...You've seen one person with brain injury
By Dr Keith Jenkins, Neuropsychiatry Lead Psychologist
From out of nowhere, a trauma to the head can cause devastating and irreversible injury to the brain. Doctors - as well as the victim, their family and friends – may not know the full extent of the damage for some time, if ever. In the most severe and complex cases, the resulting symptoms and effects may be too unpredictable or unsafe for the individual to be treated in the community. As one of the UK’s first specialist brain injury rehabilitation centres, we now provide rehabilitative care to more than 100 patients with the most complex and life-changing forms of this injury.
There is little that can be generalised from an individual with an acquired brain injury (ABI). It’s often said ‘once you have seen one person with brain injury, you have seen one person with brain injury’. Violent head trauma, substance abuse, and medical issues are all common causes of ABI but they elicit wildly different symptoms. Some patients who come here are full of hope, having been encouraged to engage in more comprehensive therapy. Others, after time, may struggle with maintaining their motivation, whilst some just want to be left alone and don’t want to come here, let alone stay.
While the needs of every patient are unique, we have a shared goal for them – that they regain a sense of control over their lives, that their behaviour improves and stabilises, and that they are able to live their life as independently as possible. Often, being surrounded by peers and feeling understood by specialist staff can make a big difference to the way patients feel about their problems. One of the ways we help facilitate this is through our social club partnership - which brings together ABI patients from across the county for a range of events such as quiz nights, discos, bake offs and animal demonstrations.
Symptoms of a brain injury present many difficult challenges for those affected, yet friends and family may also be left wanting for answers. The brain is so complex and unique that no specialist can conclusively predict the full extent of the damage, nor how much function can be regained through rehabilitation. This means that what we can do for relatives – provide emotional support, encourage information sharing and facilitate healthy relationships - becomes even more critical. At St Andrew’s this includes the Relatives Support Group, run for families and carers each month.
As well creating an opportunity for open support and discussions to occur, it also provides opportunities for expert advice about things they have never had to deal with before – whether it’s navigating the legal system, hearing from therapists, learning about medications or applying for financial assistance. Most importantly, it creates a context in which supportive relationships from others ‘who have been there’ can be nurtured.
As brain trauma treatment awaits medical and therapeutic advances, perhaps our biggest hope continues to lie in its prevention. Nothing can 'fix' the damage caused by primary injury but we are getting better at reducing the more serious consequences of secondary injury such as swelling and neurotransmitter-based damage. Speed is of the essence when it comes to minimising the secondary damage which typically occurs in the first few critical hours.
That's not to say that rehabilitation cannot make a remarkable difference to a person’s recovery much later. Through a wide range of therapies and interventions, we can help individuals to learn to manage their behaviour, their bodies, and to ultimately regain a sense of independence and a life worth living.