–   MARCH 2021   –

Spotting hidden traumatic brain injury disabilities and how you can help

Those who have experienced a traumatic brain injury (TBI), depending on the level of their executive dysfunction, will sometimes try to hide their resulting disabilities. 

There are several reasons why this happens, including:

  1. Wanting to hold on to the life they had before their traumatic brain injury

  2. Needing to feel in control of the situation

  3. Protecting loved ones’ feelings and not wishing to raise their concern or sympathy

  4. Avoiding feeling like a burden to others or being treated differently

  5. Wanting to be seen as the ‘normal’, pre-injury version of themselves they used to be

Here’s where things get tangled. You have a person who is battling with the physical, mental and emotional consequences of their TBI doing everything they can to hide the fact that this is really hard for them. If they are skilled at hiding their disabilities, and the challenges they are really facing, those around them can forgivably be unaware just how much they are truly dealing with. 

So how do you know there’s even a problem? And what do you do about it?

The first crucial step is that anyone closely involved in that person’s life – friends, family, support workers, medical professionals, physiotherapists – needs to be mindfully observing. 

A few tell-tale signs could be realising that they are walking at an unusually slow pace. This is not them daydreaming or taking in the view; it is a deliberate action to help them keep their balance while walking. Slowing down gives them more control. Sitting on their hands, or holding their hands together while talking to you, is another really common thing those with neurological disabilities do to hide their tremors. You can’t see their hands are shaking if they are sitting on them. 

Pay attention to how their behaviours change, depending on the situation and surrounding environment. While inside their own home, someone with a TBI will be more comfortable and familiar with the flooring surfaces and their surroundings. Take them walking outdoors and their walking pace might then noticeably slow down. They might also become agitated that they can’t as easily hide their hands as they could sitting down in an armchair. Were they resistant to changing position or moving into a different room? Observe these behavioural changes with mindfulness and sensitivity to their feelings.

How do you have that conversation?

In order to discuss functional challenges, it is going to require trust and safety for the person with the TBI to feel comfortable opening up to you. Put them at ease, go gently into the discussion, and lead with recognition for how well they’ve been doing. You can reference generic challenges common with TBI, rather than focusing on them personally, so it feels less threatening to them. Depending on the nature of your relationship, saying something along the lines of, “I was reading up about TBI”, or “many of the people with TBI who I work with have found it much harder to keep their balance since their injury. I don’t know if you’ve experienced this yourself but I think you’ve been doing incredibly well and I had not considered how hard this must be”. Using that approach as an opener allows them to say something about their own personal experience if they do want to open up, while removing any pressure to feel they have to do so. Talking in general terms is a safe way into the discussion. 

What happens if you don’t?

If you suspect that the person with TBI who you support is hiding their disabilities, you can be certain that this is taking a lot of energy for them to successfully do so. That’s energy that could be put to better use elsewhere. If you never address it with them, they will continue to believe they have to maintain the pretence that they are ok when they are not. Their healing journey and self-acceptance of their condition will also be hindered.

What happens if you do?

Having the courage to address this, in a gentle, non-threatening way gives the person with TBI the chance to do things differently. It allows them the opportunity to say they need help (if they choose to share this) and to explore alternatives to make their life easier and conserve their energy. Maybe with some emotional support, they can come to terms with needing to use a walking aid so that they can then enjoy outdoor adventuring more. Maybe there are things that can be purchased for their home and there’s some extra support that can be given to help with the daily tasks that their physical limitations make very difficult to do, such as getting dressed for example.

Here for you

The team at Active Edge Physio are highly skilled at identifying the right therapy for participants with TBI and then implementing the best TBI physical therapy plan to help transform people’s daily lives. We work with people for their neuro physio sessions in their own homes as the key to making meaningful, lasting improvements.

To find out how we can assist you, book a free 15-minute call with us and we’ll make sure you get the right support.