When Your Spouse Has a Traumatic Brain Injury

If you're the spouse of a service member with a traumatic brain injury, you may feel like your world's been turned upside down. Along with your home and work responsibilities, you may also be taking on a new role as caregiver. You'll probably become an expert on your spouse's injury and the different treatment methods. But along with educating yourself and adapting to your caregiver role, try to find time to take care of yourself.

After the injury

Your spouse may face weeks or months of hospital stays, rehabilitation and recovery efforts. Here are some things you can do to help manage your new priorities during this time.

• Gather information — Take notes when you talk with your spouse's doctors and health professionals, and compare them with your research. The more you understand about the complex medical terminology and specifics of your spouse's injury, the more able you'll be to make informed decisions about his or her care.
• Pace yourself — Save your strength for the long haul. A brain injury requires long-term care in many cases.
• Understand the treatment program — Brain injuries can affect a person physically, cognitively and emotionally, and each injury is different. The team of medical care providers will set up an individualized plan to address all aspects of your spouse's treatment.
• Know your health care providers — Your spouse may need treatment and therapy from rehabilitative nurses, occupational therapists, physical therapists, psychologists, neurosurgeons, social workers and speech therapists. All of the medical providers work together to treat and rehabilitate your injured spouse.
• Understand the possible changes — Your spouse may act out or behave angrily toward his or her caregivers, especially during the first few days or weeks. Understand that this behavior is a result of the brain injury and not a personal attack.
• Get help — When your family and friends offer to help you, let them. Taking care of your children, preparing meals and doing day-to-day chores are ways they can help out. Relying on them will help ease the everyday challenges that come along.
• Take care of yourself — Being at the hospital day in and day out can really wear you down, which is certainly normal. Getting plenty of rest, eating nutritious meals and finding someone to talk with can help you stay healthy. Take advantage of Military OneSource, whose consultants can put you in touch with trained counselors in your area for free. Visit the Military OneSource website or call 800-342-9647.

Understanding the challenges of TBI

The symptoms of TBI are varied and complex. Your spouse may suffer from headaches, seizures, dizziness, memory problems and difficulty focusing. Coping with the emotional and psychological changes resulting from the brain injury is often the most troubling aspect for families. Learning to understand and cope with the following problems your spouse may face can make things a little easier for you and your family.

• Chronic fatigue — Rehabilitation takes lots of energy. Even routine tasks like brushing teeth can be exhausting. The brain injury may also disrupt sleep cycles — your spouse may be sleeping all the time, but he or she never feels rested. Keeping a strict bed time and wake time and staying on a schedule as much as possible may help.
• Anger — Some TBI patients can seem angry all the time. They may be frustrated when doing what used to be a simple task. Loss of memory or inability to stay focused on a single project may also be frustrating. Try your best to understand, and limit the amount of activities or information your spouse has to deal with at one time.
• Too much emotion — Controlling emotions may be difficult for some TBI patients. They may cry in joy or anger, which can be upsetting to family members. Patients sometime have difficulty sorting out different stimuli like sound, touch or visual information. To help your spouse, filter out some of the stimulation — turn off the television or radio when your talk with him or her, and keep visits low key with just a couple of people at a time. Help your spouse handle emotions by showing him or her ways to express emotions more appropriately.
• Insensitivity — Your spouse may respond insensitively or unkindly in social situations. Patients don't usually recognize their behavior as inappropriate. They tend to verbalize their private thoughts without realizing it, causing them to make improper statements. You can help your spouse by avoiding nonverbal cues and speaking your feelings directly to him or her.
• Loss of focus — Losing the ability to organize thoughts may be a significant result of a brain injury. Help your spouse by establishing routines and providing a notebook or agenda to keep track of each day's schedule.

Taking care of your spouse at home

Coming home from the hospital is a joyous event. But for patients with a brain injury, the recovery process continues for the long term. Getting back to a routine at home may present new challenges for you and your family.

• Adjust to changing roles — Becoming the sole caregiver is a great responsibility. Don't be afraid to ask for help when you need it. Talk with your spouse about the changing roles.
• Understand changes in your spouse — He or she may still have the emotional and behavioral symptoms of the brain injury. Understand that these symptoms take longer to heal. He or she may still get angry easily or become overemotional, especially when tired.
• Let your spouse rest — Patients with TBI tire easily, even months after the injury. Schedule outings in the morning. If you're planning to have family or friends over in the evening, plan time in the afternoon for rest.
• Treat your spouse normally — If possible, let your spouse do some of the things he or she used to do. This will ease your burden and make him or her feel useful.
• Let your spouse take on new tasks — It will take time, but brain injury patients need to learn tasks. Although it may be frustrating at first, let your spouse learn routine chores and help around the house. Pay attention to safety as you add new tasks.
• Remember what you have together — Focus on your new normal and what you have together now. As a caregiver, it may be difficult to remember your role as a spouse. Take time to nurture your relationship together.
• Find a TBI survivors group — You can have a support system by being with others who are facing the same difficulties as you. Attending as a couple will get you involved with new friends and help you cope with the long-term challenges of living with a brain injury.