k) Impacts on life

The common effects of ABI described in the previous section impact on peoples lives and relationships.
For people with moderate or severe acquired brain injury the impacts on life and relationships can be extensive.

Work

Many people are unable to return to the work they had previously done.
For people with TBI with severe injuries, a Melbourne study found that only 40% of people were employed at five years post-injury.

Leisure pursuits

Many people either lose all their leisure activities or have to change activities.
The Melbourne study found that at five years post-injury, 63% of people with TBI had had to make changes to the sort of leisure activities that they had enjoyed prior to their injuries.

Marriage or relationship

Marriage or relationship breakdown are common.
A Sydney study found that at six years post-injury, 55% of marriages had broken down. For marriages that do stay together, there can still be a number of changes, for example, the loss of the sexual component of the relationship.

Friendships

Loss of friendships is common.

The Melbourne study found that at five years post-injury, 50% of people with TBI reported that they had lost friends and become more socially isolated since the injury.

Impact on family

The majority of people with a brain injury are discharged from an acute rehabilitation unit to return to their parents or partners. This often produces enormous changes and stress for the family unit as well as for individual family members.

Many families find it a rewarding experience to provide support for a family member with ABI. However, in other cases, it can be extremely stressful.

Sources of stress can relate to:

• Family members having to give up work, and being financially worse off
• Increased level of conflict due to temper control problems
• Family members (especially partners) having to take on new roles if partner with TBI no longer able to play these roles (e.g. financial manager, home maintenance, disciplinarian with children, etc.)
• Family members who play a caring or support role losing touch with their own social networks, becoming more socially isolated
• Family members experiencing grief or depression mourning for the person "they knew before" the ABI
• Family members experiencing post traumatic stress if they witnessed or were involved in the accident that caused the injury.
• Changed relationships with siblings taking on greater responsibilities and needing to be more grown up.

Psychological reactions

People with ABI can experience a range of differing psychological reactions. This can include depression, anxiety, low self-esteem and thinking about suicide. Between 30–40% of people can experience periods of depression.
Almost 1 in 5 people will attempt suicide after a TBI.

(c) Copyright - See: Module 1: An Introduction to Traumatic Brain Injury www.TBIStaffTraining.info for full references.