Support for Patients of Traumatic Brain Injury

According to the Brain Injury Association of America (BIAA), 1.5 million people in the US sustain a traumatic brain injury (TBI) every year, out of which nearly 80,000 victims suffer from long-term disabilities resulting from the injury.

As many as 5.3 million Americans live with disabilities due to traumatic brain injury. According to a BIAA report published in 2007, one person in America sustains a TBI every 23 seconds.

If you or a family member has suffered a severe brain injury in an accident due to someone else’s negligence, you could be entitled to monetary compensation for your damages. Contact our experienced traumatic brain injury attorney for a free consultation at (415) 805-7284 to learn more about your legal options.

After receiving brain injury treatment, returning home to restart everyday life can be a long-drawn and complex process for the patient. Irrespective of the severity of the injury, the patient will need the support of their close ones following the treatment. The recovery process can be emotionally draining and physically exhausting for the patients and their families.

Most TBI patients are happy to return home after undergoing rehabilitation under professional care. Home is the safest and most comfortable place to recuperate for most of them. Friends and family of the patient are usually happy and excited to welcome them home. However, within a few days, friends and family will likely return to their original routine of work, school, or other day-to-day activities. While life quickly returns to normal for others at home, the patient goes through emotional and psychological changes. In many cases, family members might fail to recognize the extent of these changes.

Due to brain damage involving temporal or frontal brain lobes, the patient can experience memory loss, confusion, disconnect with reality, loss of organizational skills, poor judgment, and weakened reasoning ability. On the other hand, in a hospital setting or rehabilitation center, the patient is more likely to have a disciplined and well-organized day. Once they return home, this arrangement may be disrupted quickly, leaving the patient isolated, lonely, and depressed.

Friends, family members, and caretakers must understand that the patient does not feel or act difficult out of choice. Traumatic brain injury can have long-lasting neurological after-effects, and the journey to full recovery can be challenging.

Family members and caregivers should assess the home thoroughly before the patient returns from rehabilitation. They should ensure that the residence would be safe and accessible for the patient. Here are a few ideas for modifying the home to accommodate a TBI patient’s needs:

• Wheelchair Ramps – A ramp is crucial for efficiently getting in and out of the house. According to the Americans with Disabilities Act (ADA) guidelines, the slope rule for a wheelchair ramp must be 1:12.
• Roll-in Showers – This allows the patient to get into the shower directly without getting out of their wheelchair.
• Ceiling Lifts – Ceiling lifts are essential to move the patient without causing strain or risking an injury. They run on a track system that is fixed to the home ceiling.
• Wider Doors – Wider doorways are also significant; they make it easy for the patient to safely maneuver within the home.
• Door Openers – Door openers will automatically open and close the door for the patient to enter and exit the house without aid. Based on the patient, the timing of the open and close settings can be adjusted. These door-opening units include electric strikes, digital keypads, outdoor access, and various switches.

Be Empathetic and Patient

The side effects of a traumatic brain injury can often be unpredictable. The caregiver must be empathetic and compassionate when caring for a TBI patient. The patient may exhibit mood swings – calm one day and hyper the next –but it gets easier with time.

Some days, when you find yourself trying to explain the same thing repeatedly, patience can be hard to practice. But it helps to remember that your loved one is enduring an intense time. He or she needs your love and support, not judgment and negativity.

Never take it personally if they seem angry or lash out at you. It is usual for a TBI patient to have outbursts of frustration, confusion, and other negative emotions. Damage to the frontal or temporal lobe regions often manifests as such negative emotions.

Help Them Become Organized

Quite often, traumatic brain injury results in temporary or intermittent memory loss. If your loved one also shows signs of memory weakness due to their injury, they may find it hard to remember the appointments they made, where they put their things, or even how to execute simple, everyday tasks.

You can help them deal with this situation and be more organized. However, just ensure they don’t feel like you are controlling or overpowering in any way. Approach the situation respectfully so that they don’t feel irritated or stressed.

Here are a few ways you can help them become more organized:

• Label the drawers, cabinets, baskets, and other areas to help them remember where things are kept.
• Offer to drive them to their appointments.
• Help them create lists so they can stay organized.
• Explain every activity before engaging in it, and review each step as you are doing it.
• Teach them how to set reminders in their cell phone calendar.

Provide Structure and a Sense of Normalcy

A traumatic brain injury can bring an unexpected, unwelcome change in a person’s life. The patient may feel fatigued, uncomfortable, and out of place most days. They may also feel tentative about how to act or react in specific circumstances.

Here are a few steps you can take to help them build a more structured daily life:

• Place objects the patient needs within easy access.
• Create and maintain a regular routine.
• Keep a schedule/calendar of activities within convenient views, such as on a wall, and add these entries to their phone calendar.
• Treat them as you did before their injury (this will help them feel more normal).
• Keep a photo album with labeled pictures of family members, friends, and known places to help them re-familiarize themselves.
• Include them in all possible family activities while prioritizing their safety.
• Encourage them to rest often.

Offer to Run Their Errands

Even a mild TBI can cause a lack of energy or fatigue in the patient. A severe injury could also cause them to struggle with accomplishing basic, everyday tasks. However, they may hesitate to ask for your help due to the fear that they will come across as needy and helpless.

