“When you are a Bear of Very Little Brain, and you Think of Things, you find sometimes that a Thing which seemed very Thingish inside you is quite different when it gets out into the open and has other people looking at it.”
He’s very good at quotes, is Winnie the Pooh. Here are a few more “Things” that brain injured people (NOT people of Very Little Brain!) have to deal with-which may well be very different if we can get the right people to look at it.
In brain injury cases, as with all personal injury or clinical negligence cases, we do this by getting independent experts to provide reports and very often recommendations as to that person’s needs now and into the future. That way we try and ensure that the injured person has a secure future in terms of things like care and accommodation and that there can be compensation for say, lost earnings.
No-one would choose to be injured, but we don’t have that choice. As Eeyore, Winnie the Pooh’s friend tells us:
“They’re funny things, Accidents. You never have them till you’re having them.”
If you find yourself in this situation, the key is to make the litigation process work for you. You only get the one chance-use it.
If this happens, then the brain injured person will often manage less well with their cognitive communication skills. Attention and concentration will be reduced, they will be less able to think clearly and they may become irritable and agitated. Fatigue can also make other communication impairments worse, e.g. aphasia, dysarthria and dyspraxia of speech.
It is important to watch out for signs of this, along with physical fatigue, another feature of brain injury. If you are planning a day out, for instance, best have a pleasant few hours rather than being too adventurous and going for a full day’s activity. Try to end on a good note.
Slowed speed of information processing
If a brain injured person cannot say, keep up with a conversation, they may then become overwhelmed and ‘switch off’ or get frustrated and angry. It’s often due to an “overload” of information.
Try to pace conversations and activities with brain injured people to avoid this. Again, this doesn’t mean they lack intelligence-they just take longer to work through information. Don’t forget this can be frustrating for them as well.
Impaired social communication skills
Often associated with frontal lobe injury, damage in this area can mean the person does not recognise everyday social cues, both verbal and non-verbal. For example, they may not realise that someone is uncomfortable with the topic of conversation or that they are in a hurry.
They can also interrupt inappropriately, but quite often there’s a simple explanation for that-they’ll forget what they want to say otherwise!
There is a condition called “disinhibition”, where the injured person no longer recognises social “norms” and will say and do things that are socially unacceptable; possibly aggressive or sexual in nature, or using swear words a lot. This can make them difficult to place in work situations where fellow employees may take offence.
It’s important to raise the profile of brain injuries in a workplace environment, not only to keep the individual safe, but to open more opportunities for them. Many young people suffer brain injuries and they may well have a long life in front of them if their life expectancy is not reduced. The thought of 40-50 years twiddling your thumbs is not an enticing one for many people with the ability to do something useful and meaningful, but just need the support to do it.
Brain injured people can also become “fixated” on certain topics and repeat them continually, often focused on themselves. They can also do this with actions, repeating the same things over and over again. This is known as “perseveration”-sort of getting stuck on a topic or action.
When we act for brain injured clients, this has to present one of our greatest challenges in trying to help the injured person.
The injured person may have no or very limited insight into their condition, problems and capabilities. They think they are acting ‘normally’ and exactly as they would have done before. They may not believe they have any injury at all, especially if they have no visible physical injury that you can point to as evidence that they may have other “hidden” injuries as well. So they don’t realise or believe they need help and support and may be actively resistant to it.
This can be hard for those interacting with them. If the person lacks insight, it makes changing the problematic behaviours extremely difficult because it is hard for them to deal with a problem if they don’t know there is one.
Reduced reasoning and problem-solving skills
A brain injured person may have the ability to function by following patterns of behaviour, or will be fine in familiar situations, but when confronted with a problem, cannot solve it. Thus they could for instance, get on a bus to school at the same point and the same time every morning, but if they missed it, they wouldn’t understand why it was not there or what to do about it.
As a result, they may make unwise “decisions”, such as trying to walk somewhere where it’s not safe to do so. They may not think of calling home for a lift.
It can also lead to people experiencing difficulties in their conversational style. They may fail to understand the logic of someone’s point of view, and be inflexible in their own opinions, thus potentially leading to arguments and aggression.
This is one of the things that causes most worry for those involved in the care or support of brain injured people, especially if they are young. They fear they will put themselves in danger and as a result, they can tend to be “over-protective” and the brain injured person can be a bit “smothered”, all with good intentions.
When we are building claims for brain injured people, it can be hard to persuade Defendants that a person does actually need a high level of care and supervision to keep them safe.
Rehabilitation can be helpful in trying to teach skills for brain injured people to regain at least some level of independence where this is possible. We try where we can and where appropriate to get Defendants to engage with and pay for rehabilitation through the Rehabilitation Code. We often start with an “Immediate Needs Assessment” to find out what the injured person needs right now because their injuries. It helps where there is an early admission of liability from Defendants and either rehabilitation can commence, or an interim payment against final damages requested to pay for it and other needs the injured person may have.
For further information talk to Brenda Gilligan or one of the team – call 01522 561020 or email firstname.lastname@example.org