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Possible Effects

Possible effects following a brain injury Relationship issues Loss / bereavement cognitive deficits physical effects emotional / behavioural issues

Issues for families / carers following a brain injury are:

  1. The need for attention, education, guidance and support to survive, regroup in order to rebuild their lives. Relatives of people who have sustained a head injury report that the 10 most difficult problems to cope with are:
    1. Personality changes.
    2. Slowness.
    3. Poor memory retention.
    4. Irritability.
    5. Bad temper.
    6. Tiredness.
    7. Depression.
    8. Rapid mood swings.
    9. Tension and increased anxiety.
    10. Threats of violence.
  2. Close family members are likely to experience high levels of anxiety & depression during the years following a brain injury. As time passes, relatives' abilities to cope, particularly with emotional and behavioural problems decrease/reduce.
  3. Partners often feel isolated and trapped within the relationship, where their emotional needs are not being met.
  4. Children often experience emotional problems coping particularly with the initial trauma, subsequently followed by the difficult behaviour of a parent with a head injury. This often results with the child's needs being neglected, which can impair school performance.
  5. Not knowing whom to turn to for support or advice.

Loss/Bereavement:

It is frequently said that there are not just head injured individuals but rather head-injured families, because the whole family unit is affected. It is often said that families are the real victims and suffer more than the head injured person, as family members are more likely to have accurate insight into the problems as a result of the injury. Some of the problems that may occur following a head injury can result with long-term or even permanent changes, in the individualís ability to communicate, think or perform everyday activities independently. Changes in a loved oneís personality and/or behaviour can be difficult to accept, with the notion of coping with these changes particularly daunting for everyone involved.

Research into the effects of severe head injury on the other family members provides some indication of the extent of their difficulties. The following points are worth noting:

  1. Close family members are likely to experience high levels of anxiety and depression during the years following a head injury. As time passes, there is often a reduction in relativesí capacity for coping, particularly with emotional and behavioural problems, which cause feelings of frustration, embarrassment, guilt and anger.
  2. Spouses often feel isolated and trapped with a marriage where their emotional needs are not being met, due to the changes within the relationship with the head-injured person. Some describe this as being neither married nor single. Relationships are put under enormous strain, and it is estimated that a high per cent of all marriages in which one spouse has had a severe head injury end in divorce.
  3. Children often experience emotional problems as, alongside coping with the initial trauma, and the subsequent difficult behaviour of a parent with a head injury, their own needs are often neglected, and this can affect their performance at school.

It takes a long time for individuals to accept that their loved one is not going to get back to "normal", even though the familiar figure is there bodily, there are many changes, most of which are losses. As family members are trying to cope with feelings of loss, they also have to manage everyday events and difficulties associated with head injury. Coping with the cognitive, behavioural and social problems, in addition to uncertainty about the future, possible financial difficulties and role reversal are just some of the issues families have to deal with.

Just as the person with the head injury goes through various stages of recovery and acceptance, so does the family. Different stages of emotional reactions that families are likely to experience are:

  • Stage 1 ñ Shock, panic, denial elation e.g. "please God let him live".
  • Stage 2 ñ Relief, elation, denial e.g. "Thank God heís going to be fine".
  • Stage 3 ñ "Hope heís still making progress even though itís slow".
  • Stage 4 ñ Realisation, anger, depression, mourning e.g. "heís not going to get back to his old self".
  • Stage 5 ñ Acceptance and recognition e.g. "our lives are now very different".

Families need attention; education, guidance and support if they are to survive, regroup and rebuild their lives. Some families cope better than others, but all have difficulties. There is no normal way of responding to a head injury.

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