Gabrielle Giffords out of hospital but facing years of rehab

(CBS/AP) - She's out of the hospital, but doctors say Gabrielle Giffords faces years of rehabilitation as she recovers from the devastating gunshot wound to the head she sustained five months ago.

The Arizona congressman, who was was released on Wednesday from TIRR Memorial Hermann in Houston, struggles to speak and walk, and will need daily, intensive therapy.

Will she ever recover enough to resume her congressional duties? No one knows. But doctors, her astronaut husband, Mark Kelly, and experts who have been observing Giffords' recovery say that going home is a key milestone and could help accelerate her progress.

"Anyone who knows Gabby knows that she loves being outside," Kelly said in a statement released by the hospital. "Living and working in a rehab facility for five months straight has been especially challenging for her."

Giffords will still go to the hospital each day to participate in speech, music, physical and occupational therapy with the same team that has treated her since she arrived in Houston in late January. But she'll be living in Kelly's home in League City, a suburb near the Johnson Space Center, where she will have 24-hour help from a home-care assistant.

The 41-year-old was shot in the left side of the brain, the part that controls speech and communication, on Jan. 8 in Tucson.

Jordan Grafman, director of the Traumatic Brain Injury Research Laboratory at the Kessler Foundation Research Center in West Orange, N.J., said that being around family often motivates patients. He warned, however, that the congresswoman's recovery will be a long one.

"Often, you can do many things for yourself but not everything, that's not unusual after a severe traumatic brain injury," Grafman said, explaining why she would need help at home. "It's not unusual to be released before complete independence and you may never achieve complete independence"

Giffords' Chief of Staff Pia Carusone recently gave a clear indication of how slowly Giffords is recovering. After months of rosy reports from Giffords' doctors, Carusone said that while the congresswoman can speak, she struggles to express complex thoughts and sentences.

"Her words are back more and more now, but she's still using facial expressions as a way to express. Pointing. Gesturing," Carusone told the Arizona Republic.

"Add it all together, and she's able to express the basics of what she wants or needs," Carusone said. "But when it comes to a bigger and more complex thought that requires words, that's where she's had the trouble."

Better news came on Sunday, when the first photos of Giffords since the shooting were posted on her Facebook page. Though wearing glasses and sporting shorter, darker hair, she showed few indications of her injury.

The pictures were taken shortly after Giffords' returned from Florida in May, where she traveled to watch Kelly command the space shuttle Endeavour's last mission. After that, while Kelly was still in space, she underwent surgery to replace a piece of her skull that was removed shortly after the shooting to allow her brain to swell. Until the surgery, she wore a helmet to protect her head. 

Even with intensive rehab, victims of gunshot wounds like the one Giffords sustained often have long-term neuropsychological deficits, such as memory and cognition problems, as well as physical disabilities, according to the UCLA Health System website.

But so far things seem to be going okay for Giffords. Asked on Thursday about his wife's first night since being discharged from the hospital, Kelly told CBS New that Giffords slept great.

The National Institute of Neurological Disorders and Stroke has more on traumatic brain injury.