Caregiving for a Person with a TBI By Roya Lackey, OTR/L, CBIS DVBIC Regional Education Coordinator This month is a time to recognize the hard work of family caregivers. A caregiver is someone who provides any level of assistance to those who may need extra help due to changes in physical or mental health. Those with a traumatic brain injury (TBI) present with a unique set of needs which may require a more specialized approach to caregiving. From 2000-2019, the Department of Defense reported 413, 858 medically documented TBIs across U.S. forces. Although the majority of TBIs are mild and recover within a few weeks or months, those with moderate to severe brain injuries often experience prolonged and unpredictable recovery trajectories. The journey to healing will look different for everyone and can span a range of changes in behavior, cognition, mood, and physical ability throughout the lifetime. The Defense and Veterans Brain Injury Center (DVBIC) provides a host of free resources accessible online to help guide caregivers of service members and veterans who have sustained a TBI. These tools cover the broad spectrum of effects seen after a TBI and offer practical strategies to help caregivers better understand and mitigate these effects. For example, changes in cognition, or thinking, are common after a TBI and can be especially challenging for caregivers to navigate. Here are some helpful tips to incorporate: • Use external cues to keep your loved one oriented: keep large clocks, calendars, and family photos in plain sight.
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Direct your loved one to use these cues instead of relying on others for simple information. Visual aids around the house can serve as helpful reminders for frequently asked questions, such as “dinner is ready at 5:00.” • Maintain a structured routine: Limit changes as much as possible. Create a daily schedule so your loved one knows what to expect. Review the schedule each morning and evening, or as needed. • Provide information in a slow and simple manner: Give your loved one ample time to comprehend what is said, and encourage them to ask others to do the same. • Provide choices: Offer two or three choices so as not to overwhelm your loved one while still allowing them to be an active decision maker in their daily activities. This can help offset feelings of frustration over a loss of control. • Take breaks: When you notice increased frustration, take a ten minute break to cool off before revisiting the task at hand. It is important to be patient both with yourself and your loved one. • Use constructive language: Provide your loved one with questions to help them find solutions more independently, such as “what could you do to find that answer?” instead of “why don’t you remember that?” • Provide alternative behaviors: For example, if your loved one becomes distracted during a conversation, say things like “please look at me when we are talking” instead of “stop looking at the TV.” It can be easier to understand concrete actions. It is imperative that caregivers be equipped with the knowledge to not only best care for their loved ones, but to also provide that same level of care for themselves. This month, take the time to share your appreciation for the caregivers in your life, even if that means showing yourself a little extra appreciation! For additional tips and caregiver resources, visit: www.dvbic.dcoe.mil