Working with a TBI Patient

Working With Traumatic Brain Injury (TBI)

According to the Mayo Clinic:

Traumatic brain injury usually results from a violent blow or jolt to the head that causes the brain to collide with the inside of the skull. An object penetrating the skull, such as a bullet or shattered piece of skull, also can cause traumatic brain injury.

Mild traumatic brain injury may cause temporary dysfunction of brain cells. More serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain that can result in long-term complications or death.”

Most TBIs happen because of motor vehicle accidents, falls, and sports injuries.

Things that may be affected by a TBI:

  • Less able to pay attention or keep concentration
  • May become upset or agitated easier than before
  • Not seeing or registering what they see as well as they used to
  • Memory problems
  • Less smooth and controlled movements
  • Less able to problem-solve or think as clearly as they used to
  • Pain
  • Problems doing things they used to do everyday with ease, like bathing, dressing, and eating.

Tips for working with someone who has a TBI:

  • Work in a quiet room with calm lighting, little noise, few visual distractions, and with very few people.
  • Make night and day time more obvious for them. For example, during the daytime leave lights on, but at night make sure the room is dark and quiet.
  • Use hand mits if they are trying to pull out their IV’s or oxygen tubes.
  • Save their bed and the area close to it for sleeping only. Encourage them to do exercises and therapy in an area away from where they sleep.
  • Help them stick to a strict routine.
  • Try to orient them as much as possible. In their room, try to have a calendar, clock, pictures of loved ones, and other things that mean something to them to help them figure out who, when, and where they are.
  • When out of bed, have them sit in a hard-back chair with the hips, knees, and ankles all at a 90-degree angle with their feet on the floor.
  • A great position for working with a person with a TBI is to kneel with one knee beside them and one knee behind them in their chair. Place one hand around their back on their far hip and the other hand on the hip closest to you to help them regain balance if they get dizzy. Stay to their side, because this will help lessen their distractions.
  • Use short commands or statements when speaking to them, and give them time to process what you said.
  • Set up everything you’ll need when working with them before you start to work with them.
  • Be patient.
  • Take lots of rest breaks for yourself and for them.

Adaptive Equipment for TBI

  • Alarms
  • Color Coding
  • As much organization as possible with clothing, food, medications, etc
  • Pictures showing them what to do
  • Carrying notecards with them to help them remember things

Helpful Resources:

Mayo Clinic

Center for Disease Control (CDC)

The Traumatic Brain Injury Survival Guide

By Dr. Glen Johnson, Clinical Neuropsychologist
5123 North Royal Drive, Traverse City, MI 49684
Phone 231-929-7358, Email

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