Family Adjustment

Be consistent

Brain injury reduces one’s ability to be flexible with changes, so prepare your loved one for any changes that will need to be made and minimize the number of changes taking place at once. Situations such as a new daily routine, new people, or a new sequence of steps can cause increased confusion and anxiety if not properly anticipated.

Be inclusive

When having conversations about your loved one, do not forget to include them. You have been in a position to make decisions about the care of your loved one throughout this experience, but as they are able to participate in conversations, make sure to ask for their input. If left out of conversations, your loved one may begin to feel frustrated, isolated, helpless, and even resentful. They will appreciate the opportunity to begin regaining some control over the decisions related to the
present situation.

Be patient

Following a brain injury, a person may take longer than usual to think, move, speak, and understand. Help decrease their frustration by being patient. Allowing extra time will help improve the effectiveness and success of basic tasks.

Encourage independence

The ultimate goal of the rehabilitation process is to achieve the maximum level of independence. Your family member may be fearful of trying new things as a result of the changes since their injury. Although you are required to supervise your family member for safety, it is important to redirect them to try new things and build independence.

Offer cues

Following a brain injury, your loved one may need a little extra assistance in answering questions and starting or completing a task. Sometimes cues to help them move in the right direction, without doing the tasks for them, is all they need to be successful. While it may be easy for you to complete tasks for them, it is far more important for you to promote their success.

Provide positive reinforcement

Provide frequent praise throughout each day as a means of reinforcement for handling difficult situations. Since some amount of frustration is normal and expected for you and your family member, it is important to create a positive environment and provide support throughout the treatment progression. This also helps to boost the self-image of your family member as they work through this difficult process.

Provide structure

Organizing thoughts and activities following a brain injury can be very difficult for the injured person. It may be helpful to help establish the framework for organization in the form of a calendar, a daily to-do list, or even writing out the steps to a task. Spending a few minutes each day reviewing these items will assist your loved one in feeling more successful in activities and more in control of their time.

Simplify

Too much information regarding any topic may confuse or overwhelm your family member. When providing information or making requests, try to leave out unnecessary details. Keep lists to a minimum of 2 to 3 items. Try to be specific and omit extra details to decrease chances of becoming overwhelmed and confused. Your loved one may also take things very literally, so this will help to prevent misunderstandings.

Temporary vs. permanent role shifts

When a family member becomes injured or ill, other members of the family often take on extra roles.

For example, if a father who always does the yard work now has a broken leg, a spouse or child may jump in to help. These changes are usually temporary, since Dad likes yard work and wants to do it again.

After a brain injury, changes in family roles may not be temporary.

Impact on couples

When one member of a couple is seriously injured, the other one becomes responsible for the physical and emotional support of the couple. This can create changes in the relationship, as well.

Helping children adjust

Children in the family of a seriously injured person may need help learning that the rest of the family will need to pitch in more. Give them a list of the tasks that need to be done, and let them choose the tasks they like to do or dislike the least. Praise them for a job well done. Remember they are children and need time to play and be with friends, and not feel like they must act like adults.

Finding strength in change

While role changes are often hard, many good things may happen as a result. Families may learn to work together and support each other better. Children may begin to have confidence from learning new tasks. Families may find that life can still be fun, even though it is different. It takes patience, understanding, and teamwork to get to that point.

Some families put their lives on hold, waiting for things to return to the way they used to be. Even in the best of times, life will never be the way it was before. Both the injured person and the family have gone through a major, life-changing event. Getting back into daily routines often helps families keep good support that brings pleasure back into life.

Accept help – you don’t have to do it all

Don’t assume you can handle everything alone. Accept help. People want to help. Don’t feel as if you are inconveniencing them.

Get organized

Get organized so that when people offer to help, you can tell them what you need. Make a list of things that need to be done and divide it into things only you can do and things that others can do.

The list will help friends and family choose a task to do or choose to relieve you so that you can do things that must be done by you. You might even let a family member or close friend use the list to coordinate help.

Make time for normal activities

Make time for the family to get back to doing some of the normal things, like going to a place of worship, allowing the teenagers to spend time with friends, or go to a football game, and getting back to work and school.

Prioritize stress relief

Find healthy ways that help you relieve stress, such as exercise, reading, meditation, or gardening. Carve out time for stress relief on a regular basis. You deserve it.

Balance is key

Everyone needs a balance between rest and responsibility. Having this balance will help you have energy to meet life’s challenges.

Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress, such as family and relationship problems, serious health problems, or workplace and financial stressors.

Developing resilience is a personal journey. People do not all react the same to traumatic and stressful life events. An approach to building resilience that works for one person might not work for another. People use varying strategies. Here we share a few to consider.

Build strong connections

• Good relationships with close family members, friends, or others are important. Accepting help and support from those who care about you and will listen to you strengthens resilience.
• Some people find that being active in civic groups, faith-based organizations, or other local groups provides social support and can help with reclaiming hope. Assisting others in their time of need also can benefit the helper.

Shift your perspective

• Avoid seeing crises as insurmountable problems. You can’t change the fact that highly stressful events happen, but you can change how you interpret and respond to these events.
• Try looking beyond the present to how future circumstances may be a little better. Note any subtle ways in which you might already feel somewhat better as you deal with difficult situations.
• Accept that change is a part of living. Certain goals may no longer be attainable as a result of adverse situations. Accepting circumstances that cannot be changed can help you focus on circumstances that you can alter.

Take action

• Move toward your goals. Develop some realistic goals. Do something regularly, even if it seems like a small accomplishment, that enables you to move toward your goals.
• Take decisive actions, rather than detaching completely from problems and stresses and wishing they would just go away.

Find growth in struggles

• Look for opportunities for self-discovery. People often learn something about themselves and may find that they have grown in some respect as a result of their struggle with loss.
• People who have experienced tragedies and hardship can report better relationships, greater sense of strength even while feeling vulnerable, increased sense of self-worth, a more developed spirituality, and heightened appreciation for life.

Stay positive

• Nurture a positive view of yourself. Developing confidence in your ability to solve problems and trusting your instincts helps build resilience.
• Keep things in perspective. Even when facing very painful events, try to consider the stressful situation in a broader context and keep a long-term perspective. Avoid blowing the event out of proportion.
• Maintain a hopeful outlook. An optimistic outlook enables you to expect that good things will happen in your life. Try visualizing what you want, rather than worrying about what you fear.

Prioritize self-care

• Take care of yourself. Pay attention to your own needs and feelings. Engage in activities that you enjoy and find relaxing. Exercise regularly. Taking care of yourself helps to keep your mind and body primed to deal with situations that require resilience.
• Additional ways of strengthening resilience may be helpful. For example, some people write about their deepest thoughts and feelings related to trauma or other stressful events in their life. Meditation and spiritual practices help some people build connections and restore hope.

The key is to identify ways that are likely to work well for you as part of your own personal strategy for fostering resilience.