Living Environments for People with Moderate to Severe Acquired Brain Injury

Acquired brain injury (ABI), which can result from traumatic or non-traumatic events, is a leading cause of death and disability worldwide (O'Reilly and Pryor 2002; Cameron et al. 2001; Thurman et al. 1999). A recent report identified over 30,000 emergency visits and/or hospitalizations for ABI in Ontario in one year alone (Colantonio et al. 2009). Advances in medicine, medical technology and rehabilitation have increased survival rates and life expectancies such that survivors may live for decades with disability. Persons who sustain traumatic injuries are often young, and even mild injuries can lead to long-term disability (Colantonio et al. 1998; O'Connor et al. 2005). The consequences for families and caregivers, in terms of caregiving responsibilities and quality of life, are enormous (Kolakowsky-Hayner et al. 2001; DeMatteo et al. 2008). Families require long-term support, but most professional interventions are provided during the acute period (Lefebvre et al. 2005; Leith et al. 2004). In addition, a large percentage (11%) of all acute care admissions have at least one alternate level of care day, indicating difficulties in care options beyond the acute care setting (Colantonio et al. 2009). The goal of this study was to gain a better understanding of placement issues related to living environments for adults with moderate to severe ABI in the post-acute phase. Specifically, we explored inappropriate living environments, defined as those that fail to meet all of an individual's ABI-specific housing, support and treatment needs, as well as potential solutions to improve quality of life, by capturing the perspectives of a broad range of providers, consumer advocates and government policy administrators.