ABSTRACT
It is frequently said that there are not just head-injured individuals but rather head-injured families, because the whole family is affected. Some would say that families are the real victims and often suffer more than the head-injured person because they are more likely to have accurate insight into the problem. No family is ever prepared and ready for a head injury; most families already have a full agenda of problems to cope with before clearing the decks to cope with the problems of head injury. Research into the effects of severe head injury on the other family members gives some indication of the extent of their difficulties. The following points are worth noting:
Close family members are likely to experience high levels of anxiety and depression during the years following a head injury. As time elapses, there is often a decrease in relatives’ capacity for coping. Research is unanimous about what causes most family stress. It is not the physical or cognitive problems, but the emotional or behavioural problems - aggression and lowered tolerance, poor social judgement, inappropriate behaviour, reduced empathy, apathy, self-centredness and lack of insight.
138Spouses often feel isolated and trapped with a marriage where their emotional needs are not being met. Some describe this as being neither married nor single but ‘living in a social limbo, unable to mourn decently, unable to divorce or separate without recrimination or guilt’. Relationships are put under enormous strain, and it is estimated that between 40 and 55 per cent of all marriages in which one spouse has had a severe head injury end in divorce. Relationships formed after injury have a better chance of success. The longer the relationship the greater the chances of survival.
Children often experience emotional problems as, alongside coping with the initial trauma, and the subsequent difficult behaviour of a parent with a head injury, their own needs are often neglected, and this can impair their performance at school. The number one predictor of whether a child will have problems is whether the non-injured spouse is depressed or not.
