New Normal: For caregivers after brain injury

New Normal: For caregivers after brain injury

Janet Cromer, RN, LMHC
There is no single definition of "new normal" that fits every family, since each brain injury and each family is unique. This tip card helps family caregivers understand the adjustment process after a brain injury, for themselves and the survivor, with practical tips for moving forward at home and in the community.
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Tip card explains what the “new normal” is after a brain injury and how differently it affects individual families. Feelings of sadness, guilt, worry, anger and uncertainty are all part of the caregiver’s responses and may lead to ambiguous loss, a complicated grieving process. As families journey toward a “new normal”, the tip card has strategies for helping caregivers and survivors recognize the symptoms of depression, chronic stress and burnout and how to cope and find treatments.
Pages 8
Year 2011


Janet Cromer, RN, LMHC

Janet’s career spans thirty-five years as a medical and psychiatric RN, twenty-three years as a licensed psychotherapist, and seven years as an award-winning healthcare writer, most recently from the American Medical Writers Association New England Chapter. Janet held clinical and administrative positions in hospitals and community mental health programs, and managed her successful private psychotherapy practice. As a Registered Art Therapist with a Master’s Degree in Expressive Therapies from Lesley University, Janet incorporated art, writing, drama, and movement into her treatment with people dealing with medical illness, mental illness, and brain injury. She has long been interested in the medical humanities as a way to improve patient care and foster humane relationships among professionals, patients, and families. Janet presented at the Maine Humanities Council “After Shock: Humanities Perspectives on Trauma” national conference on narrative medicine.

Since 1998, Janet has contributed her professional expertise to the brain injury and family caregiver communities as an award winning writer, support group facilitator, speaker, advisory board member, and advocate for family caregivers and survivors. Her viewpoint encompasses a broad understanding of healthcare issues and personal experience as a family caregiver for her husband who faced the challenges of brain injury, dementia, and Parkinson’s disease. Professor Cromer Learns to Read: A Couple’s New Life after Brain Injury is the recipient of a 2010 Solimene Award for Excellence in Medical Communication and the Neal Duane Award for Distinction from the American Medical Writers Association-NE Chapter.


What is the “New Normal”

Caregiver's Responses

Ambiguous loss


Journeying Toward the “New Normal”

Tips for caregivers

Tips on helping the survivor


Depression, Chronic Stress, and Burnout



Tips for caregivers to stay healthy

Tips for caregivers to build stress resilience

Tips for caregivers to boost your mood and attitude





Sample excerpt. Preview only – please do not copy

Both the survivor and family move through stages of care and adjustment after a brain injury. After months or even years, many families enter a “new normal” stage of adjustment. There are strategies and skills caregivers can practice to move forward in this adjustment process.

The “new normal” is a combination of a time period and an attitude. This tip card defines an attitude of active acceptance as being realistic about changes in the survivor’s personality, emotions, behavior and thinking.   It addresses the caregiver’s feelings of sadness, guilt, worry, anger, and uncertainty and offers tips for the caregiver’s well-being, as well as tips on helping the survivor.

There are strategies and skills caregivers can practice to move forward in the adjustment process.

Tips for Caregivers

  • Prioritize your health. Practice stress management techniques such as relaxed breathing, meditation, reframing distressing thoughts, and having a good laugh. Tend to the basics of sleep, exercise, and healthy food.
  • Involve your family in choosing new roles and routines. Celebrate the progress you’ve made together.
  • Form a circle of support to get help and make life run smoother. Ask a friend to coordinate offers and schedules. It’s never too late to ask for help!

Tips on helping the survivor…

  • Get to know the whole person, beyond impairments or disabilities. Find a few new qualities to admire and like.
  • Encourage more independence as skills and judgment improve. Try not to let your anxiety get in the way of letting the survivor try something new.

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