Presented at the recent Brain Injury Forum, hosted by the Mercy Foundation and the Haymarket Foundation.

1. Brain Injury Association NSW
(BIA NSW)
Presentation
Rachel Merton – CEO
Bev Taylor – Training and
Development Manager
ABI and Homelessness
April 2013

2. Outline
 BIA NSW
 What is Acquired Brain Injury (ABI)
 A few statistics
 Living life after an ABI
 How can BIA NSW assist you?
 Questions

3. Who is BIA NSW?
The Brain Injury Association of NSW (BIA NSW)
 the peak body in NSW for people affected by
acquired brain injury (ABI)
 advocacy and support
 information and resources

4. What do we do?
 Support for people with an ABI, their families and
carers:
 Information and referral service (1800 number)
 Individual advocacy service
 Brokerage packages
 CarerLink mentoring program
 Systemic advocacy
 Representation to government and policy makers
 Submissions
 Media advocacy

5. What do we do?
 Building knowledge and networks
 Training (general and tailored)
 Facilitating networks – interagency and partnerships
 Raising awareness of ABI:
 Speakers Bureau: supporting people with ABI to share
their story – for education and awareness-raising
 Using the media
 Newsletters, fact-sheets, presentations

6. What do we do?
We shine the spotlight on ABI to
make visible the invisible disability!

7.  BIA NSW
 What is Acquired Brain Injury (ABI)
 A few statistics
 Living life after an ABI
 How can BIA NSW assist you?
 Discussion

8. Definition of ABI
 An injury to the brain after birth.
 The effects may be either temporary or
permanent.
 May cause partial or total disability.
 ABI can happen to anybody at any time

9. Types of Acquired Brain Injury
 Traumatic Brain Injury (TBI)
 Non-traumatic Brain Injury

10. What is TBI?
 TBI (Traumatic Brain Injury) is one type of ABI
 TBI is caused by violent physical force to the head (eg:
MVA’s, assaults, falls, sporting accidents or
acceleration forces alone (eg: MVA)
 TBI may cause the brain to bleed, tear, be
penetrated, stretched, bruised or become swollen
 TBI can result in complete recovery, permanent
disability or death

11. How does ABI happen?
Acquired
Brain
Injury
Trauma
Brain
Tumour
Toxins
Hypoxia
Degen.
Diseases
Infection
Stroke
MVA
Falls
Assaults
Sport
Pedestrians
Growths
(malignant
& benign)
Surgery to
remove
Alcohol
Drugs
Chemicals
Medication
Petrol
Heart Attack
Drowning
Suffocation
Suicide
Childbirth
Medical
Ischaemic
blocked-artery
Haemorrhagic
(bleed in the
brain)
Dementia
Alzheimer’s
Parkinson’s
Encephalitis
Meningitis
Dental abscess
Cold sores
/herpes

12.  BIA NSW
 What is Acquired Brain Injury (ABI)
 A few statistics
 Living life after an ABI
 How can BIA NSW assist you?
 Discussion/brainstorm

13.  BIA NSW
 What is Acquired Brain Injury (ABI)
 A few statistics
 Living life after an ABI
 How can BIA NSW assist you?
 Discussion/brainstorm

14. Prevalence:
How many people have an ABI?
 1 in 45 Australians (432,700 people) have ABI with
activity limitations or participation restrictions due to
disability.
 Almost three-quarters of these people are under 65 years
 About 20,000 are under 15 years
 Now: there are more survivors from MVAs – many are
living with severe injuries and limited access to support
Source: ABS Survey of Disability, Ageing and Carers 2003

15. Incidence:
No. of TBIs per year
Source: AIHW 2007 Bulletin 55
21,800 hospital stays
69% males
Peaks: Males 15-24 years (MVAs, sport accidents); Both sexes: >75 years (falls)
Hospitalisations for TBI, Australia, 2004-05

