#COVIDCantStopRehab is the latest message from the national brain injury charity Acquired Brain Injury Ireland. With more than 300 staff nationwide, the organisation has launched new telerehabilitation services to ensure 1,200 brain injury survivors in their services continue to receive vital neuro-rehabilitative and psychological support during the pandemic.
Acquired Brain Injury Ireland currently has 16 residential rehabilitation services around Ireland that are cocooning to stop the spread of coronavirus. According to the charity, social isolation is an everyday reality for people who live with a brain injury. The latest national restrictions have been a major blow to its service users, threatening a reversal in progress for some clients. Frontline rehabilitation teams have been working around the clock to keep residential clients safe and to deliver necessary support during this crisis to those in community.
Like so many organisations, Acquired Brain Injury Ireland has turned to technology for solutions to maintain essential rehabilitation services and continue as a lifeline to hundreds of brain injury survivors and their families across the country. Their goal is clear – to keep people with brain injuries and their families safe and well, to avoid additional demands being placed on an already stretched national health service during the COVID-19 crisis.
Barbara O’Connell, Chief Executive with Acquired Brain Injury Ireland said: “Our use of telerehabilitation has been borne out of necessity during this health crisis but it is already proving its worth as an invaluable new aspect of our service delivery. Neuro-rehabilitation is not a quick fix and the process centres around making plans and setting goals with our clients along with guidance and support from a range of professionals. Using telerehabilitation has allowed our clinicians and teams to continue to deliver essential neuro-rehabilitation right into the client’s home via video call or other remote means without breaking compliance with national COVID-19 restrictions.”
Ms O’Connell added: “As an NGO, adaptability is in our DNA. We regularly flex our creative and innovative muscles in order to find solutions to enable our clients do things they have a right to do, in a world that is not set up for them. We couldn’t deliver personalised neuro-rehabilitation any other way.”
Every year in Ireland an estimated 19,000 new brain injuries are acquired from causes including stroke, road traffic accidents, brain tumours, falls and assaults. The national brain injury charity says that brain injuries can happen to anyone, at any age, at any time.
Principal Clinical Psychologist with Acquired Brain Injury Ireland Dr Brian McClean believes there is value both for the clients and the organisation, to increase the availability of telerehabilitation when the pandemic is over.
Dr McClean said: “Telerehabilitation is proving effective in delivering therapies to many clients during this time of physical distancing and it could play a role in the longer term as part of our toolkit. Talking therapies are central to psychology work and thankfully technology has improved so much that remote sessions using video call are practically seamless. Much of the work I’m doing with clients is no different if it was physically face to face. Using technology, I can still perform client assessments and deliver a range of therapies very successfully remotely, such as working with clients on memory strategies, fatigue management, helping people build structure and routine in their life.”
Under the current COVID-19 restrictions, many brain injury survivors fall into at-risk groups and have been subject to cocooning. Others are struggling with the national restrictions which have put all opportunities on hold for socialising and integrating in community activities.
One brain injury survivor with Acquired Brain Injury Ireland’s midlands service, Glenn Maher, 49, said: “It is tough not being able to get out and talk to people. I really like talking to people and it’s been hard not to see the lads.”
Thanks to Dr McClean, Glenn has been able to continue to participate in cognitive group sessions and “see the lads” via video call during the pandemic restrictions. The former truck driver from Portlaoise continued: “The first time I did a video session, it really gave me a lift. In the real world, we meet every Friday in the parish centre and it’s a highlight of my week. Thanks to telerehab, I like the fact that we’re still in touch with each other. It’s given me structure which is really important. It’s keeping me ticking over until I get out and about again.”
Thanks to telerehabilitation sessions organised by Acquired Brain Injury Ireland, Glenn can participate online in psychology therapy on a Monday, mindfulness on a Wednesday and engage in cognitive group sessions on a Friday where he can interact and enjoy peer support from other people living with a brain injury.
While the exploration into telerehab was unplanned by Acquired Brain Injury Ireland, it has shown many positive results already. The organisation’s use of online video contact has proven a good alternative to maintain many relationships with clients and continue the pursuit of vital rehabilitation goals.
Local Services Manager with Acquired Brain Injury Ireland Catherine Lacey said: “The use of telerehabilitation is based on the support needs of the individual and their ability to use technology. For those that have broadband and can use a computer, or smartphone app, it can be very effective. I can provide structured sessions of varying timespans for clients online as well as other supports like checking in to see how they’re getting on with their goals or if they are struggling to cope in the uncertain circumstances we all find ourselves in, which can pose particular difficulties for individuals with a brain injury. The relationships our rehab teams have with our clients are essential to the achievement of the rehab goals individuals are working on and rebuilding lives.”
For instance, a young brain injury survivor who is applying for a college course and has to write an essay as part of the application, has been able to avail of telerehabilitation to connect with his keyworker and receive support to help him remain focused on his application and essay.
But Ms Lacey stressed that telerehabilitation is not a like-for-like replacement for in-person community visitation to people living with a brain injury. She added: “Our biopsychosocial model of neuro-rehabilitation means that we take the whole person into account. We look at their environment where they live, their ability, support needs and we consider the life they had before their brain injury. Face to face community visits are crucial for people living by themselves so we can check that they are managing well in areas like independently running their own home, cooking meals, taking medications and so on.”
Acquired Brain Injury Ireland’s Case Manager Marian O’Neill acts a single point of contact for brain injury survivors and their families, providing support as individual’s transition from hospital to home after their injury and linking them to relevant services.
Ms O’Neill said: “Telerehabilitation has certainly had an important and positive role to play during these unprecedented times, but for a significant cohort of people with an acquired brain injury, it can’t replace real social contact. A huge part of my work is supporting people with a brain injury to integrate back into their community. Rebuilding their confidence to be able to interact socially is a major milestone for many and one which has now been paused during the pandemic. Telerehab has a role to play but only as one piece in the overall mix of neuro-rehabilitation methods that we provide.”
Benefits of Telerehab for brain injury during COVID-19:
- Continuity of rehabilitation and goals for brain injury survivors
- Maintaining keyworker/client relationships remotely
- Structured online sessions for clients with follow-up
Drawbacks of Telerehab for brain injury during COVID-19:
- Lack of broadband is a barrier for many
- Not suitable for all client abilities
- Unable to assess client environment and supports at home
Acquired Brain Injury Ireland is the nation’s leading provider of community rehabilitation for those of working age (18-65 years) living with and recovering from an acquired brain injury. To support their frontline workers delivering essential services to brain injury survivors during the pandemic, donate at abiireland.ie/aprilappeal.
