It is good news to hear that the Formula 1 racing driver,Michael Schumacher has emerged from his coma, although understandably his family and medical team are remaining silent on the extent of his recovery to date. He is out of the critical phase and the fact he has survived is down to advances in medical science. More people are surviving devastating brain injuries as a result of the quick reactions of the emergency response team and the neurosurgical teams working with the injured in the acute stages post-accident. A neurosurgeon’s philosophy is to save immediate life and to stem the flow of further secondary damage arising from the brain injury. This is increasingly successful, although sadly not for all.
But what about the longer term? Neurosurgeons are predominantly concerned with life-saving and minimising the severity of brain damage. Once a patient has been stabilised and they are considered to have come through the critical life-saving phase, they will move into the rehabilitation phase of their recovery.
This should be seen as important as the acute life-saving phase, but all too often it is not, as financial resources within the NHS are limited and often cannot be utilised to provide the type of support brain injured people and their families require in the long term. Financial resource is key and those with the financial backing will have the best rehabilitation provision and longer term support package available, but what of those people who sustain a brain injury and do not have the funds available to them to push for the best?
Unfortunately, lack of resources is such in the NHS that comprehensive rehabilitation is limited. Only too often, brain injured people are discharged from hospital into the community with little or no follow up provision. Those with devastating brain injuries leaving them with significant physical disabilities will be catered for, but what of the ‘walking wounded’? Those patients with brain injury who, on the surface, appear to have made a good recovery?
To a lay person this may seem fine. However a brain injury can have a devastating effect on a person’s ability to lead a normal life. This not only impacts the injured person but also their family. All too often family members will say that the brain injured person is ‘not the person they were’. It is hard to understand just what the impact of a brain injury can be without seeing that first hand. Many brain injured people suffer with personality changes and have difficulties with concentration and memory. A previously laid back person can become short tempered and irritable, without any rationality. The pre accident person is lost and all too often someone with brain injury struggles on a day to day basis to care for themselves.
In larger society this can go unnoticed, leading to a huge deterioration in quality of life and much too often, people leading solitary lives. Many may say that the critical fact is that a person’s life has been saved. Many also see a brain injury as enduring. The brain cannot repair like a broken leg for example and so the person just has to adapt.
However, it is understood that the brain can to a certain level, repair and adapt for up to two years following an injury and with the right rehabilitation and support, an individual’s quality of life, whilst not necessarily being as they were before the accident, can be so much better than if they are left to struggle in the community without support. The intention with rehabilitation is not to create a dependency situation, but to guide and rehabilitate the patient towards a goal of independence (whether complete or partial), with the right support in place where needed. Perversely therefore, someone who has been injured as a result of another’s negligence can find themselves with a better outcome than those who are left with no avenue of financial recompense. Compensation claims play a vital role in improving the quality of life of a brain injured person. An early financial interim payment as the claim progresses should be sought, enabling an appropriate rehabilitation regime for the patient to be set up. It is evident that the earlier the right rehabilitation and support is offered, the better the long term outcome for a patient. There is no doubt, in my many years’ experience of working with brain injured clients that setting up the right rehabilitation programme at an early stage is just as important to the patient as the ultimate compensation payment.