This PhD thesis explores issues around acquired brain injury, focusing particularly on
changing relationships between patients and carers and the trajectories they follow
from the point of injury or diagnosis as a reconstructed life unfolds. Patients are
identified as having strategies of adaptation and carers as taking on levels of agency,
both of which shift according to time, context and other complex interactions. Each
impacts on the other to produce an internal dynamic, the functionality of which is
explored. Issues of care delivery are also raised, including the effects of mismatched
expectations and of sharing or restricting information. This research is qualitative and
based on the principles of grounded theory. 62 interviews were conducted involving
82 people (52 patients and 30 carers) and additional evidence was gathered from
professional records, media reports and personal diaries. Themes were developed that
can be linked together to form a trajectory of care, inside of which there is a finely
balanced ecology. It is proposed that this trajectory although developed around data
from people with brain injury is also applicable to other chronic conditions.
A Doctoral Thesis. Submitted in partial fulfilment of the requirements for the award of Doctor of Philosophy of Loughborough University.