21st June 2017

10 things not to say to someone with a brain injury

The brilliant Headway organisation has produced a short film, highlighting the most annoying things we can say to someone living with a brain injury. It’s about the things people say when they’re trying to be kind (‘I know what you mean, I’ve got a terrible memory too!’) or perhaps a bit less kind (‘You’re tired? At your age?!’ or ‘Chin up – there’s always someone worse off.’)

See: https://www.headway.org.uk/get-involved/campaigns/a-new-me.

This film is light-hearted but packs a punch: I’m struck by how relevant it is to other health and care settings. So why not show it in a staff meeting, and discuss how its messages apply to other people who use services?

The ‘protection imperative’

There is sometimes a temptation among people in the caring professions to keep people safe at all costs. The urge to overprotect people often arises out of a fear of being unjustly blamed, if anything bad ever results from allowing someone who is receiving services to do something that might be a challenge for them.

It’s certainly not fair to stereotype the providers and professionals who are trying their best to get the balance right, between enabling independence and protecting from harm. But, with the best of intentions, we can try to stop someone doing something they’re struggling with: ‘Are you sure you should be doing that?’ is the version in the ‘10 things not to say’ article. And, of course, sometimes people recovering from a brain injury can over-estimate their abilities to do something. It may well be the right thing to do to take the car keys off them, or discourage them rock-climbing, if the person is unable to focus or balance reliably, or their short-term memory is still very erratic.

But, as the Headway magazine points out, ‘an essential part of the rehabilitation process is relearning lost skills by pushing yourself to do challenging tasks.’  Recognising that people are only trying to help, they point out that ‘having your ability judged by someone else can be extremely frustrating.’

Working within the empowering ethos of the MCA

The Mental Capacity Act (MCA) emphasises how crucial it is, to avoid stereotyping people on the grounds of their age, their diagnosis or clinical history, or any feature of their appearance. There may be times when someone living with a brain injury has to be protected against their wishes, but we must remember how much the MCA focuses on the importance of doing all you can to enable somebody to make their own decisions, even if others think they are deciding unwisely, if they can be assisted to have the capacity to do so.

‘Foot in Mouth’

Clearly, everyone had a ball making this short film, and their good humour makes it easier for us to take on board the messages we need to hear. I’m glad they can laugh at our tactlessness, and I know we’ll be less ‘foot in mouth’, after seeing the film.

*All information is correct at the time of publishing

Rachel Griffiths

Mental Capacity and Human Rights Specialist

Rachel has huge experience and knowledge in the area of Mental Capacity, including how to recognise deprivation of liberty, when and how to assess capacity and how to go about making decisions in someone’s best interests. She is nationally recognised as a leading voice with regards to Mental Capacity, and is involved with setting the agenda as well as providing advice and information about Mental Capacity. The information, guidance and support that Rachel provides helps to ensure that the way people work is within the law and recognises that the person using services is always at the centre of any decisions made. Read more

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