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How to Take Care of Someone With a Traumatic Brain Injury

Caring for somebody with a TBI

As attorneys who handle grievous injuries stemming from car accidents, workplace accidents, and other traumatic events, we have witnessed first-hand how traumatic brain injuries (TBIs) impact victims and their families.

This educational guide is to help you better understand your loved one’s injuries and show how you can be supportive of them during the recovery process.

What to Do If There’s a Medical Emergency

If the person who sustained the brain injury is experiencing a medical emergency, call 911 on their behalf or take them to the nearest emergency room for evaluation and treatment.

They need to go to the emergency room if you notice any of the following conditions:

  • Loss of consciousness
  • Inability to wake them up
  • Double vision or loss of sight
  • Weakness or burning in their arms or legs
  • Severe headache or one that progressively gets worse
  • Seizure or convulsions
  • Bad nausea or excessive vomiting
  • Unsteadiness while they are walking or standing
  • Bruising around their eyes or ears
  • Slurred speech
  • Confusion or odd behavior

Caring for Your Loved One

We realize that the TBI affects not only your loved one; it impacts your entire family. It may cause you to question why your loved one is acting differently. They may be exhibiting extreme emotional swings or feeling depressed.

It is important for you to understand that each person’s brain is unique, just as each traumatic incident that causes the injury can be different. The effects of a concussion or TBI may be temporary for some, while for others it can be long-term or even permanent.

It may be difficult for the patient to clearly express or put into words what they are experiencing. This is not an injury like a broken bone that will show up on an X-ray. TBIs are different.

We can’t see the actual injury to the brain unless there was a brain bleed that was detected through a CT scan or some other diagnostic device. (And sometimes these imaging tests miss signs of a concussion or TBI.)

With a broken bone, we know we either reset the bone and cast it, or perform surgery to repair and stabilize the fracture. The guidelines and treatment protocols are straightforward and clear for those types of injuries.

But with a TBI, there is no real timeline or formula for recovery. Each person is uniquely affected by the traumatic event.

A head injury goes beyond the physical. It affects the mind, our most sensitive organ, causing issues such as emotional outbursts, mood swings, depression, memory challenges, and disorientation.

Don’t Go It Alone

Trying to be the only caregiver to your injured loved one is a recipe for burnout. This state of utter exhaustion can be physical, mental, or emotional, and can affect the attitude you have towards the patient.

If you are experiencing burnout, please know it happens. Feeling frustrated, overwhelmed, or exhausted doesn’t mean you are a bad person. You have a lot of worries, such as:

  • Will they fully recover from their traumatic brain injury?
  • How long will it take for them to recover from their concussion?
  • What are the lasting physical effects of the TBI?
  • What are the lasting financial effects?
  • Will this be the “new normal”?

Don’t Be Afraid to Ask for Help

Enlist the help of family and friends. This will allow you to take a break and recharge yourself so you can continue to care for the patient.

Make sure you are getting enough sleep. Watch what you are eating and take breaks. If you are struggling emotionally with all the changes in your life, find a therapist or support group to help assist you through the process.

Do not take the behavior of your loved one personally. Sometimes normal activities may cause an exaggerated reaction from them.

For example, you click the remote for the television and it turns on with the sound blaring. You quickly try to turn down the volume but you fumble with the remote and it takes a few seconds to find the button and lower the sound.

But they scream at you — not because you did something terrible, but the loud noise triggered something in their brain that was painful or made them panic. These outbursts can and will happen. This lack of emotional control is difficult for them to understand and accept as well.

If you have children that may be affected by these outbursts, it might help to have them sit down with you or a professional to help explain that their family member’s brain is not like it was before. It needs time to heal and “calm down".

Medical Appointments

From the beginning, you can help play an integral part in keeping track of all medical appointments for testing, treatment, and therapy. Some people with TBIs can do more than others at the beginning, but it is best to err on the safe side and help coordinate the family calendar.

