Too many adults who are survivors of brain injury have had multiple losses and lead isolated, lonely lives. Brain injury rehabilitation services have focused too much on trying to “fix” the survivor through rehabilitation treatment rather than helping the survivor develop a community with meaningful relationships that contribute to quality of life. This new direction is based on Condeluci’s concept of social capital and could change how rehabilitation programs and human services are delivered.

Questions about the way a person who has experienced a brain injury will act and what their personality will be like are the most frequently asked. Over time, it is the changes in social skills and behavior that are the biggest concern to families. More than the physical effects of a brain injury, changes in how a person acts post brain injury can be more difficult to adjust to.

One out of two adolescents or adults with brain injury abuses substances like alcohol or drugs. Some survivors trying to cope with depression, social isolation and other losses turn to alcohol or drugs. Abusing these substances can slow or complicate recovery.

There is an overlap between traumatic brain injury (TBI) and violence which is an important yet little understood problem. The exact number of violence-related TBIs each year is not known, but the CDC estimates 11% of TBI deaths, hospitalizations and emergency room visits combined are related to assaults.

One of the common consequences of traumatic brain injury (TBI) is sexual dysfunction. Unfortunately addressing sexual issues as a component of rehabilitation is often overlooked for a variety of reasons.

“Sexuality is an integral part of the human experience” (Sander). We are all sexual beings and sexuality is part of our life experience. Social mores and cultural differences make sexuality a taboo issue in some societies. Many therapists and other direct care providers in hospital and rehabilitation settings are untrained about sexuality and persons with disabilities. Their personal values often interfere with their ability or comfort level discussing the topic. When sexuality is overlooked as part of rehabilitation, sexual dysfunction can become an issue that is very difficult for families to understand. Social isolation, common for persons after TBI, limits opportunities for developing meaningful relationships.

Identification and treatment of behavior challenges after acquired brain injury (ABI) have included behavioral modification programs, medications to control abnormal behaviors, token economies, and social reinforcement. Despite the widespread recognition of behavioral issues, today few resources exist for crisis hospitalization and treatment by mental health programs.

Concussion is the most common type of traumatic brain injury in adults. Concussion symptoms can include headaches, dizziness, trouble sleeping and difficulty concentrating. Mild traumatic brain injury is a “hidden” condition because too often it is not diagnosed by medical professionals. Many individuals are unaware that their brain has been injured and do not see a doctor or go to an emergency department. Most symptoms are temporary but some adults have long term effects with post concussion syndrome.

Treatment for traumatic brain injury can be costly for the child or adult who has been injured as well as the family. Hospital care, rehabilitation, therapies, medication, home care, equipment – all can be costly. These expenses are added to lost income of family members. The costs of care for traumatic brain injury, insurance limits, and limited community resources add to the stress of families.

Survivors of traumatic brain injury worry about the effects of aging on cognition, depression, Alzheimer’s disease, and epilepsy. Aging is not a disease, but aging can compound the effects of brain trauma including memory, organization, and problem solving. Ten rules are given to help adults with TBI with the aging process.