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Rehabilitation Institute of Chicago-Brain Injury Team, Rehabilitation Institute of Chicago, LIFE CENTER (page 2 of 3) Page 2 of 3
When Will I be Able to Start Doing the Things that I Used to Do Like WORK, Driving, School?
Some of these things can be restarted as soon as a person becomes aware of their limitation, has mastered some techniques to make up for weaknesses, and has realistic goals. Doctors and therapists will have advice on these matters. Work and driving are very complex behaviors. Limitations that you do not yet fully understand may make it hard to be successful returning to work. Driving can be very dangerous if there are impairments that affect vision or speed or reflexes or problem solving. A special driving evaluation can be done for individuals with brain impairments. The goal should be to do things in a way that is safe and rewarding. This may require changes in the definition of acceptable behaviors. It is more important to go slow and be successful at "things that you used to do," than think that nothing has changed and do things that result in hurt feelings and failures.
What Does the Term “Minimally Conscious” Mean?
People who are minimally conscious are more awake than someone in a deep coma, but they may actually have little awareness of their surroundings. They may even open their eyes and look around the room, but they may not respond to what they see or hear in the room.
What is the Best Way to Talk to Or Help a Person in This State?
Some people have suggested that it helps minimally conscious people to give them things to think about; for example, to bring in a lot of visitors, to talk to them a lot, to leave the TV on, to read to them, etc. None of these activities have been proven to help the person recover, but there are some stories that suggest it may be helpful to do certain simple activities. It may help for the minimally conscious person to start using their different senses again, so some people talk to them or play music for them. They hold their hand, or bring them sweet smelling flowers. Some have said that playing tape recorded messages from family or friends can be helpful. It is probably not helpful to expose them to complex stimuli they can no longer understand (e.g., playing books on tape, making them watch TV). When people are around minimally conscious patients, it is best to avoid speaking about them as if they are not there and can not hear you.
How Can I talk to My Kids About Brain Injury?
Children need to know some basic things about brain impairment. You might tell them that people with brain impairments may act confused or have trouble remembering or talking about things. Remind your children that the brain impaired person is not "retarded", "stupid" or "child like" even if other adults use those labels. Ask your child what questions they have and if you do not have an answer for them, don't hesitate to ask for help to understand both the question and the appropriate response. Do not think that you have to be an expert in brain impairment. Ask staff and professionals you trust for help.
What Are the Ways That Family Members React to a Person with a Brain Injury?
A brain injury can be scary and confusing. Sometimes someone with a brain injury is treated like a child or a baby by other family members. This is not a good response. Sometimes family members get angry at the person with the impairment because they think that they were somehow responsible for their problem. This is understandable under some circumstances, but usually not a helpful way to respond. Sometimes family members have different ideas about what is best for the individual and they disagree with each other. This usually makes everyone feel upset because everyone likes others to see things the same way they do. Brain impairments can make family members feel personally vulnerable, frustrated and misunderstood. Like any other big family problem, it is not always possible to agree about what to do, but it is important that family members try to listen to different points of view and treat others with respect and kindness. Even under the best of conditions, there will be times when some family members will stay upset and distant and may even withdraw from family contact. With patience and time, they will hopefully come to a better understanding of the injury and re-establish contact.
What Should I Do If My Brain Injured Family Member Has Problems with Anger and Becomes Violent?
Some times people have difficulty with emotional control after brain injury and this can include having a short temper. Family members need to learn different ways to respond to someone with a brain injury who is easily angered. The best way to deal with violence is to learn how to prevent it. Watch for patterns or triggers that set off the brain injured family member and avoid responses that will only make anger build. It is important to remain calm. It is usually not a good idea to argue logically when a brain injured person has become upset. Diversion or redirection in any form is often the best response. This takes away the irritation or trigger and allows the person time to calm down. Try not to physically restrict the person within limits and allow them to freely express themselves physically and verbally. If they become physically violent or threatening, direct appeals for calm can be tried, but may not have the desired effect. In extreme situations, where physical restraint seems necessary, it is always a good idea to have a phone available and numbers to call (such as the doctor or police) for quick, efficient use. Don’t try to handle these situations alone. If anger control is a chronic problem, consult with your doctor about the possibility of using medication to help manage the behavior.
How Should I Respond When My Loved One Denies That S/He Has an Impairment?
One of the most difficult challenges facing family members can be helping a brain injured person fully realize the changes brought on by their accident. Denial or lack of awareness can be an actual part of the injury effects and not just a lack of information or an emotional defense. It is important to realize that sometimes a brain injury survivor is never capable of fully understanding their impairments. In this case, it is not a good idea to logically argue or explain their impairment to them, especially during times of conflict. It may be best to provide a simple, short reason why they are restricted (e.g., it's from the accident; your doctor has said so) and leave it at that. Some times, over a long period of time and experiences, the survivor may come to learn that the injury has put limits on them that they must live with.
Copyright 2008 Rehabilitation Institute of Chicago, LIFE Center, reprinted with permission.
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