Continuing care after brain injury
If your relative no longer requires intensive rehabilitation, but isn't able to return home, they may be assessed as requiring long-term residential care. Funding will be means-tested, so your relative may have to contribute some of the costs themselves. However, if they are entitled to nursing care then this should be funded by NHS Continuing Healthcare.
There are many residential homes which specialise in caring for people with brain injuries. These units provide long-term rehabilitation services and enable people with brain injuries to continue to maximise their potential for improvement, so it is important to access one of these units if possible. Further information on residential care units with specialist brain injury services is available from the Headway helpline, or you can search for a unit near you on the Headway approved care providers page.
All residential care services should be registered with the Care Quality Commission (CQC). You can check whether a particular unit is registered and view reports on the service by contacting the CQC.
If your relative does not require long-term care they may be provided with NHS funded Intermediate Care. This is an integrated programme of therapy and treatment, which usually lasts no more than six weeks. It can be provided in your relative's own home or in a care home and is designed to support the transition from hospital back into the home environment.
Care at home
It is important that you do not feel rushed into bringing your relative home before you are ready. Try not to feel under pressure from your relative (who may be very keen to get back to familiar surroundings), other family members, friends, or staff at the hospital, rehabilitation unit or care home. Only accept a proposed discharge date when you are certain that you and your relative have had the necessary assessments and that you have sufficient support and all necessary equipment in place at home.
If it is decided that your relative will return home, it may be a good idea to ask for a staged discharge, or 'trial run', first. This could be once or twice a week, with an overnight stay, or whatever is best for you. This will help you to find out if any adaptations will be needed for the home, such as wheelchair ramps and handrails, and will give you the opportunity to ask questions and get help while you are still in contact with the hospital or rehabilitation team.
An occupational therapist from the hospital, rehabilitation team or social services should visit the home initially to assess you and your relative's needs and any home adaptations that may be required.
Home care services
Your relative may be entitled to the following home care services:
- Help with bathing and washing
- Help with getting up and going to bed
- Help with shopping
- Help with managing finances
- Help with cleaning, cooking and tidying the house
- Adaptations to the home
- Provision of meals by home delivery or at a day centre or lunch club
- Provision of recreational, educational and occupational activities, such as lectures, games and outings
- Help with transport and costs of transport
- Respite care - this can provide you with a break from caring and may involve your relative moving into a care home for a short period or having a paid carer take over your duties for a while.
Adaptations to the home
If the local authority considers that adaptations to the home are necessary to meet your relative's needs, and that the work is reasonable and practical, then a means-tested Disabled Facilities Grant should be available to help to meet the costs. This is available in all parts of the UK except Scotland, so Scottish residents should consult their local authority for information on any grants that are available.
An occupational therapist can assess the home and recommend the adaptations that will be needed.
Adaptations that may be available include:
- Widening doors and installing ramps
- Providing or improving access to rooms and facilities - for example, by installing a stair lift or providing a downstairs bathroom
- Improving or providing a suitable heating system
- Adapting heating or lighting controls to make them easier to use
- Improving access and movement around the home.
There are also a number of organisations who supply equipment, guidance on purchasing the right supplies for your needs and grants to help with the cost.
If there has been no provision of social care you can purchase social care services, including home care, from independent providers. It is important to remember to try, wherever possible, to utilise services with some knowledge and experience of working with clients who have had a brain injury.
Contact the Headway helpline if you require support or have any questions relating to care.