From inpatient rehabilitation into the community: experiences of adults with traumatic brain injury

Background: It is estimated that half a million people in the UK are currently living with long term disability stemming from a traumatic brain injury (TBI) (Headway,2012). From clinical experience, consulting with service users and discussion with voluntary groups, the transition from inpatient rehabilitation into their community is a time when individuals with TBI and their carers feel particularly unsupported. There appears to be a gap in the literature as to what is most beneficial to individuals during this transition (UKABIF, 2012).

This pilot project aims to explore with service users and carers their experiences of the transition from inpatient rehabilitation into their community to identify perceived gaps in services, what interventions they valued and their perceptions of how this transition could be better supported.

Method: semi-structured interviews are being carried out one month post-discharge with adults admitted to our Neurorehabilitation Unit with severe TBI. Recruitment is opportunistic and we aim to interview ten service users, and their self-selected carer, where possible. Analysis will be thematic (Braun & Clarke, 2006).

Emerging findings: participants are struggling with emotional and practical adjustment. Problems include insufficient guidance; lack of meaningful activities and subsequent boredom; a sense of isolation and fear. Continuity of care is lacking, related to poor communication and inadequate follow up.

Relevance to OT: we should have a strong role in enabling service users to participate in meaningful goal-directed activities but this does not appear to be happening.