Each brain injury is unique in what was its cause and what damage was sustained--and yet brain injuries can be similar on various levels of recovery. No matter what the type of injury is--Acquired Brain Injury (stroke, abscess, aneurysm, or damage to the brain caused by something abnormal within the body) or Traumatic Brain Injury (from car or motorcycle wrecks, falls, football accidents, or any external cause from outside the body)--recovery from both types of brain injuries can be very similar.
After rehabilitation, deficits can remain that are characteristic to both ABI and TBI--unclear thinking, loss of short-term or long-term memory, word recall in conversation, personality changes, balance issues, dizziness, various levels of loss of use of one or more limbs, etc. At this point, the survivor moves forward to live his life as he adapts to his "new normal." However, those around him, and particularly the world around him, have more difficulty adjusting and accepting how things are permanently different due to the brain injury.
It's easy for the caregiver to gradually slip back into the old routine thinking things are back to normal. Things will never be back to normal after a brain injury! The deficits that are now experienced by the survivor affect those around him as well. Accepting and remaining aware of how the deficits affect the survivor are vital for the caregiver to experience.
Living out in the world is a challenge for the survivor because a brain injury is known as the invisible injury. People often say to Bruce, "Why, I'd never know you had brain surgery." Well, WE know, but they can't see it. So for them, it doesn't exist. A friend of ours who struggles with thinking and cognitive abilities, worked full-time at his business before his accident. Now, fatigue takes a toll on him each day as well as the frustration of not being able to think through issues as he used to. His co-workers are short with him when he doesn't react or think as quickly as they do. They expect life to be "back to normal." It is--but he has a NEW normal.
We met a beautiful 22-year-old girl who was involved in a car accident. Now she is two years out from the injury, and experiences severe expressive and receptive aphasia. The difficulty of expressing words and thoughts is an every-day part of her life. She also cannot receive or sort through information that she hears in order to respond. You'd never know by looking at her beautiful face that anything was different from anyone else--the invisible injury.
If ten people stand in a line and five have brain injuries, you would have a difficult time distinguishing the brain injury survivors from the others until you talk with them or watch them move.
The moral of the story is to be patient with all people. You never know which ones have brain injuries and may need a little extra time to think things through. What they have to say or contribute is important. It may just take a little more effort to share it with you! But it's worth it--for both of you.