The impact of coping, family changes and loss on adjusting to life after acquired brain injury

Acquired brain injury (ABI) can be a life-changing condition, potentially resulting in emotional, cognitive, physical, and/or behavioural changes. For families, the impact of such changes can be devastating. Current rehabilitation focuses on the person with the injury, with support for relatives often a secondary consideration. There remains a need to understand how best families can be supported to adjust to life after ABI. To investigate potential areas of importance which may aid adjustment to living with the impact of ABI, 21 individuals with ABI and 19 family members took part in semistructured interviews exploring the following research questions: a) does ABI change families and if so, do family changes impact on adjustment and does this differ for the individual with ABI and relatives?, b) what is the experience of coping with ABI like for individuals with ABI and their relatives, and does this change over time?, c) do individuals with ABI and their relatives use different coping styles for ABI related stress, and how do the effects of the ABI interact with this coping?, and d) what is the experience of loss after ABI and do these feelings relate to subsequent experiences of adjustment? Qualitative data was analysed using thematic analysis, with two exemplary dyadic case studies analysed using interpretative phenomenological analysis. Main results indicated that ABI impacts in specific ways dependent on participant type. Pre-existing coping strategies can be compromised, and new ways of overcoming challenges need to be established. Injury related loss is a multifaceted concept that can present differently for individuals with ABI opposed to relatives. Despite significant adversity, most participants were able to identify positives and felt adjusted to their situation. Further suggestions for research in this area are presented to help improve understanding of adjustment to life after ABI, and support challenges faced in the areas of coping, family change and loss.