Programs

NRIO offers customized programs for adults, youth and families. The rehabilitation programs are developed to assist persons with moderate to severe brain injuries and other neurologic impairments in achieving success in increasing their level of independence.

Adult programs include:

Coma Stimulation/Minimally Conscious

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 the environment
  • Increase response and participation in environment
  • Increase ability to communicate with caregivers

NRIO also offers a Coma Stimulation program in our Mississauga and Hamilton residences. The program provides a 24-hour care environment offering services such as deemed appropriate:

• Physiotherapy/Neuromotor Therapy
• Occupational Therapy
• Speech and Language Therapy
• Neuropsychology
• Behavioural Therapy
• OTA/PTA
• Avocational and Leisure Therapies
• Personal Attendant Care

Testimonial:
“Thank you for the positive impression you made on me with your knowledge and expertise in the health care industry. I have always admired health care professionals for their choice in choosing the career that helps people that are sick and in need. People with compassion and integrity and a sense of purpose are the real heroes regardless of profession and education. I wanted to express to you my gratitude for being an outstanding person who chose a profession where you could make a difference, and for that, I am grateful we made the connection. Thank you so much for taking the time to meet with me and trying to help another family in an otherwise impossible and tragic situation.” – LP

Slow to Recover

Our Slow to Recover program begins with coma stimulation/minimally conscious clients and continued rehabilitation services for those individuals identified as “slow to recover.” The program begins with tactile, sound, olfactory 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 the environment
  • Increase participation in environment
  • Increase ability to communicate with caregivers

The Hamilton and Mississauga residence service clients who are slow to recover.

The program provides a 24-hour care environment offering services such as:
• Physiotherapy/Neuromotor Therapy
• Occupational Therapy
• Speech and Language Therapy
• Neuropsychology
• Behavioural Therapy
• OTA/PTA
• Avocational and Leisure Therapies
• Personal Attendant Care

Complex Care

Located in the Hamilton and Mississauga residences, our Complex Care program offers a complete program of rehabilitation, nursing (via Bayshore Home Health) 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 24-hour care environment offering services such as:

  • Physiotherapy/Neuromotor Therapy
  • Occupational Therapy
  • Speech and Language Therapy
  • Neuropsychology
  • Behavioural Therapy
  • OTA/PTA
  • Avocational and Leisure Therapies
  • 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, receiving nursing services through Bayshore Home Health 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 consistent progress. The client and their family are vital members 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, counseling 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 as well as working with community based addiction programs. 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 a consultant Neuropsychiatrist and Substance Abuse Physician to support the clients in residence.

NRIO has programs for clients with:

  • Pre- and post-injury psychiatric problems exacerbated by brain injury
  • Substance abuse / addictive problems
  • 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 Services and Group Programming

The Comprehensive Day Rehabilitation program offered within the clinic setting of Etobicoke 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
  • Behavioural Therapy
  • Counseling
  • Fitness
  • Life Skills Retraining
  • Vocational Re-Entry
  • Community Reintegration
  • Group Programming

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

  • Increase levels of independence
  • Promote community reintegration
  • Improved functional and “real life” rehabilitation
  • Increase ability to participate in treatment and community activities
  • Return to modified lifestyle and activity level

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Supported Living Apartment Services

NRIO’s Supported Living Apartment Services program offers clients the opportunity to regain their independence and to return to living in their own apartment.

Our first independent living project was opened in 2005, in the Lakeshore area of Toronto. This sixplex apartment building is one block away from the lake and close to shopping, restaurants, recreation, hospitals and public transportation into downtown Toronto. Other clients participating in the Supported Living Apartment program maintain their own apartments throughout the city and receive services from NRIO’s rehabilitation staff.

Clients in the NRIO Supported Living program receive support from our Rehabilitation Therapists and can continue in restorative therapies with our physiotherapists, occupational therapists, speech therapists and other regulated health care professionals. Each individual’s return to an independent lifestyle can be maximized through practical and functional solutions to the barriers related to their brain injuries. The SLA program is for clients who are ambulatory and access to 24/7 supports.

The NRIO Supported Living Apartment program works with community-based services which are already in place for some clients. Our services can provide a specific rehabilitation component to complement an existing program or extend a full range of services to an individual.

Residential Rehabilitation

A total rehabilitation environment is offered to those individuals who require extensive physical, functional, cognitive and behavioural supports as well as 24 hour care. NRIO operates residential programs in Mississauga and Hamilton for individuals who require more complex rehabilitation and care in long-term supported living programs. Etobicoke and the Supported Living Apartment programs also offers a residential program for individuals who are preparing a return to independence and are learning to manage behavioural, substance abuse and/or psychiatric problems related to their brain injury.

