Brain injury - dischargeHead injury - discharge; Head trauma - discharge; Contusion - discharge; Shaken baby syndrome - discharge
Someone you know was in the hospital for a serious brain injury. At home, it will take time for them to feel better. This article describes what to expect during their recovery and how to help them at home.
When You're in the Hospital
First, health care providers provided treatment to prevent any further damage to the brain, and to help the heart, lungs, and other important parts of the body.
After the person became stable, treatment was done to help them recover from the brain injury. The person may have stayed in a special unit that helps people with brain injuries.
What to Expect at Home
People with a serious brain injury improve at their own pace. Some skills, such as movement or speech, may go back and forth between getting better and then worse. But usually there is improvement.
Behavior and Social Interaction
People may display inappropriate behavior after a brain injury. It is OK to point out when behavior is not appropriate. Explain the reason and suggest a different behavior. Offer praise when the person calms down or changes their behavior.
Sometimes suggesting a new activity or a new place to go is the best option.
It is important for family members and others to stay calm.
- Try to ignore angry behavior. DO NOT make a face or show anger or judgment.
- The providers will teach you when to decide to step in and when to ignore certain behavior.
Muscles, Joints, and Movement
At home, the person who had the brain injury may need to practice everyday activities. It may help to create a routine. This means certain activities are done at the same time each day.
The providers will help you decide how independent the person can be and when you can leave them alone. Make sure your home is safe so injuries do not happen. This includes making the bathroom safe, for either a child or an adult , and protecting against falls .
Well child - bathroom safety
Older adult bathroom safety; Falls - bathroom safety
Protecting against falls
Home safety; Safety in the home; Fall prevention
Family and caregivers may need to help the person with the following:
- Exercising the elbows, shoulders, and other joints, to keep them loose
- Watching for joint tightening (contractures)
- Making sure splints are used in the correct way
- Making sure arms and legs are in a good position when sitting or lying
Caring for muscle spasticity or spasms
Caring for muscle spasticity or spasms
High muscle tone - care; Increased muscle tension - care; Upper motor neuron syndrome - care; Muscle stiffness - care
If the person is using a wheelchair, they will need follow-up visits with their provider to make sure it fits well. The person also needs to change positions in the wheelchair several times an hour during the day, to help prevent skin ulcers .
To help prevent skin ulcers
Decubitus ulcer prevention; Bedsore prevention; Pressure sores prevention
Learn to make your home safer if the person with the brain injury wanders in or from the home.
Make your home safer
Getting your home ready after you have been in the hospital often requires much preparation. Set up your home to make your life is easier and safer w...
Diet and Swallowing
Some people with brain injuries forget about eating. If so, help them learn to add extra calories . Talk with the provider if the person is a child. Children need to get enough calories and nutrition to grow . Ask the provider if you need the advice of a dietitian.
Add extra calories
Getting more calories - adults; Chemotherapy - calories; Transplant - calories; Cancer treatment - calories
Children need to get enough calories an...
Getting more calories - children; Chemotherapy - calories; Transplant - calories; Cancer treatment - calories
If the person with the brain injury has problems with swallowing, help them follow any special diet that makes eating safer. Ask the provider what the signs of swallowing problems are. Learn tips to make feeding and swallowing easier and safer.
Difficulty with swallowing is the feeling that food or liquid is stuck in the throat or at any point before the food enters the stomach. This proble...
Dysphagia - self-care
Tips for Daily Life
Tips for making clothing easier to put on and take off:
- DO NOT give the person too many choices.
- Velcro is much easier than buttons and zippers. If the clothing has buttons or zippers, they should be in the front.
- Use pullover clothes when possible and slip on shoes.
Tips for talking to the person with a brain injury (if they have problems understanding):
- Keep distractions and noise down. Move to a quieter room.
- Use simple words and sentences, speak slowly. Keep your voice lower. Repeat if needed. Use familiar names and places. Tell them when you are going to change the subject.
- If possible, make eye contact before touching or speaking to them.
- Ask questions so the person can answer "yes" or "no." When possible, give clear choices. Use props or visual prompts when possible. DO NOT give the person too many options.
When giving instructions:
- Break down instructions into small and simple steps.
- Allow time for the person to understand.
- If the person becomes frustrated, take a break or consider redirecting them to another activity.
Try using other methods of communicating:
- You may want to use pointing, hand gestures, or drawings.
- Develop a book with pictures of words or photographs to use when communicating about common topics or people.
Bladder, Bowels, and Bathing
Have a routine. Once the person finds a bowel routine that works, help them stick with it. Pick a regular time, such as after a meal or a warm bath.
Nerves that help your bowels work smoothly can be damaged after a brain or spinal cord injury. People with multiple sclerosis also have problems wit...
- Be patient. It may take 15 to 45 minutes for the person to have bowel movements.
- Try having the person gently rub their stomach to help stool move through their colon.
The person may have problems starting to urinate or emptying all of the urine out of their bladder . The bladder may empty too often or at the wrong time. The bladder may become too full, and they may leak urine out of the overfilled bladder.
Problems starting to urinate or emptyin...
Loss of bladder control - care at home; Uncontrollable urination - care at home; Stress incontinence - care at home; Bladder incontinence - care at h...
Some men and women may need to use a urinary catheter. This is a thin tube that is inserted into the bladder. Learn how to care for the catheter .
Clean intermittent catheterization - male; CIC - male
Clean intermittent catheterization - female; CIC - female
How to care for the catheter
You have an indwelling catheter (tube) in your bladder. "Indwelling" means inside your body. This catheter drains urine from your bladder into a ba...
When to Call the Doctor
Call the person's provider if they have:
- Problems taking drugs for muscle spasms
- Problems moving their joints (joint contracture)
- Problems moving around or it is getting harder for them to transfer out of a bed or chair
- Skin sores or redness
- Pain that is becoming worse
- Choking or coughing when eating
- Signs of a bladder infection (fever, burning with urination, or frequent urination)
- Behavior issues that are hard to manage
Brain Injury Association of America. Family and caregivers. Biausa.org. www.biausa.org/brain-injury-family-caregivers.htm#Manage the Home . Accessed December 8, 2016.
Dobkin BH. Neurologic rehabilitation. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 57.
Family Caregiver Alliance; National Center on Caregiving. Traumatic brain injury. Updated 2015. Caregiver.org. www.caregiver.org/traumatic-brain-injury . Accessed December 8, 2016.
Review Date: 10/24/2016
Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.