Agitation |
- Alternates between being hyperactive and sleeping
- Cries, yells, flails arms or thrashes in bed
- Hits others
- Is self-destructive
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- Touch or talk to the person during periods of attention.
- Ask simple, short questions. Limit the number of distractions to create a quiet setting.
- Know your loved one will likely have reduced tolerance for stress; think about how to reduce stressors before episodes happen.
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Confusion |
- Is inattentive
- Forgets
- Asks questions over and over again
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- Give one-step instructions.
- Use memory tools, such as a calendar or date book.
- Repeat answers patiently.
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Denial |
- Does not admit to changes or problems
- Believes that they are ready and able to do things the same as before
- Makes excuses for not completing certain tasks
- Manipulates others into performing tasks
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- If it is not dangerous, let the person try a desired activity.
- Once you feel the person is ready, show that a seemingly “impossible” activity is simple to do.
- Make sure that lack of confidence or ability is not the real root of the problem.
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Depression |
- Cries frequently
- Lacks interest in life in general
- Exhibits changes in appetite and sleep patterns
- Lacks motivation
- Withdraws from social contacts
- Talks about dying
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- If symptoms persist or suicidal thoughts are expressed, seek professional help.
- Give praise for progress made.
- Try to engage the person in activities that they can tolerate.
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Disorientation |
- Talks in a disorganized, disconnected way
- Mixes fact and fantasy
- Isn’t aware of location, date, own identity or identity of others
- Mixes up time periods
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- Review details like who and where you are and what the date is.
- Talk about familiar things and people.
- Use calendars, pictures and favourite music to orient the person.
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Egocentricity |
- Is self-centred and insensitive
- Misinterprets other people’s responses or actions
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- Do not allow the person to get everything they want.
- Do not expect the person to understand your point of view and respect your rights; you may have to stand up to them.
- Get the person involved in a brain injury support group.
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Emotional Instability |
- Can’t control emotions
- Expresses emotions at the wrong time and in the wrong place
- Has mood swings
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- Do not criticize.
- Praise the person when they show self-control.
- Do not confront the person about their behaviour; it may cause embarrassment.
- Be a model of calm behaviour.
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Excessive Eating |
- Constantly eats
- Secretly eats
- Doesn’t remember eating
- Frequently complains of hunger despite having recently eaten
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- Seek medical advice.
- Provide other activities, such as exercise or hobbies.
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Excessive Talking |
- Talks constantly
- Doesn’t remember previous discussions
- Can’t come to a conclusion or solution
- Can’t break the cycle
- Can’t take turns in a conversation
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- Redirect the person’s attention to a task.
- If the talking seems related to anxiety, tolerate some talking.
- Do not feel obligated to respond.
- Suggest listening to music.
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Memory Problems |
- Forgets to complete tasks
- Can’t remember events since the injury or certain periods of time before it
- Recalls information slowly
- Has trouble remembering things like names or appointments
- Often misplaces things
- Repeats the same things over and over again
- Has a hard time learning new things
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- Provide a quiet, calm setting.
- Correct wrong answers gently.
- Give reminder clues (e.g., “Was it this or was it that?”)
- When clues don’t work, provide the forgotten information.
- Use signs or other visuals to reinforce what needs to be remembered, including a memory book, calendars, and clocks or watches.
- Exercise the person’s memory by asking for a recap of events or activities.
- Try not to interrupt because it may cause the person to forget what they wanted to say.
- Try to maintain a consistent routine.
- Label cupboards and drawers.
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Change in Sexual Interest |
- Makes inappropriate sexual remarks or advances
- Manipulates partner for the sake of physical contact
- Becomes threatening when partner is not willing to be sexually involved
- Has a decreased libido
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- Tell the person that their behaviour is unacceptable.
- Make them aware of the consequences of such behaviour.
- Do not feel obligated to respond to the person’s sexual demands.
- Ask about medication and counselling.
- Discuss self-gratification options.
- If necessary and possible, remove yourself or the person.
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Lack of Awareness
(Anosognosia) |
- Seems unaware of the existence of their disability
- Lacks insight into the effects of personal actions
- May not be able to fully appreciate or understand the effect that the brain injury is having on their life
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- Be as active as possible in the rehabilitation process.
- Do not let the person drive a car or operate any dangerous equipment unless approved by a doctor.
- Help them set realistic goals.
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Apathy |
- Diminished initiative, motivation or interest
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- Provide a routine by structuring daily activities.
- Set up multi-step procedures in which one step leads directly to and cues the next step.
- Seek professional help.
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Impulsivity
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- Tends to speak or act first and think later
- Acts on inappropriate or confused thoughts
- Is excessively demanding
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- Set short-term rewards for brief periods of self-control.
- Suggest more acceptable behaviour.
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