Young peo­ple with brain in­juries ‘face a life­time in care homes’

More than 13,000 suf­fer brain in­jury each year but don’t get the re­ha­bil­i­ta­tion they need, writes Alan O’Ke­effe

Sunday Independent (Ireland) - - News -

MANY young brain­in­jured peo­ple have been sen­tenced to a life­time in nurs­ing homes for the el­derly, ac­cord­ing to an ex­pert who has crit­i­cised the grave lack of re­ha­bil­i­ta­tion ser­vices in Ire­land.

Thou­sands of Ir­ish peo­ple with brain in­juries are not get­ting suf­fi­cient neuro-re­ha­bil­i­ta­tion that could help them live more nor­mal lives, warned Don­n­chadh Whe­lan, na­tional ser­vices man­ager of Ac­quired Brain In­jury Ire­land.

Some vic­tims, in­clud­ing many young peo­ple, find them­selves in nurs­ing homes de­signed for the el­derly.

“Most nurs­ing homes are not suit­able for these peo­ple as they lack suf­fi­cient re­ha­bil­i­ta­tion ser­vices that could help re­store them to their own homes,” he said.

“It is time to stop us­ing the Fair Deal scheme as a mech­a­nism for putting peo­ple with brain dam­age into nurs­ing homes. They don’t get the re­ha­bil­i­ta­tion they need in most nurs­ing homes.”

Some 13,000 peo­ple suf­fer some form of brain in­jury ev­ery year in Ire­land. “It’s a silent epi­demic,” said Mr Whe­lan. That does not in­clude the 7,000 peo­ple who suf­fer strokes.

“Far more ef­fec­tive sup­ports are needed by in­di­vid­u­als and their fam­i­lies. Re­ha­bil­i­ta­tion would be far more ef­fec­tive in help­ing them,” he added.

“Re­ha­bil­i­ta­tion would also be cost-ef­fec­tive. Nurs­ing home care is in­ef­fec­tive and costs up to €1,700 to €2,000 per week in Dublin.

“If Fair Deal fund­ing could be changed to to­tal care, so that the scheme would in­clude re­ha­bil­i­ta­tion that could be done in the com­mu­nity, it would make a big dif­fer­ence.”

When peo­ple fin­ish their stan­dard three-month stay at the Na­tional Re­ha­bil­i­ta­tion Hospi­tal, they of­ten suf­fer from a grave lack of ef­fec­tive, on­go­ing re­ha­bil­i­ta­tion that would be es­sen­tial for them if they are to have some chance of re-learn­ing how to use their bod­ies to do or­di­nary things once more.

Some peo­ple are trans­ferred back to hos­pi­tals with no re­ha­bil­i­ta­tion ser­vices. Many peo­ple are just placed straight into nurs­ing homes, he said.

A long-run­ning cam­paign by Ac­quired Brain In­jury Ire­land has the poignant slo­gan ‘Don’t save me, then leave me’.

“The sit­u­a­tion is that all the re­sources are go­ing into acute care and peo­ple that would have died are now liv­ing,” said Mr Whe­lan. “But then the mes­sage to the sur­vivors seems to be: ‘Well, that’s tough that you man­aged to live, be­cause we are not pro­vid­ing you or your fam­i­lies with the sup­ports you need.’ Morally, that’s just ter­ri­ble.”

He added that, ex­clud­ing strokes, the ma­jor causes of brain in­juries are road ac­ci­dents, falls and as­saults. Car­diac ar­rests, drug over­doses, failed sui­cides, do­mes­tic vi­o­lence and brain tu­mours were some of the other causes.

“As­saults are a grow­ing cause of brain in­juries. I don’t know de­tails of what hap­pened to Sean Cox when he was at­tacked. Sean was very un­lucky. We come across peo­ple who were the sub­jects of as­saults all the time, out­side night­clubs, af­ter sport­ing events, all that sort of thing. It’s be­come very com­mon, un­for­tu­nately,” Mr Whe­lan said.

The fam­i­lies of peo­ple who are brain-dam­aged can suf­fer a great deal from the lack of re­ha­bil­i­ta­tion and treat­ment that is needed af­ter the acute stage.

Vic­tims can some­times suf­fer per­son­al­ity changes and be­come deeply frus­trated, de­pressed or an­gry. They can lose their abil­ity to fil­ter their emo­tions and be­come un­able to con­trol ag­gres­sion or other be­hav­iour.

Spouses some­times re­port that they feel they lost the per­son they mar­ried, and mar­riages can break down, said Mr Whe­lan.

Fam­i­lies des­per­ately need sup­port ser­vices in the com­mu­nity but such ser­vices are al­most com­pletely lack­ing in many parts of Ire­land, he said.

The char­ity has 14 res­i­den­tial cen­tres in Ire­land and only one tran­si­tional liv­ing unit for peo­ple mak­ing the move from hospi­tal to the com­mu­nity.

There needs to be far more cen­tres and fa­cil­i­ties around Ire­land and far more re­ha­bil­i­ta­tion as­sis­tants who can work with peo­ple and their fam­i­lies in their own homes, he said.

Last week’s Bud­get was a dis­ap­point­ment to the char­ity — there was no men­tion in the Dail of fund­ing for the im­ple­men­ta­tion of the Na­tional Neuro-Re­ha­bil­i­ta­tion Strat­egy.

If the ap­pro­pri­ate ser­vices in the com­mu­nity were put in place, the dis­charge of pa­tients from hos­pi­tals would not be de­layed and un­nec­es­sary hospi­tal ad­mis­sions would be re­duced, Mr Whe­lan said.

The char­ity stated an in­vest­ment of €47m is needed in com­mu­nity-based ser­vices to en­sure fair treat­ment for peo­ple in all re­gions of the coun­try.

This in­vest­ment would cover com­mu­nity-based clin­i­cal teams in each HSE area com­pris­ing psy­chol­ogy, so­cial work, oc­cu­pa­tional ther­apy, phys­io­ther­apy, speech and lan­guage ther­apy, and di­eti­cians, com­mu­nity re­ha­bil­i­ta­tion teams in each area, and a roll-out of tran­si­tional liv­ing units.

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