Let me tell you the story about Mary and Joe, a couple who have been married for 15 years. Mary, a former project manager, had made an appointment with me because she was concerned about the drastic changes that had occurred in her relationship with Joe since his discharge from the hospital 18 months earlier. She worried that Joe had sustained a traumatic brain injury (TBI) when the driver of a dump truck dozed off and struck Joe's car head-on, crushing his car and pinning him inside. Airlifted to the local trauma center, Joe had suffered multiple broken bones, lacerated organs, and a serious head injury that left him in a coma. When he emerged from the coma five days later, the doctors and nurses commented that his survival was a miracle given the seriousness of his injuries.

mary recounted the immense relief and gratitude she felt once Joe finally emerged from the coma. She energetically began making plans to assist Joe with his recovery and get their lives back on track. Once Joe returned home, Mary assumed her role as his caregiver with a positive, can-do attitude. Initially alarmed at the many drastic changes she saw in Joe's personality and behavior, Mary trusted that his impairments and unusual behaviors would clear after a while if they worked diligently. "If his survival was a miracle, then surely he would have a miraculous recovery," she thought.

一个fter three months, however, Mary left her job because Joe's problems with confusion and memory had not subsided and he required closer supervision. The medical appointments also seemed to be endless and Mary was becoming increasingly anxious. Now, a year and a half after Joe's injury, experiencing financial insecurity, and their relationship marked by constant conflicts and arguments, Mary shared that she felt terrified and hopeless about the future. Her "old Joe" had not returned despite her best efforts.

T.he Reality of Caregiving

玛丽和乔都是虚构的人物,但坐uation described above is all too real for many couples recovering from the effects of TBI. A wide variety of confusing and frustrating physical, cognitive, emotional, and behavioral changes accompany TBI that not only affect the survivor, but their caregivers and entire families. Because no two brain injuries are alike, it is impossible to accurately predict the length of recovery, and TBI-related changes can last for months or for a lifetime.

For caregivers, the stress of dealing with changes in their loved ones is magnified by changes in roles and added responsibilities that can quickly become overwhelming; exhaustion, worry, inadequate resources, and the demands of caregiving are constant companions. Caregivers I meet with frequently report that they are angry and frustrated because life revolves around caring for the survivor and they themselves get no assistance. They are sad because they've lost their dreams and aspirations and afraid that their loved ones will never fully recover, which makes for an uncertain future. If you are a caregiver and these emotions seem familiar, the good news is that there are actions you can take to ward off these negative emotions to ultimately increase your wellbeing.

专注于今天的成功

采用成功的新定义可能是您可以朝向的最重要的行动之一。许多护理人员节约了巨大的时间和精力,以帮助他们所爱的人恢复受伤的自我。然而,这是一个崇高的努力,并且随着TBI,这种设置的护理人员每天都会遇到失望,失败,恐惧和绝望,他们所爱的人不符合预期或表现出对其伤害的运作水平的运动。在我的工作中,我挑战照顾者,而是通过排放日以来的所有收益来定义成功。鉴于许多幸存者在死亡的家门口上,这些收益通常是非常纪念的,并且可能必须学会在受伤后再次走路和谈话。以这种方式重新定位成功可以帮助您将日常焦点转移到成功和消除损失的感受和感知失败。

S.et SMART Goals

S.etting reasonable goals is another action you can employ to reduce distress and promote feelings of success. Brain injury brings on a huge variety of new, frightening problems in addition to those of normal life. I often hear caregivers express that there are too many things to keep track of, resulting in nothing getting done correctly, if at all, unless they do it themselves.

当我要求照顾者列出他们的目标时,常见的答案包括:“让我的配偶做我问的事情,”“让我的配偶更好,”或“让生活恢复正常”。如果像这样的目标没有分解成较小的目标,可能会缺乏进展,看明者可能会缺乏沮丧和惊慌失措。

  • S.pecific
  • measurable
  • 一个可削弱
  • R.ealistic
  • T.imely

I use the acronym SMART to remember the components of reasonable goal setting. With a little practice, setting reasonable goals that support success and positive outcomes becomes second nature. It not only assists you in accomplishing many of tasks, but also allows for setting very concrete, clearly communicated goals for your loved one, whether it's accomplishing household chores, making appointments, or conducting rehabilitation exercises.

制定计划减少生命中的压力

It's also helpful for you, as the caregiver to develop a stress management plan to reduce stress in your life. This includes three parts:

  1. 识别压力硕士学位: You must first become aware of the sources and early signs of your stress. To do this, I encourage caregivers to track their stresses and check-in with themselves to identify any early signs of stress they might be experiencing. By taking your "stress temperature" in this way throughout the day, you can maintain better awareness of stress-causing events that might be avoided or rescheduled, such as an oil change for the car, family visits, or a doctor's appointment.
  2. R.eview a History of Success: I also urge you to examine how you have managed stress in the past, both successfully and unsuccessfully. In high stress instances when it is impossible to "reschedule life," caregivers are then better able to employ skills they know have worked previously. This adaptation can be used as part of a short-term stress management plan, along with stress relieving methods like deep breathing for five minutes, listening to soothing music, or visualizing a favorite place or experience.
  3. Establish a Weekly Anti-Stress Goal: A final component of a stress management plan is to develop at least one activity that you can accomplish each week that can serve as a long-term buffer against stress. Giving yourself permission to engage in pleasurable and relaxing alone-time, such as listening to a guided visualization or meditation, engaging in a favorite hobby, exercising, or calling friends, is as important as any doctor's appointment and serves as a buffer against stress.

R.each Out For Support and Community

向别人带来并给自己允许寻求帮助可能是你可以采取最重要的行动之一,你可以避免负面情绪,例如恐惧,愤怒和悲伤。许多护理人员已经失去了他们在受宠物的受伤之前与支持网络的支持网络丢失,认为没有人能够真正帮助,因为他们不了解与TBI的某人的关心困境。在我的经验中,这不是真的。

以下是建立社区和支持的一些想法:

  1. Other Caregivers of TBI:面临同样挑战的其他人往往渴望有机会与另一个护理人员会面,以“比较笔记”,并以人物或在线提供实力和鼓励。
  2. 一个dult Day Care:许多信仰社区很高兴为照顾者提供成人日托和其他喘息服务。
  3. 脑损伤支持群体:脑损伤支持群是应探索的另一种优秀的资源。这些群体有多种格式;有些人针对护理人员,一些用于幸存者,有些是针对夫妻的目标。状态级脑损伤关联维持这些会议的列表,描述和主题,退伍军人事务部有一个免费的退伍军人护理人员支援线,在1-855-260-3274,以及美国军团和受伤的非盈利战士基金会还拥有军事家庭的资源。许多护理人员通过与他人在类似的道路上与他人与他人一起参与脑损伤的新方法,找到了这些会议的希望和鼓励。

有办法过上一个幸福的生活

不幸的是,奇迹的生存故事不等于TBI后的神奇恢复的故事。尽管玛丽和乔的故事是虚构的,但你和其他关心TBI幸存者的感情和挑战是真实的。虽然上面提供的建议不会加速恢复过程,但您可以通过对成功的定义来提高生活质量,制定合理的目标,制定压力管理计划,并向他人伸出援手。我鼓励你努力为这些活动提供努力,向前迈进,以创造没有抑郁,愤怒和焦虑的生活,并希望充满喜悦和满足。

R.ecommended For You

Katherine J. Gold,M.D.,M.S.W.,M.S.。
michele Rosenthal
一个bigail Powers Lott, Ph.D.
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Chloe Carmichael, Ph.D.

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原始出版日期:

Updated: September 20, 2016