Home › Conditions we care for › Traumatic brain injury

Recovery after a brain injury does not follow a schedule.

Traumatic brain injury care at home means watching for seizures, managing tone and feeding, and carrying therapy into ordinary days. Georgia Medicaid covers in-home skilled nursing for children after a brain injury through the Georgia Pediatric Program.

Check eligibility Try the Path Finder

Where these children come home from

Most children with a severe brain injury do not come home from intensive care. They come home from inpatient rehabilitation, often weeks or months after the injury, and in Georgia that is usually Children’s Healthcare of Atlanta. By the time discharge is being planned a family has already learned a great deal of nursing, and is usually worn out by it.

The injury may have been a fall, a car crash, a near drowning or a sports injury. A brain injury caused by lack of oxygen, which a team may call hypoxic or anoxic, has a different cause but brings many of the same daily needs.

What a nurse is actually watching for

Seizures. Seizures after a brain injury are common enough that many children go home on an antiseizure medicine. Somebody has to recognise one, time it, follow the rescue plan and write down what happened, because the neurologist’s next decision depends on that record.

Storming. Sudden episodes of racing heart, high blood pressure, fever, sweating and stiffening, which a team may call autonomic storming or paroxysmal sympathetic hyperactivity. They are frightening to watch and they respond to quiet, routine and careful medicine timing.

Swallowing. A child can aspirate silently and develop pneumonia without ever appearing to choke, so positioning, pacing and feeding method matter at every single feed.

Tone and posture. Spasticity pulls joints toward contracture. Positioning, splint schedules and range of motion are daily work, not something that happens only at a therapy appointment.

Sleep and agitation. Reversed sleep, a short fuse and agitation are part of recovery for many children. They are a stage of healing, not a behaviour problem.

What a nurse actually does in the home

Medicines on a schedule, including antiseizure medicine where the timing genuinely matters. Feeding through a G-tube or J-tube, by pump or bolus as ordered. Tracheostomy and suctioning care where a trach is still in place. A bowel and bladder programme. Skin checks and repositioning. Range of motion and splint wear between therapy visits. Seizure logs and a written record the neurologist can actually use.

And the part that appears on no care plan: being a second capable adult in the house, so a parent can sleep, take a sibling somewhere, or go back to work.

Recovery is not a straight line, and approved hours can change

Brain injury recovery comes in bursts and plateaus, and the second year often brings gains the first year did not. That is good news families sometimes dread, because as a child becomes more independent the documented need for skilled nursing can fall, and Georgia Medicaid reauthorizes hours on current need rather than on the original injury.

We are not going to pretend otherwise, and we are not going to pad a plan of care to hold on to hours. What we will do is document honestly and completely at every reauthorization, so the decision gets made on an accurate picture of your child’s actual day.

Going back to school

Traumatic brain injury is its own eligibility category under federal special education law, separate from other health impairment, so a recovering child can qualify for an IEP on the basis of the injury itself. In a classroom, fatigue, memory, attention and processing speed usually cause more trouble than anything physical.

If your child is under three, Babies Can’t Wait, Georgia’s Part C early intervention program, is the door. After three it is your local school system, and GAPP nursing continues either way.

Questions families ask

Does a brain injury qualify a child for GAPP?

It can. Georgia Medicaid looks at how much hands-on skilled care your child needs each day, not at the diagnosis on the chart, so a child on antiseizure medicine with tube feeds and significant help with transfers is assessed on that daily need. A brain injury by itself does not guarantee approval, and nobody at an agency can promise you hours.

My child was hurt in a car accident. Does the insurance or a settlement affect Medicaid?

It can affect who pays first. Medicaid is generally the payer of last resort, so auto or liability coverage is usually billed ahead of it, and Georgia Medicaid can have a claim against money recovered later. Tell your Medicaid caseworker and your attorney early, and keep them talking to each other. We cannot advise on a claim and nothing here is legal advice.

Is a brain injury from lack of oxygen cared for the same way?

At home, largely yes. A hypoxic or anoxic injury, from a near drowning or a cardiac arrest for example, has a different cause but often brings the same daily needs: seizure risk, tube feeding, tone and positioning work, and close watching. The recovery pattern can differ, so your child’s own team should set expectations.

How do we start?

Call 678-459-2590 or use the eligibility check on this site. We will tell you honestly whether your child looks like a GAPP fit, at no charge and with no obligation to choose us.

Ready when you are.

Tell us about your child and a real person will walk you through what comes next. No cost, no obligation.

Check eligibility Call 678-459-2590

Keep reading

Brain injury care by county

We staff these cases across metro Atlanta and the surrounding counties. Your county page has the local detail: which hospitals children come home from, which Babies Can’t Wait district you are in, and how we schedule around the drive.

HeartPath Home Care is an approved provider for the Georgia Pediatric Program. We are not a government agency, and this page is not medical advice. Georgia Medicaid decides who is approved, which services are authorized and how many hours. Talk to your child’s physician about your child’s care.