Brain Waves: UAB Traumatic Brain Injury Model System Newsletter Volume 15 | Number 1 | Page 2

LIFE AFTER TBI Managing Behavior Problems after TBI: Being Uncooperative Behavior problems can be a major challenge for families who have a loved one with a traumatic brain injury (TBI). The University of Alabama at Birmingham Traumatic Brain Injury Model System (UAB- TBIMS) is helping families by offering a series of articles in Brain Waves on understanding and managing many of the most challenging behavior issues after TBI. Here, we focus on what you can do on those times when your loved one is being uncooperative. What is uncooperative behavior? Uncooperative behavior is when there’s an unwillingness to take part in activities that are necessary to maintain health and welfare. For someone with a TBI, some examples might be refusing to dress, eat, or do other everyday tasks. Why are people with TBI uncooperative? The first thing to know is that your loved one isn’t being uncooperative to spite you. The behavior is usually a way to tell you something that she or he can’t express to you verbally. Your loved one is usually uncooperative because she or he is: 1. Confused about the activity; 2. Not comfortable doing the activity; or 3. Tired and needs some rest. What can I do to gain cooperation? This can be a delicate situation to manage. While you do not want to force your loved one to do something, you do need to see that certain tasks are completed. If you can, you want to first find out the reason there’s an unwillingness to take part in the activity. If your loved one is confused, you may need to ask several questions to get to the actual answer. And remember, something that may not seem important to you can be important to him or her. An example might be that your loved one doesn’t want to get dressed. You can ask why she or he doesn’t want to get dressed. The answer may as simple as a dislike for the color of the clothing, or it may be that the clothing is uncomfortable. Once you determine why, there may be an easy solution to gain cooperation. In the example above, you simply find different color clothing or more comfortably clothing. If your loved one is tired, you might schedule a rest period or add more rest periods during the day. Other situations may not be as simple to resolve. Below are eight suggestions that might be helpful when you’re trying to gain cooperation in problem situations. You can try one or a combination of suggestions to find what works. 1- Explain the activity Explaining the task, why it’s being done, and what’s required is a good way to help someone with TBI know what to expect. Answer all questions. Your loved one is more likely to cooperate when he or she understands what’s happening. 2 - Change the order of the tasks Sometimes you can get better cooperation with tasks by simply adjusting the order of the way they’re done. Let’s say, for example, dressing is a difficult or tiring task for your loved one to do. If dressing early in the day is frustrating or tiring, it may lead the person to then become uncooperative with other tasks left to be done. So instead of dressing early, you might wait until the very end of the morning routine to dress. Other Get Involved In UAB Research! Brave Initiative The University of Alabama in Birmingham (UAB) aims to improve the motor deficit of veterans who have sustained a traumatic brain injury. Potential participants must: • be at least 19 years old and 3 months post TBI; • have movement problems or weakness of the • • arms, but the ability to make at least some limited movements with the more affected hand; have no excessive pain; and be able to undergo MRI If you believe you meet the criteria above and would like to participate in this study, Go to the website, call 205- 934-9768, or email for more information. 2 Project LIFT The University of Alabama at Birmingham Traumatic Brain Injury Model System is evaluating the impact of telephone-based health education programs on health, lifestyle, and aspects of quality of life for people with TBI and their families. Participants are asked to: • answer questions over the phone about your health and lifestyle; • have 2 in-person visits to UAB to collect additional information about your health; and • participate in a 24-26 week telehealth program designed for people with TBI and their families. Call 205-934-3345 or email [email protected] for more information.