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Brain injury - discharge

Head injury - discharge; Head trauma - discharge; Contusion - discharge; Shaken baby syndrome - discharge

Someone you know was in the hospital for a serious brain injury. At home, it will take time for them to feel better. This article describes what to expect during their recovery and how to help them at home.

When You're in the Hospital

First, health care providers provided treatment to prevent any further damage to the brain, and to help the heart, lungs, and other important parts of the body.

After the person became stable, treatment was done to help them recover from the brain injury. The person may have stayed in a special unit that helps people with brain injuries.

What to Expect at Home

People with a serious brain injury improve at their own pace. Some skills, such as movement or speech, may go back and forth between getting better and then worse. But usually there is improvement.

Behavior and Social Interaction

People may display inappropriate behavior after a brain injury. It is OK to point out when behavior is not appropriate. Explain the reason and suggest a different behavior. Offer praise when the person calms down or changes their behavior.

Sometimes suggesting a new activity or a new place to go is the best option.

It is important for family members and others to stay calm.

Muscles, Joints, and Movement

At home, the person who had the brain injury may need to practice everyday activities. It may help to create a routine. This means certain activities are done at the same time each day.

The providers will help you decide how independent the person can be and when you can leave them alone. Make sure your home is safe so injuries do not happen. This includes making the bathroom safe, for either a child or an adult, and protecting against falls.

Family and caregivers may need to help the person with the following:

If the person is using a wheelchair, they will need follow-up visits with their provider to make sure it fits well. The person also needs to change positions in the wheelchair several times an hour during the day, to help prevent skin ulcers.

Learn to make your home safer if the person with the brain injury wanders in or from the home.

Diet and Swallowing

Some people with brain injuries forget about eating. If so, help them learn to add extra calories. Talk with the provider if the person is a child. Children need to get enough calories and nutrition to grow. Ask the provider if you need the advice of a dietitian.

If the person with the brain injury has problems with swallowing, help them follow any special diet that makes eating safer. Ask the provider what the signs of swallowing problems are. Learn tips to make feeding and swallowing easier and safer.

Tips for Daily Life

Tips for making clothing easier to put on and take off:

Tips for talking to the person with a brain injury (if they have problems understanding):

When giving instructions:

Try using other methods of communicating:

Bladder, Bowels, and Bathing

Have a routine. Once the person finds a bowel routine that works, help them stick with it. Pick a regular time, such as after a meal or a warm bath.

The person may have problems starting to urinate or emptying all of the urine out of their bladder. The bladder may empty too often or at the wrong time. The bladder may become too full, and they may leak urine out of the overfilled bladder.

Some men and women may need to use a urinary catheter. This is a thin tube that is inserted into the bladder. Learn how to care for the catheter.

When to Call the Doctor

Call the person's provider if they have:

Related Information

Head injury - first aid
Brain herniation
Bathroom safety for adults
Preventing falls
Caring for muscle spasticity or spasms
Concussion in children - discharge
Concussion in adults - discharge
Daily bowel care program
When you have urinary incontinence
Bathroom safety - children
Concussion in adults - what to ask your doctor
Concussion in children - what to ask your doctor

References

Brain Injury Association of America website. Adults: what to expect at home. www.biausa.org/brain-injury/about-brain-injury/adults-what-to-expect/adults-what-to-expect-at-home. Accessed March 15, 2021.

Dobkin BH. Neurological rehabilitation. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 55.

Family Caregiver Alliance; National Center on Caregiving website. Traumatic brain injury. www.caregiver.org/traumatic-brain-injury. Updated 2020. Accessed March 15, 2021.

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Review Date: 11/4/2020  

Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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