Tree of Life: Giving People with Brain Injuries Hope and a Future

When “Lisa” came to Tree of Life in 2002, she drank too much, needed psychiatric care for depression, could not walk up steps or on uneven ground, had gained 50 pounds and needed 24-7 care because of her brain injury, suffered in a car accident. Now Lisa, who wishes to remain anonymous, has lost the weight, gained a boyfriend, conquered the drinking problem and run a 5K. She works part time in retail and lives in a supervised apartment.

Lisa and others who’ve suffered traumatic brain injury say they have been transformed by a comprehensive rehabilitation program at Tree of Life, a private facility for brain injury patients located in Richmond.

Lisa originally went to a residential facility and outpatient rehab in Michigan, where she lived at the time of her accident, say her parents, who live in Williamsburg. But instead of getting the help she desperately needed, Lisa was raped by one of the center’s drivers.

“She was so without hope [after that] that she said she no longer wanted to live,” says Lisa’s mother. “She was extremely depressed. She was extremely damaged mentally.”

So Lisa’s parents, who, because of the nature of their daughter’s injuries, have also requested anonymity, began looking for another place where their daughter could at least be safe and possibly rehabilitated.

“We went to see a lot of places in Michigan,” says Lisa’s father. “Every one we saw was like a dog kennel. People were just shoved into rooms. They didn’t even have their sheets changed sometimes. Basically, it was a storehouse for damaged people.”

Then they found Tree of Life. “We were welcomed with open arms,” says Lisa’s father. “The house was very warm, very family-oriented. The people who spoke to us were so kind, so welcoming. I knew this was the place where she could recuperate.” An added bonus: Tree of Life is less than an hour’s drive from their home in Williamsburg.

Internationally known neuro-rehabilitation physician Dr. Nathan D. Zasler started Tree of Life in 1997 with a five-bedroom house and one patient. The goal: to help people with brain injuries achieve as much independence as possible. Zasler teaches in the departments of physical medicine rehabilitation at both Virginia Commonwealth University and the University of Virginia schools of medicine and has lectured and written extensively on the unique challenges of rehabilitating brain injury patients.

Zasler saw the need for a long-term program, one that worked with such patients beyond the acute rehab and therapy patients receive immediately following an accident or other event that caused the brain injury.

Tree of Life has grown to a full staff including physical therapists, cognitive behavioral therapists, neurorehabilitation psychologists and others. During the day, staff-to-patient ratios are at least one-to-one, Zasler says.

Tree of Life is not a hospital, nursing home or adult day care center. Therapy works toward getting patients back into the community as fully as possible. Patients come from all over the East Coast and as far west as Illinois and Michigan, he says.

A typical day might include formal one-on-one therapy, a group therapy session, recreation time, music, art, and a meal out at a restaurant. Average transitional length of stay is six to 12 months.

The cost is high—about $650 a day. But that cost includes room and board and more important, 24-7 access to Zasler, Tree of Life’s medical director, and Dr. Michael F. Martelli, director of neuropsychology. A patient who needed 24-7 supervision from a certified nurse assistant might pay almost $400 a day, not including room and board, Zasler says.

The recovery time for people with brain injuries is longer than usually funded by commercial or government insurance, Zasler says, so almost all of the patients rely on workers’ compensation to help pay for care. “Unfortunately for people with these type of injuries, insurance won’t pay for long-term care or transitional care,” he explains.

Among Zasler’s goals: to educate private and federal insurance programs across the country about the many benefits of neuro-rehabilitation services. Even though a rehabilitated patient may still be considered 100-percent disabled and not necessarily able to get a job on his or her own, even a part-time job and the social life enabled by the program offers a huge benefit.

“It’s more than just the financial benefits of working,” Zasler says. “There are the psychological benefits, the social benefits. Many of these people with brain injuries are socially isolated. We’re getting these people out of their homes and into the community.”

Lisa is still in the program, living mostly independently in one of Tree of Life’s apartments. She still needs the supervision, her parents say. “But if you would talk to her now, you might not even know she had a brain injury,” her mother says. “Her recovery is absolutely a miracle. Yes, it’s due to her efforts. It’s also due to Tree of Life. They gave her hope. It’s an incredible transformation.”

Tree of Life employs the “bio-psycho-social” model in treating patients—another way to say the program approaches treatment from the physical, emotional and social aspects (i.e., treating the “whole person”).<b> “We want to understand who the person was before their injury,”</b> Zasler says. “One of the mistakes other programs make is they don’t take enough time to figure [that out].”