TBI and Behavioral Concerns

Traumatic Brain Injuries/Catastrophic Accidents and Behavioral Concerns

There are many changes an individual goes through after experiencing a traumatic brain injury (TBI) or catastrophic accident. The areas of change include physical, emotional, cognitive and behavior changes. Ninety per cent of clients with a TBI experience some related emotional, neurobehavioral or psychiatric problem and 40% experience these problems up to five years after injury.

Most behavioral problems are due to damage to the frontal lobe that is the area responsible for “executive functions.” Executive functions are organizing, planning, creating, evaluating, reasoning, communication and problem-solving skills[1]. Some neurobehavioral problems could be due to adjusting to the changes from the injury. The intensity of behavior disorders has been associated with the severity of the injury. When such an individual is admitted to NeuLife, he or she will participate with the staff to develop a Client Goal Plan that includes clinical goals, personal goals and activities of specific interest.

The common behavior changes an individual might experience after injury is described below[2].

Aggression

• Aggression occurs in at least 25% of TBI clients[3].
• The client might display temper outbursts, hostility or irritability.
• The client is easily frustrated.
• The client might express his or her aggression verbally or physically.
• Aggression is consistently associated with depression.

Emotional

• Trouble adjusting to the injury is common and can lead to emotional distress.
• The client might experience feelings of depression and anxiety.
• There will be changes in mood and trouble concentrating and paying attention.
• A family member or caregiver might notice changes in the client’s personality. The client could be less motivated, patient, outgoing or active.

Social Relationships

• Socially inappropriate behaviors. The client may make non-tactful statements or use inappropriate language to others.
• Trouble with direct eye contact and non-verbal communication (e.g., gestures, facial expressions, body language).
• Difficulty with appropriate interpersonal space and respect for others space.

Executive functioning

• Difficulty connecting thoughts, actions and consequences
• Impulsiveness
• Learning and memory problems
• Impaired planning and problem solving
• Inflexibility, concrete thinking
• The client could have trouble communicating with others. They may be very blunt in conversation or not speak until engaged by others.

There has been some research that has show that mild brain injuries display behavioral issues related to mood, fatigue and irritability. These issues are sometime overlooked and sometimes more difficult to identify.

It can be challenging to deal with a client who is having trouble with behavior. Here are a few suggestions to help[4].

1. Make sure the client is not left alone. This allows him or her to orient and adjust to the things around him or her.
2. Comfort appropriately while encouraging independence from the start.
3. Coach, encourage and reinforce positive behavior.
4. Help the person get physically involved in his or her environment.
5. Adjust your expectation to the new situation.
6. Develop a descriptive style of interacting. Describe the place and the people around, such as, “Mary, you are in the hospital. I’m, Bob, and John and Sarah are here, also.” It is important to repeat this often so the client can begin to associate places and people.
7. Encourage safe exploration.
8. Gradually raise expectation.
9. Discover the client’s preferences. Listen to the client’s needs and wants.
10. Listen with ears and eyes. Clients with a traumatic brain injury communicate verbally and non-verbally.
11. Bounce back quickly from problems. Staying positive will provide momentum to continue toward recovery.

The behavioral/emotional changes can be very alarming for the client and his or her family or caregiver. Participation in behavioral intervention has proven to be very successful in decreasing and changing negative behaviors. Behavioral concerns can be identified and addressed by specialists. Our behavior analyst, neuropsychiatrist and neuropsychologist are trained to help the client modify his or her behaviors. Poorly controlled behaviors have been linked to difficulty in family reintegration, trouble reaching education, vocational and social goals. It is important for the family or caregiver to be educated on what to expect and how to deal with a client who is struggling with behavioral issues. There is professional help and support groups that can provide guidance during the difficult time.

NeuLife has wonderful neurobehavioral and related services for clients experiencing these behavioral and emotional difficulties. We use a positive approach toward decreasing and modifying behaviors, allowing the client to develop skills to help live a safe, happy and independent life. Our location offers numerous opportunities for community integration, outings, recreation, job training and placement, and much more.

NeuLife, in Mount Dora, Florida, is a fully accessible residential post-acute program providing superior care and specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.

2725 Robie Avenue

Mount Dora, Florida 32757

Call: 800-626-3878

Email: Info@NeuLifeRehab.com

Visit: NeuLifeRehab.com