Observations on Traumatic Brain Injury


 These observations are none scientific and are relayed below after nine years of being involved on a daily basis with one person’s TBI.  This journey has also brought me in contact with others suffering TBI.  I have come in contact with numerous individuals who suffered what on the surface were similar accidents.  Then observed the difference in how a seemingly similar injury affects each person differently in impairment and rehabilitation, sometimes markedly.  It is obvious that no two TBI's are the same.


These observations are random thoughts jotted down of a general nature and I believe would apply to all TBI injuries::

  • Talk to the TBI sufferer from day one.  Carry on complete conversations even if initial responsiveness is lacking.  I am convinced that this interaction is critical to the persons coming back to conciseness.

  • Hope for the best and expect the worst.  Doctors are very reluctant to provide diagnosis in such cases because the outcomes are so varied.

  • Resist the attempt to gauge your TBI sufferers progress or outcome based on others you observe with TBI.

  • Serious brain injuries can require years of recovery.

  • Active daily participation of family is critical to a quicker and more complete recovery.

  • The personality of the person you knew will be changed.  The change may be minor or substantial.  Accept the changes and move forward.

  • The TBI sufferer must have constant input from loved ones.  I believe there is a direct correlation between this input and progress.

  • You must continually advocate for the victim.  Do not expect for others, including the experts, to do everyting that is required.  You must study the issue yourself and question what is being done or not being done until you are satisfied that the suffer is receivng everything required.

The following observations will not be specific to all TBI injuries.  They did however apply to my stepson:

  • Talk more slowly.  I did not say to act like you are talking down to a child.  Just talk more slowly as it takes additional time for the person to comprehend what you are saying, try to formulate a logical answer, and respond.  TBI's affect the brain.  Though this may seem obvious, think about it for a minute.  The brain is how creatures make decisions and through which all aspects of life is conducted by the person.  Brain injuries interrupt the brains ability to think as they did prior to the accident.

  • Avoid distractions.  While the person is in the early stages of the TBI, do  not conduct conversations with the TBI sufferer in surroundings that are loud or where other conversations are occurring.  Turn off the TV when conversing.  You will know if or when more varied stimuli can be absorbed.

  • Do not ask any follow up questions until the 1st one has been answered.  Remember the slowness in responding.  We take this for granted as we can accomplish this on the fly.  A TBI sufferer often cannot.  Early on we would ask Brad a questions, go on to other conversation and sometimes several seconds later Brad would respond to the original question.

  • Watch closely for signs of fatigue.  TBI suffers become mentally fatigued very easily.  This can manifest itself in the TBI suffer spacing out, becoming angry, or having increased confusion.  Such symptom can remain years after the accident.

  • Each emotion requires different methods to handle.  Watch for clues and draw on experience.  Many TBI sufferers have emotional changes.  Brad is a college educated adult and retains many of those educated bits of information.  When he becomes tired however Brad sometimes responds as you would expect from a child with anger and will lash out.  After a certain point has been reached, more progress will not occur or may come very slowly.  This may be weeks or years later.  You may need to understand that unlike a child who learns from experience, the TBI sufferer may not "learn".  It is hard to learn if you do not remember the last outburst.

  • Do not give up and do not punish the TBI sufferer for something they cannot control.

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Bradley Makowski