Caring for Someone with a Brain Injury

Stay on your toes if you're caring for someone with a brain injury. Changes in their behavior, speech, sensation, and movement may appear months or even years after their injury.

Whenever a severe, violent strike to the head causes the brain to bump against the inside of the skull, or if a piece of the skull or another object like a bullet penetrates the brain, it will be injured. It may bleed or swell, and nerve cells may be damaged, disrupting messages sent out to the rest of the body. A traumatic brain injury, often called a “TBI,” therefore can affect behavior, speech, sensation, and movement. 

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Most of the time TBIs don’t involve a loss of consciousness, though the victim may immediately notice blurred vision, feel dizzy and confused, hear ringing in the ears, feel tired, and have trouble concentrating. An “intracranial hematoma” is a mass of clotted blood that forms within the brain tissue or between the brain and the skull. It may not be apparent for a day or even as long as several weeks; take your loved one to a doctor if he feels or acts strangely or gets a headache, vomits, becomes listless, or develops balance problems. Effects typically depend on the severity and location of the injury, and the age and health of the patient.

Serious TBIs have a very unpredictable course of recovery. If your loved one has endured a coma, you’ll rejoice when he awakes and be thrilled at the first attempts to communicate or walk. Most people feel confident that rehabilitation will bring a full recovery. But it’s important to be prepared for lasting changes. While a TBI survivor may look normal, he may function differently long after the first outpouring of support. He may be unable to organize a day, recall information, or stay focused on tasks. Or he may begin acting strangely months or even years later. When TBI survivors end up unable to lead an engaged life and become bored, things only get worse. 

Sometimes the effects are subtle. People who have suffered brain injuries are more likely to experience road rage, one study found, though the researchers didn’t just mean cursing in your car. Road rage was defined as making threats to harm another driver or passenger, or damage another vehicle. 

If you are caring for someone with a brain injury, like all caregivers you need to mind your own health as well. You might particularly notice your anger and look for relief. In the study “The Man I Once Knew: Grief and Inflammation in Female Partners of Veterans With Traumatic Brain Injury,” caregivers who said they felt angry about the changes in their partners were more likely to have elevated levels of TNF-alpha in their saliva, which has been tied to inflammation and conditions like heart disease. In the research, 40 wives or partners reported on how much grief and stress they felt. Researchers also tested their saliva each morning for levels of TNF-alpha. 

Co-author Karen Saban, PhD, RN, an associate professor in the School of Nursing at Loyola University Chicago, explained: “Traumatic brain injuries can result in devastating physical and cognitive [mental] impairments. Grief, anger and blame are common among caregivers who are left to cope with these profound disabilities and the loss of the person they once knew. These feelings may put these individuals at risk for inflammatory-related disease."

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Resources 

• The Brain Injury Association of America has state chapters with support groups. 
• Learnet is designed to help people caring for students with brain injuries. 
• Realistic Hope, founded by a TBI survivor, offers a library of moving stories by survivors and their family members and announcements of events. Many survivors have their own websites.
• Stories from the Brainreels Podcast is a monthy streaming radio interview show that features guests with brain and injuries and is hosted by Cheryl Green, who has suffered a TBI.
• Brain Injury Radio network offers call-ins and interviews on streaming radio shows seven nights a week, and is hosted by TBI survivors.
• Traumatic Brain Injury Resource provides tips for parents and teachers.
• TraumaticBrainInjury.com is sponsored by and paid for by the law firm of Cohen, Placitella, and Roth, P.C., with offices in Pennsylvania and New Jersey.
• The National Institute of Neurological Disorders and Stroke promotes research and services for a population that includes those with TBIs.
• The CDC offers Injury Prevention & Control: Traumatic Brain Injury & Concussion.
• TBI Survivors Network is an online social community.
• The Dr. Jill Bolte Taylor home page offers the wisdom of a Harvard-trained and published neuroanatomist who experienced a severe hemorrhage in the left hemisphere of her brain in 1996.