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Alcohol-related brain injury: Impact on family and society


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Dr Helen McMonagle BSc. MSc. PGDip. DCounsPsych
ARBI Rehabilitation Coordinator

Published in: Healthcare, Health & Medicine
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Alcohol-related brain injury: Impact on family and society

  1. 1. Alcohol-Related Brain Injury: Impact on Family and Society Dr Helen McMonagle BSc. MSc. PGDip. DCounsPsych ARBI Rehabilitation Coordinator
  2. 2. 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 conditions.
  3. 3. Structural Changes 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 reserved
  4. 4. Functional Changes Key cognitive skills affected by ARBI: •Memory •Executive functions •Balance & Coordination These can range from mild to severe.
  5. 5. 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.
  6. 6. National Prevalence 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 Disease 1995;10:17–24.
  7. 7. 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 acute hospitals. • 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.
  8. 8. Homelessness Population 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
  9. 9. Prison Population 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. 10. Dementia Population 10% of Dementia population = 4170 of Irish Dementia Population 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.
  11. 11. Key Challenges
  12. 12. Two Tier Service Response
  13. 13. Case Study • Matthew – Aged 48 • Longstanding Alcohol- Dependence • Observations of deterioration in cognitive/functional abilities over 3 years. • Admitted to LGH • Structured routine of activities including placement in community gardening project – 4 days per week • Introduction of P.A • Graduated discharge. • Living successfully in the community. Remains abstinent
  14. 14. Impact on Family • The hidden patient of ARBI • Caregiver ambivalence • Ambiguous loss • Repeated difficulties accessing services
  15. 15. Impact on Family • Caring for someone with ARBI is a hugely challenging process. • But, if well supported can be mutually beneficial. • Families need attention, education, guidance and support if they are to survive, regroup and rebuild their lives.
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