title: Paid attendant carers hold important and unexpected roles which contribute to the lives of people with brain injury.
abstract: OBJECTIVE
  Paid attendant carers spend many hours assisting people with a brain injury. Despite this considerable responsibility, most carers receive little support or training and their roles are often ill-defined. This exploratory study set out to define the key roles of paid carers.
  
  
  METHODS
  Ten semi-structured interviews were conducted. Perspectives were sought from 10 participants: five people with a traumatic brain injury and five paid carers. A computer software package, NUD*IST was used during analysis to help identifvy and categorize commonly recurring themes.
  
  
  RESULTS
  Five major roles were identified: Attendant, Protector, Friend, Coach and Negotiator. Friendship was the most important aspect of the care relationship for three of the people with a brain injury, most of whom had lost their pre-injury friends and associates. Carers were required to negotiate frequently with clients and their families, and with other service providers. Sound communication skills were required.
  
  
  CONCLUSIONS
  In addition to further research, industry guidelines are required which take account of the wider suite of roles fulfilled by paid carers, address training and support needs, and occupational health and safety issues.
authors: University of Western Sydney Macarthur, Campbelltown, NSW, Australia. a.mccluskey@uws.edu.au
authors: A
authors: A
authors: McCluskey
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000451:nursing* / Q000523:psychology; D017028:Caregivers / Q000193:education / Q000523:psychology*; D005260:Female; D018574:Home Care Agencies; D018576:Home Health Aides; D006801:Humans; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D012380:Role; D012494:Sampling Studies; D013315:Stress, Psychological; D011795:Surveys and Questionnaires