Excerpts

Managing difficult behavior of a family member can be one of the most stressful aspects of caregiving. Irritability, inappropriate comments, unpredictable responses, poor self-awareness, impulsive behavior, lack of motivation, or refusing to do things – these are just some of the behaviors that family members and caregivers may see when a person survives a severe brain injury.

How does a caregiver deal with this while still helping with the survivor's recovery and maintaining one's own sanity? First, understand why this is happening and, second, learn what you can do to improve the situation.

Survivors with more serious brain injuries may find it hard to communicate clearly and also may have difficulty understanding what is said to them. Following long instructions or conversations and staying on topic may be difficult. A survivor of a brain injury may have difficulty using and following social cues such as body language, tone of voice or facial expressions during conversations.

It's hard for others – family, caregivers, even therapists and clinicians – to understand the frustration that a person living with a brain injury often feels. In addition to depending on others, they are often told they can not work, drive, drink, or go out as they did before.

There's a reason. Trauma to the frontal part of the brain (just behind the forehead) can affect behavior directly. This area controls what are often called “executive skills.” Like an executive of a company, the frontal areas of the brain help a person establish goals, choose patterns of behavior to achieve those goals, and inhibits (stops) behavior that is not consistent with those goals.