Managing Cognitive Effects of TBI

ALAN
Hey good morning Cullen.

CULLEN
Alan.

ALAN
Come on in. 

CULLEN
Thank you.

ALAN
Take a seat. It’s good to see you again. How are you and your brother, Evan, doing these days?

CULLEN
Pretty great, actually, considering where we started. Evan’s come a long way. We’re all really proud.

ALAN
That is great to hear. Now, if I remember correctly, Evan had some challenges with following directions and remembering peoples’ names.

CULLEN
He did. Especially in the beginning, he was very confused and had a hard time understanding what was going on. Had a lot of memory problems too. The confusion was mostly gone after a couple months, but the memory issues have continued. Even today, several years later, his ability to recall certain words, information, conversations… it just isn’t what it was before the injury.

ALAN
You mention confusion and memory problems, which are both fairly common after a TBI. Some people with a TBI have challenges with paying attention, staying focused, planning, organization, decision making, problem solving. Did Evan experience any of these at any point?

CULLEN
Well, it’s hard to say. Planning and organization were hard for a long time because of his memory problems. I had to post reminder notes for him everywhere about simple tasks or things we had coming up on the calendar. I had to be more organized and make sure everything had a particular place and that I always put it back in that place so he could find it.

ALAN
Can you give me an example?

CULLEN
Let’s see. Oh, I know. Evan’s shoes used to be a big deal. He would take off his shoes in a different place every time, and if I didn’t see them to pick them up and put them by the front door, we would end up spending a long time looking for his shoes all over the house because he couldn’t remember where he had taken them off. So I posted a note right by the front door that he would see as soon as he walked in to remind him to take off his shoes and put them on the mat.

ALAN
That’s a great story. And it’s a perfect example of the kinds of things caregivers can do to help.

CULLEN
Yeah. Over time, as his memory improved, I was able to take down a lot of the reminder notes. But like I said, his memory still isn’t what it used to be. He still forgets things like what we talked about at breakfast or the name of the movie we saw last week.

ALAN
Do you have any stories about ways of which you helped Evan while he was confused?

CULLEN
Sure. That was a huge challenge. Evan could not figure out what had happened to him and where he was, why he was in the hospital. He even started making up false memories because he couldn’t remember certain things –

ALAN
Right. That can happen after a TBI too.

CULLEN
Yeah, and he would be completely convinced that these were real memories.

ALAN
So how did you help him during that time?

CULLEN
Mostly, I just tried to keep Evan oriented to where he was and what time of day it was and things like that. I put a digital clock next to his bed because it wasn’t always easy for him to read the clock on the wall. I also put up a calendar, and at the end of every day I would write all the things that had happened that day on the calendar. This helped him not only to recall events, but it also gave him sort of a visual representation of the days that had passed and what day it was. Other than that, it was just about gently correcting him about details of what had happened and what was currently happening. A lot of repetition.

ALAN
Evan’s lucky to have such a dedicated brother.

ALAN
Thank you for sharing those stories.

CULLEN
My pleasure.