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 neighborhoods 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, functional rehabilitation and quality of life. 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 comprehensive 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 are encouraged to 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
• Speech and Language Therapy
• Behaviour Therapy
• Neuropsychology
• Personal Attendant Care
• OTA/PTA
• Rehabilitation Therapists
• Neuropsychiatry
• Substance Abuse Physician

Individualized goals are determined upon intake to the program and reassessed throughout treatment. These goals include:
• Increase levels of independence
• Community reintegration
• Improved functional and “real life” rehabilitation
• Increase level of participation in life activities
• Social reintegration
• Avocational and volunteer activities

Youth and family programs include:

School Resource (Teacher/Academic Support) Services

NRIO’s School Resource Services (SRS) are designed for young people suffering the effects of an acquired brain injury at the elementary, secondary, college or university levels. NRIO also has programs to assist young people currently in a vocational training setting that are interested in once again pursuing academics.

The SRS program occurs in the setting of the school environment with educational or rehabilitation staff providing the cognitive, psychological and behavioural services required for the young person to succeed. The program is fully coordinated with each individual school program and is designed to provide reintegration into community education.

The philosophy of the SRS program is help individuals attain maximum function and independence through the extension of services into a learning environment where problems or challenges are occurring. The NRIO School Resource Services program may also include other restorative or support services through NRIO or other community providers. NRIO staff may work as a direct service teacher to the individual or serve to provide educational supports in the classroom, in tutoring or at home.

The SRS staff can assist the school personnel as well with other aspects of integration and school return. Ensuring that the child or adolescent is supported by their teacher and any other education provider is a positive step towards the success of that client. The effects of brain injury and other useful information about the recovery are provided to the teacher so they are more aware of the deficits the client could be experiencing.

The SRS team includes special educators, teachers, instructional aides, tutors who work closely with guidance counselors, school administrators, rehabilitation specialists and therapists, social workers, the child, their family and any others that are involved in the rehabilitation process (such as case manager, lawyer or insurance adjuster).

NRIO’s School Resource Services include:

  • Coordination of the transition from hospital to home to school with inter-disciplinary members of the rehabilitation team and receiving school
  • In-clinic transitional educational programming
  • Identification of specialized supports needed in school (school accommodations, program modifications)
  • Participation in the development of the student’s Individual Education Plan (IEP) or in the Identification Placement Review Committee (IPRC) process
  • Support of an Educational Assessment (WIAT-II); Ed./Voc. Assessment
  • Support of a Neuropsychological assessment
  • Individualized (one-to-one) academic support in-school and/or in home
  • Study / Test taking strategies and learning supports
  • Curriculum review and customization of learning materials

Individualized academic goals are determined upon intake and re-evaluated regularly throughout treatment.

  • Effective transition to school life
  • Academic Supports
  • Social and Life Skills
  • Greater independence within the classroom and school

Sessions can be held at the NRIO office, in your home or a community location.

College/University Supports

This post-secondary level support program facilitates the young adult’s transition from hospital rehabilitation facility or home to high school, college or university. This is done through the provision of individualized in-home or in-school academic supports.

NRIO’s College/University Services include:

  • Identification of student’s strengths/needs/interests
  • Identification of current information about post-secondary education options, in order to help the student make informed decisions
  • Identification of specialized supports available and services the student will require (i.e. Special Needs Offices in colleges and universities) and assisting the student in accessing support
  • Home-schooling in preparation for return to college/university
  • In-clinic transitional educational programming (i.e. STEP program – School Transition Education Program)
  • Study, research, test-taking and organizational skills development in preparation for post-secondary studies
  • Support of an Educational Assessment (WIAT-II); Ed./Voc. Assessment
  • Individualized (one-to-one) academic support in-school and/or in-home
  • Ongoing communication/collaboration with the student and support team
  • Curriculum review and customization of learning materials

Individualized academic goals are determined upon intake and reevaluated regularly throughout treatment.

  • Individualized academic goals are determined upon intake and reevaluated regularly throughout treatment
  • Effective transition to college/university life and academic success

Family Services

As an integral member of the rehabilitation team, the family and/or significant others are involved in the rehabilitation process from admission through to discharge. Necessary education and support is provided to family members to improve their understanding of the implications of brain injury.

NRIO includes the family in goal setting and encourages ongoing communication with the rehabilitation team.

  • To include the family in the decision making process as it relates to rehabilitation
  • To provide the family with an understanding of their role in promoting a successful outcome
  • To enhance the transfer and generalization of skills to the home, workplace and other environments
  • To supply the family and/or caregivers with all the training, understanding and ability to better assist and participate in the care of their loved one

NRIO offers the following services to families and caregivers:

  • Family education
  • Family counseling
  • Assistance in the implementation of home-based rehabilitation programs
  • Recreational activities

Testimonial

NRIO helped me get my life back again. I learned how to walk, talk, cook, to be productive and drive my car again. It took a lot of work, drive and determination. I had to get through many obstacles to get better, however, you have to work HARD for it. NRIO empowered me to work HARD and never give up HOPE.

-GF- Discharged Client

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