After a brain injury, a person may behave in new or different ways and may have personality changes. Patients may become agitated or aggressive, and these mood changes may be disturbing. Some may curse, laugh, or cry out of context. Others may show increased or decreased sexual interest. Judgment may be altered. This can have financial and legal implications.
Behavior changes may be caused by damage to the brain. Or they may result from the person’s increasing awareness of what has happened. Such changes may be linked to frustration, anger, or grief.
Many patients have extreme mood swings. Others show no change in emotions. As a patient becomes more aware, depression may set in. Signs of depression should be brought to the attention of health care professionals. A number of treatments are available that may be helpful for improving the patient's quality of life.
Team members address the patient’s feelings and behavior. A team member may ask an angry patient to “calm down.” If the person does so, he or she is praised for using self-control. Then the patient may be asked how he or she was able to handle the emotion. If the patient knows, the technique can be used again.
Agitation and aggression may be stages a patient passes through. One needs to ensure that there is no physical, medical, or psychiatric cause for the agitation. If the patient’s safety is a concern, restraints may be used. Also be sure to contact the health care team. Or team members may take turns staying with the patient. As a patient becomes calmer, the team may do the following:
Point out when a behavior is not proper. Then explain what the patient could do instead.
Redirect agitated actions such as pacing.
Divert the patient from tasks that are upsetting.
After a brain injury, some patients see only how matters relate to themselves. They may not be aware of how their actions and words affect others. Group rehab helps patients learn to deal with others. It also improves speech. Playing games helps patients link ideas and increase hand-eye skills.
Try to act in ways that teach good behavior. Also, let the person know he or she is still needed and loved. Try the tips below.
Do not hold a grudge.
Do not always give in to demands.
See depression as a stage of recovery.
Ignore outbursts of anger. Direct the person toward a task he or she can do.
Do not cringe, frown, roll your eyes, shake your head, or clear your throat.
Make contact. Hug, hold hands, offer a gentle touch.
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