How to Talk to a Person with Brain Injury: Tips for Navigating Conversations After TBI

People living with brain injury face a variety of challenges that can be physical, cognitive, or sensory. For many survivors, however, one of the most frustrating aspects of their recovery is a lack of understanding from family and friends. 

Because brain injury is a hidden disability that people often misunderstand, TBI survivors can face well-meaning comments from strangers and even loved ones that can be hurtful or discouraging.

To remedy this problem, this article will offer helpful tips on how to talk to a person with a brain injury in a way that makes them feel encouraged and supported. To start, we’ll discuss what not to say.

How Not to Talk to Someone with Brain Injury 

The most important thing to remember when talking to a person with brain injury is that they are still a person with feelings, opinions, and goals. Although they may talk a little slower, have trouble following a conversation, or seem different from before their injury, they are still the same person.

One of the most frequent complaints TBI patients have is being treated differently following their injury. People often talk to survivors as if they are fragile or sometimes even address them as if they are children. This can come across as demeaning and can be incredibly frustrating for these individuals.

Traumatic brain injury survivors are exactly that: survivors! Many wish to be treated exactly as they were treated before injury, and you will be appreciated for doing so. If you are meeting a survivor for the first time, address them as you would any other person. You might need to make a few adjustments during the conversation, but if they are an adult, treat them like an adult. 

Now that we have discussed some general advice on how to talk to a person with a brain injury, let’s review a few examples of things you might say that can be unhelpful or frustrating for a TBI survivor:

Do NOT say, “Let me do that for you.” 

As tempting as it is to want to help your loved one, doing everything for them can hinder their recovery. In order to relearn skills or tasks through neuroplasticity (the brain’s ability to heal and rewire itself), repetition is needed to help regain control and function that may have been affected by brain injury. This means it is important for survivors of TBI to actively participate in daily activities to help regain function. In addition, brain injury patients often lose some or most of their independence, which can contribute to depression. Encouraging them to perform some tasks on their own can increase their self-esteem and help speed up their recovery. 

Do NOT say, “You need to be more active.”

Apathy and lack of motivation are common side effects of brain injury due to changes in cognitive function. Therefore, even if your loved one seems like they are being lazy or disengaged, they really aren’t. Survivors of brain injury often have difficulty initiating an activity or staying engaged in activities of daily living.

Staying active is crucial to maximize recovery from brain injury. However, because a survivor’s lack of motivation is related to cognitive and emotional changes, it is unhelpful to simply tell the person to get off the couch.

As an alternative, try to gently encourage them to practice their therapy exercises. Sometimes offering them a reward or incentive can give them the external motivation they need to get started. You can also help motivate them by doing their exercises alongside them!

Do NOT say, “Don’t worry, I forget things all the time too.” 

While you naturally will want to comfort your loved one when they experience memory loss, it is not usually helpful to draw a comparison to your own problems. Memory loss can be extremely frustrating for the individual as it impacts many aspects of their daily life. Keep in mind that the differences between normal forgetfulness and memory problems after brain injury are significant and, even with good intentions, comparing the two can come across as patronizing to a person with brain injury.

Instead, try to say something like, “I can’t imagine what that must be like. Let’s see if we can come up with ways to help you remember more in the future.” This can help you be more supportive of the individual and less dismissive of their difficulties.

Do NOT say, “You look fine, why don’t you feel back to normal yet?” 

Many people with brain injury can look and seem normal, yet still deal with the cognitive, emotional, and behavioral effects of brain injury. That is why TBI is often known as an invisible disability.

In fact, some brain injury survivors struggle to accept that their problems are valid because there may not be any physical proof of their injury. They might worry that their problems are “all in their head,” especially if they are not receiving support or reassurance from their loved ones.

Therefore, when talking to someone with brain injury, try not to make the person feel bad if they struggle to remember things or if they talk or think a little slower. Instead, be as compassionate and patient as possible, allowing them time to process at their own speed. That can often make all the difference in the world.

How to Talk to a Person with Brain Injury with Empathy and Compassion

Now that we’ve looked at some things you should not say to a person with brain injury, let’s discuss some positive things you can do to be supportive and encouraging. With enough insight and empathy, you can have a great conversation and help someone with brain injury feel understood.

Here are some tips to help you talk to someone with brain injury to encourage a positive interaction:

DO: Stay on one topic at a time

A brain injury can cause cognitive effects that make it more difficult to follow conversations and maintain concentration. Therefore, it’s best to avoid jumping back and forth between topics. If you want to change the subject, let them know by clearly communicating the transition. This is especially helpful if the person is overcoming executive dysfunction, a condition than can cause cognitive difficulties like impaired attention or memory.

DO: Make sure they are comfortable

If you want to have an extended conversation, make sure the person is sitting down so they can pay attention without using too much energy. Many of the effects of a TBI can interfere with mobility, which can cause survivors to expend more energy during normal daily activities. Sitting down while having a conversation will be more comfortable than walking or standing and will also allow the person to focus more on what you are saying.

DO: Limit background noise and distractions

After a brain injury, a survivor may be more sensitive to stimuli in the environment, such as lights and sounds. In fact, too much stimulation can lead to or worsen cognitive fatigue as the brain works overtime to both heal itself and process the excess stimuli. By limiting background noise and distractions, you can help make it easier for the survivor to focus on the conversation. Another strategy to reduce distraction is to maintain good eye contact since this can help keep the survivor more engaged.

DO: Give them time to respond

It can take a person with brain injury longer to respond to conversation if they are still recovering cognitive function. Be patient and avoid putting words into the person’s mouth or interrupting them mid-sentence. Just as doing too much for a survivor can set back their physical recovery, frequently finding their words for them can set back their cognitive recovery.

Also, keep in mind that the person may know exactly what they want to say but may struggle with word-finding. This is known as expressive aphasia and can be very frustrating for the survivor if they have difficulty communicating their thoughts. Be patient and give the person plenty of time to hunt for just the right words in order to reduce frustration and allow them to feel like they are being heard.

DO: Include them

Some TBI survivors feel hesitant to join a conversation on their own because this can feel intimidating or overwhelming. Language difficulties (like aphasia) or cognitive challenges (such as attention problems) can cause survivors to shy away from group conversation. To help a survivor feel more comfortable, you can invite them to join a conversation in order to lessen the burden of initiation. It is also important to limit speaking to one person at a time, which allows the survivor to concentrate and process what is being said.

Great Conversation After Brain Injury

Talking to someone with a brain injury can feel intimidating at first if you are worried about what to say or about accidentally offending them. While there are a few things you should avoid saying, talking to someone with a brain injury is generally the same as talking to any other person.

It helps to keep some of the effects of a TBI in mind, such as language or cognitive difficulties that can make conversation more challenging. By taking extra steps like limiting background noise and giving the person plenty of time to respond, you can help TBI survivors feel respected and heard when having a conversation.