While you may know that a family is struggling to process that their family member has sustained a traumatic brain injury (TBI), it can be easy to lose sight of that emotional burden when you are wrapped up in the details and logistics of making sure that an injured worker receives the care that they need. Not only do families have a much better experience when they feel supported by their case managers, but this also reduces the likelihood of litigation and increased claims costs.
As a clinical care manager (Craig Hospital’s terminology for our internal case managers) with more than 30 years of experience focused in brain injury rehabilitation, I have seen families from all over the country in all of the various stages of acceptance of their loved one’s “new normal.”
From this experience I have learned that there are some important things to keep in mind as you are communicating with a family of a newly injured worker with a TBI:
- Understand that the family may still be in shock
The phone call every parent, husband, wife or friend fears the most is one informing them that their loved one has a serious and potentially life-threating medical condition. This is unsettling to say the least. One mother once told me, “This accident has rocked me and my family to the core.” Shock, bewilderment, fear and feeling overwhelmed are common and expected feelings that can impact family members’ interactions with everyone on the care team, from the surgeon to the workers’ compensation professional. - Share honest and compassionate information
Traumatic brain injury is a medical diagnosis that has many unknowns, which can be very frustrating for families who are craving information and solutions. Many times the most honest answer that you can provide is “I don’t know” or “It is going to take time to understand the reality.” Providing this honest and compassionate information is vital for families looking for both solace and truth. - Be concrete and repeat yourself
Soon after an injury, family members are often not quite ready to emotionally process everything. This is a good time to focus on the next steps and provide clear direction, even providing simple information like where the family could grocery shop and pick up essentials near the hospital where they’re located. It is important during this overwhelming time to be concrete with your directions and repeat yourself regularly since families are taking in so much new information. - Provide space and permission for families to mourn
In the fast-paced world of healthcare, patients are moved quickly through the emergency department, critical care unit, long term acute care, acute rehabilitation, residential transitional living, outpatient therapies and more. In the midst of all these transitions, families are often not given permission to mourn their loss and the abrupt changes in their lives. The opportunity to grieve and talk with mental health professionals can be healing and cathartic for families in the process of adapting. - Help set realistic goals
Many people with traumatic brain injuries make outstanding functional gains, however; it is very difficult to predict how a person will recover. For families and patients, hope is critical to endure the daily grind of rehabilitation and maintain motivation, but it’s also important to have realistic expectations regarding recovery. Families depend on medical professionals to provide compassionate education about brain injuries and set realistic goals for the future. - Think toward the future
Despite the overwhelming impact of a traumatic brain injury for a family, the world continues to go on at its rapid pace. Making plans as a family for the future is very important in relieving stress and providing some structure and control, and this work can be supported by the experts on the care team. Some areas to consider in planning would be:
Medical: What is the current treatment plan? What are the options for continued care? What are realistic benchmarks that will help medical professionals determine the next level of care?Financial: How do I pay my bills? What assistance am I eligible to receive and what is the process to apply for that help?
Insurance: What does my insurance cover and what does it exclude?
Childcare: How do I care for my children and my injured spouse?
Caregiving: What is expected of me and my family for providing support and care now and in the future?
Resources: Where do I go for local help?
Most importantly, it’s important to remember that patients with brain injuries are being cared for by a team of professionals who are working together closely to make sure that the patient and their family are informed and supported. Families should be encouraged to lean on that team network and feel comfortable asking questions and expressing their needs and concerns. The best patient outcomes, decreased litigation and an overall positive experience are achieved when families feel informed, engaged and hopeful.
By Kent Hamstra
Director of Clinical Care Management
