Alcohol related brain impairment - support

Alcohol related brain impairment (ARBI) may affect the way people think and behave in everyday life. They often experience feelings of anxiety and stress, and an inability to cope.

You can help someone with ARBI with daily routines and by being there to support and guide them. The amount of support and direction they may need will depend on how severe the brain injury is and will work best if it is tailored to their specific needs and goals.

Learning to live with ARBI

An important and often difficult step for people with ARBI is developing self-awareness and insight into their condition so that they can learn to live with it.

They may need professional help with:

• accepting that they have a brain injury
• understanding how this injury affects their memory, thinking and behaviour
• setting realistic goals and making plans that take their condition into account.

Communicating effectively with ARBI

ARBI can affect communication skills and the ability to take in new information and ideas. When you are communicating with someone with ARBI, it may help if you:

• Avoid overloading them with too much information at once.
• Break down information into points or steps.
• Repeat instructions or important points.
• Use familiar language.
• Give the person plenty of time to process information or complete a task at their own pace.
• Give written information, preferably in point form, as well as discussing it.
• Restrict discussions to one topic or issue at a time.

Establishing daily routines

People with ARBI live to their best potential when their life is organised and follows a good structure. Take some time to help establish routines so that all activities follow a predictable pattern.

Aim to build routine into all aspects of their life such as:

• household chores
• personal hygiene
• shopping
• social activities
• employment
• appointments.

Minimise changes to routines or environment

To help reduce feelings of anxiety or stress in people with more severe ARBI, try to:

• Gradually introduce changes in small ways.
• Plan well ahead and allow plenty of time for discussion.
• Surround the person with familiar objects and people as much as possible.

Be available to listen and support

Other simple ways you can help someone with ARBI include:

• Listen – provide a friendly ear and let them talk about problems and frustrations.
• Guide – in stressful times or times of change, be available to help guide them through the decision-making process.
• Give feedback – be honest and helpful about what you think of their choices or decisions.
• Prompt – help them to follow routines by reminding them of activities and appointments planned for the day.

Behaviours of concern with ARBI

Some people with an ARBI may display behaviours of concern, which are behaviours that may make others uncomfortable, pose a safety risk, limit access to community facilities or cause distress to the person or others.

Behaviours of concern can be the result of medical, cognitive (thinking-related), psychological or environmental causes, or simply the frustration of coping with everyday life.

These behaviour changes can include:

• lack of motivation or initiative leading to withdrawal
• lack of concern or awareness of the impact of their behaviour on others
• impulsivity
• aggressive behaviour – verbal or physical.

If behaviours of concern persist after possible medical causes have been investigated, then it may be necessary to ask for specialist assessment and intervention.

Where to get help

• arbias – specialist services for people with acquired brain injury, including alcohol and other substance related brain impairment Tel. (03) 8388 1222
• Brain Disorders Program Victoria, Austin Health Tel. (03) 9490 7366
• Your regional Department of Health office
• Family Drug Help – for information and support for people concerned about a relative or friend using drugs Tel. 1300 660 068