Rehabilitation

There are no happy endings to brain injury. It's lifelong, it's devastating. Sometimes we're asked to get somebody back to work after six weeks with a brain injury. That's not going to happen. It's a long-term condition. But we can improve people's outcomes, we can give them a better quality of life. The important thing is that they have expert help straight away. The brain needs that rehab as soon as it happens, and it needs to be continuous and it needs to be often and frequent. The more support the person gets, the better it's going to be. It's ideal to be given by specialists who understand brain injury, understand the behaviours, and know what sort of rehab's needed. But friends and family can help too. The more games of Scrabble we play, the more we take somebody out and about, the better it's going to be. After brain injury, someone should have counselling. Even if they can't talk, there are other ways that counselling can be achieved such as drawing or sign language.

It's important that friends and family are given counselling as well so they understand. People make a better recovery if they're given the information about the brain. We do an excellent Understanding Brain Injury course which talks about the anatomy of the brain, how it can recover itself, and what to expect. When people have that information, even if they can't retain all of it, it helps them to understand what's going on. We had one person come out of the course saying, "I'm angry. It's not my fault, it's my neurons". At least he had some understanding that he wasn't actually personally responsible for his behaviour, but he needed help to overcome that. We can do courses such as anger management courses, stress courses, managing fatigue. We have an excellent team of physiotherapists. It's important that the physiotherapist is neuro-trained and understands about the brain. The more physio we can give, the easier it's going to be for someone to walk again and regain their independence.

When talking to people, what they want after brain injury is be independent, to be in a relationship, and back to work. We always set long-term goals, but we can predict that that's what it going to be. We have to break it down into bite-sized slices in how we're going to achieve that. Occupational therapists are able to help with everyday living; maybe someone needs to re-learn how to dress themselves. And that's not physically just how to do the buttons and zips up, but what do we wear on a cold winter's day? Is it a summer dress? What order do we put it in? Do our underclothes come first, or is it the coat? Do we put our pants on top of our trousers? To those of us without brain injury, that sounds obvious, but to people with a brain injury, it's confusing. What do I wear? What order do I put it in? Cleaning my teeth. Well that's simple, is it not? No, it's not. Do I have to take the top off the toothpaste? Do I put the toothbrush under the tap? Do I turn the tap on? We have to teach people to do these simple tasks again, and that might take lots of practice, lots of patience.

It's physically doing it, maybe we have to write a flowchart on the bathroom with Post-its so people can read that and understand what they've got to do. Unfortunately, because a brain injury is unique, for each person we're going to come up with a slightly different solution. Other people ill need help to communicate. Speech and language therapists come into play there. It could be teaching somebody to physically talk again or to have the right conversation in the right place. We have a different conversation down the pub to that that we have with our wife or our partner or at work. Speech and language therapists can help us understand what conversation to have in what place and at what time. Other things such as learning to cook, learning how to behave in society. We have set rules in society which we all take for granted.

We know that when we're at the bus stop, we have to queue and we have to pay for it. Someone with a brain injury may not know that. One of the big things is that people lose their driving licences. And in order to be independent, they want to learn to drive again. But we use so many skills in driving, it's really important they don't drive until they are capable of doing that. The last thing we want is yet another brain injury. So we have to teach people all the things they need to do to drive again, and not be pushed for them to want to do it too quickly. Rehab is massive, and it's life-long, and it's different for every single person. But we do know the sooner they have it, the more they have it, and the more frequent they have rehab, the better the outcomes are going to be.