Third, it is best not to focus on what they should have
done or could have done, but to accept the brain injury
has occurred and use their energy for assistance with
the recovery. Just talking to someone about the feelings
of frustration and stress may be beneficial. It may be
beneficial to seek counseling or attend a brain injury
support group. It may be helpful to have health care
professionals educate you on what things you can do to
assist in the rehab process.
Fourth, accept help when someone offers to help do
something for you during this time. They may help with
cleaning your house, mowing your lawn, caring for the
other children, or grocery shopping.
Fifth, work with the medical team to identify what to do
to facilitate recovery. There are various stages the injured
person goes through and loved ones will need to respond
differently for each stage.
Step by Step, How to Help the Person
with the Brain Injury
When someone has survived a brain injury they can go
through various stages of recovery. There are times when
the person may stop at one of the levels indefinitely.
Family involvement is very important in the recovery
process. During the various stages, there are different
approaches the family should take in dealing with their
family member.
Unresponsive or Minimally Responsive
(Rancho Levels 1-3)
During this phase of recovery, the person with a brain
injury may not respond or the responses may be general
most of the time. There may be some localized responses
to sound and physical discomfort. Any responses are
inconsistent. Responses should be as follows:
• Speak to the person using a calm and comforting
tone of voice. You should assume the person may
be able to understand what you say, therefore be
cautious not to speak negatively about them in their
presence.
• Talk to the person about people they know and
recent current events.
• Limit the number of visitors to 1-2. Be sure there
is not too much stimulation. One person at a time
should speak to the person with the brain injury.
• Bring pictures and personal items they are familiar
with, read to them and play music they like. Try to
change the stimulation every 20 – 30 minutes or so
and also allow some quiet time.
• Give the person plenty of time to respond. It may
take 1-2 minutes to get the response you are seeking.
• Do not overstimulate the person as they will need a
great deal of sleep and will be easily fatigued.
Agitated and Confused Stage
(Rancho Level 4)
During this phase of recovery the person has begun to
become more awake and alert but is not oriented and
is very confused about his/her environment. They may
become agitated very easily and can use curse words
or attempt to hit at people or inanimate objects. They
may have wide mood swings and are not usually able to
cooperate with the therapy treatment program. These
agitated behaviors commonly occur when someone with
a brain injury enters this phase.
• Anticipate that the person will have a very short
memory for information, possibly lasting only a few
seconds.
• It is best to try to redirect the person when they
focus on negative thoughts or behaviors rather than
trying to scold them.
• You should try to redirect them and remove any
stimuli that may be contributing to the negative
behavior.
• Do not overwhelm with information or visitors.
Keep visitors to 1-2 people at a time.
• The person will not be able to learn new information
at this time so do not expect them to remember
information such as what they did during therapy or
what they had for lunch.
• Do not say “You are wrong” but provide them
withcorrect information.
• Do not show anger or frustration towards the person.
Please do not take the behavior personally. You
may need to rely on the facility staff to have more
interaction during this time than you are able to have
with the patient.
2020-2022 BIAK Resource Journal 13