Life after brain injury can be a lonely place, and while social opportunities - particularly with others living with brain injury - are hugely important, for many they are hard to find. Here, Dr Keith Jenkins, consultant clinical neuropsychologist at St Andrew’s Healthcare, discusses how care providers can make these opportunities happen, and how collaboration between professionals in this way can deliver hugely positive results for patients 

After brain injury, one of the most common wishes cited by survivors is the desire to feel ‘normal’ again. To be able to do the things they used to do before their life changed forever, and to feel - as much as possible - like the person they used to be. 
A core part of that is through social interaction. Many people living with brain injury find themselves lacking opportunities to do this; either through their own choice, painfully conscious over how they will be perceived, or through the devastating loss of the friendship circles they previously enjoyed. 
All too often, this contributes to the isolation and loneliness felt by so many people after brain injury, which can seriously impact their ongoing neuro-rehabilitation and quality of life. 
By addressing this, and creating opportunities for social interaction, the process of adapting to life after brain injury can be eased. Removing the taboo around returning to activities that used to be enjoyed and regaining the enjoyment of the company of others can greatly benefit mood and well-being. 

“These are things most of us take for granted, if we want to go out and do something social, we can. Whereas if you are living in a service and are dependent upon support workers, it’s not so easy”. 
“But although it’s not easy, it’s very important - that feeling of normality is vital.”
St Andrew’s, based in Northampton, has a longstanding commitment to recognising this and to creating and enabling opportunities for social interaction to happen. 
Holding regular sessions for people living with brain injury and their supports in the evening - replicating the time of day that leisure-based social interactions most often take place - St Andrew’s offers a whole new level of support to its patients, in addition to the therapies that form their conventional neuro-rehab. 
“It has a very big impact on mood, a positive impact, many of our service users are very positive the day after they have been to one of our clubs or sessions,” says Dr Jenkins, who has a long track record of establishing support and social opportunities for both people living with brain injury and their families. 
“And with our upcoming Christmas lunch, we’ve had service users who wanted to book their place very shortly after it was advertised, to make sure they could get a place. That shows how much they look forward to it.”
St Andrew’s was one of the founder members of the ROCK Club in Northampton - an acronym which takes the names of Richardson Partnership, Oakleaf, Christchurch and Kemsley (the latter being the specialist brain injury service at St Andrew’s) . The ROCK Club that came together in 2008 continues to thrive. 
As well as participants from all four founding services, people from other services in and around Northamptonshire also attend the ROCK Club sessions, which are held from 7pm to 9pm in the evening. Attendees can help themselves to soft drinks, tea, coffee and food, with the arms-length assistance of their support workers to enable them to enjoy their evening independently as much as possible. 
“It is a great opportunity to be in a room full of people who all live with brain injury, who are all there for the purpose of having fun and socialising together, with low level support from the staff who need to come with them,” says Dr Jenkins. 
“As well as the fact it’s a really good evening, there is also that comradeship and universalisation, the realisation that you are
not alone”. 
“Clearly these sessions have to be carefully and individually assessed, because in order to go out to a social event with lots of people, many from other services, you have to be sure that the people we take from St Andrew’s are going to feel safe and are able to cope. 
“While it does give autonomy in an environment that is normalised as much as possible, it has to be carefully monitored. In a care setting, very often there are tight controls around meals, there are set times or set amounts that you can have. But at the ROCK Club, people are able to help themselves, it’s readily available. So we need to give support in developing that self-control and self-regulation, and the support workers are there to help with that.”
While social opportunities, particularly those ‘out of hours’, are of great importance, they depend to a great extent on the ability of staff to deliver these sessions. 
“It depends very much on the motivation and goodwill of staff, because often useful social events happen outside the core working day,” says Dr Jenkins. 

“Staff have to give up their own time, or stay on later than they would normally work, in order to help somebody go to an evening event. It very much relies upon staff staying beyond their normal shift. 
“As a person living with brain injury, you don't want all of your social events to happen during core therapy working time, and none of us go to the bulk of our social events between nine to five, Monday to Friday. If we do go to things during the week, they'll be in the evening. That's normal adult social behaviour, so we've tried to offer that opportunity. But it remains so dependent upon staff goodwill, or the shift systems within care providers that enable that to happen. 
“There are day services in Northampton and Headway groups locally, and we’ve offered the opportunity for them to come to our ROCK Club events too, but to date they haven’t taken us up on it, most probably because they don’t have the staff flexibility to come out in the evening. 
“It really does rely on staff to go above and beyond their normal daily remit. In the ROCK Club, there is a very small group of us, including some volunteers, and some people who have been committed to this for a long time. 
“We have one key volunteer called Alistair McCarter who used to work for Oakleaf, although he has been retired for several years he still comes along and brings friends as volunteers.
He has also raised money for our events through a range of things he does in the community. People like Alistair see the need to put themselves out to help us deliver these opportunities, and we’re very, very blessed to have that.”
In addition to the regular ROCK Club sessions, there are two main events each year - a summer event and the upcoming Christmas lunch, which this year will be held on December 19. 
“The beauty of the Christmas lunch is its sheer normality. It’s no different to a firm’s Christmas lunch, if someone saw it, they wouldn’t know any different.” says Dr Jenkins. 
“Some years, we’ve had just under 200 people coming along. It’s a sit down, three-course Christmas lunch, with a raffle and then a DJ for people to continue socialising after the meal.
It’s a fantastic event because it’s just people having lunch, enjoying themselves, as people do at Christmas. 
“From our ROCK Club events during the year, we are able to subsidise the Christmas lunch, so it’s an affordable price for anyone who wants to come. 
“The money also supports our summer event, which is held in the local village hall. We do a whole day with a barbecue and entertainment, with stalls or activities, it’s indoor but is
also able to spill over into the adjacent playing fields.
“These events are particularly well received and we know people look forward to them.”
While St Andrew’s is a keen advocate of the need for social opportunities, Dr Jenkins admits he is aware that many other providers around the country do not take such proactive action, but stresses the benefits of them doing so and in working in collaboration for the benefit of those who need it. 
“By working together with people that, in other settings, might be perceived as rivals or competition, to work aside from that to deliver social events and work together collaboratively, is really positive for the services individually and collectively.
“Most importantly, it gives people living with a brain injury the chance to go to a social event and see people that they're not living with all the time in their own hospital, care setting or home. It also gives that chance to a wide range of staff to mix together, so everybody really gets that sense of getting to meet each other, working together and in collaboration. 
“And that's a really positive thing for everyone.”