What Happens to Family After Brain Injury

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Jeffrey S. Kreutzer, PhD, ABPP, is the Rosa Schwarz Cifu Professor of Physical Medicine and Rehabilitation at Virginia Commonwealth University (VCU), Medical College of Virginia Campus. There, he is also a professor of Neurosurgery and Psychiatry. Dr. Kreutzer serves as Director of Virginia’s federally designated Traumatic Brain Injury Model System and coordinates VCU Health System outpatient services for families and persons with brain injury. For the last two decades, he has been active in implementing empirically based vocational rehabilitation, psychological support, cognitive rehabilitation, and family support programs. Dr. Kreutzer has co-authored nearly 150 peer-reviewed publications, most in the area of traumatic brain injury and rehabilitation. Co-Editor-in-Chief of the international journals Brain Injury and Neurorehabilitation, he has also published a dozen books focused on topics including vocational rehabilitation, community integration, behavior management, and cognitive rehabilitation. Currently, he serves as Editor-in-Chief of the soon to be published by Springer, New York, Encyclopedia of Clinical Neuropsychology.

Taryn M. Stejskal, PhD is a licensed marriage and family therapist and an Advanced Rehabilitation Research Training (ARRT) postdoctoral research fellow at Virginia Commonwealth Medical University (VCU) in the division of neuropsychology in the department of Physical Medicine and Rehabilitation (PM& R). She received her masters degree in Marriage and Family Therapy (MFT) as well as her doctoral degree from the University of Maryland, College Park (UMCP). At present, Dr. Stejskal is the family support and education coordinator at VCU. She conducts the Brain Injury Family Intervention (BIFI), funded by National Institute of Disabilities and Rehabilitation Research (NIDRR), a clinical research program designed to help families and couples gain necessary education, psychological support, and personal skills after brain injury. Dr. Stejskal trains clinicians to implement the BIFI and presents her work nationally as well as internationally. She has written numerous peer reviewed research and newsletter articles on the impact of brain injury on couple and family relationships. Dr. Stejskal is also a volunteer co-facilitator for the Brain Injury Association of Virginias (BIAV) family support group, and she is an executive board member of the Community Futures Foundation (CFF).

On April 24th, 2009, BrainLine had the opportunity to sit down with Dr. Kreutzer and Dr. Stejskal to talk about their work with traumatic brain injury survivors and their families.

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Rosemerryn McMillan says:

We see our son getting LESS competent as time goes on (17 yrs on from an extremely severe TBI sustained at 17 yrs old in a motorbike accident) Apparently this is what happens often with brain injury. It gets worse as the brain injured persons get older and they are more susceptible to dementia and Alzheimer's. My opinion is drugs and alcohol should most definitely NOT be consumed by a brain injured person. It affects them twice as badly as the brain can't operate normally very well let alone with drugs or alcohol. I've seen it happen and it can be quite dangerous for the brain injured persons. Unfortunately the brain injured person will need oversight and safe people and places to hang out with. This will involve usually not hanging with old friends anymore who use alcohol and drugs and making new friends with people who don't use these drugs. The Brain I hired person might need to be prescribed impulse control medication or other medication. Young brain injured adults often have failed relationships or marriage. Often this is because the partner did not fully understand the brain injury and also because the brain injured partner did receive the DEPTH of support needed from the spouses family or his own. Brain Injury requires the support usually of a team of dedicated carers or family members. When that support is taken away by a marriage where the spouse doesn't fully understand the brain INJURY OF THEIR SPOUSE and how the support team will NEED to CONTINUE their SUPPORT often intruding into the privacy of their marriage then it will and does fail. The Brain Injured adult will fail miserably without support. If the brain injured adult moves interstate with the new partner or spouse that will spell certain disaster too. REALISTICALLY brain injured adults cannot sustain a marriage relationship and all of the responsibilities it entails. They may love the idea of being married with children and even intensely love their partners and children but it will inevitably fail because the brain injured person cannot meet what is required in a marriage situation without a huge amount of support. The problem is you have to LIVE with brain injury to understand it. And usually the brain injured person looks quite normal on the outside so the future or present partner really doesn't get it or understand the situation properly. It can really.make their life extremely difficult too for the future as the then separated spouse will often have to navigate life as a single parent after the relationship or marriage fails. The separated or divorced spouses usually have recriminations too against the family such as "Why didn't you tell me or explain better this persons brain injury?". This is further complicated by the brain injured person being in DENIAL and refusing to let the future partner KNOW what they have i.e. a brain injury. The Brain Injured person is trying to and wants to be NORMAL. They often think if they do normal things like start a relationship or get married they CAN be normal. But their brain injury can't sustain something as complicated and demanding as marriage etc. It Is a very sad fact of brain injury and a great grief to brain injured persons and their families that they may never marry or their marriages may fail. I'm not saying don't try and make it work. Just be aware that one of the big things with brain injury is MAKING and then SUSTAINING relationships. It's often exhausting, overwhelming, complicated and painful for the brain injured persons to try and cope in a normal relationship such as a marriage ect

Rosemerryn McMillan says:

Quite often adult children with brain injury will want to become independent, live alone or get married. It can often be a trial or error thing. When the living independently fails or their relationship or marriage fails they have to come back home and reassess things. They may have got in trouble with the law and then this further complicates things. Carers and family can then suffer the grief of seeing their brain injured children go to prison for something that is a result of that persons brain injury. This is why SUPERVISION and SHELTERING become ABSOLUTELY VITAL for the brain injured person in order to keep them out of the legal system and its ramifications. Their brain injury may worsen over time which is often the case. The reassessment may involve constant supervision and the person with the brain injury living in a "sheltered" situation whilst maintaining their safety and dignity and the safety of others. Aging parents who are carers creates worries for the future and also problems caring in the present. There are no longer live in institutions or special care facilities to support brain injured people where they may have enjoyed the company, society and family like atmosphere of others in the same situation. Brain injured and intellectually or physically disabled people are now isolated in the community with individual carers on shifts often supporting them. They may have day centres or organized outings under an organizational umbrella but it's not the same as having their own safe community environment to operate in. Parents can and will most likely also suffer isolation from other family.members or siblings of the brain injured adult who don't understand brain injury and can't be bothered understanding it. Yes ACCEPTANCE is KEY and something one MUST DO in order to have a REALISTIC grasp on the situation. One must MANAGE Brain Injury and not have unrealistic expectations of what kind of "recovery" is possible and learn to LIVE with it. Yes it's great to encourage each new achievement but having ideas of complete recovery from say an extremely severe traumatic brain injury is completely unrealistic. People who can't cope with brain injury and its lifetime effects will often apply popular methods such as " positive thinking" or " Pentecostal or Charismatic prayer for COMPLETE healing" in an effort to change the situation. These people are usually in medical denial and need help, education and counselling understanding brain injury and its impact on them personally and on their friend or relative who is affected.

Playne Jayne says:

Negotiating roles with an adult child with TBI is very difficult. This person is an adult, not a child, and yet. . . How to set limits that the impulsive adult child will or do. This person's friends may believe the relationship is the same. How about when they are alcohol and drug abusers? Should the adult parent at least try to clue them in on how dangerous that is for their old friend?

ElusvOptmst1 says:

Wonderful information.

Doyle Raizner LLP says:

Brain injuries do affect entire families. As indicated in this video, how and to what extent of that affect, will depend on which family member is injured and their role in the family.

Matheson System says:

This is a great video, thanks for sharing. Added it to our TBI playlist.

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