You can offer to do some tasks for them, such as going to the grocery store, cooking food, tidying up the kitchen, doing laundry, etc. Instead of waiting for them to ask you for assistance, you should ask them first. This way, you help and make them feel you care for them.

Get Them Out of the House

Your loved one may want to stay home after a traumatic brain injury. The impact of the physical injury to their brain, in addition to staying in and doing nothing, can lead to feelings of depression or anxiety. That’s why a TBI patient must leave the house for a few hours, at least some days of the week.

Just make sure to take them somewhere that will not:

• Increase any possible discomfort the patient may feel about being in large crowds.
• Aggravate their sensitivities to sound and light.
• Put pressure on their head or neck.

You should take them somewhere quiet, such as a park, beach, massage parlor, or a small, cozy restaurant.

TBI patients have successfully gained and retained employment when accessing employment support programs. The employment specialists may use the following key points to develop support programs for TBI patients:

• Every TBI patient has unique physical and mental capabilities and limitations based on the extent and the nature of their head injury.
• Many challenges caused by TBI injury can be minimized by compensatory workplace strategies.
• The employment process should be guided by the patient’s interests, abilities, and skills and not their disabilities and limitations.
• It is essential to involve the patient in designing and applying support and training strategies for finding and maintaining gainful employment.

Physical Disabilities

A traumatic brain injury can often cause the patient to experience physical or motor challenges, such as difficulty maintaining balance, walking, coordinating, etc. The patient may also experience a decline in strength, speed, and accuracy of their movements.

Support Strategies

A TBI patient suffering from physical challenges will need workplace accommodations, especially for jobs involving standing or using hands for extended periods. If they also have low stamina and reduced endurance levels, part-time employment might be more suitable for them. In addition, they should ask for short breaks at regular intervals so as not to over-stress themselves.

Here are a few examples of support strategies that might be helpful for an employed TBI patient:

• Take three 10-minute breaks spread out over a block of time instead of one 30-minute break.
• Set up opportunities so the patient can alternate between sitting and standing while executing a task.
• Arrange for a standing aid to help the patient stand comfortably while maintaining balance.

Speech Disabilities

In addition to the physical challenges, TBI patients may experience problems with their speaking ability; for example, they may begin to stammer.

The loss of motor skills sometimes causes communication issues, i.e., the ability to talk clearly. If the patient finds it difficult to express themselves, they could suffer from ‘expressive aphasia.’

On the other hand, if they find it hard to comprehend what other people are saying, they may have ‘receptive aphasia.’ Recognizing and dealing with these conditions effectively in the workplace is essential.

Support Strategies

Patients with traumatic brain injury and their family members should consider their communication support needs while seeking employment. For example, a customer service agent must frequently interact with clients over the phone. A TBI patient with either receptive or expressive aphasia may find this job position particularly difficult to handle. However, it should be noted that many similar job positions could be executed differently. For example, while some customer representatives need to interact over the phone, others may be required to communicate in writing only.

The internet has changed the face of customer service, and many companies now offer customer support via email and online chat. This is where a TBI patient with vocal communication limitations could work more efficiently.

Another salient example is a teacher who used to be able to give long lectures before their traumatic brain injury. After the injury, they might find it easier to work individually with students on a one-to-one basis in a small classroom tutorial or even an online tutorial setting.

Cognitive Disabilities

The patient’s ability to think can drastically change after a TBI. Short- and long-term memory may be significantly impacted following a traumatic brain injury. If the patient experiences short-term memory loss, their ability to learn and retain new skills may be disrupted, too.

A TBI sometimes also leads to a decrease in the concentration and attention facilities of the patient. Their cognitive processing abilities, such as abstract reasoning and problem-solving, may also be affected, i.e., the patient might find it extremely difficult to solve any problem.

Support Strategies

As mentioned, the employment support experts must consider the patient’s strengths and abilities while accommodating them in an appropriate job. The expert should also assess the nature of work to determine what kind of memory skills will be required to accomplish day-to-day job tasks. This information will also help design the right compensatory memory strategies to assist the patient in ‘remembering’ and learning what to do.

Here are a few examples of such memory strategies:

• Create and follow a flow chart to decide what to accomplish.
• Create a checklist that clearly defines the job duties in order.
• Eliminate any distractions such as visual stimuli or noises.
• Create a connection between a person’s face and their name to recall it at a later point.

While it can be difficult for family members at home and co-workers at the workplace to maintain patience and empathy with a TBI victim, that is the best support they can provide. Spending time with patients is vital so they don’t feel ignored or alone. At the same time, make sure they also have adequate time to rest every few hours a day during their recovery phase.

Sergeant Aaron Tippett suffered a mild traumatic brain injury after returning home from deployment. This video shows how family support helps him cope with his TBI.

A traumatic brain injury can have life-long complications. If you or a family member has suffered a traumatic brain injury in an accident due to someone else’s negligence, you will need the help of an experienced Bay Area traumatic injury attorney. Call me for free and friendly advice at (415) 805-7284 or (800) 404-5400.

^{Editor’s Note: updated [cha 10.19.23] Photos: rawpixel.com from Pexels, adamtepl on Pixabay br cha [cs 2237]}