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human being and deserves respect. For example, if a person is unable to communicate, we may assume that he does not understand what is going on around him. Someone who cannot speak may be perfectly able to hear and understand language. Speak to the adult patient as an adult and treat her as an adult. In the presence of others, show respect for the patient. Share in her joy and accomplishments, no matter how small they may seem to you.

Understanding—in order to practice patience and respect, caregivers and loved ones need to adopt a well-informed perspective. This means not only learning about brain-injury and its consequences, but also being able to show the patient and others that you are aware of and empathize with her situation. Patients do not want your pity but rather an acceptance of who they are, even with their limitations and abilities.

Knowing When and When Not to Push—This can be very tricky. Different patients will respond to different types of encouragement to recover their abilities. Use the patient as your guide. Begin by gradually encouraging the patient. At each step of the way, either ask the patient how he is doing or observe his behavior and facial expressions to determine if you need to back off. The goal is to help him try to the best of his ability while minimizing the frustration that accompanies the effort. You can acknowledge how difficult this process is and give him positive feedback.

Flexibility—You have figured out the right way to encourage the patient. Even if one day you unwittingly upset her, you may have done nothing different than before. Brain-injury survivors can experience mood changes. What worked once may not work another time. The range of emotions and challenges the patient experiences changes throughout the recovery process. You may need to change your routine or how you behave.

Sense of Humor—Many people in the company of a brain-injury survivor are so afraid to offend the survivor that they clam up or act stiff and distant. Remember that brain-injury survivors spend much of their time “surrounded” by their injury. Sometimes, lighten the seriousness of the moment by saying or doing something to make the patient laugh. Naturally, you won’t make


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