• Try and make the environment as homely as possible.
  • If living in a care home or hospital setting, have familiar items from the person’s home e.g. photos, pictures, cushions, a favourite chair etc.
  • Reduce noise and distractions in the environment as much as possible but especially during interaction.
  • If the person has memory problems:
    • Provide relevant orientation material in the environment about where the person is and their circumstances.  Ensure this is clearly visible and understandable (i.e. tailored to the person’s communication, language, cognitive, perceptual and sensory abilities).
    • Carers should wear badges with name and role in large, clear font.
    • Provide a photo board of staff members.
  • Provide frequent opportunities for lots of positive social interaction with people who have unimpaired communication and cognition. This may need to be provided by families/carers, as there are a number of reasons why it may be difficult for the person to access these opportunities without support.
  • Please do not assume that interaction with other brain injured individuals is adequate to fulfil the person’s communicative and social needs.
  • Provide the person with varied experiences which will facilitate communication; engaging the person in activities will provide experiences to communicate about. It is always easier to interact when doing something about which you can communicate, for example:
    • Have a programme of appropriate activities for the person.
    • Involve the person as much as possible in normal home routines (cooking, washing dishes, dusting, putting things away etc).
    • Support the person to get out and about as much as possible (e.g. for shopping, a coffee, to visit friends/family, to cinema, library, college, football match etc). They will then have something to talk about when they get back home.

Refer to Speech and Language Therapist for support and advice if necessary. Follow any guidelines provided by the Speech and Language Therapist in order to support communication.

Characteristics of an environment which is supportive of effective communication include:

  • A culture of unconditional positive regard where staff are fully aware of the impact of the brain injury upon the person’s everyday presentation, communication and behaviour.
  • Staffing levels/levels of support matched to the person’s needs.
  • Quieter environment.
  • Calm setting.
  • Comfortable settings which support the person to feel relaxed.
  • Care/support staff who are aware of the person’s communication difficulties, understand how to help and are willing to adapt their own communication in order to support the person.
  • Other people to interact with (e.g. staff, friends, family) who understand brain injury and who are able to spend time with the person.
  • Being able to provide a consistent approach to the management of the potential sequelae of brain injury (communicative, cognitive, behavioural, physical, psychological and psychiatric etc).
  • Flexible and responsive approach to the person’s changing needs over time.
  • Access to a range of activities (with appropriate levels of support) that the person can talk about.
  • Provision of levels of stimulation appropriate to the person’s ability.
  • Provision of opportunities to engage in interaction for social and quality of life purposes as well as needs based purposes.
  • Provision of opportunities for making choices (within the person’s capacity to do so).
  • A culture of positive reinforcement.
  • Care and rehabilitation is provided by staff with appropriate levels of training and support.