Monday, December 5, 2011

Helping a Brain-Injured Person - Part Two

Last month, Dr. Kerpelman described exactly what a traumatic brain injury is (TBI), the signs and symptoms to look out for, and what to do if you suspect an injury has occurred.  Explaining to children that a loved one may have "pieces missing" after hurting their head is a simple way to convey the changes in memory, language and behavior they may find confusing.  In this month's article, you'll learn the challenges a brain-injured person faces, how you and young children can support the patient's recovery, and most importantly, how to help children empathize and interact appropriately and compassionately with anyone we may encounter with a brain injury or other disability.
By Larry C. Kerpelman, author of Pieces Missing: A Family’s Journey of Recovery from a Traumatic Brain Injury (Two Harbors Press, 2011)
In Part One last month, I described how my wife sustained a moderately severe traumatic brain injury after falling while jogging, and I described the many symptoms that can result from such an injury to so sensitive (and important) an organ of the body.  It took three emergency room visits, two hospitalizations, one brain surgery, and months of rehabilitation for her to regain the pieces missing from her speech, thought, reading, confidence, and zest for life.  In Part Two below, I discuss some of the things you can do to help a brain-injured person’s rehabilitation.  Even young children can play an important role in the healing and recovery process.
1.)    Support the person in their rehabilitation, whether it’s through reminding that person to do the exercises prescribed by the medical and rehabilitation therapists, helping with those exercises, or understanding and accommodating the sufferer's limitations.  Kids may enjoy being a “personal trainer”, doing the exercises alongside their relative, and coaching them along.
2.)    You can expect that a brain injury may cause disruption or even disappearance of previously normal physical, cognitive, and emotional functions.  Ensure that daily activities can be carried out safely.  A brain-injured person may have balance and strength issues; the worst thing that can happen to a person during the first year after the original injury would be to suffer another fall or bump that injures her head.  Children can also take an active role caring for their relative…they can play “Police Officer”, reminding the person not to forget their cane or walker.  Or they might want to be a “Bodyguard”, and escort their relative by the hand to their destination.  Until the injured person’s physical strength, balance, and coordination is substantially restored, a family member or friend should be near her when she walks or goes up and down the stairs in case she loses her balance.  It’s especially important to follow this practice when outside the house because outside surfaces are a lot more uneven than those in a house.  The brain-injured person should not be hurried to resume any normal activity until she feels ready to do it and do it safely, and even then, a friend or loved one should monitor the activity to ensure that it is indeed being done safely before she is left on her own to do it independently.
3.)    Be patient and understanding.  In the cognitive area, the person’s memory, reading, problem-solving, and logical sequencing of activities may be impaired.  If a person with a TBI cannot remember a person’s name or the name of a place, encourage her to describe the person or her associations with the place.  Using different thought processes may help her to recover the name.  The speech and thought processes of someone with a TBI may be slower and punctuated by pauses as she searches for the next words.  If that person’s speech becomes hesitant because he or she cannot get a word out she is trying to say, you should resist the natural urge to supply the word or finish her sentence for her.  Ask your kids to do the same, although recognize that it will be harder for them not to prompt the person than it will be for you (and it is hard).  Only by working through the cognitive processes to find the word or words and say them will the brain-injured person gain practice in being able to recall or recognize words.
4.)    Remember that the injured person may feel more fragile and vulnerable.  A person who is recovering from a brain injury may very well appear physically to be just the same as before the injury, but there may be incredible changes within the person emotionally.  He or she may think, feel, or act differently than before.  Children may pick up on these new behaviors and become confused.  You can do your part by recognizing this new reality and working with the injured person to accommodate to, and possibly gradually improve, the new emotional state.  Emphasize to children that this is still the same relative they know and love, and the changes they see are part of the injury.  Some changes may resolve over time, and some may not, which might be difficult for children to understand.  Counsel children to be patient and understanding and, even more importantly, model the behavior for them.  Kids do what you do, more often than what you say.   
5.)    Treat him or her with respect, and be ready to help that person.  Above all else, remember that a person with a brain injury is a person first.  Also remember that no two brain injuries are exactly the same. The effects of a brain injury are complex and vary greatly from individual to individual. Those effects will be different depending on the injury’s cause, extent, location in the brain, and severity.  Consequently, I can only give a partial picture here of what to expect and how to interact with a person who has suffered a brain injury.  For more information on other support mechanisms, go to the excellent website of Brainline, 

Would you like to use this article for your own website or newsletter?  No problem!  But here's what you must include: 
“Larry C. Kerpelman is author of Pieces Missing: A Family’s Journey of Recovery from a Traumatic Brain Injury (Two Harbors Press, 2011). Dr. Kerpelman is a psychologist and award-winning health care communicator who never would have imagined his writing would be inspired by experiences in his own family.  When his wife suffered a brain injury from a freak accident, the journey toward recovery took his family through the maze of a less-than-perfect healthcare system.  The book inspired by this experience provides a moving story of the endurance of the human spirit, combined with insights about brain injury and recovery and pointed questions about how our health care system functions. For more book details, please visit him on If you or someone you know would like to buy Pieces Missing, you may order it from,,, or your local bookseller.”
Dr. Kerpelman will be speaking at Sargent Memorial Library in Boxborough, MA on January 24, 2012 at 7pm (snow date January 31).

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