It is an exhausting, often thankless job of understanding the family member's strengths and weaknesses and how to provide the cueing, monitoring, structuring and other strategies necessary to maintain harmony and safety. Intensive interactive communication is required to accomplish that goal. New technology that decreases secondary brain damage and allows for improved medical outcomes increases family optimism about recovery. At the same time, families are experiencing less awareness of and preparation for changes affecting cognition and behavior that may not surface until months after discharge. Decreased reimbursement for extended rehabilitation coupled with the busy lifestyle of families whose presence in the rehabilitation setting is not always welcomed or even looked on as a priority increases the possibility for greater dysfunction at a later date.
Good communication is as germane as the treatment one receives.
It is particularly important that communication be established from the onset. Repeating information and requesting that the family keep a list of questions handy when meeting with clinicians enhances communication. Being more introspective, clinicians should remain sensitive to their own value system and philosophies regarding care, thereby improving their ability to communicate with families. Balancing honesty while keeping hope alive is difficult but necessary. No family readily understands how brain injury affects cognition, creating changes in functional capabilities.