Key Points for Families
Provide positive reinforcement
Brain injury will cause your family member to experience many new and confused feelings. Doubts and frustration are very common. Provide praise frequently during the course of the day as a means of creating a positive self-image for your family member. Should a difficult situation arise, turn it into a pleasant one. It can be hard to provide positive reinforcement when you, yourself, are experiencing frustration. While you may sometimes be tempted to deny the problems your family member is having, you need to provide support and encouragement throughout the treatment process.
Write things down
We all have our bouts of forgetfulness. However, memory difficulties are perhaps the most common lingering problem following brain injury. Having the survivor use a planner, iPhone or similar PDA to keep track of scheduled events, appointments, and important information will aid in overcoming this problem. Also, a strategically located checklist will help to ensure that appliances and lights are turned off, that doors are locked, and that the environment is generally kept safe. Verbal reminders can contribute to the consistent use of these memory aids.
Although treatment goals focus on the achievement by your family member with a brain injury of a maximum level of independence with functional activities, he/she may be fearful of trying new or previous tasks as a result of physical, cognitive, and emotional changes.
Therefore, it is essential that your family member be encouraged to strive for self-sufficiency. Should your family member request that you perform a task that you feel he/she is capable of completing, tactfully redirect him/her to complete this task himself/herself.
Keep things simple
When requesting that your family member help around the home, just list one or two items that you would like him/her to complete. Also, when relating information, omit extraneous details and condense the information. When provided with too much information or too many responsibilities, your family member may feel overwhelmed and confused.
Don’t forget me
Envision this: a single room...a group of people...the conversation is about you! No problem, you say....except that everyone is participating in the conversation but you. No one asks about your feelings, no one asks for your input when decisions are being made. This does create a problem. It leads to feelings of frustration, isolation, helplessness, and resentment. Your family member is all too aware of this situation. Integrate your family member into all discussions, especially when he/she is the topic of conversation.
Your family member with a brain injury may have difficulty organizing his/her day and filling empty hours with constructive tasks. Spend time outlining a daily schedule and in the morning (or the previous evening) review the schedule of the day’s events to assist him/her to move through the day with a feeling of greater control and less anxiety.
Have you ever started an activity and suddenly forgot what you were doing or the steps required to complete your task—or even how to begin? We all probably have. This situation occurs more frequently following a brain injury. Assist your family member by asking questions or providing “cues” that will help him/her to get restarted. It will be tempting to complete the task for your family member, but it will be far more beneficial to him/her if you merely provide the guidance he/she needs to continue.
Schedule changes, interruptions in a routine, a new teacher, or boss, or a rearrangement of the regular lineup of TV shows all can lead to confusion and anxiety. A brain injury reduces a person’s ability to react flexibly to changes. The most effective way to handle this problem is to prepare your family member to anticipate changes whenever possible. Should changes happen without notice, take time to explain them as they occur.
Did you ever hear the old saying, “Patience is a virtue?” Well, patience is now a necessity. Thoughts, words, or tasks may take a greater amount of time to complete. Let your family member take the time that is required to respond or complete an activity. Your patience and your understanding of the difficulties often function as the very boost he/she needs to do a task more effectively and successfully.
While patience is important, it is equally important to avoid being overly indulgent or accepting of inappropriate behavior. Be sure to clearly identify inappropriate behavior when it occurs, and avoid allowing it because you feel sympathetic or sorry for the person who has been injured. It benefits all of us to have consequences to our behavior so that we can continue to feel socially comfortable.
Say what you mean and mean what you say. Your family member may interpret your statements very literally, which can sometimes create misunderstandings. It is best to avoid colorful and abstract analogies and stick to the facts.