ARBD is possibly one of the hardest conditions to care for at home… These are our top 10 tips for how to do it.

Living with someone who has sustained a brain injury due to excessive alcohol use can be a real labour of love. You will need plenty of patience and be prepared to change your own habits in order to keep them safe. We are asked regularly about how to support someone at home, particularly straight after diagnosis and perhaps just for the interim period before professional help is provided, but also for a longer period where it’s difficult to get external support.

Our top tips are as follows:

1. Limit access to alcohol – if possible, remove it completely

All the while someone is not drinking, they can recover – to a degree- from the damage they have sustained. Alcohol consumption – even in small quantities – will cause a slow but steady slide into even worse brain damage that will be irreversible.

However, someone with ARBD is likely to lack insight into their alcohol dependency and complete abstention could be very difficult to achieve without locking the person into the house (which is obviously against the law!).
Tactics which can work include having no extra alcohol in the house and buying none with your weekly shop. There are also medicines that a person can take which make drinking alcohol extremely unattractive – you can get these from the GP, but only if the person wants to stop.

If the person is amenable to it – and if the damage they have already sustained is not too severe – AA meetings might help. Find a meeting here: AA Meetings

2. Make sure your GP is involved.

Whether or not the person is drinking alcohol still, it is vitally important that the person is taking extra thiamine (Vitamin B1) – this is available from your GP. A PPI like Omeprazole or Lansoprazole is also useful – this is because excess acid in the person’s stomach caused by alcohol consumption will limit their absorption of vitamins and minerals through their normal diet.

Your GP can also offer signposting to other services such as the mental health team and addiction support.

3. Concentrate on the person’s nutrition.

Whether or not the person is still drinking alcohol, their nutrition is vitally important. Their diet should be rich in vitamins and minerals and include plenty of fresh fruit and vegetables rich in B vitamins. Fast food and most snacks contain nothing useful for a body already under nutritional stress.

Try to include thiamine-rich foods such as wholemeal bread, sweetcorn, leafy vegetables such as kale, and pork. Marmite is also rich in crucial B vitamins, although not everyone’s first choice!

You can find about more about healthy eating for ARBD and Korsakoff’s Syndrome here: Eating Well for ARBD

4. Support the person with their personal hygiene.

Excessive alcohol consumption and the brain damage caused by it can often have a very negative effect on a person’s self-care and personal hygiene. Poor self-hygiene can lead to social isolation and an increased risk of depression.

Supporting someone to improve their self-care isn’t always easy and the best tactics will depend on the person. Supporting the person to lay out clean clothes the previous night to wear the following day might be a good approach. Encouraging the person to change out of their day clothes into nightwear and then taking the day clothes for washing can also help.

Getting into the bath or shower doesn’t need to be a battle – lots of praise and encouragement for the person is key.

5. Exercise is really important – for both of you!

Try to get out for at least a walk every single day. Pick a route that doesn’t go past any pubs or bars or corner shops so that the alcohol need can’t be triggered. If you have a dog, this is the perfect excuse. It’s also a good way of encouraging a person to get changed into clean clothes if necessary.

Joining a walking group can be a good way for both of you to have a better time and meet new people.

6. Keep the grey cells moving

Encourage the person to do any or all of the following:

• read the paper
• read a book
• play games
• sudoku
• crosswords
• quiz shows on the television
• play memory games
• anything that stimulates the brain.

Sitting for hours on end in front of daytime television is not good for anyone.

7. Work on coping strategies

It’s hard to remember that you can’t remember.

Losing your keys or forgetting where you put your bag is annoying, but leaving the gas on and going out is potentially fatal. Alarms on your phone and Post-It notes are your friend.

Work on ways to help the person remember all the things they need to be able to do to live without your full-time support.

Sometimes the person will tell you that they have remembered something but it isn’t actually the case. And sometimes the person will recount something to you that definitely has not taken place. You probably aren’t going mad – this is called confabulation and you can find out more about it here: Confabulation – making up memories

8. Join a group or a club

If the person has a hobby of any kind, they may have let it slip over the years. Try to re-kindle that interest. It doesn’t matter what it is, so long as it doesn’t involve alcohol.

9.Look after yourself

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It’s so important that you find a way of taking time out for yourself. If you are completely exhausted, who is going to care for your loved one? There is nothing to gain from you being a martyr.

10. Get in touch with social services

When it eventually gets too much, social services will be able to help you access extra support for your loved one. It’s better to flag up the need earlier rather than later, because solutions don’t appear overnight. You may need to be prepared for a long wait and a bit of a struggle getting the support you need. When the time comes, give us a call. We will be there to catch you both.