The short answer

Home care after severe brain injury needs a coordinated discharge plan and trained support. A family member should not be expected to replace nursing, medical or specialist rehabilitation care that the person still needs.

Before discharge, ask whether the proposed home arrangement can meet the person's needs throughout the day and night. Being medically ready to leave one hospital ward does not mean every task can be handled by an untrained caregiver. State clearly what support the household can and cannot provide.

Ask about rehabilitation care

Turn the discharge plan into a workable home plan

Identify who handles medical follow-up, therapy, daily care and equipment. Clarify which appointments are booked and which still need arranging. Ask who is responsible if a service is delayed.

MSKTC describes home transition as a planned process involving the patient, family and rehabilitation team. Use that discussion to raise practical barriers before leaving the facility, not after the first difficult night.

Further reading: MSKTC: Transitioning home after rehabilitation

Caregiver training should include demonstration and checking

Ask staff to teach the tasks you are expected to carry out, then confirm that you can perform them safely. Transfers, feeding arrangements, skin care and medicines may have individual instructions; this article cannot provide those instructions for a particular patient.

Do not lift, move or feed the person in a way you have not been trained and authorised to use. If a task needs two people or specialised equipment, that requirement should be reflected in the support plan.

Organise the day around essential care and manageable activity

A written routine can help different helpers understand responsibilities without assuming the patient can tolerate the same schedule every day. Ask the team how therapy, rest and appointments should be balanced.

  • Keep the current medicine and follow-up instructions accessible to authorised carers.
  • Agree who provides assistance at each part of the day.
  • Ask which activities the person can choose and do independently.
  • Record changes that should be discussed at review.
  • Make a backup plan if the main caregiver becomes unavailable.

When ordinary home therapy is not enough

Some people with severe injury or disorders of consciousness need specialist rehabilitation and close monitoring. Ask the treating team about the appropriate programme and what expertise is required. A visit from a physiotherapist does not provide continuous medical supervision.

If the care requirement exceeds what is available at home, say so. Asking for a different setting, professional nursing or more support is responsible planning, not a lack of commitment to your relative.

Further reading: MSKTC: Family guide to programmes for disorders of consciousness

Support the caregiver as well as the patient

Identify which tasks can be shared and which require professional training. Another relative may be able to manage appointments or meals even if they cannot provide physical care. Plan breaks and ask about local respite or caregiver services.

NeuroFicio can confirm whether its home or remote physiotherapy scope is appropriate. It should not be assumed to provide a complete severe-brain-injury home nursing package. For new deterioration, use the medical or emergency pathway in the discharge instructions.

Frequently asked questions

Can I learn severe brain injury care from videos?

Videos do not replace patient-specific training and checking by the care team. Ask for a demonstration and written instructions for the tasks you will perform.

Is a home physiotherapist enough for all severe TBI needs?

Not necessarily. Medical, nursing, therapy and supervision needs must be assessed together. The treating team should identify the required level of support.

Sources and further reading

Sources checked on 14 October 2026. Written by the NeuroFicio editorial team; no named clinical reviewer is represented here.

General information, not an individual diagnosis or treatment plan. Ask the relevant qualified professional about your needs. For sudden or worsening neurological symptoms, seek urgent local medical care.