Young adults with acquired brain injury in nursing homes in Glasgow

Abstract

Objective:Tosurvey the characteristics, level of disability and services received by young adults with acquired brain injury(ABI)resident in nursing home sin Greater Glasgow. Design:Telephone survey of 75nursinghomesfollowedby a questionnaire survey and review of medication cardexes. Included were all peopleunder65 years with ABI resident in nursing home sin Greater Glasgow between 1February2000and31January 2001. Setting: Twenty-eight nursing home sin Greater Glasgow, Scotland(population 0.9million). Subjects: Young adults (16–64)withABI. Main out come measures: Structured questionnaire, Barthel Index, Office of Population Census Survey (OPCS)Disability Form, review of medication cardexe. Results: Information was obtainedon all cases identified in 75 nursing homes. There were92peoplewith ABIin 28nursinghomes;43/92werein threehomes. Only 42 had inpatient rehabilitation preadmission. Severe disability (OPCS categories 7–10)was foundin54cases andminimal/minor disability (OPCS categories 1–2)in 18.Thirty-two exhibited challenging behaviour, nine of these were physically violent. Homes were staffed by unqualifiedassistants, supervised by nurses. No home itself offered rehabilitation, but some had accessed an NHS physical disability community team (28/92cases) orothercommunityteams (5/92). Proactive medical review was uncommon. Medication had been reviewed since admission in a minority (21/92). Most had regular visits from relatives. Conclusions: There is awide range of disability in nursing home residents in Greater Glasgow. Proactive, routine review of medical, rehabilitation and medication needs is rare, as is rehabilitation preand post discharge. This is serious given the likely hood of reduced intellectual and/or physical capacity in