A few suggestions of ways you can help your loved one through the different stages of brain injury.

Caring for a loved one who has a brain injury can be extremely difficult. As the caregiver you may experience emotions ranging from fear to guilt to hope. Learning to deal with these emotions is an important first step in providing care.

First, learn as much as you can about the phases of brain injury. Since there are several different stages, it’s important to understand where your loved one fits into the continuum and to adjust the care you provide to fit his or her transition through these phases.

Unresponsive Phase

In the unresponsive phase your loved one may not respond to his/her surroundings and may appear to be sleeping. Much of the care provided during in this phase will involve medical professionals, but there also are ways you can help. While your loved one may not seem to respond, you may be able to stimulate his or her mental state by providing positive sensory inputs.

• Talk to your loved one as if he/she can hear you.
• Speak in a positive and familiar way, making sure to pronounce words clearly and slowly.
• Encourage other relatives or friends to visit and to focus on your loved one.
• Surround your loved one with familiar pictures and personal belongings.
• When performing activities such as brushing hair, try to add a personal touch such as using a favorite hairbrush to reinforce the message that you care.

Early Response

Early responses occur when your loved one begins to respond to other individuals. He/she may turn toward your voice or squeeze your hand. While you will want to encourage these responses, remember that your loved one’s endurance may be low—he or she may only be able to respond for about five minutes. Creating rest periods, can help your loved one gain strength and recuperate. Additionally, you should continue to talk to your loved one and encourage others to do so.

Later Phases

As your loved one’s responses become stronger, he or she may seem confused or agitated, or exhibit socially unacceptable behavior. Try to encourage your loved one to become oriented to his or her surroundings and maintain his or her physical needs. In conjunction with the health care team, continue to encourage participation in mentally stimulating activities based on your loved one’s responsiveness and endurance. Finally, it’s normal for your loved one to confuse events during this phase. Providing him or her with concrete objects such as photographs or an old calendar may make remembering easier.

The final stage reached by some patients is termed the higher-level response phase. During this period, your loved one should be expected to help with his/her daily problem solving tasks, as well as in making personal decisions. During this phase, it’s a good idea to encourage your loved one to be as independent as possible. You can help by making his/her living environment safer, helping him/her reason through situations that involve problem solving and decision making, and encouraging the use of an appointment book or calendar to help regain a sense of time. Finally, encourage your loved one to maintain his or her health through regular doctor visits, rest, and the appropriate use of medications.

These, of course, are only a few of the many ways you can help. If you are a long distance caregiver, for example, writing letters that another member of your loved one’s care team can read to him/her can help stimulate mental activity. By beginning with these ideas and continuing to come up with creative ways to encourage your loved one to remain healthy and as active as possible, you will be an irreplaceable member of your loved one’s caregiving team.

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