Concussion/Mild Traumatic Brain Injury (mTBI): Families

As a family member, it’s important to recognize a concussion is a brain injury. Suffering a brain injury can result in cognitive, behavioural and emotional changes. Once someone has suffered a brain injury, it’s important for those around them to understand they are now a different person than they were before. Recognize that a brain injury can affect the whole family.

One of the most significant changes a survivor can experience is in their personality. They may also have fatigue, anxiety, be depressed and change how they interact with others. 

A survivor may feel a loss of their sense of self.  It’s important for those around them, regardless of the nature of their injury to still recognize the person as who they are; your mother, father, spouse, friend etc. Treating them in any other way can make them feel more of a loss of themselves and they can react emotionally. This article explains what a brain injury survivor wants their loved ones to know. 

How your loved one communicates with you may have changed. They may:

  • be quick to anger 
  • not know how to express themselves
  • show childlike behaviour
  • have emotional outbursts of anger or sadness
  • have trouble in social situations
  • have impaired judgment and poor decision making
  • be irritable

What you say and how you react to your loved one can have an impact on their recovery. When you care for a loved one with a brain injury, you may say things to be helpful or even out of frustration. This article has good advice on nine things not to say to someone with a brain injury

Communicating with someone with a brain injury

It’s important to stay calm and patient when someone with a brain injury is trying to communicate with you. To help you can:

  • ask the person to talk slowly
  • repeat what the person has said to make sure you have understood what they are saying
  • ask them to explain or repeat what they have said
  • slow down your delivery of information
  • give them extra time to process and respond
  • write down important information (as simply as possible) vs. just telling or asking them to do something
  • provide information in smaller chunks
  • decrease distractions (turn off TV, radio) while speaking

Hearing loss – how families can help

Your loved one may suffer hearing loss, be sensitive to noise, or have tinnitus (ringing in the ears) after their brain injury. You can help by:

  • telling them the topic of a conversation before starting the conversation 
  • reducing background noise where you are talking
  • staying within a handshakes distance when having a conversation 
  • keeping eye contact when talking
  • talking slowly
  • not giving too much information at once

Sleep – how families can help

Having a brain injury can impact a person’s sleep habits, schedule and even the ability to sleep. Learn more (link to sleep section). You can help your family member by:

  • keeping the same sleep schedule as your partner, if possible
  • encouraging your loved one to follow good sleep hygiene
  • modeling good sleep hygiene
  • keeping the temperature of the house cooler
  • avoid serving caffeine and heavy meals before bed

Resources for families

http://braininjurycanada.ca/2010/06/28/brain-injury-and-its-impact-on-fa...

http://www.brainline.org/landing_pages/Family.html

What to ask your doctor

http://www.mayoclinic.org/diseases-conditions/concussion/diagnosis-treat...

http://rethinkconcussions.upmc.com/2016/03/questions-ask-doctor-concussi...

Changes in emotions, behaviour and mental health

You may notice after a concussion that your loved one is not themselves. Their personality may change. They may have a severe range in emotion or show no emotion at all. They may exhibit socially inappropriate behaviour. They may be self- centred and lack empathy. They may dominate conversations, constantly talking about him/herself with no acknowledgement of the needs or interests of the other person. You can help the survivor manage their emotions by:

  • listening and validating what the person is feeling
  • helping them reframe or redirect their thoughts
  • providing positive, realistic feedback
  • seeking assistance from professionals trained to treat mental illness and behavioural issues
  • keeping to a schedule as much as possible, if there is going to be a change in the schedule, tell the survivor as soon as you know

Try not to react when your loved one becomes emotional. This can be difficult. Remember, it is the brain injury making your loved one react the way they are, not something you have or have not done. Negative consequences do not work well for people with brain injuries. Use rewards and reinforcement to help the person modify their behaviour.

Learn more at http://www.msktc.org/tbi/factsheets/Emotional-Problems-After-Traumatic-Brain-Injury

Other things you can do to help

  • help the person to pace and plan their day
  • help them set small goals and help them to reach these goals. 
  • do not compare the person to who they were before their injury. Instead focus on positives in what they are doing now

Take care of yourself

Family members need support. The Ontario Brain Injury Association runs a Peer mentoring Program. Family members can link up with someone who is also dealing with similar issues. 

Family members need to relax, have time for them. Look into things like mindfulness, Yoga, Tai Chi or medication to help everyone through this journey.