Understanding TBI, Part 4: The Impact of a Recent TBI on Family Members and What They Can Do to Help with Recovery

Thomas Novack, PhD and Tamara Bushnik, PhD , Model Systems Knowledge Translation Center

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Multimedia

• BrainLine's webcast "Caregiving and TBI: What You Need to Know" offers ideas and strategies for people caring for a loved one with TBI. Produced by BrainLine.org. View this video in a webcast format. Transcript of this video.
  Caregiving and TBI: What You Need to Know
• Dr. Arango-Lasprilla is currently a research assistant professor in the Department of PM&R at Virginia Commonwealth University. Dr. Arango-Lasprilla is also the cultural competency coordinator for the National Institute on Disability and Rehabilitation Research's (NIDRR) Traumatic Brain Injury Model Systems and co-director for the NIDRR-funded Advanced Rehabilitation Research Training Program. This is BrainLine's exclusive interview with Dr. Arango-Lasprilla recorded on June 5th, 2008. Transcript of the video here. Dr. Juan Carlos Arango-Lasprilla Talks About Cultural Differences in Caregiving
• A brain injury can change everything -- for everyone in the family. Learn more about practical and emotional roles that can change after a brain injury in the family. Transcript of this video. Changes in Family Roles After Traumatic Brain Injury

How does brain injury affect family members?

For most family members, life is not the same after TBI. We want you to know that you are not alone in what you are feeling. While everyone’s situation is a bit different, there are some common problems that many family members experience such as less time for yourself, financial difficulties, role changes of family members, problems with communication, and lack of support from other family members and friends. These are just some of the problems that family members may face after injury. Sometimes these problems can seem too much and you may become overwhelmed, not seeing any way out. Family members have commonly reported feeling sad, anxious, angry, guilty, and frustrated.

Ways to reduce stress

Since the injury, you have likely been under a great deal of stress. A little stress is part of life, but stress that goes on for a long time can have a negative effect on the mind and body.

Stress is related to medical problems such as heart disease, cancer, and stroke.

• Stress can make you do things less well because it affects your ability to concentrate, to be organized, and to think clearly.
• Stress also has a negative effect on your relationships with other people because it makes you irritable, less patient, and more likely to lash out at others.
• Stress can lead to depression and/or anxiety.

If you are under constant stress, you are not going to be as helpful to your injured family member or anyone else. If you do not take the time to rest and care for yourself, you will get fewer things done, which will lead to more stress. If you won’t do this for yourself, do it for your injured family member. They will be better off if you are healthy and rested. Here are some suggestions for ways to reduce stress and stay healthy. These things have worked for many people, but not all of them may work for you. The important thing is that you begin thinking about ways to improve your life.

Learn to relax
Taking a few moments to relax can help you be more ready for the things you need to do. Learning to relax is not easy, especially in your current situation. There are relaxation techniques that can help you such as breathing deeply and focusing on your breathing, stating a word or phrase that has positive meaning (e.g. peace), or visual imagery. In order to train your body and mind to relax, you need to practice often. Don’t give up if it doesn’t work right away. If you keep practicing these techniques, you will feel more relaxed in the long run, and you will find that you’re able to function better in all areas of your life.

Learn which coping strategies work for you
No matter what was going on in your life before, the injury has caused changes. You may never have experienced anything similar to the injury, and some of your usual coping strategies may not work in your current situation. The best thing that you can do for yourself is to be open to trying new ways of coping and find out what works for you.

Some coping strategies that others have found helpful:

• Taking time for yourself
• Keeping a regular schedule for yourself
• Getting regular exercise such as taking a 20-30 minute walk each day
• Participating in support groups
• Maintaining a sense of humor
• Being more assertive about getting the sup¬port you need
• Changing roles and responsibilities within the family

Learn how to reward yourself
Everyone needs something to look forward to. You’ll probably say, “I have no time; it’s impossible.” Just remember that you will be more ready to do the things you have to do if you take some time to do some things that you want to do. Even if you have very limited time, you can find some small way to reward yourself. Promise yourself a cup of your favorite coffee or an opportunity to watch a good TV show or read something you enjoy.

Problem-solving for caregivers

Sometimes you may feel overwhelmed by problems. There may be so many problems that you’re not sure which one to tackle first. You can only solve one problem at a time, so pick one. Use the problem solving steps below to find a good solution. Try to choose a smaller problem to solve first. This will give you practice and make you more confident about solving bigger problems. If you deal with problems in this way, they may seem easier to handle.

Steps in Problem Solving

1. Identify the problem: What is the problem? Define it as clearly and specifically as possible. Remember that you can only solve one problem at a time.
2. Brainstorm solutions: What can be done? Think of as many things as you can. Don’t worry about whether they sound silly or realistic. This is the time to think about all possibilities, even the ones that you don’t think will happen. Be creative.
3. Evaluate the alternatives: Now you will start thinking about the consequences of the ideas you came up with in Step 2. For each idea, make a list of positives on one side of the page and a list of negatives on the other side.
4. Choose a solution: Pick the solution with the best consequences based on your list of positives and negatives. Keep in mind that more positives than negatives is not always the best rule. Sometimes you will have one negative that outweighs many positives.
5. Try the solution: Try out the idea you have chosen. Give it more than one chance to work. If it doesn’t work right away, try to figure out why. Was there some consequence you didn’t think of? Is there another problem in the way that could be easily solved?
6. If your first solution doesn’t work, try another one: Don’t give up. Everything doesn’t always work out the first time. You can learn from your mistakes; they may help you to choose a better solution next time.

Ways family members can help the injured person

The treatment team can provide you with guidance in how to help the person while not giving them too much or too little assistance. Attending therapy when possible and working with the therapists and nurses are the best ways to learn to help the person before discharge from the hospital.

The following recommendations are intended to help families and caregivers care for their loved one once they have returned home. Not all of the following recommendation may apply to your situation.