The needs of people with alcohol-related brain injury (ARBI): a review of the international literature
Purpose - Alcohol-related brain injury (ARBI) is part of a group of conditions that do not fit easily into existing systems of care. People living with ARBI require flexible health and social services to ensure they receive person-centred, therapeutic care and treatment. Effective service provision promotes recovery for people who continue to experience significant levels of morbidity and mortality due to symptoms that are potentially reversible or at least amendable to appropriate care and treatment options. There exist significant gaps in the provision of this care for these vulnerable populations. Design/methodology/approach - A literature review was undertaken of various scholarly databases (e.g. CINAHL, MEDLINE and Web of Science), as well as government and non-government publications and reference materials. Publications were included for analysis if they reported participant cohorts who had a diagnosis of ARBI or were carers or service staff involved with individuals who lived with ARBI. Findings - In total, 31 publications on the needs of people living with ARBI were reviewed. Of the 67 sources identified a total of 31 were accessed and retrieved. Four main themes were identified: under-recognition and lack of a timely diagnosis, inadequate service provision and limited care pathways, stigma, and homelessness. Sources came from Australian, British, North American and Canadian literature. Research limitations/implications - Significant gaps were found in both the literature and in current clinical practices when it comes to the identification, care and treatment of people with ARBI. Globally, ARBI policy, treatments and service provision is often not available and when it does exist, it lacks consistency. Variations in models of care are significant given the fact that the predicted increase in per capita alcohol consumption will see a disproportionate increase in ARBI in future generations. This review was generated by the lack of contemporaneous evidence and may be considered a starting point for future research looking into the needs of individuals living with ARBI. Originality/value - This international literature review contributes to a broader understanding of the issues and problems faced by people with ARBI. Of the 67 resources identified through a rigorous search method only 31 were relevant to people who live with ARBI in relation to care and support services. This indicates a lack of research in this area but that which needs to be undertaken. The review also highlighted service disconnection and the need for specific, tailored treatment approaches for people with ARBI. It was also found that the identification of ARBI in clinical practice has been protracted by the lack of systemised and standardised screening tools to use in the assessment of those who display signs and symptoms of these conditions.
Brighton, R., Traynor, V., Moxham, L. & Curtis, J. (2013). The needs of people with alcohol-related brain injury (ARBI): a review of the international literature. Drugs and Alcohol Today, 13 (3), 205-214.