The Psycho-Social Rehabilitation of Patients with Alcohol-Related Brain Damage in the Community†

Abstract

A community team with experience in working with younger people with cognitive impairment can provide a service for people with ARBD. Such a service is not dependent on pre-designated specialist institutions but relies on person-centred care planning, close follow-up and collaborative work with a variety of community agencies. A structured rehabilitation programme provides a framework for intervention.

Neurocognitive, psychosocial and functional status of individuals with alcohol-related brain damage (ARBD) on admission to specialist residential care

“…Nevertheless, anxiety and depression are recognised to be common comorbidities in this population (MacRae & Cox, 2003;Wilson et al, 2012). The findings from the self-report questionnaires provide evidence for relatively low levels of vigour, as well as elevated levels of confusion in individuals with ARBD.…”

Interventions for alcohol-related brain damage (ARBD): Do specific approaches restrict the evolution of comprehensive patient care?

“…Nonetheless, the findings from this review indicate that a variety of psychosocial interventions are beneficial in the rehabilitation of ARBD. It is therefore recommended that practitioners should deliver structured group and individual psychosocial interventions which focus on establishing regular daily routines, such as self-care habits, regular meal times and participation in timetabled activities, within an alcohol-free environment (Lenanne, 1986;Monteiro et al, 2011;Wilson et al, 2012). Many individuals with ARBD may be socially isolated (MacRae & Cox, 2003).…”

“…Many individuals with ARBD may be socially isolated (MacRae & Cox, 2003). Thus, it is also recommended that psychosocial interventions should focus on promoting family involvement, as well as encouraging the development of social support networks by facilitating engagement in meaningful social activities (Wilson et al, 2012). The reviewed evidence suggests that ARBD interventions should take place within supported accommodation facilities, as Blansjaar et al (1992) and Irvine and Mawhinney (2008) highlighted the potential value of specialist residential rehabilitation in enhancing social and behavioural functioning and improving physical and mental health.…”

“…A recent descriptive study by Wilson et al (2012) presented information about a phased psychosocial rehabilitation programme for individuals with ARBD living in the community, which aimed to enhance self-efficacy, independence and the development of life-skills. Particular intervention strategies included psychological therapies, social support and the implementation of structured activity schedules to establish daily routines.…”

“…However, a report by the Mental Welfare Commission for Scotland (2010) demonstrated that mainstream care homes for older people do not adequately meet the needs of people with ARBD. In particular, traditional care homes for older people may offer little opportunity for rehabilitation, which can lead to further functional losses and exacerbate co-morbid mental and physical health problems in people with ARBD (Wilson et al, 2012). Moreover, Kopelman et al (2009) argued that dementia services are not equipped to meet the needs of younger adults with ARBD.…”