May 17, 2023
Last Updated on May 17, 2023
To mark Brain Injury Awareness Week, which aims to raise awareness of brain injury and give a voice to those affected, Rudi Coetzer, Clinical Director of The Disabilities Trust, shares his insights and thoughts on best practice, new research, and the optimal techniques to give people with an acquired injury the best possible outcomes.
As is common with many chronic illnesses, taking a long-term view can be an area that’s lacking in care. However, this is a particular problem for brain injury care due to the ‘hidden’ nature of the difficulties people with acquired brain injury (ABI) experience. Disabilities linked to ABI are likely to be invisible to detect, but they have a profound effect on how a person can successfully conduct day-to-day activities essential for jobs, education, and relationships.
There must be a wider recognition that brain injury is a long-term condition. Best practice is to provide lifelong access to tailored rehabilitation and support services – acute hospital input and rehabilitation is critical, but a longer-term pathway is essential to ensure all populations are receiving the ongoing care needed to avoid relapse and social isolation, such as loss of jobs and friends, and loneliness.
What’s more, care must be accessible to everyone with improved access to services for neglected populations, such as minority groups, homeless people and those with mental health issues who may slip through the net.
What the research tells us
A demoralising feeling of loneliness is an ongoing challenge for people with acquired brain injury. This can be connected with social isolation, but the two should be considered as separate things – for example a person can experience loneliness in a room full of people.
This observation was explored in a recent study published in the National Library of Medicine, where researchers provided the first large scale and comprehensive estimate of loneliness in the stroke survivor population.
The results consistently showed that human stroke survivors report higher levels of loneliness compared with healthy individuals, and this feeling could not be accounted for by demographic factors or whether or not they lived alone (social isolation). These findings demonstrate that the elevated levels of loneliness experienced by people with stroke-induced brain injury are unlikely to be adequately treated if only the quantity – and not the quality – of social experiences are considered.
Although this research is based around the subsection of people with ABI through stroke, loneliness and social isolation are common across all types of brain injury, with many individuals struggling with both of these distinct challenges over the long term.
Some studies suggest that social media could be an important tool to help combat the issues of loneliness and social isolation after brain injury, particularly for younger people and people in rural areas.
A recent article published in the International Journal of Psychology and Neuroscience proposed that social media use could offer potential benefits for people with acquired brain injury, concluding that future research is needed to further explore factors associated with social media use contributing to, or protecting against social isolation, to reduce the high levels of loneliness reported in this population.
Treatments and rehabilitation
Treatment and rehabilitation for people with acquired brain injury is continually evolving, with increasing recognition of the importance of approaches that adopt a multidisciplinary biopsychosocial perspective. This is focused on improving adjustment, social participation, and wellbeing. However, there is significant variability as to how such approaches are delivered, across the various stages of recovery, rehabilitation settings, and within different healthcare systems.
Engaging people following brain injury in meaningful activities, from a psychological perspective, provides a sense of purpose and reduces isolation and loneliness. What’s more, bringing people who can genuinely understand what it’s like to have experienced a brain injury together in a social setting can create an important sense of cohesion – a powerful mechanism for change and wellbeing.
Essentially, it’s important to acknowledge that rehabilitation is a challenging and a long process, with repetition playing a key part in the recovery process. The multidisciplinary model capitalises on that. In short, front-line staff working with people 24 hours a day, seven days a week, to reinforce learning is the best practice approach in social care for brain injury.
Looking forward
A positive future for ABI is centered around achieving outcomes where people with brain injury can return to society, with meaningful lifestyles such as returning to work, education, and families, in a way that is quick, efficient and fully supported.
Beyond that, I’d like to see continuous improvement and focus on brain injury prevention. From using technology to reduce accidents, to innovations in detection and diagnosis of brain injury inducing illnesses. More work needs to be done to ensure the more hidden populations are protected – for example, there is a direct correlation between socioeconomic status and the likelihood of a brain injury.
With a combination of ongoing research, investment in services, and broader awareness around brain injury, great steps can be taken to ensure people with ABIs receive the best care possible – and better still, injuries are prevented in the first place.