ACQUIRED BRAIN INJURY (ABI)

Research Highlights

• Each year more than 50,000 Canadians are affected by an ABI with an estimated 16,000 in Ontario. 
• Approximately 270 new cases are reported to the Brain Injury Association of Waterloo-Wellington each year.
• The two greatest social service issues affecting individuals with an ABI in Guelph-Wellington are:
  • Social isolation due to decreased mobility and decreased sensory abilities and/or brain function.
  • Caregivers/family members need assistance in identifying, preventing and coping with the challenge of caring for someone with an ABI.

Research Profile on Health & Independent Living

What is an ABI?
An Acquired Brain Injury (ABI) is defined as damage to the brain which occurs after birth and is not the result of a congenital disorder or a degenerative disease.  ABIs cover a wide-spectrum of causes and impacts, and are the number one killer and a leading cause of disabilities in Canada[1]. ABIs are commonly broken down into two categories: trauma events, such as motor vehicle accidents, falls or sports injuries, and those caused by internal events such as an aneurysm or infections of the brain. The severity of an ABI varies substantially from very mild, such as a concussion, which can be largely recovered from, to severe, such as a deep coma and/or severe brain damage, which may require a substantial period of acute care and a lifetime of close support.
 
The Burden of ABI
The majority (greater than 80%) of ABIs result in largely recoverable injuries, those which impact mobility, sensory ability or brain function, and require short-term support. The greatest impact of ABIs come from major events, where long-term support is often necessary after a period of acute care. With the need for specialized care, recuperative therapy and substantial financial expense in many instances of severe ABIs, the impacts of ABI extends far beyond the injured individual. In cases of severe ABIs, both the injured and their immediate family will be directly and indirectly affected, often for the duration of the life of the injured individual.
 
Behavioural Affects of an ABI
Survivors of an ABI experience challenges, which affect every aspect of their lives. Some of the most long term and difficult changes to manage are the behavioural effects. Many of these behaviours do not become apparent until after the patient is discharged from rehabilitation programs. The result is a family left to deal with complex issues without the knowledge or resources to do so. Behavioural challenges include fatigue, lack of impulse control, frustration, anger, social isolation, failure to initiate, decreased social skills, disinhibition, physical or verbal outbursts, sleep disturbances, unrealistic expectations, lack of self-awareness, agitation, and repetitive behaviours.
 
Incidence
According to Statistics Canada, each year in Canada, more than 50,000 Canadians are affected by an ABI, 16,000 in Ontario, of which greater than 81% are deemed to be ‘mild’ ABIs[2].
 
Overall, young adults between 15 and 35 are at greatest risk of an ABI. And, incidence rates are twice that for males than females. In particular, males between the ages of 16-25 are over-represented in the data, largely due to motor vehicle accidents.
 
Specific to Guelph/Wellington County/Waterloo, the Brain Injury Association Waterloo Wellington reports 269 new cases of ABIs each year.

Community Supports & Services (non-medical)

The Brain Injury Association of Waterloo-Wellington (BIAWW) (part of the Ontario Brain Injury Association) is located in Kitchener. It provides social support services which include mutual support groups, education, literature, and social and recreation events for both individuals affected by ABIs and their families. The BIAWW also makes available a Brain Injury Resource Guide, which is a comprehensive list of contacts, services and resources available in Waterloo, Wellington and surrounding regions. The ‘Making Headway’ program, also offered by the BIAWW is a day program offered for individuals with a head injury as an opportunity to form friendships among peers. St. Joseph’s Health Centre provides a part-time social/recreation day program for individuals 16+ with ABI injuries.
 
Of the above mentioned services the United Way of Guelph & Wellington funds the Brain Injury Association Waterloo-Wellington and its two programs: Social Support Services and ‘Making Headway’ Day Program.


What are the Social Service Issues in Guelph and Wellington?

Social Isolation
The issues of social isolation and quality of living come into play in many ABI cases. There are limited support structures currently in existence. And due to the fact that the impacts vary substantially between different ABI injuries, finding of meaningful daily activities can be both straining and unfulfilling for both those inflicted with ABIs and their caregivers/family members.
 
Social support networks are necessary to allow ABI survivors and their families to meet peers, make friends and exchange information. Although several small networks presently exist in Guelph and Wellington County, an enhancement of support, combined with social outings and a sharing of resources will lead to a decrease in social isolation for those with ABI injuries and their families.
 
Family Support
Individuals who survive an ABI often have residual effects from their injury, including depression, cognitive deficits, and impaired social and sensory functioning, often lasting years after the injury has occurred, and sometimes lasting for life. The adaptations that an individual with an ABI must undergo, regarding their increased dependency and significant life changes can be a difficult process for the survivor and his or her family to manage.
 
The two groups of people most likely to care for an individual with an ABI are parents and spouses. Factors most associated with the level of burden experienced appear to be related to the behavioural and emotional changes in an individual, and the amount of support given to the family. Caregivers need assistance in identifying, preventing and coping with these challenges. It is also important for the caregivers to understand that the person with the brain injury cannot control these behaviours and sometimes is truly unaware of the effects they may be having on the people around them. Counselling for the family as well as the survivor is a positive way to assist in coping with these changes. A comprehensive program of therapy, training and support is necessary in order to help both the survivor and family return to a level of normalcy.

1. The Ontario Brain Injury Association (2005).  What is an Acquired Brain Injury? Retrieved May 14, 2005, from http://www.bvmschool.on.ca/courses/abi/ABI_03.htm.
2. Central West Health Planning Information Network (2005). The burden of Acquired Brain Injury.  Retrieved May 14, 2005, from http://www.cwhpin.ca/.