Many of the long-term effects of brain injury are not immediately obvious to others. Action for Brain Injury (ABI) Week is an important opportunity to raise awareness and a chance to challenge assumptions, improve understanding, and highlight the support available to survivors and their families.
We see first hand the impact of isolation, be that physical or mental loneliness, that can impact our clients. The impact of every brain injury is different from the next. As lawyers who represent survivors of brain injuries, we pride ourselves in prioritising the provision of a supportive framework of treatment, rehabilitation alongside our experience of brain injury and its impact, to seek to mitigate the effects of isolation.
The effects after suffering a brain injury
For many people, the impact of a brain injury does not end when they leave hospital. It can affect memory, concentration, mood, communication, confidence, relationships, work and everyday routines. Some of these changes are visible but many are not. That can make life after brain injury particularly difficult, because the people around the survivor may not always understand what has changed or why.
Headway, the Brain Injury Association, launches their Action for Brain Injury Week campaign annually, with a focus this year on isolation after brain injury.
The charity has described isolation and loneliness as common experiences after brain injury and has gathered survey evidence from survivors, families and carers to help shape the campaign.
How people feel isolated
Brain injury, and the subsequent challenges it creates, can leave someone feeling cut off from the life they had before the injury. They may no longer be able to work in the same way, socialise as they once did, manage noise or busy environments, or take part in family life without becoming exhausted. Headway’s research has shown that more than 70% of brain injury survivors have seen a deterioration in their social life.
Some survivors feel isolated even when they are surrounded by people, because they no longer feel understood.
That sense of separation can be made worse by the hidden nature of many brain injury symptoms. A person can look physically well after sustaining brain injury but still be dealing with the enduring impact of fatigue, cognitive, executive, behavioural and emotional problems.
Fatigue
There are many reasons why a brain injury can lead to isolation. One of the most common is fatigue. This is not ordinary tiredness. Cognitive fatigue can be overwhelming and can make conversation, planning, travelling, working or attending social events extremely difficult and overwhelming. A survivor may have to cancel arrangements at short notice or avoid social contact altogether because the effort is simply too great.
Memory
Memory and concentration problems can also affect confidence. Someone who previously managed work, family responsibilities and friendships with ease may suddenly find it difficult to follow conversations, remember appointments, deal with paperwork or keep track of daily tasks. This can be embarrassing and frustrating. Over time, some people withdraw rather than risk feeling exposed and vulnerable.
Behaviour
Changes in mood, behaviour or personality can place a strain on relationships. Family members and friends may not know how to respond. Survivors may feel that others expect them to “get back to normal”, when in reality they are adjusting to a very different life. Sometimes the survivor can lack insight into how their behaviour or personality has changed.
Work
Work is another major factor. Employment often provides structure, purpose, income and social contact. Where a brain injury prevents someone returning to their previous role, or forces them to reduce hours or change career, the loss can be profound. It is not just a financial issue. It can affect identity, confidence and independence.
Support
Access to rehabilitation and support also matters. The right input from professional neurorehabilitation specialists such as occupational therapists, neuropsychologists, speech and language therapists, case managers and support workers can make an enormous difference to combat isolation. Without these kinds of support systems, survivors and families can be left trying to cope alone.
Headway’s support, be that through group sessions via their day services, or 1:1 outreach support, also offers an invaluable lifeline to many survivors and family members.
