Caregiver Tips for Helping with Cognition and Communication Skills

By Kelly Harrigan

Traumatic brain injuries profoundly affect an individual’s ability to perform many cognitive skills, particularly those relating to emotional lability, attention, planning, judgment, and decision making. It is difficult for an affected individual to comprehend these difficulties, and hard for caregivers and loved ones to accept that a person’s cognition fundamentally changed.

Frustration, a sense of loss, anger, and withdrawal are commonly seen in individuals with cognition and communication problems following a traumatic brain injury. These same symptoms can be mirrored by their caregivers as they cannot grasp why their loved one no longer functions at the same level before their traumatic brain injury took place. There are simple steps both affected individuals and caregivers can take to ameliorate these symptoms.

The most important step a caregiver can do is to practice patience and acceptance. You should realize the magnitude of cognitive and communicative issues stemming from the TBI and take steps to assist the affected individual.

Using a gentle and kind tone goes a long way in making the affected individual feel secure and safe. Oftentimes, they realize they cannot perform their usual tasks, and fear underlies their anger and frustration. Caregivers should never expect an individual to just ‘keep up’ or be able to do normal activities in the same manner they used to.

Allow your loved one extra thinking time to respond or work through a task. Help them by breaking the overall task into small pieces, addressing each piece individually and in chronological order. Offer to help them with alternative solutions if they struggle with a task or process. Keep your sentences simple and slow your speech down to help the affected individual  better understand what you say. Limiting your conversations to one-on-one is best in order to keep from overwhelming an affected individual  by trying to follow and process a conversation between multiple people. You, as the caregiver, should have a clear understanding of the cognitive therapies being utilized with your loved one and reinforce the skills being taught.

An affected individual may lack the ability to remember what they should focus on to help them regain their skills. The following points are great reminders to help them with their cognitive and communicative therapies.

You might consider using images to link to information you wish your loved one to remember. Try to connect new information with something they already know to provide a building block. Writing out step by step instructions for simple, repetitive tasks helps until that building block gets embedded in muscle memory.

Using memory aids such as calendar reminders or other memory aiding computer apps can be powerful and wonderful tools. You should keep in mind several big caveats, the two most important being limiting screen time following a TBI, and learning to use a new app is suboptimal when a person already struggles with cognitive deficiencies.

Below are the key tips to assist your loved one:

• Provide structure and routine.
• Put everything away in the exact same place.
• Keep a quiet environment with minimal distractions.
• Ensure a good night’s rest for a person with TBI. Sleep provides the necessary foundation to give the rest a person needs to properly focus and heal.
• Remind your loved one often that it is ok for them to have these issues and that you love and accept them for who they are now.

Kelly is a single mum, veteran, TBI survivor with a girl child and a frenchie, oolong tea in hand and humor on hand, who lives in Annapolis, Maryland.