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Life After Brain Injury

Life After Brain Injury

Finding the New Normal with Therapy

A toddler falling down the stairs, a teen taking a hit at a sports game, a parent being involved in a car accident, or a grandfather slipping in the shower. Brain injury can occur at any point across the age spectrum. When an individual suffers a brain injury, the family system is dramatically affected.

There are six stages of acceptance according to the Academy of Certified Brain Injury Specialists. Initially, family members may be in shock, hoping for a full recovery for their loved one. As time goes on, they begin to recognize the severity of the injury and often feel helpless, frustrated, annoyed, and increasingly exhausted. They also may feel profound sadness and grief over the loss of their loved one’s personality. Once family members begin accepting their new reality, they are prepared to address the needs of the entire family unit.

Occupational therapy is the holistic approach that considers all aspects of life, from the activities in which people engage while awake to how well they sleep at night. Therapists take into consideration factors such as the mental, spiritual, and psychological well-being of their patients. They also look at the support system, culture, values, and environment, which make up their quality of life.

During occupational therapy, time is spent analyzing the roles and activities that are most meaningful to individuals. From there, clinicians determine the biomechanical and rehabilitative approaches, or compensatory strategies, that can be used to reengage people in their activities of daily living, often referred to as ADLs. These activities may include complex tasks like preparing a meal, managing finances, and returning to work, or simply mastering basic care, such as relearning how to use a utensil at mealtime.

Occupational therapy services are most effective when family members are able to actively participate. Having family support allows individuals to translate the skills learned during therapy into practice at home. This is important as research suggests that continued repetition of learned skills can repair brain damage and create new neural pathways in the brain.

Families may have a hard time acclimating to their roles when dealing with the new dynamics a brain injury creates. Frequently, individuals with brain injury report feeling like a burden to their families and wishing they could do something to help. Occupational therapists encourage families to promote their loved ones’ independence and create a home environment in which they can best function. This allows the individuals with brain injury to participate in their own care, while providing a level of comfort for everyone.

Many family members fall into the role of full-time caregiver and, due to time constraints and exhaustion, neglect the importance of focusing on their own well-being. To prevent caregiver burnout and foster the ability to offer more meaningful support in the long run, occupational therapists often recommend that families seek the assistance of other relatives, friends, or hired workers. Even an hour or two can provide enough relief to make a difference.

In addition to therapy, a variety of clinical and support services can prove helpful. Medical psychology is valuable in the process of recognizing and overcoming obstacles to emotional well-being that can accompany brain injury. Day-long recreation programs are also good for overall well-being, offering opportunities for supervised social, recreational, and wellness activities, along with respite for family caregivers. Exercise-based programs designed to help people with neurological illness or injury can improve physical strength, endurance, and balance.

The Brain Injury Association of Virginia ( is another excellent resource for families to learn about the Richmond area’s support services.

Kathryn Pruett
Kathryn Pruett, OTR/L, CBIS is an occupational therapist at Sheltering Arms. She has been in the profession for ten years and is the mother of a young son.
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