The Big Picture
An acquired brain injury (ABI) happens when a sudden injury or illness causes temporary or permanent damage to the brain.
After an ABI, a client may notice changes in how they feel or behave. Support can include reassurance, routines, realistic goals, access to helpful devices, and careful observation.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- An acquired brain injury (ABI) is sudden brain damage caused by an injury or illness.
- Clients with ABI may experience frustration, anxiety, mood swings, or depression.
- Follow the client’s care plan when providing reassurance about changes related to the brain injury.
- Encourage routines and realistic short-term and long-term goals.
- Keep needed adaptive devices within the client’s reach.
- Observe for and report signs that may indicate alcohol or substance use.
Jump to:
Course Notes: Key Ideas You Need to Know
What Is an Acquired Brain Injury?
An acquired brain injury (ABI) is a sudden injury or illness that causes damage to the brain. The damage may be temporary or permanent.
Clients living with ABI may have an increased risk of:
- frustration
- anxiety
- mood swings
- depression
Anxiety is a vague feeling of uneasiness in response to stress.
Some people with a mild or undiagnosed ABI may be mislabelled, misdiagnosed, or misunderstood. This can increase their frustration or anxiety.
How ABI Can Affect Families
An ABI can also affect the client’s family.
Family members may need to adjust when:
- the client develops changes in personality
- the client can no longer contribute to the family income as before
These changes can require adjustment from both the client and the family.
Follow the Client’s Care Plan When Providing Reassurance
A client with ABI may forget that the brain injury happened. At the same time, the client may realize that they feel different from before.
CCA action: Follow the client’s care plan when reassuring them that what they are experiencing is related to the brain injury.
One goal of the health care team is to teach and reinforce information about the reasons for the client’s symptoms. This can help reduce fear and anxiety.
Encourage Routines and Structure
Encourage the client to develop routines for everyday tasks.
Examples include:
- bathing
- dressing
- eating
- toileting
Following a routine can help the client feel a sense of accomplishment and self-esteem . It can also reduce anxiety caused by having to decide what to do.
Encourage Realistic Goals
Encourage both short-term and long-term goals.
Goals can help the client:
- focus on a specific task
- stay motivated to work toward the goal
Goals should be realistic and achievable.
If a client does not reach a goal, support the client in accepting that the goal was not achieved and trying again.
Keep Adaptive Devices Within Reach
Some clients use adaptive devices to help with moving around or communicating.
Examples include:
- a wheelchair
- a memory aid
- a picture board
CCA action: Make sure the client’s adaptive devices are easy to reach and use.
Help the Client Move Forward
A client may focus on abilities that were lost after the brain injury. This may lead the client to refuse rehabilitation activities.
This reaction can be normal for a short time. If it continues for a longer period, it may prevent the client from reaching their full potential.
Encourage the client to put the past behind them and continue working toward their goals.
Support for Anxiety or Depressive Disorders
Anxiety disorders are mental health disorders in which anxiety is the main symptom. The person’s fears and worries are out of proportion to the situation and affect normal functioning.
Depressive disorders involve sad, empty, or irritable moods along with physical and thought changes that are serious enough to affect functioning.
CCA action: If your supervisor directs you to do so, follow the appropriate support steps for clients with anxiety disorders or a depressive disorder.
Observe for Alcohol or Substance Use
A client with ABI who feels depressed may want to drink alcohol or use recreational drugs or other substances. The client may have difficulty reasoning that these substances may be harmful.
Report: Observe for and report signs that indicate alcohol or substance use.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition tells you to observe and report signs of alcohol or substance use and to follow the care plan. Current Nova Scotia standards add more detail about the CCA’s role when a person’s behaviour or needs change.
In Nova Scotia, a CCA monitors behaviour while providing care, recognizes when changing needs or symptoms should be reported, and responds to behavioural expressions using planned interventions and strategies. The CCA also observes changes in a person’s emotional, cognitive, or physical status and psychosocial needs so changes can be escalated to a supervisor according to the care plan.
This is an observational point-of-care assessment. It is not a nursing assessment and does not allow the CCA to complete the comprehensive evaluation used to make care-planning decisions.
Why this matters in Nova Scotia: When a client with ABI shows a change in behaviour or needs, the CCA observes, follows planned care, and reports or escalates the change within the CCA role rather than making an independent clinical assessment.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: October 6, 2026
Exam Clue Words
- Follow the care plan: Reassurance about changes related to ABI should follow the client’s care plan.
- Ensure: Keep the client’s needed adaptive devices within reach.
- Report: Signs indicating alcohol or substance use should be reported.
- If directed by your supervisor: Follow the support steps for anxiety disorders or a depressive disorder only when directed to do so.
Fast Review
Focus on the main facts and support points before moving on.
- An acquired brain injury (ABI) is sudden brain damage caused by an injury or illness, and the damage may be temporary or permanent.
- Clients with ABI may experience frustration, anxiety, mood swings, or depression.
- Families may need to adjust to personality changes or changes in the client’s ability to contribute to family income.
- Follow the care plan when reassuring a client about changes related to the brain injury.
- Encourage routines for everyday activities such as bathing, dressing, eating, and toileting.
- Encourage realistic and achievable short-term and long-term goals.
- Keep adaptive devices within the client’s reach.
- If directed by a supervisor, follow the appropriate support steps for anxiety disorders or a depressive disorder.
- Observe for and report signs that indicate alcohol or substance use.
Final Pep Talk
There are several support points in this topic, so review them in small groups instead of trying to remember everything at once. Pay special attention to the care-plan direction, routines and goals, adaptive devices, and the reporting point when you review again.