Long-term support is likely to be needed as treatment and recovery for ARBD can take several years. Some key elements of support that might be needed is relapse prevention, ongoing cognitive rehabilitation, and establishing a good diet. Maintaining abstinence is the most important factor in making sure that recovery from ARBD continues.
A lapse is defined as the first time an individual consumes alcohol after having treatment and detoxing from alcohol. A relapse is defined as being unable to remain sober after becoming abstinent. This does not mean that all progress is lost and that the treatment did not work, however, it indicates that additional support is needed in these cases.
Once treatment has started, strategies should be in place within this holistic model to support the individual in maintaining abstinence. This may involve long-term ongoing support such as an engagement plan which takes other health and social care needs into consideration. As part of an individual’s on-going care, an assessment can be made by social services, and occupational therapists to see if adaptations are needed to accommodate that individual and their ongoing level of need.
As part of this ongoing care, some adaptations can be made to adapt to the environment that the individual is in that may help in reducing the risk of relapse. Eventually, for those individuals who do recover from ARBD, the aim may be for them to return to an independent living situation, rebuild family relationships and gain employment.
Relapse is unfortunately frequent in those who struggle with addictions. Research suggests that between 40-60% of individuals who have an addiction, which includes an addiction to alcohol will experience relapse. Ongoing support and evaluation is necessary in these cases to avoid ARBD developing again.
Some factors may contribute to, or trigger a relapse such as:
- Association of places and people with alcohol
- Withdrawal symptoms
- Challenging life events (e.g. job loss)
There are several strategies to help with maintaining abstinence and organizations to help individuals in these circumstances such as:
- Joining new support networks with others
- Organizations such as Alcoholics Anonymous
- SMART Recovery programs
- Identifying triggers and symptoms of relapse
- Learning new skills or taking up new hobbies
Cognitive rehabilitation is also frequently used to help re-develop abilities in individuals with ARBD. Some of the approaches used in assisting with memory impairments that are used for clients with dementia may be helpful and routines may also assist when memory impairments are apparent.
Errorless learning has been recommended for cognitive rehabilitation in those with ARBD and is reported to improve the quality of life in this population. Errorless learning strategies are used to avoid the possibility of an individual making an error or giving wrong answers by giving explicit instructions and with building memory skills.
Improvements in those with ARBD are likely to vary from individual to individual and some aspects of a person's memory and thinking ability may improve more than others. Strategies can be used to play to the strengths of each individual to help address the weaknesses seen in other areas.
The body cannot produce Thiamine on its own, so it has to absorb it through diet. Thiamine has been fortified in bread since the 1950s. Once an individual has stopped drinking alcohol, the need to consume adequate nutrients is higher than normal because the body will use nutrient stores to repair the damage that has been caused.
Foods that are rich in thiamine include:
- Meat (especially pork)
- Breakfast cereals (especially those with oats)
During cooking, the nutritional properties of Thiamine may be reduced (especially when boiled). To preserve as much Thiamine as possible when cooking, steaming foods may help or using smaller amounts of water.
Some tips that may help with maintaining a healthy diet in those recovering from ARBD include:
- Taking multivitamin supplements (after consulting a healthcare practitioner). Research suggests that those who abused alcohol had lower mortality rates if they were taking supplements
- Eating a variety of food from all food groups (fruits, vegetables, grains, dairy and meat or meat-alternatives)
- Reduce sugar and salt intake and try to swap to healthy alternatives to fast foods
- Try to reduce caffeine intake and limit the number of cups of tea or coffee
- Increase activity rates and try to incorporate a small amount of activity into daily routines
- Alcohol Change UK - https://alcoholchange.org.uk
- Drink Wise Age Well - https://drinkwiseagewell.org.uk
- The Brain Injury Workbook - Authored by Trevor Powell and published by Headway
- Arbennig Unit - North Wales residential rehabilitation unit
- Alzheimer's Society - Information and a practical tooljit for clinicians
- Royal College of Physicians and Royal College of Psychiartists - Guide on alcohol and brain damage in adults
- Dan 24/7 - Drug and Alcohol Helpline and Support - http://dan247.org.uk