At Livability, we work with people every day who have gone through the trauma of their life changing in a moment. Whether it’s expert rehabilitation at our treatment centre, or support for someone at a residential home who has undergone a stroke, we can provide them and their families with our specialist care and support.
Several of our residential homes offer specialised nursing and rehabilitation, including Livability Kenway Court and Livability Treetops. In her early twenties, Becky experienced a massive bleed on her brain, on what had been an ordinary day. Now she is being supported at Livability Treetops and gradually regaining some of her communication, movement and musical skills.
Acquired brain injury
Ahead of our forthcoming campaign to raise awareness of acquired disability, we take a closer look at acquired brain injury (ABI) and speak to Julie O’Brien, clinical lead at rehabilitation centre Livability Icanho.
Julie, who has decades of experience in rehabilitation, tells us about the journey people are on when they arrive at Icanho. Here is what she has to say:
Everyone who comes to Icanho is different and everyone’s acquired brain injury is different. Very often, people’s emotional response is “I just want to get back to normal”, meaning things like walking, dressing yourself, going to the toilet, driving and going to work. Family members describe how different their loved one is since their injury saying things like “he’s not the man I married”, because the injury has affected the way the person processes things, how they behave, their emotional responses or their personality.
Some people experience problems with speaking or understanding speech and the ability to communicate with family and friends, which has a huge impact because we’re social people and if we can’t communicate with others, it can be very difficult. People often report a sense of great loss, grieving for the skills and abilities they have lost. We all have plans, hopes for the future, and having a severe brain injury can completely disrupt that. It can be difficult to recover fully from a severe acquired brain injury; there are often some residual difficulties. So a big part of what we do is to support people to minimise the problems they have, as far as is possible, and help them to adjust to what we call a ‘new reality’ – how they want to live their lives, moving forward.
When clients first arrive, we want to build a therapeutic relationship or rapport with them fairly quickly, so they’re comfortable with the people they’re working with. We have a wide range of therapists and clinicians on our interdisciplinary team, so they may see a psychologist as well as an occupational therapist, a speech and language therapist or a physiotherapist and their family may see our social worker. People are seen as a whole here because of our interdisciplinary team, a real one stop shop, instead of going to different places for different parts of their recovery. As we do nothing but work with ABI here, we have a significant level of expertise. General therapists can be brilliant but may only see one or two people a year with ABI and we have the skills and equipment here that only a specialist service would have.
Something that’s really important is encouraging people to realise that they’re jointly responsible for their recovery. It’s learning to self-manage, rather than they come to us and we ‘do to them’. Rehabilitation is an interactive process that they need to participate in and this means we’re not fostering dependence on services, which is so important. It may mean a change in lifestyle, like giving up smoking or changing your diet. This is a fundamental part of how our team starts to work with somebody.
The bigger picture
The fact that we have a social worker who works with our families is extremely important for the families. Brain injury is like a pebble in a pond; the pebble dropped is the injury and then it ripples out to affect everyone around that individual, including work, family and friends. We can carry out joint sessions with our clients and their families for example with our social worker and psychologist working together. We can adapt our resources like this to meet individual needs, because of our interdisciplinary team, which is less likely to happen elsewhere.
We also do something called a ‘formulation’. Because we’re specialists and the people we see have complex needs, we have the ability to try to understand the complexity and how this is impacting on people’s lives. We try to understand someone’s pre-injury life, how the injury has effected them, making sense of something which might have previously been too difficult to untangle or understand.
Generally people are sad to leave Icanho because they feel they’re in a service that’s supporting them, so we have to manage discharge, and we do that from the moment they come here. It’s not a long-term service, it has an endpoint and we’re here for people to get what they can from the service. We make sure we ‘hand them on’, signposting to resources that can take them forward. People are usually very positive. Feedback is often “we don’t know what we’d have done without you”.
I think they value Icanho so much because we focus very much on what the client wants to achieve. So at our first meeting we discuss what they hope to get out of coming to us, and then those hopes are translated into therapeutic goals which are achievable and measurable. We do sometimes have to work with people on what is realistic, because ‘getting back to normal’ is not always possible following a severe brain injury. It’s helping people to find that new reality so they establish their quality of life in a different way. For many, it’s almost a sense of graduating and moving on from Icanho in their recovery.
Livability Icanho in Stowmarket, Suffolk, is a non-residential service and has an open referral system, with most clients referred by the NHS.
Visit > https://icanho.org.uk/