By Ipek Tugcu, a Senior Associate in the Brain Injury Team at Bolt Burdon Kemp
THE impact of Covid-19 on neurorehabilitation is likely to be catastrophic to brain injury survivors, and highlights the crucial need for support for these services.
Alarming results from a recent survey by brain injury charity Headway show that: 57% of people who were injured in the last two years have had access to neurorehabilitation stopped – and that 65% feel isolated after lockdown.
I represent adults who have suffered varying degrees of brain injury. From my experience, these findings paint a starkly accurate picture of the reality for most brain injury survivors. I fear that this period may cause lasting damage to their recovery.
Sadly, fractured personal relationships are common after a brain injury, when loved ones often feel that the person they knew before the injury is gone. Breakdowns in relationships make it difficult for survivors to maintain the same social support group they had before their injury.
I have several clients who have lived alone since their injury and are utterly isolated in their community in general. They rely on specialist charities, such as Headway, as well as community services as a means to have routine to their days, therapy and support.
For many of them, these services may be their only link to the outside world. An abrupt stop to rehabilitation has led to feelings of isolation, anxiety and depression. This can cause a relapse in recovery.
Effective rehabilitation relies on continued neuroplasticity to train the mind to establish alternative neurological responses. Depression and anxiety cause a natural disruption in neuroplasticity, which can then be further damaged by the lack of continual engagement in therapy. This means that critical time is being lost, not just in failing to provide neurorehabilitation, but also in the likely dismantling of progress made.
Several of my clients have suffered setbacks from having their rehabilitation withdrawn, but one, in particular, comes to mind. Living alone, unable to speak on the phone and without access to the internet at home – this client previously relied on a local brain injury charity to connected with others face to face and access the internet to contact me and others.
Classified as a vulnerable person, he shielded for months without any contact from anyone.
The longer isolation continued, the deeper his anxiety became about conversing with others. Even after restrictions were eased, he has struggled to reintegrate back into the community and their normal routines.
He refuses to engage with support workers from his brain injury charity, both due to his low mood and out of fear of becoming unwell.
These months have completely ruined years of stability, routine and recovery. The wider implications on society should also not be ignored: Neurorehabilitation aims to help the individual regain their independence.
Helping to reintegrate a brain injury survivor back into the community and the workforce, where possible, will alleviate huge administrative and financial pressures faced by loved ones and local authorities who often have to step up to provide assistance.
The reality is that patients may suffer a relapse, and have to rely on outside services, including the NHS, to get them back on their feet.
To avoid the unsurmountable pressure that NHS A&E and psychiatric units may face, should an influx of brain injury survivors turn to them following a deterioration in their condition or relapse in their progress, increased financial support is required for adult social care services in the community.
Within the NHS, and working in conjunction with local authorities and charities, we need an increase in the provision of alternative forms of outpatient neurorehabilitation, to save both costs and resources.
We owe it to our communities to ensure continued neurorehabilitation services, to protect both the individual and wider public from permanent socio-economic repercussions.