The rehabilitation phase of recovery is likely to overlap with the post-acute phase. Ongoing nutritional assessment will be required to ensure that any residual nutritional deficiencies are addressed.
During this phase it is important to 
establish and maintain adequate nutrition and hydration. The neurological sequelae of brain injury can potentially affect maintenance of nutrition and hydration and therefore must be addressed. For example, a person with perceptual impairments may not be able to feed themselves and will require additional help. Neurological impairments which may impact upon the person’s ability to maintain adequate nutrition and hydration include:
- Dysphagia.
- Cognitive problems (e.g. attention, memory, executive functioning).
- Communicative problems (e.g. aphasia/dysphasia).
- Behavioural difficulties (e.g. agitation, aggression).
- Changes to appetite and thirst mechanisms (e.g. not eating/drinking enough, over-eating, drinking excessively).
- Changes in taste and smell.
- Physical difficulties affecting ability to eat or drink.
- Perceptual Impairment (e.g. impaired visual/spatial perception, neglect).
Management of nutrition and hydration, alongside dietetic intervention, should include:
- Multidisciplinary approach e.g. Speech and Language Therapy assessment of dysphagia, Occupational Therapy assessment for adaptive cutlery, Physiotherapy review of seating position and/or medical management to ensure a holistic approach.
- Consideration of environmental issues affecting eating and drinking (e.g. adapted seating requirements, noisy environment affecting the person’s ability to eat because of attentional impairments).
- Consideration of the time required by the person to eat and drink. Staff may need to ensure the person gets as much time as necessary to eat and drink.
- The person may also require smaller amounts of food/fluid more frequently.
- Provision of assistance as required.
