By Jennifer Olsen, a Registered Nurse with Caregiver Homes. 

Terry* is polite, optimistic, and fun to be around. In conversation, his words and mannerisms don’t raise any eyebrows—as long as the topic doesn’t drift beyond the past few minutes. When I first met him, I asked, “What time did you leave the house this morning?” He reached into his pocket, pulled out a notebook, scanned the page, and confidently responded, “7:30 a.m.” Terry has no short-term memory.

Many years ago before I became his nurse, Terry sustained a Traumatic Brain Injury (TBI) from a motor vehicle accident. Terry’s life has undergone drastic changes, and he now needs full-time care from a live-in caregiver and professional support, which he has found through Caregiver Homes. To compensate for his short term memory loss, Terry carries around a notebook with him at all times as a record of his day. When Adult Day Care picks him up, he writes down what time. When he changes from one activity to the next, he jots down another note. His mood and personality have also shifted since the accident. His demeanor is friendlier and his outlook, more positive.

Not all people with brain injuries show these types of symptoms, though. Earlier in my career as a Registered Nurse, I worked for a school for adolescents and adults with brain injuries and neurological issues. People can often have longer-term memory impairments as well, such as amnesia. For mood shifts, the more common changes I have seen are ones that veer towards more agitated or aggressive after their accident. But how these injuries manifest is difficult to predict—two people who have been in the same type of accident can show a completely different set of symptoms. Here are some common accommodations caregivers should be aware of when supporting people with Traumatic Brain Injuries:

• Keep things organized. Make sure to keep the home organized. Be conscious of the specific places items go so as not to confuse them.
• Maintain their routine. Keep their day-to-day lives as consistent as possible. This will be helpful for memory issues and prevent them from getting overwhelmed. If there’s going to be change, discuss it with your loved one beforehand and prepare them for the transition. 
• Be patient. Let the individual take as much time as necessary to complete tasks. It can be frustrating, but it is important to encourage them to work through it slowly at their own pace.
• Help them develop strategies. People with TBIs can become very frustrated due to memory loss and fatigue. Like Terry with his notebook, it can be very helpful to develop reliable techniques your loved one can depend on.
• Understand their fatigue. People suffering with brain trauma can easily become tired, particularly during the recovery stages. When the brain is healing, people can become overwhelmingly exhausted, particularly when undergoing multiple forms of therapy (e.g. physical, occupational, speech therapy). Understanding what stage they are at in the healing process and catering their support specifically to that stage is important to their care.
• Support them psychologically. Caregivers and members of their care team can be a huge support in identifying what makes their lives worthwhile and what it takes for them to be happy. Focusing on their personal goals despite their mood changes and physical symptoms can make their lives fulfilling even with their injury. In Terry’s situation, he often feels lonely. Assisting him in his interpersonal and relationship-building goals are important for his overall emotional well-being.

Caring for people with Traumatic Brain Injuries requires patience and specific attention to their individual needs. Terry lives with a family that supports him and his progress, and now he has learned to find methods of coping with his symptoms to live a fulfilling life.

*Name has been changed to protect identity.