Alcohol-Related Brain Injury:
Impact on Family and Society
Dr Helen McMonagle BSc. MSc. PGDip. DCounsPsych
ARBI Rehabilitation Coordinator
What is an
Alcohol-Related Brain Injury?
•Is a term used to describe the injury or damage
caused to the brain as a result of excessive alcohol
intake and related nutritional deficiencies.
•A spectrum of psycho-neurological/cognitive
Sullivan E V , and Pfefferbaum A Alcohol and Alcoholism 2009;44:155-165
Published by Oxford University Press on behalf of the Medical Council on Alcohol. All rights
Key cognitive skills affected by ARBI:
•Balance & Coordination
These can range from mild to severe.
Who’s at Risk?
• Men drinking 35 standard drinks per week or women drinking 28
standard drinks per week for 5-10 or more years.
• Admitted to acute hospital in the past year due to drinking.
• Those neglecting their nutrition.
• Those with Alcohol-Related liver damage.
• Multiple detoxifications.
• Has a close relative who has a suspected ARBI
• Oslin, D., Aktinson, R.M., Smith, D.M. and Hendrie, H. (1998) Alcohol-Related Dementia: Proposed Clinical Criteria. International Journal of Geriatric Psychiatry 13, 203-212.
Autopsy Studies: 0.4% - 2.8%
Irish Estimate: 18,320 - 128,240
Harper C, Fornes P, Duyckaerts C, Lecomte D, Hauw JJ. An international perspective on the prevalence of the Wernicke-Korsakoff syndrome. Metabolic Brain
Acute Hospitals in Ireland
• 17% of alcohol-related hospital admissions will
feature varying degrees of cognitive impairment
• 84 days= Average length of stay per person in
• 16 = Lost bed days at acute hospital per person.
Popoola A, Keating A, Cassidy E (2008); Alcohol, cognitive impairment and hard to discharge acute hospital inpatients. Ir J Med Sci 2008; 177:141–5.
21% of homeless hostel dwellers.
Gilchrist, G, and Morrishon, DS (2005) Prevalence of alcohol related brain damage among homeless hostel dwellers in Glasgow. European Journal of Public
Health, 15 (6). Pp. 587-588
15-42% of prison population
“male impairment profile more resembled that seen in alcohol
related brain injury- alcohol use was the main cause of brain
injury among prisoners, while in the general community
traumatic head injury is the most common cause”
Arbias: Acquired Brain Injury in the Victorian Prison System & Famularo-Doyle, Jo. "Homelessness, Acquired Brain Injury and Corrections
Victoria." Parity 23.1 (2010): 18.
10% of Dementia population = 4170 of Irish
12.5% of dementias in under 65's
MacRae, Rhoda, and Sylvia Cox. Meeting the needs of people with alcohol related brain damage: a literature review on the existing and
recommended service provision and models of care. Dementia Services Development Centre, 2003.
• Matthew – Aged 48
• Longstanding Alcohol-
• Observations of
abilities over 3 years.
• Admitted to LGH
• Structured routine of
placement in community
gardening project – 4 days
• Introduction of P.A
• Graduated discharge.
• Living successfully in the
Impact on Family
• The hidden patient of ARBI
• Caregiver ambivalence
• Ambiguous loss
• Repeated difficulties accessing services
Impact on Family
• Caring for someone with ARBI is a hugely
• But, if well supported can be mutually beneficial.
• Families need attention, education, guidance and
support if they are to survive, regroup and rebuild
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