Supporting with differences in brain injury

In clients living with brain injury, their presentation, behaviours and reactions can vary significantly. Here, Austin Tooze, rehabilitation assistant at BIS Services, discusses how supporting in these vastly different situations enables him to develop as a professional

I have been a rehabilitation assistant (RA) for a little over a year now, and have found that there are significant differences between clients and their injuries. Each client has a significant variety of deficits that they experience.

Needless to say, this is what makes our job as an RA different every day! Individual differences can be defined as ‘the ways in which individuals differ in their behaviour and the processes that underlie it’.

With regards to brain injury, individual differences are the biggest factor in what makes our job so difficult. It is very difficult to go to a client and implement one strategy of neuro-rehab and then go to a different client and implement the same or a very similar approach. It demonstrates that all brain injuries and all people are different, and their neuro-rehab is case specific, and it is based on what it is best and individual for the client. 

Although injuries to the brain can show some consistency, such as frontal lobe injuries decrease executive functioning and cognitive skills, clients often have different outcomes when it comes to these types of injuries. The range of these deficits will range from client to client. I have clients that have similar types of injuries but have completely different ranges of deficits that they have. One client tends to have more executive functioning deficits but less impulsivity, and vice versa for the other client.

Another key area is the range of fatique that affects nearly all my clients differently. Some of my clients can become quite physically fatigued quite quickly compared to others, and some other clients can become cognitively fatigued quicker than others. All clients possess differences, and it is important as an RA to help clients manage this despite the deficits being so vastly different between clients.

Clients often interact with the community and other environmental factors. Clients will interpret the world significantly differently to anyone else. It is likely that they will react to certain stimuli very differently to other clients, and it is not known whether clients will manage a similar situation a similar way.

From my experience, clients react to certain incidents completely differently and can be a staggering difference in the way they react. When clients are denied capacity, whether that is financial capacity or whether they can make their own decisions, they again can react completely differently to each other. One client can ruminate on why he had been denied capacity and may become upset, angry disappointed etc. Whereas another client can be understanding and cooperative.

This ultimately is what makes our jobs as an RA so exciting and fulfilling. Not always knowing how a client is going to react to something or wondering why a client is behaving in a certain way. Your knowledge of brain injury and significant and awareness of the range and scale of individual differences in brain injury is almost infinite.

In almost all cases from what I experienced, I am learning something new all the time and I know for that no matter how long I work in brain injury for, I know that the wealth of knowledge I have already accumulated will keep growing.

The biggest strength to this and dealing with clients with such staggering individual differences, both as an RA and a person, is the amount of resilience, quick thinking and intuition you must already have and develop. Not just in brain injury, but developing that resilience that you devolop by working in brain injury is transferable in everyday life.

In these blogs, I tend to talk about how much working in brain injury can benefit clients’ lives, but I believe it is important to say that these skills are not just transferrable within brain injury. They are part of developing one’s character and their career progression, and as a result people can make a positive impact in the world and have a major positive impact and awareness with people in brain injury.

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