VIRGINIA COMMONWEALTH UNIVERSITY

NATIONAL RESOURCE CENTER
FOR TRAUMATIC BRAIN INJURY

Neuropsychology and Rehabilitation Psychology Division Department of Physical Medicine and Rehabilitation.

Pat #24

DEAR PAT: Our 26-year-old daughter was badly hurt in a motorcycle accident 3 years ago. She broke a leg and both arms, had bruises from head to toe, and had a massive brain hemorrhage. There was a time when we didn’t think she would make it. Luckily, she had great surgeons that literally saved her life. We were filled with hope during her quick physical recovery. What has been most difficult has been watching her mental struggle with the effects of a brain injury. Even after all this time, she still forgets everyday things, has trouble keeping up with conversations, and gets tired so fast.

Since she was discharged from the hospital and finished treatment, my husband and I have been taking care of her at home. We love our daughter very much and would do anything to help her get better. I have noticed, though, that her temper is much shorter since the accident. She argues with my husband about everything. In her defense, my husband likes to tell her what to do and how to do things. I think he has a hard time letting her make her own decisions and mistakes. I know my daughter is growing more angry and resentful about the way she is being treated. What can I do, Pat, to keep the peace at home between my daughter and husband?

PAT’S RESPONSE: Wanting the members of your family to be happy and to get along is a natural response. I bet your motherly instincts about conflicts between your daughter and husband are right on target. The trick, however, is to avoid being the target! In other words, when family members argue, some unlucky person may find herself caught in the middle. During stressful times, you may also feel extra pressure to help everyone in the family get along.

Realizing that your family has been through a series of stressful events since your daughter was injured is important. First, you and your husband were faced with the possibility that she may not survive the accident. Second, you were concerned about her mental recovery once her physical health was restored. Lastly, you have seen signs of lingering cognitive and emotional problems that are worrisome.

You and your husband may also be under stress because of the responsibilities of taking care of your daughter. Assuming she was living on her own before the accident, you and your husband had probably just gotten used to having an “empty nest” when she moved back home. Having an adult child in the home after a period of absence would be a significant change for any couple. Also, the strain of caregiving should not be overlooked. Relatives providing care to persons with brain injury may find the responsibility rewarding but burdensome. Adjusting to these life-altering changes is understandably difficult for your family.

Following a brain injury, survivors are more vulnerable to stress of daily hassles as well as major life changes. That’s one reason why people with brain injury often have trouble controlling frustration and anger. There are a number of constructive ways to cope with anger problems that survivors and their families have shared with me over the years. To help your daughter increase her self-control, try the following ideas other survivors and their families have found helpful:

* Encourage her to be positive and sensitive to others’ feelings. Remind her to explain herself calmly. Doing so will make it easier for others to understand and help.
* Help your daughter remember that controlling anger will improve relationships with family and friends.
* Encourage your daughter and husband to take a “time out” and try to relax when angry feelings start to build. Helpful strategies include breathing deeply and slowly or counting to ten before speaking or acting.
* Identify trouble situations, people, and places that bring out your daughter’s anger. Make a plan to deal with trouble situations and practice the plan ahead of time.
* Be a good role model and encourage your husband to do the same. Teach good anger management skills by using them yourself.

Patients and families may need additional help during especially stressful times. Talking to extended family members, friends, or professionals can benefit families with complex and challenging issues as the ones you have described. For example, you may consider asking others for help in caregiving. A short break or chance for respite often makes it easier for family caregivers to cope over the long term. You may also wish to contact the Brain Injury Association of America (BIAA). BIAA offers a telephone helpline for families (1-800-444-6443) as a nationwide source of information and referral services. For emotional support, participating in a local support group for persons with brain injury and their families is another possibility. The Brain Injury Association of Virginia (BIAV; 804-355-5748 or 1-800-334-8443) provides information about support groups and other useful services for survivors of brain injury and families.

If you are seeking individualized help, you may wish to consider counseling for yourself or your family. BIAV has a list of mental health professionals with brain injury experience throughout Virginia offering individual and family counseling. Another source of treatment may be found in the Department of Physical Medicine and Rehabilitation at Virginia Commonwealth University (VCU). The family support program at VCU provides education, counseling, and referral services addressing the unique needs of persons with brain injury and their families. Laura Taylor may be contacted to learn more about this program and to see if you are interested in participating (phone: 804-828-3703/1-866-286-6904 or email: taylorla@vcu.edu).

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