brain injury might need. If a caregiver is the primary decision-maker for the person with a brain injury, consult with other immediate family members and explain how the decision has been reached.

See sources

Disclaimer: There is no shortage of web-based online medical diagnostic tools, self-help or support groups, or sites that make unsubstantiated claims around diagnosis, treatment and recovery. Please note these sources may not be evidence-based, regulated or moderated properly and it is encouraged individuals seek advice and recommendations regarding diagnosis, treatment and symptom management from a regulated healthcare professional such as a physician or nurse practitioner. Individuals should be cautioned about sites that make any of the following statements or claims that:

  • The product or service promises a quick fix
  • Sound too good to be true
  • Are dramatic or sweeping and are not supported by reputable medical and scientific organizations.
  • Use of terminology such as “research is currently underway” or “preliminary research results” which indicate there is no current research.
  • The results or recommendations of product or treatment are based on a single or small number of case studies and has not been peer-reviewed by external experts
  • Use of testimonials from celebrities or previous clients/patients that are anecdotal and not evidence-based 

Always proceed with caution and with the advice of your medical team. 

Long-term care planning resources by province and territory

Long-term care homes offer a safe, supportive environment for people who can no longer live at home. These facilities address their medical needs and give you peace of mind. The key is finding the right long-term care home that works with the required specific needs.

Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland & Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon

Recovery

A person with a first-time concussion typically recovers fully within a few days to weeks after the injury. No two concussions are the same. This means that recovery is different for everyone.

The Ontario Neurotrauma Foundation guidelines for Concussion/ mTBI and Persistent Symptoms was developed to improve patient care by creating a framework that can be implemented by healthcare professionals to effectively identify and treat individuals with persistent symptoms following a concussion/mTBI.

The patient version of the Guidelines for Concussion/mTBI and Persistent Symptoms is for adults over the age of 18. These were developed to make communication between healthcare provider and patient easier. Starting in 2019 these guidelines will become living guidelines to ensure that the most current research literature is incorporated into the recommendations.

Topics in this section include:

Concussion recovery tips

The symptoms you experience can be difficult to manage and have an impact on your daily life. Some symptoms may come and go, and your recovery may take longer than expected. It can be frustrating, debilitating, and scary. You’re not alone – recovery can be challenging for many people. With the right education and support, you’ll be able to face those challenges and make positive progress.

Here are some ways you can proactively assist your concussion recovery. You should make sure to listen to your doctor if they have more specifics steps for your recovery plan.

Appropriate rest and activity
The concussion guidelines say you should slowly become more active after 24 – 48 hours of rest. This is a change from ‘cocoon therapy’ – the practice of long periods of rest in low lighting with little to no activity.  Recent research indicates that long periods of rest may do more harm than good [1].

Daily activities of living should be re-introduced gradually. Overtime as symptoms decrease, the more active you can become [2]. You should always consult with your doctor before resuming activity that includes a significant risk of injury. If your symptoms get worse when you’re active, try scaling back. Every person has a threshold for activity, and it may take awhile to find yours.

There is no set timeline for when you’re supposed to be able to return to regular activity. The important thing is that you take your time and consult with your doctor.

Return to work gradually
Like with physical activity, your return to work should be gradual, building up over time. Depending on the severity of your concussion, your return to work could begin a few days to a few weeks after your injury. You should make sure to talk with your employer about your concussion, any symptoms you’re still experiencing, and how best to transition back to your full responsibilities [3].

Keep a journal of how you’re feeling both at and after work. This will help track your symptoms and whether you’re ready to take a step forward and increase your workload. While working, you should take frequent breaks to give your brain time to rest. You should also plan for additional time to finish tasks and try to find a quiet environment to complete your work.

If you’re ready to return to work, but need a little help getting the process started, visit the return to work section for tips and resources.

Ask for help
If you are having trouble with household tasks like cooking or cleaning, ask a family member or friend for assistance. Return to activities gradually according to doctor recommendations.
Bring someone with you to appointments
When you experience a concussion, symptoms can make it difficult for you to keep track of information or get to appointments. Bringing a friend or family member with you to appointments can be helpful. They can write down information and communicate with your medical team.

Risk factors

There are several risk factors that are taken into consideration when doctors are mapping out your recovery.

Medical
  • History of previous brain injury
  • Previous neurological or psychiatric problems
  • Effects of other health issues like medications, bodily injuries, etc.
  • Anxiety
  • Depression
  • Insomnia
  • The number of symptoms you are experiencing
Personal or environmental factors that may negatively affect recovery
  • Mechanism of injury (e.g. motor vehicle accident, assault)
  • Significant delays or not returning to work following the injury
  • Being a student
  • Life stressors
  • Older age
  • Lack of social support
  • Female gender
  • Lower resilience
  • Returning to a contact sport too early
Multiple concussions and second impact syndrome
Getting another concussion while still recovering from a previous one may increase the risk for long-term problems. Second impact syndrome is an extremely rare event where a second concussion in close succession to a previous, not yet healed concussion leads to uncontrolled brain swelling. Most reported cases have been in teenagers and young adults. In a few cases worldwide, it has even been linked to death [4].

