A grounded theory of care management after traumatic brain injury

This study explores the processes and conditions surrounding long-term care decision-making and care management after traumatic brain injury. Grounded theory methodology and methods were used. Semi-structured interviews were conducted with a total of 51 participants in New South Wales, Australia. A grounded theory of care management was developed through constant comparison of data and cases and identified a social problem, a core social process, strategies, conditions and consequences. The basic social problem was the need for ongoing care, a problem which the person with brain injury and others managed collectively. Together, they determined an appropriate care location or living situation, configuration of carers and level of care. This study provides a framework for understanding preferred ways of living with care after brain injury. Increased autonomy was a desired outcome. Living alone and spending time alone were associated with increased autonomy and increased risk. A series of strategies and processes are suggested that allow professionals and family carers to gradually increase risk, and share responsibility for risk management. The findings have implications for health professional and legal practice, education, research and policy