Family Dynamics Post Catastrophic Injury

A catastrophic injury does not only affect the injured individual, it also affects the family and can change the family dynamics. Family dynamics consists of the role and responsibilities of each family member. A few examples of this are: Who takes out the garbage? Who picks up a child from soccer practice? Who pays the electric bill? These are tasks that help a family function from day to day.

A family may consist of a spouse/significant other, children or parents of the individual who has had the catastrophic injury. Once the individual has completed the acute phase of care and has moved on to the rehabilitation phase, he or she will be preparing to come home. Is the person coming home going to be different? The answer is “yes.” It is important to identify who in the family will be the primary caregiver and the dynamics in the family will change. The primary caregiver will need to prepare for a lifetime commitment of care. The level of assistance that will be needed is based on the injury itself. Some individuals need minimum care. Some will need full-time care.

The reversal of a role can lead to resentment, when the uninjured spouse or family member, by necessity, must become the breadwinner while still maintaining the daily running of the household. Spouses and children now have the burden of caring for the head of household. The nurturer of the family, traditionally the mother, now has to bear the survival of the family. This can place a large strain on marriages and can create friction[1].  Many caregivers find themselves having to take over the finances, transportation, manage family decision making or childcare. Older siblings often take on a role in the family of caring for any younger siblings. This increase of responsibilities has shown to lead to an increase of depression and anxiety in caregivers. Some caregivers have feelings of burden and alienation from other members of the family because as time goes on those willing to help at the beginning tend to distance themselves. The mere presence of the individual in the home can change the family atmosphere, if prior to the injury that person was primarily at work, at school or living away from home[2].

Traumatic events either bring families closer together or drive them further apart. Families with a positive family structure tend to have better coping skills and are more capable of dealing with the changes from the injury. A family that has an unhealthy family structure presents when family members remain rigid in their customary roles, unable or unwilling to compensate for the limitations of the injured family member.  Therefore, important duties and responsibilities are left unfulfilled often to the detriment of the family. Another challenge is a family member who overcompensates often neglecting important responsibilities because he or she is caring for the injured family member[3].

It is very important for the primary caregiver to care for himself /herself as well as caring for the injured family member. As time goes on, the stress of duties, responsibilities and other important tasks can cause distress. The more a caregiver takes care of himself/herself, the more likely the injured family member will have a successful recovery and the family dynamics will be healthy.

It is often appropriate and necessary that an injured individual is admitted to a residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries. At NeuLife, in Mount Dora, Florida, a customized Client Goal Plan will be developed with the input of the individual, his or her family and our multidisciplinary staff to achieve the best possible outcome for the client.

Family training and education, cognitive support services and psychology services are important for the client and family to consider participating in, in addition to physical, occupational, recreational and speech therapies. Cognitive behavioral therapy is a form of treatment that focuses on examining the relationship between thoughts, feelings and behaviors for both the client and family.

Education and training, as part of a holistic approach to recovery has proven to be very beneficial to a client and family. The importance of being able to communicate needs and wants is a key area of the recovery process. These services allow the client and family to practice and develop skills necessary for a positive recovery experience regarding the client’s goals and plans to achieve those goals. These sessions can be arranged on an individual basis or involve the client’s family.

Proper and timely post-acute rehabilitation that may determine the difference between disability and independence is what NeuLife refers to as the “platinum post-acute period” — the crucial window following acute care that is needed to nurture the whole person to health with specialized, clinically relevant services.

NeuLife’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to increase function and independence. NeuLife seeks to achieve, for all of its clients, maximized, sustained outcomes that exceed the expectations of all persons served.