Traumatic Brain Injuries: The Dynamics
When a loved one experiences a traumatic brain injury (TBI), family dynamics are forever changed.
The athletic boy who suffered a blow to the head during batting practice no longer is able-bodied. The academic girl who suffered a skull fracture after a fall no longer can read. A father driving to work is rear-ended, hits his head on the steering wheel, suffers a concussion and no longer can provide for his household. These stories are sad and true.
Because families usually are responsible for the care of their loved ones, the task becomes challenging when TBIs are involved. The situation can lead to depression, frustration, stress and unknown burdens in the future. Family members find themselves dealing with someone they barely recognize from their previously known loved one.
“If the injured individual was the primary earner or caregiver, other family members will have to adjust their lives to step up to the tasks,” states a blog on the Occupational Assessment Services’ Web site. “Loved ones will also need to get accustomed to the behavioral aspects of brain injury, which can include confusion, agitation, memory and concentration deficits, irritability, decreased safety awareness and judgment, and impulsivity. The family will also have to accommodate any associated physical limitations the injured individual has.”
Physical limitations mean the need for medical durable equipment (MDE). Such equipment is costly, will need to be replaced, adding to the costs, and can lead to the development of additional problems . The athletic boy now in a wheelchair probably will gain weight, which can cause health-risk factors such as diabetes and high blood pressure.
Then, a decision must be made about whether a loved one should be cared for at home, in familiar environs, or in a residential rehabilitation center staffed with highly trained caregivers. It can be heartbreaking, and bank-breaking. At home care is usually the preferred approach for the injured person and the family members. In addition to the physical care and emotional instability, often complete renovation of the home residence is needed. Ramps must be built, bathrooms completely changed and transport vehicles have to be obtained or modified,
A personal-injury attorney can help families through the process not only by representing them and making sure they are fairly compensated but also by finding a life-care planner who can formulate a course of action in the best interest of all involved. This is a crucial part of the TBI patient’s ability to progress through rehabilitation and regain as much independence as possible. Sadly, many injured people never regain any semblance of real independence and the life care plan then focuses primarily on palliative care.
“…the most difficult ongoing issue families face with brain injury, regardless of its cause, is the profound change in family dynamics due to disability,” according to The Expert Institute.
“Loved ones tolerate the inconveniences of dealing with many behavioral aspects of brain injury – confusion, agitation, memory and concentration deficits, irritability, decreased safety awareness and judgment, impulsivity, and others – feeling that these and any associated physical limitations will resolve with time.”
The most healing occurs within the first year of the TBI, during what is called the acute phase. After that, the healing slows. In three years’ time, the healing plateaus.
“At that point, for the most part, what you see is what you get,” according to The Expert Institute. “That’s when it’s a good idea to get a comprehensive evaluation panel, including neuropsychiatric examination, nursing, therapies, and social work to establish a functional baseline. This will help the family begin to prepare for their changed future.”