Burdens Imposed on the Relatives of Those With Severe Brain Damage Due to Injury
In recent years workers in several countries have established that the mental sequelae of severe brain injuries handicap the injured person far more than his or her residual physical disabilities, and that close relatives, friends, and employers find that they cause the greater disruptions of family and social life (Bond 1975, Dikman and Reitan 1977, Oddy and Humphrey 1978, Najenson et al. 1978). These observations have led to proposals that rehabilitation of severely injured individuals should include far greater attention to the problems caused by mental handicap (Bond and Brooks 1976), a point of view which receives support from the work of Najenson et al. (1978) who found that the use of family counselling, in addition to usual rehabilitation practices, significantly improved the adaptation of even the most severely disabled to his or her new social role. In order to determine the optimum time for different rehabilitative techniques it is essential to understand the process of recovery in detail (Bond and Brooks 1967), to have a conceptual model of the stages of recovery (Bond 1978), and to have acceptable methods of assessing outcome (Jennett and Bond 1975). These needs have been partly fulfilled, but greater understanding of the precise effects, at different times during recovery, of disability upon family members is required because the process of adaptation clearly involves both the patient and those caring for him. With this in mind a study of the burden imposed upon family members, and spouses in particular, was started in Glasgow in 1976.