BI-facts

Every brain injury (BI) is unique.

No one responds in exactly the same way, even if the actual physical injury is the same. Each instance is new and as a caregiver or family member, you are faced with that fact from Day 1. Remember this: even though your particular case may differ, including the effects it will have on your loved one...you are NOT alone.
Many have walked and are now walking down the same path you are. You must learn as you go, as we all do. You MUST be flexible...brain injury is a life-changing event for all concerned.

Brain injury is the disruption of normal structure and functioning of the brain,
resulting from one or more of these three things:

1. bleeding within the brain (such as when an aneurysm ruptures)
2. anoxia (lack of oxygen, such as a near drowning)
3. trauma (such as a motor vehicle accident)

Acquired Brain Injury (ABI) occurs sometime after birth and is not resulting from a hereditary or congential condition
...hence it is "acquired" later. ABI can be caused by such things as stroke, choking, asphyxiation, etc.
(anything that cuts off oxygen to the brain).

Traumatic Brain Injury (TBI) occurs when the brain tissue is injured (bruised, torn) from striking the inside of the skull
or from something piercing the skull. Generally, blood vessels in and around the brain are also injured in the trauma event.
The injured brain will swell, leading to what is termed "secondary injury". This swelling often results in coma.

As a general rule, the longer the person is in a coma or coma-like state, the more severe the head injury was.
Severe brain trauma results in a very poor prognosis, even in today's era of medical miracles.
Yet people don't even realize that they have suffered a TBI if it was a mild one!
You do NOT have to lose consciousness to receive a TBI!

Mild Brain Injury:
loss of consciousness with a Glasgow Coma Scale score (GCS) of 12 or more.
Prognosis:
usually a good outcome with a good recovery

Moderate Brain Injury:
coma with GCS score of 8 to 11; coma may last for hours or days.
Prognosis:
depends a lot on the individual; can have a good outcome, with varying degrees of disability and cognitive effects.

Severe Brain Injury:
coma with GCS score up to 7; coma may last for days, weeks, months, or even years;
some won't "wake up" but remain in a persistent vegetative state (PVS)
Prognosis:
generally not good; there are usually significant cognitive and physical deficits, though these may be reduced with
rehabilitation and therapy; some will be permanent.

Every 15 seconds, 1 person in the U.S. sustains a brain injury
Every 5 minutes, someone dies of a brain injury in the U.S.
That's 288 deaths from brain injury EVERY DAY in the U.S.!!
(As a comparison, AIDS accounts for 97 deaths per day)
An estimated 5.3 million Americans are now living with disabilities resulting from BIs
Each year, 230,000 persons are hospitalized with TBI and survive
More than 50,000 people die each year due to TBIs
The risk of TBI is highest among adolescents, young adults and those over 75
Males represent 3/4 of TBI individuals
Someone with a TBI has 7 times the chance of having a second TBI
Car accidents are by far the leading cause of TBI
The second most frequent cause is falls, especially for the elderly.
Of people with TBI:
          12% will be unable to live alone or care for themselves
          30% will be under employed
          20% will never be employed again
          48% will survive with some disabilities
          22% will die

Only 20 years ago, severe brain injury spelled out almost a certain death sentence.
Now, with medical advances and early intervention, many can not only live...but go on to enjoy productive lives.
There will always be some loss...some difference...no one with TBI is ever 100% the same as they were before the TBI.
This is a fact and one you need to accept as soon as possible. You will be going on false hope and unrealistic expectations otherwise.

Rehabilitation, or "rehab", involves helping the person with TBI to begin learning new ways in which to compensate for skills and abilities that will never be recovered. The relearning involves both physical and cognitive aspects. Rehab should begin as soon as possible...as soon as the patient is medically stable. Rehab is hard work...for the patient and for his/her caregivers. The caregiver's role is to be support for the person in rehab. Rehab must be carried out with a plan. Stability and routine is of utmost importance for TBI sufferers. They tend to become distracted or confused easily. You must remember this and be as patient as you can. Make to-do lists, calendars, daily activity sheets, etc. Stress the importance of doing things in an orderly manner (first you get out of bed, then you brush your hair, then you brush your teeth, etc...) Get help...get support...take time out for yourself. Your life has now changed, as well.

The basics that a person will be taught during rehab include:
1. Bodily functions: bladder control, bowel treatments
2. Mobility techniques: gait, walking assists
3. Communication skills, speech therapy
4. Social interaction skills: appropriate contact, initiating contact, greetings, conversation
5. Learning to control emotions: temper, frustration
6. Behavior control: avoiding dangerous actions
7. Independent living: housekeeping, cooking, cleaning
8. Planning & decision making: planning the day, making lists, following a routine, making appropriate choices

Home Care is always the best choice, if at all possible! Home means a caring, warm, nurturing environment. It's a familiar setting for the TBI patient and that is good. It also lets all members of the family take part in the rehabilitation and care of the loved one.

It is important to keep in mind that the injured person may be quite different from the person they were before. They may not even KNOW who they were before...and temperment, likes, dislikes, moods, sense of humor, tastes...may be quite different than before. This is not their fault and they must not be blamed for it. It can be a challenge for those who were closest to them before the injury, though.

The costs associated with caring for someone with severe disabilities is staggering. Medical equipment, medicines, transportation, etc... You will need to understand all of this BEFORE you bring the person home and make necessary arrangements ahead of time. You will need to change a lot of things around your home to accomodate the injured person now.

Independence is the goal for any TBI sufferer. Let them do as much as they can from the beginning...even if they "make a mess". As long as it's a safe environment, let them take a try at things for themselves. This will not only give YOU more time and less obligations, but will positively re-inforce the person doing it and create more self-confidence!

1. Remember that you're not alone!
2. Watch for signs of depression and guilt; avoid self-destructive behaviour
3. Maintain your health - physical AND mental!
4. Accept help from family, friends, and the community; utilize community resources
5. Join support groups - they really do help!
6. Allow personal time for yourself; take breaks occasionally
7. Don't tolerate negative attitudes from family members, friends, or medical personnel
8. Trust your instints - if you feel strongly about something, there's a reason!
9. Talk to others...communicate...laugh...keep balance in all areas of your life, if you can
10. Set realistic goals and remain open to new technologies, treatments, and ideas!
11. Read and learn...keep up-to-date on medical advances and therapies
12. Be patient - with yourself and with your loved ones, including your "charge"