The Psycho-Social Rehabilitation of Patients with Alcohol-Related Brain Damage in the Community

Aims: To describe the clinical presentation, course and psycho-social outcome of patients with alcohol-related brain damage (ARBD) referred from acute general hospital inpatient settings to a newly commissioned community team. Methods: A follow-up study of a consecutive series of 41 patients subjected to a developing, phased rehabilitation programme in community set- tings. Results: Patients were followed for an average of 25 months. Thirty-two patients were either abstinent or categorized as 'con- trolled drinkers' and were placed in appropriate community settings. Acute hospital admissions were reduced by 85%. The various domains of a neuropsychiatric assessment tool, the health of the nation outcome scale-acquired brain damage, improved with the ex- ception of concomitant mental illness and self-directed harmful behaviour. Conclusions: A community team with experience in working with younger people with cognitive impairment can provide a service for people with ARBD. Such a service is not depend- ent on pre-designated specialist institutions but relies on person-centred care planning, close follow-up and collaborative work with a variety of community agencies. A structured rehabilitation programme provides a framework for intervention.