It requires patience and understanding.

Key points

• People who have problems with brain functioning require a different approach from family members.
• Most important are problems related to processing verbal information and verbal memory.
• The brain heals better and faster when a person is emotionally well.

During holiday times we tend to have more social interactions, especially with our immediate and/or extended family. People who have problems related to brain functioning require a somewhat different approach from their loved ones, though. Their issues may be mild, such as temporary problems after mild brain trauma or transient ischemic attack, or they may be major, such as after a stroke or a traumatic brain injury, or if they're living with dementia. This also now includes people who suffer from long-term Covid, as research finds that the condition causes changes in the brain similar to a traumatic brain injury.

Most important are problems related to processing verbal information and verbal memory, because they affect verbal comprehension, everyday functioning, and social interactions, including communication with family members. Of course, it’s difficult to change your way of communicating with your loved ones from day to day, but with practice, it’ll get better. The goal is to make sure that the communication is ongoing. A loved one with any kind of brain ailment is already going through the difficult process of finding a new normal, and you and other family members need to help facilitate that process as much as possible. There will be good days and bad days, but don’t get discouraged and don’t give up on keeping the communication going, despite difficulties. Do not feel guilty if you aren’t getting your point across or if your loved one becomes irritable. It’ll get better with practice.

If you feel you've hit the wall, try to find professional help. Make an appointment with a therapist and discuss your difficulties. Taking time to take care of your feelings is important for your own peace of mind and for the family relationship. If you’re lucky, your loved one will agree to counseling themself. If not, and he/she gets angry about the suggestion, or starts to make degrading comments, please remember that their ability to reason may be compromised. So go ahead and go by yourself because you need guidance and support, especially in the case of a progressive decline of overall functioning, such as with dementia.

Here are some other recommendations:

• Try to speak slowly to your loved one and in short sentences. Don’t try to tell them everything at once. For example, don’t tell the whole long story of what happened to the neighbor’s dog. They’ll probably get lost in the middle of the telling. If you see that happening, start again, but make it simpler and more to the point.
• If you need to discuss some important issue, make sure that your loved one understands it properly. If it feels like they're lost, ask, “What did you hear me saying?” If it wasn’t what you meant, then repeat it slowly and use an example.
• Don’t argue or try to get your point across several times if your loved one doesn’t understand. Unfortunately, with some more advanced brain conditions, reasoning may be compromised. There’s no point in attempting to reason with somebody whose ability to do so is compromised. It will only make the other person irritable or agitated, which may cause more problems. Also, please remember that anxiety, depression, and agitation will not facilitate healing. A peaceful environment helps everyone in the family.
• At some point, written communication may be helpful, especially if the loved one has problems with executive functioning. If you want them to do some chores around the house or go shopping, you need to make a list or a step-by-step flowchart. This is also helpful for people who have difficulty starting projects.
• Remember that the brain, after any kind of trauma, is a less-efficient functioning brain and can’t manage too much at once. If too much is going on around your loved one, they can suddenly become agitated. Don’t plan too much for the same day or plan any long or tiring trips. Make sure there’s time to rest. Plan doctor visits and other important meetings or family gatherings in the morning, with only one visit or event per day, if possible. With dementia and some brain traumas, there is a well-known phenomenon known as "sundown syndrome." Simply stated, when the sun goes down, brain functioning goes down, becoming much less efficient. If you keep that in mind, it’ll make your life much easier.
• General rule: a person’s brain heals better and faster if that person is emotionally well, optimistic about the future, and believes in their ability to overcome current problems. Let your loved one enjoy their life the way they want if it isn’t harmful and they're in a comfortable social environment. Try not to add a lot of restrictions all at once, believing that it will speed recovery. It may not, but loving support and patience will always pay off. Happiness can sometimes be as powerful as medication. An extra little piece of chocolate, at times, can make a person a little happier. Why not make things a little nicer if we can?

About the Author

Barbara Koltuska-Haskin, Ph.D., is a neuropsychologist in private practice in Albuquerque, New Mexico with over 30 years of clinical experience, and the author of How My Brain Works: A Guide to Understanding It Better and Keeping It Healthy. Her book has won 2 International Book Awards and 5 National Book Awards.

Dr. Barbara Koltuska-Haskin has received her first foreign translation. How My Brain Works was recently translated into Polish and published in Poland.