Thursday 21 November 2019

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

WARNING: Donnchadh Whelan
WARNING: Donnchadh Whelan

Alan O'Keeffe

Many young brain-injured 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.

Sunday Independent

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