Return to graphic version of Understanding TBI Part 2
Infocomic Main Characters
Sam: A young White woman with blonde, shoulder-length hair.
Teacher: A middle-aged White woman with dark bangs.
Mike: A young White man. He has a shaved head and a visible scar on his scalp. He is Sam’s brother.
Carolyn: A middle-aged White woman. She has long blonde hair, bangs, and thick-framed glasses.
Therapist: A middle-aged Asian woman. She has long dark hair tied into a ponytail and thin-framed glasses.
Sam’s Friends: A group of four young women of different ethnic backgrounds.
Lewis: A middle-aged White man. He has short dark hair and thick-framed glasses.
Jeanne: A middle-aged White woman. She is a clinical psychologist, and she has short, wavy dark hair.
Plot
RECAP FROM PART 1
Mike is about to come home from the hospital. He was in the inpatient rehabilitation unit because of his TBI. While he was there, we met different therapists he worked with and saw his family use the problem-solving method. People around him are starting to notice that he’s acting a bit differently. His sister Sam is about to give a class presentation about what she learned while he was in the hospital.
LEARNING ABOUT TRAUMATIC BRAIN INJURY
Sam is standing in front of school lockers, talking to the reader.
Sam says, “We learned so much about TBI that I did a presentation about it for my science class.”
Sam is shown standing next to her teacher in a classroom.
Sam’s teacher says, “For our next presentation, Sam is going to teach you about the brain!”
Sam is seen standing at a white board. The white board has a drawing of the human brain. It shows the right brain, the left brain, and the front.
Sam says, “Thank you! I’m going to share what I’ve learned about the brain while my brother has been in the hospital. This is the brain; it controls everything that we do, from moving to thinking. It has two halves or hemispheres.”
“The left hemisphere controls the right side of the body and vice versa. Usually the left half of the brain controls verbal and logical thinking.”
Sam writes on the board, “Left Brain: Speech, Reading, Writing, Some kinds of memories.”
Sam says, “The right brain deals with intuition, it makes a big picture out of little parts, and sees or hears patterns in music or visual art.”
She writes on the board, “Also controls emotions.”
Sam says, “You might think any brain injury is traumatic, right? But traumatic means that an outside force has injured the brain. The brain is soft tissue floating inside the skull. A trauma to the head can make the brain bash into the skull, bruising tissue or even damaging blood vessels.”
A magnifying glass is held up to the image of the brain. It shows the synapses.
Sam says, “When cells in the brain are hurt, they can’t talk to each other the right way. That can change people’s behavior or how they to do things. There are three things that are typically affected by TBI.”
A list is shown on the whiteboard:
- Physical Abilities
- Thinking or Information Processing
- Behavior and Emotions
Sam continues, “The effects of a TBI depend on which areas of the brain are injured.”
PREPARING TO MOVE BACK HOME
Sam is seen with her brother Mike, her mother Carolyn, and the therapist.
Sam says, “We wanted to know how to help Mike at home, so my mom and I often went to his therapies with him.”
After a TBI, the fastest improvements happen in the first six months. Recovery continues after six months but at a slower pace.
The therapist is shown talking to Mike. She says, “Mike, you must be excited to go home soon!”
Mike responds, “I just want to get back to my normal life.”
The therapist replies, “Well, things may not be exactly how they were before. It may take some adjustment.”
Improvements can continue for many years after the injury. People recover at different speeds.
Mike says, “Yeah, I’ll be living with my parents. But I’m ready to get out there.”
The therapist points to a calendar and replies, “All of your schedules are connected now, having one calendar with everyone’s plans on it may help. Also Mike, things may be overwhelming. It can help to have a daily routine.” Images of a loud TV, a phone, and a barking dog are shown as examples.
READJUSTING TO HOME LIFE
Mike is shown relaxing on the couch alone. He’s watching TV. Sam enters with a group of friends.
Try to restrict the number of visitors. Stick to one or two at a time.
Sam’s friends swarm Mike. They ask him different questions at once.
“Wow Mike, you look great!”
“How you been man?”
“Must be nice to be home huh?”
Only one person should speak at a time. Use short sentences with direct and clear words.
One friend asks, “Ooh, can we see your scar?” She reaches toward Mike’s head.
Stimulate only one sense (hearing, visual, or touch) at a time. Avoid crowded places.
Mike stands up and shouts, “I’m trying to watch my show!”
Sam responds, “Mike, calm down! We’re just going to watch a movie.”
Use a calm, soft voice.
Mike leaves the room and slams the door behind him.
Sam and her friends look at each other in shock. One says, “Whoa.” Sam leaves the room, saying, “I’ll go talk to him.”
As she walks down the hall she thinks, “He’s not really mad at me.”
At Mike’s door, Sam asks, “Mike, can I come in?”
Through the door Mike says, “Sure.”
Sam goes into the room. Their dad Lewis listens from the hall. Sam says, “I’m sorry if we were too noisy… you ok?”
Mike replies, “It’s alright, I just wasn’t expecting a bunch of people asking me questions.”
AVOIDING OVERSTIMULATION
After a TBI, a person can be more easily agitated by too much activity or stimulation. Here are a few ways to help. Some of these suggestions may not apply to your situation.
- Limit the number of visitors (1 or 2 at a time).
- Only one person should speak at a time.
- Use short sentences and simple words.
- Present only one thought or request at a time; allow extra time for a response.
- Use a calm, soft voice when speaking to the person.
