Confusion and obstinacy after aneurysm

Hi. My father had a ruptured brain aneurysm almost four months ago. He’s been home and out of in-patient recovery for about 6 weeks. When I would speak to him on the phone he would sound fine but now that I’m home for a visit I’m seeing that he is very confused at many points throughout the day. Like he insisted that he had a meeting about the North Korea summit that he had to make it to (he watches a lot of news). But one of the biggest challenges for his caregiver, my mom, is that it takes him forever to do simple tasks like getting ready for an appointment. You have to ask him repeatedly to take a shower or to take his meds. And then once in the shower he refuses to get out. For all of year tasks he says he will complete them but then does nothing. We have not been seeing any cognitive improvement since he got home and some doctors are saying that the brain can have permanent injury from a bleed (his was in frontal lobe). Any experience with this confusion or stubborness? Are we hoping to see improvement too soon? Is this common? Advice? Any thoughts you may have to share are appreciated. This has been extremely challenging for my mom because every moment of the day is a struggle with him. Thank you in advance.

Hey Cigale,
A frontal lobe bleed can be particularly devastating for those around the patient depending on the extent of the actual damage and although another individual may have exactly the same type of bleed in exactly the same region of the brain, the impacts can be vastly different.
Prior to my own injury I worked in the disability sector for near on 20yrs, which is a bit ironic considering my present situation, but such is life. In those 20yrs I worked with individuals with intellectual, physical, sensory and brain injury impairments. And some of those clients had frontal lobe damage.
To have a conversation with these particular clients you may not know they had an impairment, but once you ask them to complete a task or you examine their behaviour it becomes a bit more obvious. In some instances it can be as if they have returned to a teenage state, less responsive(almost combative) when given direction sometimes with a large dose of arrogance ie “I KNOW, I DON’T NEED TO BE TOLD…” but they do need direction at times. Nobody likes to be told they are doing a task wrong, so I’d lighten the load on them by saying “I’ll show you a trick to make it easier…” (Hence my nickname ‘Merlin’) because everyone likes tricks. I also found often it was easier or less combative to have a joke with them as part of the process, not poking fun at them as this can have the opposite effect, but making the task less arduous and taking the focus of what was wrong with the way in which they were doing the task.
A change in roles can be difficult for anyone, but when you add in the husband/wife relationship, those changes can be a real challenge. I’m unsure of what services may be available to you in your area, but it maybe an idea to look into some sort of respite for your mother, so that she can have some ‘timeout’. Burnout of carers is VERY common, especially when their adult partner becomes a child due to illness or injury.
The Brain Injury Association of America https://www.biausa.org/ maybe a good place to start to find services specific to your needs and location. I see that you are in Illinois and another resource you could try is http://www.biail.org/ They both should be able to give you information on other agencies that maybe able to assist. If they can’t, let us know and I’ll hunt them down for you. As I say this used to be my job and if I can assist I will.

Merl from the Moderator Support Team

Merl,
That is so kind of you to take the time to respond to me. I really appreciate your thoughts. My mother just attended her first support group (for caregivers of patients with alzheimers) this week and will attend another next week for caregivers of individuals with brain injury. I’ve relayed some of your strategies along to her. It’s tough…but one day at a time, I suppose. Thanks again.

Hey Cigale,
That’s great that your mother has reached out for assistance. I have known many who have persevered at their own emotional expense which has resulted in some very negative outcomes. Brains are funny things, no two are the same and nor are any 2 brain injuries. This can make things extremely challenging, but networking with others can assist in developing management plans ie how to diffuse a situation or manage a situation in a non confrontational manner. As you say “…but one day at a time…” but please, if you need, please ask.

Merl from the Moderator Support Team