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. Currently, as many as 5.3 million Americans are living 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.Returning Home after TBI Treatment
After receiving brain injury treatment, returning home to re-start normal 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 as well as physically exhausting for both the patients and their family.
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 are likely to go back 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.
It is vital that friends, family members, and caretakers understand that the patient does not feel or act difficult out of choice. The traumatic brain injury can have some long-lasting neurological after-effects, and the journey to full recovery can be challenging.Care and Support for the TBI Patient at Home
How to prepare the home
Family members and caregivers should assess the home thoroughly before the patient returns back 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:
A ramp is crucial for getting in and out of the house efficiently. According to the Americans with Disabilities Act (ADA) guidelines, the slope rule for a wheelchair ramp must be 1:12.
This allows the patient to get into the shower directly without getting out of their shower wheelchair.
In order to move the patient without causing strain or risking an injury, ceiling lifts are essential. They run on a track system that is fixed to the home ceiling.
Wider doorways are also important; they make it easy for the patient to safely maneuver within the home.
There are door openers that will open and close the door automatically 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. A lot of these door opening units also include options like electric strikes, digital keypads, outdoor access, and various switches.How Family Members Can Support a TBI patient
Be Empathetic and Patient
The side effects of a traumatic brain injury can often be unpredictable. It is crucial for the caregiver to maintain an empathetic and compassionate approach when caring for a TBI patient. The patient may exhibit mood swings – calm one day and hyper the next day –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 suffering and going through a really tough time. He or she needs your love and support, not your judgment and negativity.
Never take it personally if they seem angry or lash out at you. It is normal for a TBI patient to have outbursts of frustration, confusion, and other negative emotions. Damage to the frontal or temporal lobe regions often manifests in the form of such negative emotions.
Help Them Become Organized
Quite often, traumatic brain injury results in temporary or intermittent memory loss. If your loved one also seems to show signs of memory weakness as a result of 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 make sure that 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 possibly feel fatigued, uncomfortable, and out of place on 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, which is within convenient view, such as on a wall, and also 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. But they may feel hesitant in asking for your help due to the fear that they will come across as needy and helpless.
You can offer to do some of the tasks for them, such as going to the grocery store, cooking some 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 not only help them but also make them feel that you care for them.
Get them out of the Confines of the Home
Your loved one may just want to stay home after a traumatic brain injury. The impact of the physical injury to their brain, in addition to staying in, doing nothing can lead to feelings of depression or anxiety. That’s why it’s important for a TBI patient to get out of the house for a few hours on at least some of the days in 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, or even a massage parlor or a small, cozy restaurant.Employment Support for TBI Patients
TBI patients have shown solid success in gaining and retaining employment when they have access to 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 as well as limitations based on the extent and the nature of their head injury.
- A lot of the challenges caused due to the TBI injury can be minimized by compensatory workplace strategies.
- The employment process should be guided by the interests, abilities, and skills of the patient, and not their disabilities and limitations.
- It is important to involve the patient in the design and application of support and training strategies for finding and maintaining gainful employment.
A traumatic brain injury can often cause the patient to experience some physical or motor challenges such as difficulty in maintaining balance, walking, coordinating, etc. The patient may also experience a decline in strength, speed, and accuracy of their movements.
A TBI patient suffering from physical challenges will need workplace accommodations, especially for jobs that involve standing or use of hands for extended periods of time. If they also have low stamina and reduced levels of endurance, 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 that are spread out over a block of time instead of one 30-minute break.
- Set up opportunities so that 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.
In addition to the physical challenges, TBI patients may also experience problems with their ability to speak; 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 be suffering from a condition called ‘expressive aphasia.’
On the other hand, if they find it hard to comprehend what other people are saying, they may have ‘receptive aphasia.’ It is important to recognized these conditions and then deal with them effectively in the workplace.
The patient of a traumatic brain injury and their family members should keep in mind their communication support needs while looking for employment. For example, a customer service agent needs to 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 possibly be executed in different ways. For example, while some customer representatives need to interact over the phone, some 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 with more ease.
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 possibly 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.
The patient’s ability to think can drastically change after a TBI. Both short and long-term memory may be impacted greatly following a traumatic brain injury. If the patient experiences a 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 kind of problem.
As mentioned earlier, 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 be performed 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 reach a decision about 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 at times for family members at home and co-workers at the workplace to maintain patience and empathy with a TBI victim, that is the best form of support they can provide. It’s vital to spend time with the patient so that they don’t feel ignored or alone. At the same time, make sure they also have adequate time to rest every few hours in a day during their recovery phase.
Watch YouTube Video: Family Support: Coping with TBI. Sargeant 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.San Francisco Brain Injury Lawyers