Humanising health and social care: What do family members of people with a severe acquired brain injury value most in service provision.

Abstract

Introduction: Family members living with relatives with severe acquired brain injury (ABI) face many challenges. Although this is recognised, service provision in the UK is poor and needs development. Method: In order to support innovative service delivery for family members, we reflect on the research carried out by the first author using a new perspective - a lifeworld humanising approach in order to consider (a) the dehumanising existential challenges facing family members of people living with severe ABI and (b) what family members most value in service delivery presented in humanising terms. Findings: Following ABI, family members may enter a parallel lifeworld (feeling separate from 'usual' life as it flows by) and face fundamental existential challenges of isolation, loss of agency, dislocation, loss of meaning and loss of personal journey. Family members have reported that service providers who are highly valued are those who act as 'expert companions'. This role involves supporting families in some, if not all of the following (a) reaching across into the lifeworld of the family member and appreciating and validating what they are facing, (b) helping them make sense of their situation in terms which are meaningful to them and which they can explain to others, (c) through ABI expertise, supporting their relative through knowing their interests and needs and adapting the environment to suit these to help their relative to 'settle' and flourish, (d) supporting family members to share their life experiences - developing safe and trusting relationships, (e) having a humane, positive, creative and for some, a humorous approach, (f) being responsive to changing situations, (g) being available to call during times of worry or crisis and (h) help link with others and helpful networks. Discussion: It is suggested that the role and approach of companion may help family members regain some sense of their own life and their well-being.