Acquired Brain Injury (ABI) Care at Home

Causes of ABI

An acquired brain injury is any damage to the brain that occurs after birth, from causes other than progressive neurological disease. Common causes include:

• Stroke — the most common cause. See our Stroke Recovery guide.
• Traumatic Brain Injury (TBI) — from a fall, road accident, assault or sports injury
• Hypoxic/Anoxic brain injury — damage caused by insufficient oxygen, after cardiac arrest, near-drowning or respiratory failure
• Brain tumour — whether from the tumour itself or from treatment
• Encephalitis — brain inflammation from infection or autoimmune causes
• Subarachnoid haemorrhage — bleeding around the brain, often from a ruptured aneurysm

Effects of ABI

The effects of ABI vary enormously depending on the location and severity of the injury. Common effects include:

Recovery and Neuroplasticity

The brain has remarkable capacity for recovery — particularly in the first 6–24 months after injury. This is called neuroplasticity — the brain's ability to reorganise and form new neural pathways.

Recovery is not linear. There may be plateaus, and then sudden improvements. Progress is maximised by:

• Active engagement in rehabilitation (physiotherapy, speech therapy, occupational therapy)
• Adequate sleep and nutrition
• Avoiding alcohol and drugs
• Maintaining a structured, predictable routine
• Continuing to practise and use affected functions

How Home Care Helps

Home care after an ABI must be adapted to the person's specific injuries and recovery stage. Key ways Ekvarta supports people with ABI:

• Routine and structure — consistent visit times, predictable routines and familiar faces help with cognitive recovery and reduce confusion
• Prompts and reminders — for medication, appointments, meals, hygiene. Memory difficulties are common and prompts provide the scaffolding to maintain daily function.
• Practical tasks — cooking, cleaning, shopping. Taking over the tasks the person finds most difficult or unsafe.
• Fatigue management — pacing activities, ensuring adequate rest. ABI fatigue is severe — carers must respect this and not push the person beyond their capacity.
• Safe environment — monitoring for falls, disorientation or unsafe behaviour; keeping the home hazard-free
• Communication — being patient, allowing time, using simple clear language, supporting the use of communication aids if needed
• Emotional support — consistent, positive relationship building. The person may be grieving their former self — genuine human connection matters.

Cognitive and Behavioural Changes

Caring for someone with ABI-related personality or behaviour changes is demanding. Key principles:

• Behaviour changes (irritability, impulsivity, disinhibition) are caused by the brain injury — they are not the person's "fault" and they often have limited control over them
• Stay calm and don't take challenging behaviour personally
• Maintain predictable routines — unpredictability worsens behaviour
• Reduce stimulation when the person is overwhelmed
• Redirect rather than confront when behaviour is difficult
• Report significant changes or safety concerns to family and the care team

Supporting the Family

ABI often transforms the family as much as the person who is injured. Spouses, parents and children of people with ABI frequently experience grief, carer burden and relationship difficulties. Home care provides respite and professional support that protects the family system.

The Headway brain injury charity provides support for people with ABI and their families: 0808 800 2244 (free, Mon–Fri 9am–5pm).