A few weeks ago I met a client who had suffered a spinal cord injury following a fall. After months of rehabilitation she was finally home and physically making progress. She was out of a wheelchair, managing a few steps.
I met her with her husband and daughter. They were clearly thrilled to have her home, relieved that she was alive and physically getting better.
When I asked about how her injuries affected her I was told about her problems walking, how she couldn't stand and how she couldn't get upstairs. They talked about how she didn't leave the house and how they had to look after her, cook and clean for her and do the school run she used to do for her grandchildren.
Nothing was said about how she was feeling mentally, or about the effect of all these changes to her life were having on her psychologically.
Yet as they talked I could see what a huge role she had played in the family. Prior to her injury she'd been a wife, housewife, mother to adult children and hands-on grandmother. She had been the centre of the family. Although not employed she had numerous roles; carer, nurturer, babysitter, cook, cleaner, chauffeur, which with her physical injury had all, for now at least, been taken for her. Instead, she required others to do all of those things for her.
She had suffered a loss, in fact a number of losses. She had lost her mobility, but also her independence and her role in the family, in the home and in the world in general. Her vocation had been looking after her family and she could no longer fulfil that role.
It made me think about the effect that must have been having on her, and what support could I suggest that might help her to come to cope with this change in role.
Psychiatrists talk of a period of adjustment following spinal cord injury (SCI). Statistics suggest 20% who suffer such an injury experience anxiety, 30-40% depression and 10-40% Post Traumatic Stress Disorder. Those are significant numbers and make clear (if we were in any doubt) that attention needs to be paid to the mental, as well as the physical, health of those who have suffered a SCI.
Studies show that families can sabotage an injured person’s progress without meaning to. Sometimes by helping or taking over they take away even more of the injured person’s independence. Of course, it is hard for them too; to manage and to know what is for the best.
We all know that the help and support that can be expected from overstretched poorly funded statutory mental health services is limited, if not non-existent.
That’s why SIA’s peer support is so important. It is run by those who have a spinal cord injury for those who have also suffered such an injury. It offers one to one support, practical information and advice on life after injury to the person injured, as well as helping families adjust and find support.
This is exactly what this lady and her family need and referring them to SIA made me feel I was offering something that could really help.
It also brought home to me, that whilst the difficulties of returning to work after a SCI are well recognised (and SIA offers vocational support) we should not forget those whose vocation was within the home, the loss of role they have suffered and the support they will need in dealing with that.
Nicola Wainwright, Partner - Leigh Day