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.



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.


  • 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.


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



  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。



R.ecommended For You

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



Updated: September 20, 2016