What My Traumatic Brain Injury Patients Have Taught Me
A traumatic brain injury (TBI) is a brain dysfunction that is caused by an outside force such as a blow/hit or jolt to the head, a car accident, a severe sports injury, a skiing accident, and more. There are three levels of intensity of traumatic brain injuries: a concussion (with most people recovering within three months), a moderate TBI (with some individuals recovering most of their brain functions), and a severe TBI (which is hard to predict any recovery, due to severity of the damage, if they were placed in a coma or not, and many other factors. With neurosurgery, occupational/physical therapy, speech/language therapy, psychological services, and or social services, many people experiencing a TBI can improve.
I have spent the last eight months working with clients with traumatic brain injury and I discovered that everything I had assumed was wrong. After working with dementia and hospice clients for over a decade, my first incorrect assumption is that there would be no noticeable improvements with individuals, that have experienced a TBI. After working with about 20 clients for months, I noticed that many individuals still have valuable and possible goals. These goals could be as simple as moving their arm correctly to shower themselves with soap, to contributing their opinion toward their suitcase being packed, or even deciding to volunteer or exercise during downtime while living at a facility.
My second crash-and-burn assumption was that all individuals with traumatic brain injuries need and experience the same things. I very quickly noticed that this was a novice assumption on my part, as each individual not only has interests before and after their traumatic event but they also have details and expectations for their day. One client I have worked with would start their day tickling their caregivers and making jokes about racing cars. Another would make sure she had the cutest matching jumpsuits picked out. One person really needed and leaned on community and parent involvement, while another had been betrayed by all family after their accident, so preferred to work on goals individually.
My third wrong assumption is that most people with a TBI may see a bleak future, but the opposite is the most extraordinary. One individual, hurt as an active police officer, sees that he is the perfect candidate to help start a program of support for others, “who may have been high functioning before or who want to start being high functioning again.” Another has a goal of meeting her three toddlers again, after the car accident left her with aphasia (being unable to speak). I know another who has a goal of going to an outdoor concert.
My final assumption was that even after years of therapy, there would be stagnation. The truth is that although individuals with traumatic brain injuries may have harder days (due to emotional distress, loud noises, being triggered, or due to weather changes), they are still actively improving daily. To the average eye, this may be harder to gauge, if distracted by unwanted arm movement, uncontrolled leg movements, or even yelling or mumbling. This last false fact is most important because it aims to make one a more conscious and observant individual. This might be brushing off your first impulse to say, “Stop lifting your arm up” enough to hear the individual say “armpit,” reminding you to assist them in putting on deodorant.
This might be taking the long route, just so your loved one with a TBI can feel the accomplishment of knowing they brushed their own teeth or they attempted to feed themselves. Mainly, just stop assuming we know best. Maybe an individual still needs meditation to deal with the emotional trauma they experienced from their accident. Maybe the individual still has chronic pain that only improves with compassionate people and massages. Maybe the reason this individual is mad isn’t that they don’t want to do an activity, but they want to listen to music when doing an activity. They deserve good vibes too. Sometimes that means sitting with our ego and knowing an individual may be different than they used to be, but they are still of value, with their own brain and their own opinions. Who cares that I have my Master’s degree, this individual is the master of their life. We need to continue to give them the respect they deserve. Every individual is fighting an amazing battle to recovery and we need to support their path home to themselves.