• Alternates between being hyperactive and sleeping
• Cries, yells, flails arms or thrashes in bed
• Hits others
• Is self-destructive

• 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.

• Is inattentive
• Forgets
• Asks questions over and over again

• Give one-step instructions.
• Use memory tools, such as a calendar or date book.
• Repeat answers patiently.

• 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

• 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.

• Cries frequently
• Lacks interest in life in general
• Exhibits changes in appetite and sleep patterns
• Lacks motivation
• Withdraws from social contacts
• Talks about dying

• 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.

• 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

• 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.

• Is self-centred and insensitive
• Misinterprets other people’s responses or actions

• 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.

• Can’t control emotions
• Expresses emotions at the wrong time and in the wrong place
• Has mood swings

• 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.

• Constantly eats
• Secretly eats
• Doesn’t remember eating
• Frequently complains of hunger despite having recently eaten

• Seek medical advice.
• Provide other activities, such as exercise or hobbies.

• 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

• 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.

• 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

• 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.

• 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

• 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.

• 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

• 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.

• Diminished initiative, motivation or interest

• 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.

Impulsivity

• Tends to speak or act first and think later
• Acts on inappropriate or confused thoughts
• Is excessively demanding

• Set short-term rewards for brief periods of self-control.
• Suggest more acceptable behaviour.