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Answers to your personal questions from someone who cares........Pat answers your personal questions about brain injury with compassion and practical advice. The identity of authors submitting questions to Pat's column will be kept strictly confidential.

DEAR PAT: I’m writing because my daughter had a brain injury several years ago and I need some advice about how to help her.  She was hit by a car while jogging along a road in 2001.  She spent 3 weeks in the hospital trying to recover then she spent 2 more weeks at a rehabilitation center.  She didn’t remember what happened or why she was in the hospital.  The doctors told me it would take a while for her to seem more like herself again. 

Right before she was discharged from the hospital, I was so frightened because I was sure she couldn’t live by herself anymore.  I tricked her into coming to live with me so she could “take care of dear old mom.”  Really, I was worried about her safety if she was to go back to living on her own.  She came home from the hospital with me and has been living with me ever since. 

 There are a number of things about my daughter that have been worrying me.  For example, she loses her train of thought all the time.  We can’t seem to make it through a simple conversation without her forgetting what we’re talking about. Or she’ll be in the middle of cooking some food and she’ll wander outside, forgetting that she left the stove on.   

 I am truly concerned about my daughter’s lack of awareness about her forgetfulness and trouble paying attention.  I’m afraid she’s going to burn down the house or get seriously hurt.  What can I do or say to her that will help her improve her awareness?  She appears quite content with how she is doing and thinks she is doing just fine. Would I be making things worse by bringing my concerns to her attention?

PAT’S RESPONSE:  Lack of awareness is a common problem after brain injury.  People with recent head trauma often have trouble concentrating, remembering what they are doing, or following along in conversations.  Awareness of difficulties after brain injury typically improves with time as the person heals.

A number of people, however, seem to take longer getting their awareness back after having a head injury.  They may not be aware that problems with memory, motor skills, judgment, or slowed thinking are causing them difficulty.  It is not unusual for such individuals to wonder what’s wrong with you or others in their social circle.  They could feel like there’s nothing wrong with them and that nobody understands how badly they want to live on their own, drive a car, or return to work.

Helping to improve awareness is an important goal for you and your daughter to work on together.  First, you can help her to write down all the events related to the accident and her hospital stay.  This exercise will increase her understanding about how the accident has impacted her life and your family.  Keep the list of events related to the accident nearby.  She may come to realize the seriousness of her injury and how far she’s come in the last few years. 

When the fact that she’s had a brain injury has sunk in, she may be able to handle some gentle feedback from you.  You could talk to her about things she may wish to work on in the future for getting better and staying safe.  Asking questions is a good way to get people thinking about things.  When you notice your daughter having trouble with conversations, you may say something like, “You seem to have gotten lost.  What was the last thing you remember us talking about?”  Don’t lose sight of the positive things she can do.  Praise her often!

In the meantime, make sure you continue to carefully monitor your daughter’s activities and try to keep her safe from danger.  Encourage her to try out different ways of doing things that may be less risky.  You could help her learn new recipes for cooking with the microwave or buy her a book on making sandwiches. With your enthusiasm and support, you can help improve her awareness of post-injury problems without ruining her self confidence.       

Support groups are a great way to get feedback from others, if you wish to recruit more people in helping your daughter become more aware.  Your local Brain Injury Association of American likely has a list of support groups your daughter may attend.  To contact BIAA, you may call their family helpline (1-800-444-6443) or send them an e-mail at familyhelpline@biausa.org.  The website for BIAA (www.biausa.org) provides links to state chapters and additional brain injury resources.  You may also write BIAA for more information at 8201 Greensboro Drive, Suite 611, McLean, VA 22102.

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Last updated  -  06/02/2010