Returning home following brain injury – regardless of severity – can be complex. It is often emotional, exciting, overwhelming, and exhausting for both the individual and their family. Most individuals are very happy to come home after rehabilitation; not only is home a safe and secure place but also is often perceived as a place where one will find one’s old self. Friends and family are happy, as well, but after a period of welcoming they may return to their old routines of school, work, and leisure activities.
Brain damage involving frontal or temporal lobes of the brain – resulting in confusion, memory loss, poor organizational skills, disinhibition, poor reasoning skills and judgment – can change the individual dramatically, and it is often very difficult for others to understand these changes. While in a rehabilitation or hospital setting, one is likely to have a rather busy, regimented day. Once home, this regimentation may quickly cease, and the person may find themselves slipping into a place of isolation, depression, and loneliness.
It is important that family members, friends, and caregivers understand the individual does not want to feel or act differently than they did before the injury. The journey ahead can be challenging, and may feel slow. Here are a few tips for all involved:
- Be patient
- Seek help (from professionals, peers, support groups, etc…)
- Keep a journal
- Express yourself
Preparing the Home
It is important for family members and caregivers to assess the home before the individual’s return from rehabilitation and make sure it is a safe, accessible environment. Here are some suggestions for modifying the home:
- Ramps – Getting in and out of the house is the first order of business, and a ramp may be in order. If you need a wheelchair ramp, ADA guidelines indicate a slope rule of 1:12. In other words, for every one inch of slope the ramp will need to extend 12 inches.
- Ceiling Lifts – Ceiling lifts run on a track system that is mounted to the home’s ceiling and are designed to help caregivers move an individual without causing strain or risking an injury.
- Roll-In Showers – A roll-in shower allows an individual access directly into the shower while in their shower wheelchair.
- Door Openers – There are power door opening units that will open and close the door for the person to enter and exit the house unaided. The timing of the open and close settings can be adjusted for each person, and many units include options like digital keypads, electric strikes, various switches, and outdoor access.
- Door Widening – Wider doorways make it much easier for the person in a wheelchair to navigate by ensuring there is adequate room to safely maneuver within the home.
Changes in Family Dynamics
Returning home following brain injury can quickly lead to a renegotiation of boundaries and responsibilities that existed within the family before the person’s injury. If the breadwinner has sustained the injury, there are certainly financial ramifications looming. If an adult is moving back in with their parents following a brain injury, it will likely be difficult for both the parents and the adult child to adjust.