Predictors of Living Independently After Moderate to Severe Traumatic Brain Injury: A Comparison Study

Objective: To identify factors that predict long-term, independent living for adults after traumatic brain injury (TBI). Design: A case-comparison study of unmarried adults who experienced TBI and were either living independently or living with parents. Setting: Cases drawn randomly from a state-wide needs survey of 1,265 Ohioans with brain injuries. Subjects: From a pool of 356 unmarried respondents ages 21 to 49; 32 subjects living alone and 54 living with parents were compared. Primary Measures: Age, time postinjury, education, current and previous income, prcinjury living arrangement, history of postinjury living arrangements, current and previous employment, length of loss of consciousness, and functional disabilities. Results: Of those living alone, 98% lived with their parents an average of 3 years after release from the hospital. Those currently living with parents had lived with them the entire time since being released. Almost 60% of those living with parents were 6 years or less postinjury versus 30% of those living alone. Of those living with parents, 56% were 30 years old or younger versus 13% of those living alone. Prior living arrangement, current age, time postinjury, education, and current income contributed significantly to discriminant analysis, while length of loss of consciousness and prior employment did not. The contribution of prior income and functional disabilities could not be evaluated due to problems with the self-report format of these variables. Conclusions: Living independently after moderate to severe TBI may be achieved by a complex interaction of prior skills, available resources, current capabilities, and the expectations of both family and individual. The minimal role that severity of injury appeared to play is consistent with the World Health Organization model and suggests that the determinants of independent living may be subject to systematic intervention