Abstract
Patients with acquired brain injury are not only physically impaired, but have impairment of higher cortical functions, exhibiting cognitive dysfunction and abnormal behavior. On the other hand, the cognitive impairments after brain injury are sometimes too difficult to understand for patients and their families. And there is often much discrepancy in the awareness of impairments among patients, their families and medical and rehabilitation staff. Such misunderstanding obstructs introduction of community-based rehabilitation. Acute-stage positive behavioral support is recommended for patients with cognitive disorder and their families to improve their quality of life in the chronic stage. Moreover, appropriate rehabilitation, social support, and cooperative negotiations are beneficial for patients with cognitive dysfunction who are attempting return to society. In many patients, hospital personal treatment alone is insufficient to solve all of the patients' problems, many reports showed that the effectiveness of group-style rehabilitation programs. A holistic rehabilitation programs that aim at achieving optimal functional rehabilitation outcomes, such as self-sufficiency in daily life and stable personal and interpersonal readjustment is also needed. For helping patients to gain self-efficacy, trust from others, and self-awareness, therapeutic milieus that include both patients and their families must be made. Lastly, more many trans-disciplinary network and communication among specialists of medicine, welfare, and education are desirable in Japan.
