Blog: Life Changes After a Traumatic Brain Injury

When the clock has gone forward

and all rehab has been completed,

Where exactly do we pick up our life?

Our abilities and level of function

have changed from our brain injury,

Where exactly do we pick up our life?

We cannot go back to a different time

to a place where we have already been.

Where exactly do we pick up our life?

In many ways we are now a new person

old dreams must somehow be put to rest.

Where exactly do we pick up our life?

"Going Forward with Life" – a poem by TBI Survivor Debbie Wilson, 10-16-97

While timely medical care and intense rehabilitation can make a huge difference in the survival rate of a traumatic brain injury, there is something that both the survivor and their loved ones must accept...that life has changed forever.

In our previous blog, The Anatomy of a TBI, we discussed how through rehabilitation new neurological pathways are opened up to allow the survivor to perform tasks that used to be done using pathways that were affected by the injury. These pathways relate to memory, motor skills, comprehension, and even speech and personal care. 

The difference in how things used to be and how they are now can be jarring, especially once the smoke has cleared from just wanting your loved one to survive and make progress, to integrating these changed behaviors into everyday life. This can cause stress, especially for family units who have to deal with gaps because their loved one is not operating at 100% or feels like a completely new person.

However, there is hope and there is space for understanding. But in order to understand we must be educated, so let’s look at the changes one can expect from a TBI survivor.


Memory loss is somewhat expected from a TBI, however, it is not just past memories that are affected but the ability of the TBI survivor to remember important things going forward. They may forget appointments, requests, telephone numbers and messages. It is especially painful when they forget names and important dates like birthdays, anniversaries, or special events.

Memory problems also include forgetting new information and future plans quickly. It is best not to take this personally and assume that the person does not care. Memory problems are the most commonly reported cognitive impairment after a TBI, between 56.5% and 74% of TBI survivors report changes or difficulties with memory.

Planning and Organizing

The first few days after bringing your loved one home from the hospital or rehab, you have already begun to plan all the wonderful things you and your loved one will do together to celebrate life. But these expectations need to be tempered as a TBI survivor may experience great challenges in making plans, sticking to plans, or even getting ready ‘on time’.


TBI survivors are easily distracted and find it difficult to finish certain tasks. They may also have difficulty with complex ideas or be very rigid in their thinking. Up to 40% of people may have difficulty in thinking flexibly after a TBI.

Motor-sensory Impairment/Physical Abilities

Most TBI survivors make a good physical recovery with only 25% experiencing permanent long-term physical impairments.

It is not unusual for one side of the body to be restricted in movement or experience weakness.

Visual impairment is one of the most common motor-sensory impairments along with changes in smell and taste.

Those who use mobility aids like wheelchairs or a walking aid come with their own series of constraints, such as accessibility issues. You can find workarounds by checking beforehand if the places you are visiting are accessible and planning your visit in detail.


Slurred speech, and decreased ability to recognize non-verbal communication or communication that is inappropriate are common residual effects of a traumatic brain injury.

Sometimes it goes deeper and outlasts the recovery phase such as Aphasia and Dysarthria. Aphasia is a disruption in one or more of the communication skills including understanding speech, speaking, remembering names, reading, writing, and so on.

Dysarthria arises from damage to the brain stem which can result in physical problems in the production of speech, swallowing, and drool control.

Personality & Behavioral changes

Some 60% to 80% of relatives will report behavioral changes in their loved ones up to 15 years post-injury. These changes include a difference in drive as they appear lethargic or inert. Everything seems to take a tremendous amount of effort which is often mistaken for laziness.

They may be unrealistically happy or not respond to good or bad news. They might be unaware of their limitations or have unrealistic goals or expectations. They may also exhibit “childlike” behavior and become very self-centered, demanding and have difficulty empathizing or seeing other people’s needs and point of view.

Anger Management

Anger is a significant clinical problem after traumatic brain injury. As many as one-third of survivors of TBI experience symptoms, ranging from irritability to aggressive outbursts, that are identified as new or worse since the injury.

Remain calm if an emotional outburst occurs, and avoid reacting emotionally. Take the person to a quiet area to help them calm down and regain control. Acknowledge feelings and give the person a chance to talk about feelings. Provide feedback gently and supportively after the person gains power.

There are so many changes that TBI survivors contend with daily, which can alter their life experience and quality of life. Andrea's Angel’s holistic approach to Independent Living Skills acknowledges physical and cognitive changes and assists clients and their families navigate the new lifestyle that will have to be developed to live a whole and enriched life.