16. Disadvantaged Communities
Rates of ABI are higher in socially disadvantaged populations:
 ATSI:
– prevalence estimates are three times that of non-ATSI
communities,
– One study found head injury due to assault among ATSI
communities was 21 times higher than for non-ATSI
Australians (854/100,000 cf 40.7/100,000 for the non-ATSI
population)
 People in the criminal justice system
– Higher prevalence and incidence than general population
– Estimated 60% of prisoners have ABI with one study
showing up to 80%
Sources: Jamieson et al, 2008; Schofield et al, 2006; Brain Injury Australia (July 2011) Out of
sight, out of mind: People with an acquired brain injury and the criminal justice system

17. Involvement with police
People with an ABI have:
 a higher number of contacts with police than people without
an ABI
 a higher proportion of convictions for minor offences than
offenders without an ABI (Dowse et al). 40% of convictions in
Dowse’s cohort were for ‘theft and related offences’ or ‘road
traffic and motor vehicle regulatory offences’. A further 12%
were for public order offences.
Sources:
Dowse L et al (April 2011) People with mental health disorders and cognitive disabilities in the
criminal justice system: Impact of acquired brain injury (a study of 604 people within the CJS
identified as having an ABI)
Brain Injury Australia (July 2011) Out of sight, out of mind: People with an acquired brain injury and
the criminal justice system

18.  BIA NSW
 What is Acquired Brain Injury (ABI)
 A few statistics
 Living life after an ABI
 How can BIA NSW assist you?
 Discussion/brainstorm

19.  The location of the brain damage
 The severity of the injury
 The length of time since injury
 The extent a person has been able to integrate back
into the community
 Access to rehabilitation
 The extent a person retains important/personal
relationships and friendships
The effects of ABI
can be complicated by:

20. Changes after ABI
 Physical problems
 Sensory problems
 Cognitive (thinking) problems
 Emotional problems
 Problems with social interaction
 Communication problems
 Overwhelming grief/sense of loss
 Before/Now comparisons
 Severe impact on families and friends

21. May lead to ...
 Changes to important relationships - people commonly
lose key relationships and have trouble making new ones
 Social isolation, exploitation, neglect - access to services
and support is unfair and inequitable
 Loss of employment, financial hardship, homelessness
 Loss of value status and respect in the community
 Mental health issues
 Drug and alcohol dependency
 Involvement with Criminal Justice System
 Need for long-term support

22. Some challenges to services
 Lack of motivation
 Memory problems (eg not attending appointments;
retaining information)
 Behaviours of concern
 Communication difficulties
 Lack of natural / social supports
 High rate of comorbidity with other problems
 Mild ABI – significant for person but may not meet
eligibility criteria

23. Practical Techniques
 Emotional support
– Speak clearly, calmly, reassuringly, in an adult voice
– Avoid arguments and confrontations
– Use non-verbal expressions
 Memory Aids
– Help clients with memory / reminder techniques
– Write important things down
– Use repetition
– Use visual aids

24. Practical Techniques - cont’d
 Reduce confusion
– Allow processing time
– Reduce background noise and distractions
– Keep concepts and instructions clear and concise
– Realistic goal setting
– Ask the person to repeat back to you what they understand
 Respect
– Treat people with cognitive disabilities as adults
– Adjust communication to match person’s understanding

25. ABI: ‘The Hidden Disability’
 Causes problems with a person’s basic ability to
think and make decisions
 Not as easy to distinguish as other physical
disabilities
 People with a brain injury may be
misunderstood, ignored and ‘judged’ by others
(common labels: lazy, non-
compliant, argumentative, ‘difficult’)

26.  BIA NSW
 What is Acquired Brain Injury (ABI)
 How is ABI different from …
 A few statistics
 Living life after an ABI
 How can BIA NSW assist you?

27. Brainstorm?

28. How can BIA NSW help you?
 Information and Referral service
 Training and professional development; mentoring
 Resources and handouts
 Brokerage
 Online information
 Membership and newsletters
– For you
– For people you work with
 Programs for people with an ABI and their families
 Interagencies, networking
 Other

29. BIA NSW
Phone: (02) 9868 5261
Toll free: 1800 820 840
www.biansw.org.au
You can also find us on Facebook!
Remember to ‘Bang on a Beanie’ during
Brain Injury Awareness Week
12th to 20th August 2013