Coping with a loved one’s recovery following brain injury
Posted by: Anne-Marie Burnett (Rehabilitation Case Manager, Headsmart Rehab Ltd)
There is no doubt that sustaining relationships following brain injury is often a significant challenge as the equilibrium that existed within a couple’s partnership can change, sometimes drastically. One partner may suddenly find themselves taking on roles within the family that they didn’t manage previously; doing all house chores and managing finances etc. They are perhaps doing this whilst still working, and may well be experiencing pressure in the workplace due to taking time off to support their partner or take them to appointments.
Managing competing demands of a practical nature are one thing, but the uninjured partner will also be coming to terms with the aftermath of the incident in which they may nearly have lost their loved one, as well as coping with usually huge changes in their loved one’s personality, behaviour and functional ability. This can result in significant emotional stress.
The injured partner may have little or no insight into how their brain injury has affected them or impacts on those around them. They may struggle to understand why the dynamics of relationships have changed and may blame their partner for things not being the same. Individuals that do have insight into their impairments, may have additional psychological needs as they adjust to their injury, and may feel their partner simply doesn’t understand what they are going through.
Changes to the physical intimacy within a relationship can add further to a fragile situation. Sexual function can be affected due to physical factors and/or psychological responses for the injured partner, whilst a pressurised spouse who is struggling to cope may have their own difficulties with this part of the relationship.
If you’re supporting a loved one who has been affected by brain injury; whether it’s a partner, parent or child for example, it’s important to consider your own well-being. Here is some advice on coping during the recovery process…
1. Take time to understand brain injury and the possible consequences of this. If you understand why your family member forgets things, gets angry, lacks motivation, is impulsive or inappropriate, etc. then dealing with situations becomes more manageable. Ideally, psychoeducation should be provided by a neuropsychologist. This enables the injured person and family members to be supported jointly to explore the person’s strengths and weaknesses, and to develop coping strategies to use in challenging situations. There are also numerous written resources available; Head Injury: A Practical Guide by Trevor Powell is an excellent book and Headway has a vast range of information sheets that can be downloaded from their website.
2. Seek support at the earliest opportunity and keep asking questions. If rehab professionals are in place, you should be closely involved with planning your family member’s rehab and support programme, but there may still be times when you feel a sense of despair. Accessing individual counselling or psychological support and/or sharing your experiences with families or individuals in similar circumstances, can also strengthen your coping abilities. Rehab professionals or your GP should be able to advise on services.
3. Remind yourself that the array of emotions you are feeling, and your responses to these, are entirely expected, so don’t be hard on yourself. Don’t take your loved one’s behaviour or comments personally; how your family member presents is due to his/her brain injury, not anything you have done and not because they are purposely being ‘difficult’.
4. Make time for yourself to meet with a friend, go for walk, or do something else you enjoy. Do this routinely, not just when things are particularly stressful. You need to look after your own physical and mental health for your benefit and that of your family.
5. Involve friends and other family members in the recovery and rehabilitation process, as much as possible, without overwhelming the injured person. Others may initially need support from you to understand the hidden nature of brain injury (and you could encourage them to find out more about this for themselves) but having their support will reduce feelings of isolation and can provide much needed respite if you are able to delegate certain tasks.
6. Where applicable, it is important to involve children in the recovery process. This needs to be done in an age-appropriate manner, but educating children sensitively about their parent’s brain injury, listening to their concerns and encouraging them to talk, is an essential part of supporting the development and healthy maintenance of their relationship with an injured parent and to the parent’s progress. If you are noticing any changes in a child’s behaviour, this may be an expression of feelings of upset or distress. School is often the best place to seek additional support in the first instance.
7. Don’t expect too much, too soon. Be prepared for the ups and downs of brain injury rehabilitation, the length of time it can take to see improvements, and the relative intrusion you may feel on your life, especially when rehab is running alongside the litigation process.
8. Set realistic goals and record achievements. If a rehab team is involved, a goal plan will form the framework of the rehabilitation programme and you will be closely involved with developing this. But you will probably notice small steps, that others may not, and each step is significant. Make a record of every achievement so you and your family member can reflect on progress, especially at times when things may feel a bit ‘stuck’.
9. Try and find positives in situations. Use positive language; focus on ‘strengths’ and ‘abilities’ rather than ‘problems’ and ‘difficulties’. Give praise to the family member whenever you get the chance, without being patronising.
10. Enable the family member to feel in control of their recovery and try not to ‘wrap them up in cotton wool’ even though this may feel like the natural thing to do.
To learn more about Headsmart Rehab and the services they offer, click here or contact Anne-Marie at firstname.lastname@example.org.
- About Anne-Marie and Headsmart Rehab…
The key role of case management is to identify, implement and coordinate the most suitable package of rehabilitation and support to meet the needs of the individual, and to do this within the framework of a carefully considered SMART goal plan that enables the client to maximise their future independence.
Anne-Marie has been a Rehabilitation Case Manager for over 12 years and set up Headsmart Rehab a year ago to provide a unique quality of service to clients with serious or catastrophic injuries, and their solicitors. She specialises in working with individuals who have sustained brain injuries and are experiencing significant behavioural, cognitive, emotional or physical sequelae to their injuries; usually a complex mix of these. When asked what she finds most fulfilling about her role Anne-Marie said:
“Being able to give people hope and a sense of positivity by working closely with them, empathising and being pro-active in improving their situation, is enormously rewarding. Often the client and family have endured months or years of frustration and despair post-accident through a lack of specialist support. Seeing even the tiniest steps forwards as individuals progress through rehab is really quite powerful when working with individuals and families that have been, and are going through, such a challenging time.”