- Keep stimulation to one sense (hearing, visual, or touch) at a time.
- Avoid crowded places like shopping centers or sports stadiums.
TBI AFFECTS THE WHOLE FAMILY
A TBI doesn’t affect only the person who sustained the injury. Instead, TBI affects the whole family. Some common problems experienced by families are having less time for themselves, changes in their roles, feelings of loss, financial worries, communication problems, and lack of understanding or support from extended family and friends.
Lewis is shown talking with Jeanne, the family’s clinical psychologist.
Lewis says, “Until recently I’d thought that with enough time Mike would eventually be ok. But he gets frustrated so easily; sometimes he throws tantrums like a kid!”
Jeanne responds, “That must be difficult for you and Carolyn.”
Lewis says, “Sam too! I tell him that he’ll recover before he knows it, but he’s just so down on himself.”
Jeanne responds, “Can I make some suggestions about how you can support him respectfully?”
Lewis says, “I’d welcome any guidance.”
Jeanne says, “Try not to overwhelm Mike by saying that he’ll recover quickly. If he makes a mistake, try not to make him feel guilty about it.”
Lewis says, “I try not to, but he was so independent before his TBI.”
Jeanne says, “It can frustrate people to be compared to how they were before the injury. Remind him how far he’s come already.”
Lewis says, “Great suggestions. I can do all of that!”
“Great,” says Jeanne.
Ways to respectfully support a person who’s had a TBI:
- Treat people like adults.
- Respect people’s preferences in music, food, clothes, and entertainment.
- Avoid making people feel guilty about mistakes or accidents, like spilling something.
- If the person has memory problems, explain an activity as simply as possible before you begin. Then, review each step in more detail as you go through the activity.
Sam is shown in the car with her mother, Carolyn. She says to the reader, “My mom spoke to the psychologist more than the rest of us. She often shared what they talked about with the rest of the family.”
Carolyn is shown talking with Jeanne, the family’s clinical psychologist.
Carolyn says, “It’s good to have Mike at home, but he’s different and it’s got us all a little on edge.”
Jeanne asks, “How are you guys managing that?”
Carolyn admits, “I’m just trying not to focus on it.”
Jeanne says, “Well, you shouldn’t ignore stress. It can be really negative for your body and mind.”
Stress is related to medical problems like heart disease, stroke, and cancer. It can also lead to depression or anxiety.
Carolyn asks, “I know I’d feel better if I wasn’t so stressed, but what can I do?”
Jeanne says, “Stress can make it harder to be organized and to think clearly. There are some things you can do to help deal with it. Focusing on deep breaths, thinking of a calm situation, or repeating a word with a positive meaning can help.”
Jeanne gestures to a poster. It says:
- Practice relaxation,
- Reward yourself, and
- Find the right coping strategy.
Jeanne continues, “Focusing on deep breaths, thinking of a calm situation, or repeating a word with a positive meaning can help.”
Carolyn responds, “Peace.”
Jeanne says, “Learning to relax isn’t easy, but with practice you’ll get better at it.”
Carolyn responds, “You’re right, I need to take time for myself so that I can calm my mind.”
Jeanne says, “Don’t forget to give yourself little rewards.”
Carolyn says, “I’m so busy, I can’t just go on vacation.”
Jeanne gestures to a document. It’s called “Application for Disability Benefits.” Jeanne says, “What about something smaller? Aren’t you finishing up Mike’s social security application today?”
Carolyn responds, “That’s my goal.”
Jeanne says, “Well when you’re done with that do something nice for yourself. Maybe a fancy cup of coffee?”
Carolyn responds, “Yeah...Just something small. Thank you for reminding me to do that.”
Jeanne suggests, “Also, try to find community. There are many support groups for caregivers.”
As Carolyn stands to leave, she says, “This has been so helpful. I’ll see you next week!”
AUTHORSHIP AND ILLUSTRATION
This infocomic was written by Silas James and Ayla Jacob and illustrated by David Lasky, in collaboration with the Model Systems Knowledge Translation Center. Portions of this infocomic were adapted from the factsheet series titled Understanding TBI, which was developed by Thomas Novack, PhD, and Tamara Bushnik, PhD, in collaboration with the Model System Knowledge Translation Center (https://msktc.org/tbi/factsheets/Understanding-TBI). Portions of this infocomic were also adapted from materials developed by the University of Alabama Traumatic Brain Injury Model System (TBIMS), the Baylor Institute for Rehabilitation, New York TBIMS, Mayo Clinic TBIMS, Moss TBIMS, and from “Picking up the Pieces After TBI: A Guide for Family Members”, by Angelle M. Sander, PhD, Baylor College of Medicine (2002).
Source: The content in this infocomic is based on research and/or professional consensus. This content has been reviewed and approved by experts from the Traumatic Brain Injury Model Systems (TBIMS), funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), as well as experts from the Polytrauma Rehabilitation Centers (PRCs), with funding from the U.S. Department of Veterans Affairs.
Disclaimer: This information is not meant to replace the advice of a medical professional. You should consult your health care provider regarding specific medical concerns or treatment. The contents of this infocomic were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (grant numbers: 90DP0031 and 90DP0082). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this infocomic do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the federal government. Funding for this infocomic was also provided by the Brain Injury Alliance of Washington; the University of Washington; the Veterans Training Support Center; the Washington State Department of Veterans Affairs; the Washington State Department of Social and Health Services; the Washington State TBI Council; and King County.
Copyright © 2017 Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.