By Dan Mushens
Based on my experiences of supporting people with alcohol related brain damage (ARBD) for four years, by the time someone is diagnosed with the condition, it is fair to assume that the preceding years will have featured certain characteristics.
Chaos, broken relationships, self-neglect, memory deterioration, isolation, loss of employment and financial hardship are just a few obstacles which may need addressing on the road to recovery. Here are ten effective interventions to help offer that support.
- Assistive technology: Technology is constantly advancing and products that aim to help people with dementia related conditions are widely available. I actively encourage people to purchase the digital dementia clock, which not only displays the time, but the day, date, month and year as well. More expensive models can be programmed with audio and video alarms to remind people to take their medication.
- Council tax exemption: Local authorities offer discounts and exemptions to various groups of people, including those diagnosed by a health professional as having a severe mental impairment. ARBD comes under this umbrella term and full exemption can be awarded to those in receipt of qualifying benefits if they live alone. A 25% discount is applied to those living in a house with others.
- Concessionary bus pass: For those aged over 60 or with a disability such as ARBD, concessionary bus passes or discounted travel can be a useful intervention to help people attend appointments or to explore their local or wider communities. With ARBD sufferers often experiencing reduced mobility and lack of finances, a bus pass can be a crucial asset. For people in receipt of certain benefits, a companion such as a carer or family member may also be able to travel with them for free.
- Work history: Although someone’s current situation may be hampered by relapse, chaos, crisis, ill health, unemployment or financial hardship, life probably wasn’t always like that. Charitable agencies can offer benevolent funding based on someone’s former employment history in any given sector. For example, GroceryAid can assist people who worked in the food and drink industry, and Hospitality Action can offer support to people with a history of working in the hospitality sector. A good starting point is to visit Turn2Us. Over recent years, I’ve been able to support people to acquire one-off financial grants, fridge freezers, tables and chairs, ovens and memory aids via a relatively straightforward application process.
- Memory aids: Promoting the use of memory aids such as whiteboards, diaries, calendars, post-it notes and photographs may seem simplistic, but they often prove effective and help to prompt and remind people of appointments to keep and tasks to complete.
- Recovery story: Decades of alcohol abuse invariably leads to memory deficits and periods that have been forgotten. Helping someone to talk over their life not only helps with engagement and rapport building, it’s intrinsically person-centred as it allows them to describe their life journey in their own words. An understanding of their chronology can often be worked out by using old photographs, payslips and bank statements as well as accessing medical records to pinpoint someone’s location in years gone by. The end result is a written recovery story which can be used to give to new people that they subsequently meet to prevent any future repetition.
- Family involvement: Relationships can often be strained when someone experiences alcohol dependency, with family members having often been exposed to the crisis and chaos of years earlier. Where there is a family member still involved then – with the agreement of the person diagnosed – it’s always good to try to form a relationship and to keep them involved in the support and care planning process. This can often be initiated by providing them with literature about ARBD such as general factsheets as well as the ARBD guide for families produced by the Alcohol Forum.
- Peer support: Although not suited to everyone, peer support is widely recognised as an effective way to change behaviour patterns leading to sustained recovery. Informing people of meetings, recovery cafes or community rehabilitation services may be an appropriate option to explore. Penumbra encourages applications from people with lived experiences for peer worker or peer volunteer roles.
- Effective communication: Several agencies and services may have input into a person’s care and support, such as social work, addiction services, welfare rights, psychiatry, housing support, domiciliary and mental health charities. I try to make myself known to all involved and may present a communication book for the person diagnosed with ARBD. This allows anyone with input to contribute and detail the nature of their visits, which can prevent duplication of work tasks or reduce the chance of things being missed. Ensuring all appropriate people are invited to the review process also helps to build solid multi-agency working.
- Identifying routine and structure: When people relapse and return to alcohol use, a common explanation is said to be boredom. Supporting someone to meaningfully occupy their time is therefore of paramount importance. Building on someone’s already identified skills and interests may be a good starting point with activities such as arts and crafts, walking groups and music classes. Compiling a weekly planner which details a breakdown of what a person needs to do each day can not only act as a memory prompt, but also indicate times or days where extra support or activities may be needed.