Write down all medical appointments as well as other family events on a shared calendar so you and your loved ones can see them. This better helps plan the family schedule, and the patient is not surprised by appointments. Discuss the calendar events the night before, as well as in the morning to cover all activities.

Just as the patient needs help with their schedule, they may also need extra assistance while attending medical appointments. Let the patient talk to the doctor and answer the questions as best they can.

Encourage them to be honest with their assessment of how they are doing, and to be as descriptive as possible when telling the doctor their symptoms.

Here is a sample conversation you can have with them before their health care visits:

  • If you feel you are getting better, be as specific as possible in letting your doctors know in what ways you are improving.
  • Let your doctor know the areas where you still have residual symptoms or you don’t feel like you are improving.
  • You are not whining or complaining. When you tell the doctors how you are feeling and in what ways you are still hurting, this will better help the doctor help you. Honest communication means your doctor can decide what additional tests may need to be ordered, whether to add/modify prescriptions, or refer you to specialists.
  • Start from the top of your head and go to the tip of your toes and let them know about all of your injuries and symptoms.

Sometimes the patient believes they are doing better than they are. They may not want to admit to forgetting things, or the fact that they are struggling with their brain injury and have to take frequent naps.

You may need to discuss your situation with the doctor outside of the presence of the patient. Be discreet by letting one of the nurses or the doctor know of your desire before the appointment.

It may also be helpful for you to attend therapy sessions. That way, when the person suffering from the TBI is prescribed home exercises, you can supervise them at home.

There may be times, however, when it is not in the best interests of the patient for you to be present. This is often done to more effectively promote your family member’s return to being as independent as possible. We have found that a lot of people make more progress in therapy when their family members or friends are not present and watching them.

Other Ways to Help

It can be difficult to know how to help a person suffering from a severe concussion. You may be feeling a sense of “loss” because the person you know and love may be “changed” or “different.”

Professionals that work in the mental health field all agree that it is normal for you to experience a wide range of emotions as you go through this process. It may take a significant period of time for you to adjust to the injury.

We encourage you to seek the help and support of family, friends, and others while dealing with the long-term effects of a TBI.

Here are some helpful tips to improve your interactions with your injured family member or friend:

  1. Stay calm when talking with your loved one. This may be easier said than done if you feel you are being wrongfully attacked or on the receiving end of an emotional outburst. Don’t take their bad behavior personally. Just understand that this confusion and agitation can be expected.
  2. Provide a calm, quiet environment around the home and while traveling. Make sure the noise level from televisions, phones, and radios are reduced.
  3. Talk in shorter sentences. Engage in eye contact when possible to visually confirm if they heard you and understand what you are saying.
  4. Help them break down tasks into simple, easy-to-complete stages.
  5. Safety-proof your home. This is a time to get items off of the floor that can be trip hazards like children’s toys or slippery rugs.
  6. Limit the number of visitors to see your loved one. Allow them time to rest in between those visits.
  7. Stay organized. Keep track of all of the medical appointments, including names, addresses, phone numbers, and dates of visits with health care personnel.
  8. Don’t be afraid to ask questions at a doctor or physical therapist appointment when you don’t understand something. You can be the patient’s best advocate when you are fully informed.
  9. Try to keep life as normal as possible for your children.
  10. Celebrate achievements. Enjoy the good days and learn to bounce back from the difficult ones. Take one day at a time. Remember: progress is measured in small steps and successes.
  11. Be slow and deliberate when contemplating major life and financial decisions.
  12. Seek help if you need it. This applies to tasks around the home or running errands. There is no shame in asking for help from a family member, friend, counselor, or spiritual advisor.

Resources

There are many resources and groups available to patients and their families to help them deal with TBIs. These include:

Academy of Cognitive Therapy

American Academy of Physical Medicine and Rehabilitation

Brain Injury Association of America

Brain Trauma Foundation

Family Caregiver Alliance

National Institute of Neurological Disorders and Stroke

TBI National Resource Center

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