It’s important to fully heal from a first concussion before returning to any sport or activity that could put you at high risk of getting another. When you do return to a sport or activity, you should speak with your coach/leadership team about safety precautions.

What if my symptoms aren’t going away?

All these factors will impact how quickly you recover from your concussion [5].

If you still have symptoms 1 month after your initial injury, these are called persistent symptoms (sometimes referred to as prolonged symptoms or post-concussion syndrome). Every person’s recovery is different, so don’t be alarmed if you do have some symptoms after the 1-month period. Talk to your doctor about what symptoms you are experiencing.

Persistent symptoms include:

  • Headaches
  • Fatigue or difficulty with sleep
  • Unsteadiness or decreased balance
  • Memory or concentration difficulties

If you’re experiencing seizures, slurred speech, or numbness you should consult with your doctor prior to the 1-month mark.

Prolonged symptoms can affect your daily life and make it difficult for you to perform regular activities. Your doctor may want to do more tests and check in with you more often if it turns out you have persistent symptoms. Their tests and medical investigations will tell them how best to manage your symptoms. Check the ONF guide for more information on managing prolonged symptoms.

What is Chronic Traumatic Encephalopathy (CTE)?

CTE is a neurodegenerative disease that has been found posthumously in a small number of athletes and veterans with a history of multiple head injuries. Research is continually evolving on CTE.

Private concussion clinics

There are many private concussion clinics across Canada offering a wide variety of concussion recovery methods and therapies. These private clinics have no federal or provincial oversight or regulations and there are no assurances of the services they provide. When figuring out whether a private clinic is right for you, ask the following questions [6]:

  • Does the clinic have a medical doctor?
  • Does the clinic have a team of licensed health care professionals?
  • Does the clinic follow the most up-to-date standards of care for managing a concussion?
  • What tools, tests and recommendations is the clinic using?

Disclaimer: There is no shortage of web-based online medical diagnostic tools, self-help or support groups, or sites that make unsubstantiated claims around diagnosis, treatment and recovery. Please note these sources may not be evidence-based, regulated or moderated properly and it is encouraged individuals seek advice and recommendations regarding diagnosis, treatment and symptom management from a regulated healthcare professional such as a physician or nurse practitioner. Individuals should be cautioned about sites that make any of the following statements or claims that:

  • The product or service promises a quick fix
  • Sound too good to be true
  • Are dramatic or sweeping and are not supported by reputable medical and scientific organizations.
  • Use of terminology such as “research is currently underway” or “preliminary research results” which indicate there is no current research.
  • The results or recommendations of product or treatment are based on a single or small number of case studies and has not been peer-reviewed by external experts
  • Use of testimonials from celebrities or previous clients/patients that are anecdotal and not evidence-based 

Always proceed with caution and with the advice of your medical team. 

See sources

Ways to find help after an opioid overdose

Meeting with a counsellor

Counselling is a positive step towards overcoming problematic substance use. Licensed therapists can provide one-on-one help and give concrete advice and practical tips towards change. Counselling is also beneficial for individuals with a brain injury who are learning to cope with the changes in their lives.

Help groups

Many cities have local help groups for substance use. These groups are designed to offer a supportive environment for people with living experience of substance use. Local healthcare professionals should be able to provide more information about support in a specific area and whether they can support specific needs post-injury.

There are also many brain injury associations across Canada that offer programs and resources specific to the area.

Residential rehabilitation

For those who need a different environment, residential rehabilitation centres are available. There are both private and public addiction centres in Canada. While public centres are free, they have long wait times. Private centres involve out-of-pocket expenses.

Please remember: not every centre will be equipped to meet the needs of a person with problematic substance use and brain injury. It’s important to work with a medical team to find the best course of treatment.

Supervised consumption sites

Problematic drug use is a complex issue with no easy solution. Many people struggle to stop. This is where supervised consumption sites can be useful. They are a place for people looking to stop or reduce their drug use, and research shows they are effective at improving health and saving lives.

Along with offering a safe place for consumption, many supervised consumption sites have screening services to catch potential contaminants, access to emergency services, testing for diseases/infections, and referrals/information on treatment (Source: Government of Canada).

Resources

Disclaimer: We cannot guarantee the accessibility of any resources not located on our website.There are no quick and easy answers to substance use problems, but there are resources for individuals looking for help.

Disclaimer: There is no shortage of web-based online medical diagnostic tools, self-help or support groups, or sites that make unsubstantiated claims around diagnosis, treatment and recovery. Please note these sources may not be evidence-based, regulated or moderated properly and it is encouraged individuals seek advice and recommendations regarding diagnosis, treatment and symptom management from a regulated healthcare professional such as a physician or nurse practitioner. Individuals should be cautioned about sites that make any of the following statements or claims that:

  • The product or service promises a quick fix
  • Sound too good to be true
  • Are dramatic or sweeping and are not supported by reputable medical and scientific organizations.
  • Use of terminology such as “research is currently underway” or “preliminary research results” which indicate there is no current research.
  • The results or recommendations of product or treatment are based on a single or small number of case studies and has not been peer-reviewed by external experts
  • Use of testimonials from celebrities or previous clients/patients that are anecdotal and not evidence-based 

Always proceed with caution and with the advice of your medical team.