Encouraging family engagement in the rehabilitation process: a rehabilitation provider’s development of support strategies for family members of people with traumatic brain injury

Abstract

Purpose: After a moderate to severe traumatic brain injury, it is widely recommended that family members be actively engaged in the client’s rehabilitation journey because evidence suggests that this is associated with better outcomes. The ability of family members to fully engage in rehabilitation may be hindered by the barriers (logistical and psychological) they encounter. However, rehabilitation services can facilitate family engagement through a person-centred approach that provides support to remove barriers. Limited published guidance exists regarding practical and effective methods for delivering such support. This paper describes how one rehabilitation service has developed an eight-tiered approach. Key messages and implications: Family support is provided by explicit structuring of services to include (i) early engagement, (ii) meeting cultural needs, (iii) keeping families together, (iv) actively listening, (v) active involvement, (vi) education, (vii) skills training, and (viii) support for community re-integration. Implementation of these support strategies are individualised based on the expressed needs of each family. Families report a high level of satisfaction with the service. Conclusion: A practice-based quality improvement model identified challenges, implemented changes, and observed/evaluated the results to successfully develop a multifaceted strategy for supporting families, thereby encouraging their engagement in rehabilitation. Ongoing refinements and evaluation are planned.

Implications for Rehabilitation

• Having the support and involvement of one’s family during rehabilitation after a serious traumatic brain injury can improve one’s chances of having a good outcome.

• Rehabilitation services can and should provide families with the support needed to enable engagement in the rehabilitation process.

• This paper describes the innovations that one rehabilitation service provider has established.

Keywords::

• Acquired brain injury
• adult
• family needs
• interdisciplinary rehabilitation services
• neurorehabilitation
• program evaluation and quality improvement
• TBI

Acknowledgements

The authors wish to thank the clinical staff members of the ABI Rehabilitation interdisciplinary team, both past and present, for their work in developing these practical strategies, as well as all of the service’s clients and their families, without whom none of this would have been possible.

Declaration of Interest: Allison M. Foster, Jonathan Armstrong, Ann Buckley, Joanne Sherry, Tony Young, Soana Foliaki, and Te Miria James-Hohaia are employees of ABI Rehabilitation New Zealand, Ltd. Alice Theadom’s university position is funded by ABI Rehabilitation. Kathryn M. McPherson is on the editorial board of this journal.