Impact on everyday life
Acquired brain injury (ABI) is a complex condition. It can affect almost any aspect of the way somebody functions. The effects of an ABI can range from small (and hard to spot) to large (and more obvious). Family life, friendships, intimate relationships, work/school, leisure pursuits and someone’s wellbeing can all be impacted by an ABI, but this is not to say somebody with an ABI will experience all of these.
Work & School
Returning to work or school post ABI may involve some adjustments to the workplace or the school day. A person’s abilities may not be the same as before or a child may not easily pick up skills they may otherwise have had. As such, adults and children may need to look at ways of adapting their prior life plan e.g., what other jobs might they excel at, what ways can they ensure their school day feels manageable and what support can they get to live their best possible lives.
Leisure Pursuits
Post ABI, it might not be possible to take part in the same leisure activities as before. A person may need to look at the ways they can adapt these activities so they work for them now, or perhaps, they will find entirely new activities they enjoy, that they previously might not have considered.
Marriage or Relationships
Many find adjusting to life post ABI can mean significant changes to relationships. Perhaps, they are adjusting to new roles and responsibilities within the family e.g., from partner, to partner/carer; from partner, to partner/partner receiving care; and from parent, to parent/carer etc.
Friendships
After an ABI, some find it more difficult to interact and engage with existing friends or make new friends. Until new avenues for friends and friendships have been explored, this may feel isolating and lonely.
Family Life
Many people with an ABI are discharged from an Acute Rehabilitation Unit to their home with their family, partner, or parent(s)/carer(s). This often produces enormous changes for the family unit and individual family members. This change can be both rewarding and stressful for all involved.
Psychological Reactions
It is both expected and understandable, that some people with ABI, may experience a range of different emotions after their injury – these are normal reactions to the unexpected life event they experienced. Reactions may include periods of depression, thoughts of life not worth living, anxiety, low self-esteem and self-harm. These feelings are a normal, natural emotional response and managing these feelings is not about taking them away. Instead, it about learning to live with and control these emotions in a helpful way, rather than letting them control you and your quality of life. It is important a person remembers that there is support available to help manage these feelings.
Common challenges and difficulties
Just as the specific effects of ABI will be unique to each individual and their injury, the challenges will also be unique.
Difficulty with concentration and keeping their attention on a task
Easily confused and overwhelmed
Problems learning new information and being able to use knowledge in new situations
Slower to process information
Difficulty keeping up with conversations, word finding difficulties and following the social rules
Producing or understanding language
Difficulty being motivated and starting activities, lack of initiative and drive, apathy
Getting or staying organised, problem solving and planning
Fixed thinking patterns
Loss of self-esteem and self-confidence, before and now comparisons, grief and loss
Changes in personality, more egocentric, outgoing/introverted
Irritability and “short fused”, increased anger, outbursts and difficulties with emotional control
Impaired social and personal coping skills, adjustment issues, low mood and anxiety
Impulsivity
Sexual disinhibition
Relationship changes
Communication Difficulties
The communication difficulty experienced will depend on the nature and extent of the ABI. If the parts of the brain responsible for speech and language are damaged it might result in some common difficulties, such as:
Common Difficulties:
Understanding what is said to you and finding the words you are looking for (dysphasia); muscle control and coordination difficulties (dysarthria and dyspraxia) and non-verbal communication difficulties.
Problems with memory, planning, processing information and organisation.
Understanding social cues, rules and conventions.
There are three principal sources if communication difficulties arising from damage to the brain:
Damage to the communication areas of the brain which may cause:
Dysphaisa: word finding, sentence construction and comprehension difficulties
Dysarthria: Muscle control difficulties
Dyspraxia: Muscle co-ordination difficulties
Non verbal communication difficulties
Damage to the cognitive areas of the brain which may cause:
Memory problems
Information processing problems
Planning problems
Inflexible though process
Initiation problems
Control problems
Damage to the frontal lobe which may cause social communication deficits. eg:
Difficulty following the social rules and conventions of communication
Physical and Sensory Difficulties
Our bodily functions are controlled by our brain. Many people can make an excellent physical recovery after ABI. This means there may only be a few, or even no, outward signs that an injury has occurred. Yet, even if not so apparent, these difficulties can have a real impact on daily life.
Common difficulties may include:
Fatigue and tiredness
Altered sensations (e.g., loss or altered vision, smell, hearing, taste and touch)
Increased pain
Problems with Coordination
Dizziness and Balance
Challenges with Swallowing and Eating
Bladder and Bowel control
Development of Epileptic seizures
Emotional and Behavioural Difficulties
Emotional changes can be a consequence of the area(s) of the brain that has been damaged, and the process of coming to terms with having an ABI and its impact.
Common difficulties may include:
Recognising, understanding and expressing emotions
Reduced motivation and increased restlessness
Increased irritability, anger or difficulties relating to others
Behaviour changes can include:
Apathy or reduces motivation
Increased irritability
Aggressive behaviour (verbal and/or physical)
Socially inappropriate behaviour
Difficulties relating to others
Restlessness/agitation
Changes in sexual functioning. Sexual functioning involves physical, emotional and social factors all of which can be affected by and ABI.
Cognitive Difficulties
These can affect the way a person thinks, learns and remembers. Depending on the area of the brain injured some common difficulties are:
Attention or concentration problems
Reduced flexibility in thinking
Black or white thinking and difficulties recognising people/objects
Memory difficulties
Difficulties learning new information
Attention and concentration problems
Poor planning and organisational skills which are also known as executive skills
Poor reasoning and judgement
Difficulties in recognising objects and people (changes in vision perception)
Lack of insight into their situation and life issues
Lack of initiative
Hidden Disability
Many problems for a person with an ABI are initially invisible. For some people, some effects might not come to the surface until later on. Problems may emerge over a period of months or years. This might be because the brain has not fully developed (this process continues up until the age of 25) or the effects might be more evident when the injured part of the brain starts to be used.
Many of these difficulties mentioned above may not exist on their own e.g:
If someone feels fatigued, this might impact on their mood or behaviour too
If someone has difficulties with memory, this might affect how they keep track of social conversations
ABI is best thought of as a set of overlapping difficulties that often have an impact on each other.
