Dementia in Head Injury (cont.)
Julia Frank, MD
Nestor Galvez-Jimenez, MD
Francisco Talavera, PharmD, PhD
Helmi L Lutsep, MD
IN THIS ARTICLE
Dementia in Head Injury Treatment
Head injuries often bring an abrupt “coping crisis.” The sudden adverse changes that go with a head injury inevitability cause many emotions. Anxiety is a common response, and the person may become demoralized or depressed. Damage to the brain may impair the person’s ability to cope at a time when the need to adapt is greatest. Persons with head injury typically are more distressed and have more difficulty coping with their injury than persons who have other types of injuries.
Usually, a particular family member assumes most of the responsibility for the injured person’s care. Ideally, more than one family member should be closely involved in caregiving. This helps family members share the burdens of providing care and helps the primary caregiver keep from becoming isolated or overwhelmed. Caregivers should be included in all significant interactions with health care professionals.
Caregivers must encourage and expect the injured person to be as independent and productive as possible. At the same time, caregivers need to be patient and tolerant. They should accept that the person may have real limitations and that these will likely worsen if the person is tired, ill, or stressed. Emphasizing what the person can still do, rather than what seems to be lost, is helpful.
With head injuries, the greatest improvement is expected in the first 6 months, but delayed improvement is possible as long as 5 years after injury.
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Traumatic brain injury can lead to deficits in 5 general areas: (1) short-term memory impairment, (2) slowed processing speed, (3) impaired executive function, (4) disrupted abilities of attention and concentration (which likely contributes to the deficits noted in the first 3 categories), and (5) emotional dysregulation.