Supporting children after a parent's brain injury

Having a brain injured parent return home from hospital can bring mixed feelings for children. This can depend on how long the parent has been in hospital, and how much information the child has been given in the meantime.

Some children may feel apprehensive about seeing the parent again if they know that the parent’s injury was serious or if the parent has been away from home for a long time. They may find it difficult to readjust to life again, and may be distant when the parent first returns home, especially if the parent is experiencing cognitive, emotional or behavioural effects from their injury.

How well children are able to adjust to the change in circumstances will depend on their age and the effects of brain injury that the parent is experiencing. Below is a list of some of the common changes after brain injury and how children may respond to them.

Physical changes

Young children

Children of a young age may find it easier to understand that their parent has had an injury if they can see a physical change; this might include things such as mobility issues or difficulties with speech.

Other physical issues such as headaches or sensitivity to loud noises might be more difficult for children to understand, although they are sensations that the child might still be able to relate to if simple language is used, such as ‘Daddy’s head hurts’ or ‘Mummy does not like loud noises’.

Young children may be apprehensive or fearful if they see physical changes, and they may be particularly sensitive to any facial injuries that the parent has.

Older children

Older children may understand ‘hidden’ physical effects such as pain, headaches or fatigue better than younger children. They may be asked to help around the house more, or they may be required to provide physical support to the parent.

As older children are often more independent they may not feel upset if the parent is no longer able to do physical activities with them; however, they may spend more of their time helping to look after the parent and in doing so become a young carer.

Emotional and behavioural changes

Young children

Children of all ages, even babies and toddlers, respond to simple emotions such as happiness, anger and sadness. For instance, very young children may cry in response to extreme emotional outbursts, such as anger.

The ability to understand how someone else is feeling (a skill called empathy) starts to develop at around the age of 3. At this point, children may feel sad, worried or fearful of any emotional changes the parent has, and may blame themselves for this.

Reassurance and simple language can be used to help the child understand that their parent’s behaviour is no one’s fault and the parent is not feeling angry or sad because of them, for example ‘Mummy is not angry at you, she is having a poorly moment.’

Older children

Older children will have more of an understanding about emotions and may respond directly to emotional changes in a parent. They may reciprocate happiness or sadness, or shout back if the parent gets angry.

It might help the child if you share some anger management techniques with them in simplified language.

As older children are more sensitive to emotions, their parent’s emotional changes might have an impact on their own personal emotional wellbeing. It is therefore important to ask the child how they are coping on a regular basis, and to find out if they need any support.

Cognitive changes

Young children

Cognitive changes are often the most difficult effects of brain injury for children to understand as they are often ‘hidden’.

They may only understand the cognitive effect when it has a direct impact on their own lives, such as if the parent forgets a birthday due to memory problems, or can no longer play with the child whilst cleaning because they can no longer multitask.

Again, reassurance and simple language can help the child to understand that the behaviour is not intentional. If possible, try to find children’s movies or books featuring characters that have problems with skills such as memory, as this might make it easier for the child to understand.

Older children

Older children will probably be able to better understand cognitive changes in a parent, although the term ‘thinking skills’ might be easier for them to understand than ‘cognitive skills’.

They may also find it simpler to understand if relevant examples are given, such as ‘Dad finds it really hard to concentrate, so he can only help with your homework for 10 minutes.’

Children of an older age might benefit from being taught basic information about the brain to help them with understanding how physical injury to the brain results in cognitive problems. There are plenty of children’s textbooks that have been written about the brain which might be useful for children of this age.

Ways to support a child

• Encourage the child to talk to their parent about how they feel. Communication is an important part of any relationship, especially between a child and a parent. If the parent struggles with concentrating on conversations, or remembering them, encourage the child to write letters or notes that the parent can read in their own time.
  
  
• Try to encourage the parent and child to find new activities to do together if the parent is no longer able to do things that they enjoyed before the injury. This can even be simple activities such as taking a walk, watching television or listening to music together.
  
  
• Be aware of any signs of bullying that the child may be experiencing at school because their parent is ‘different’. If you do suspect bullying, have an open conversation with the child and inform the school.
  
  
• If there is a specific change to the child’s routine, create age appropriate pictures, posters or diagrams of the new routine for the child to refer to. A visual guide such as this might help the child to remember, adapt to and accept changes.

• Acknowledge and reward children for helping out with their parent. For example, you could give stickers to a young child every time they have been quiet when the parent is fatigued. Older children can be given other types of rewards such as more time playing computer games or spending longer with their friends whenever they help out around the house.
• Encourage children to learn about the brain using interactive websites and textbooks.

Find out more

This information has been taken from our Supporting children when a parent has had a brain injury booklet, which can be downloaded below.