Brain injury rehabilitation could help minimise the long-term impact of brain injury by teaching the brain to work in alternative ways. Simon Pimlott, brain injury lawyer, speaks to Andrew Pemberton, MD of Cardinal Managment.
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Transcript of the discussion
Simon: Hello, I'm Simon Pimlott, I'm a Senior Solicitor at IBB Law. I'm speaking today with Andrew Pemberton, he is the Managing Director of Cardinal Management, and he's also a board member of the UK Council For Rehabilitation. Andrew, someone who suffered a serious brain injury following an accident, what are the immediate challenges they face?
Andrew: Ironically, the patient may not face many challenges at all apart from their own health, but often they're unaware of those challenges; the biggest and the most impact is actually on their friends and family and relatives, it's them that are actually suffering the uncertainty and the trauma and the anxiety and the distress; so the challenges that face them are numerous, but the patient themselves often is unaware of those.
Simon: What can rehabilitation do to meet those challenges?
Andrew: Well, the challenges change over time. Immediately, in the first instance, it's obviously life-threatening and rehabilitation doesn't have much part in the very acute stage, once people leave the neurosurgical environment to move out to the high dependency unit or into a hospital, a more traditional hospital environment, the challenges then become everything from physical therapy, getting people moving, stopping them from getting bed sores, getting them breathing and eating again independently; and these are speech and language therapists, occupational therapists; these are the kind of people that would be involved quite intensively at that early stage. And the challenges that face the patient are hugely different, depending on the intensity or the severity of their brain injury.
Simon: What would be a typical path for someone with a brain injury as they go through the Health Service?
Andrew: The level of support will vary, depending on from the phase of the injury; so from the outset, the level support is hugely intensive, it is a life-threatening condition. Once we've got over that and we go through the neurosurgical procedures to reduce the swelling and the hematoma, we then might move into a high dependency unit where things like pegs are fitted to enable people to breathe and eat and consume calories; we then will move into maybe a local hospital which might be nearer the home of the patient, which gets a bit easier for the family to access their loved one. Then we would start to consider community care and support services nearer where they're going to live and ultimately, possibly a transitional rehabilitation unit, which might be a stepping stone to returning home for some people. When people return home, a whole new set of challenges will face them.
Simon: And serious brain injuries can often have long-lasting effects. What can a sufferer expect in the long term once they've been discharged?
Andrew: It's very difficult to paint a consistent picture, everybody's injury is different and everybody's outcomes, long-term, are very different. There are people with similar kinds of diagnosis who go on to achieve very different levels of Independence and lifestyles moving into the future. But in terms of what they can expect to be provided to them from the state for example; unfortunately once you leave hospital and you are back at home, the level of support can vary dramatically, but it varies from not a lot to just a little bit of support. And families are often left very isolated and they become very reliant on charities; there are people like Headway, Child Brain Injury Trust for example, who can, and do provide an awful lot of support for patients and their families. But your provision from the state, I'm afraid to say, it’s patchy at best.
Simon: And why do you consider it so vital that a sufferer gets rehabilitation at such an early stage?
Andrew: I think the brain injury- we are still at a stage where we just cannot predict what some of those long-term outcomes is going to be. So if we have any chance of achieving that goal, they have to have an intensive kind of support and rehabilitation. It takes time, and patience, and money, but without that you'll never know what you're capable of.
Simon: Thank you Andrew, that's really interesting.
Andrew: Thank you.
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