The information on this page covers issues that specifically relate to friendships. For more general information on how relationships can be affected, visit Relationships.
This information is for the friend of a brain injury survivor. It tells you about brain injury and suggests ways in which you can support your friend.
Learning about brain injury is the first step towards helping someone affected by this ‘hidden’ disability. Many brain injury survivors feel that their lives would improve if their friends had a better understanding about what brain injury is. Browse through About brain injury to find out more about this life-changing condition.
While your friend is in hospital
It can be a frightening and upsetting experience for anyone to have a friend in hospital with a brain injury. Your friend may be in for tests or surgery, or they might have been in an accident. They might be in a coma or a prolonged disorder of consciousness in the early days of their injury, which can be particularly distressing to witness or know about.
Even if your friend is conscious, they might be displaying unusual or uncharacteristic behaviour, known as post-traumatic amnesia. Although it can be difficult to see a friend in this state, be assured that it is a normal part of the recovery process.
You will naturally have many questions about your friend’s condition, especially if this is the first time someone you know has been affected by brain injury. However, it can be very difficult to predict the outcome of brain injury, so hospital staff looking after your friend may not be able to give you or your friend’s family much information at this stage. These experiences might leave you feeling concerned, confused and helpless, especially if you are unable to visit your friend in hospital.
Here are some suggestions of things you can do that might help in the meantime.
Learn about the next steps of treatment, hospital care and rehabilitation to be better prepared for what may come next for your friend.
If appropriate, help your friend’s family by offering to do practical jobs such as shopping, childcare or researching where they can get support from.
When visiting your friend, try not to overwhelm them with too much information or engage them in lengthy discussions, as they may struggle with fatigue or processing information. Take turns to visit your friend rather than visiting as one big group.
Consider creating a scrap book for your friend or using social media to share well-wishes from other friends. This can not only give yourself and other friends an opportunity to share your thoughts and feelings, but can help to make your friend feel well supported, even if they do not look through it immediately.
Ask your friend if they would like you to update other friends about their recovery so that they do not have to repeat the same information when other friends ask after them.
The long-term impact of brain injury
When your friend is discharged from hospital and returns home, you might think this means that they have recovered from their injury and will soon be ‘back to normal’. However, for many survivors, the long-term effects of the injury become more noticeable once they have returned home.
This can be a frightening, confusing and frustrating time for your friend as they attempt to make sense of and adjust to their changed life. They might be unable to drive, or return to work/education. Seemingly simple tasks such as grocery shopping or travelling can become major challenges.
Many brain injury survivors report feeling like a ‘new person’ after their injury. For many, this change can be accompanied by grief for their old self or the life they had before. You may also be upset if your friend has changed, and you might deeply miss the person they were. However, try to realise that you are grieving together and that it is possible to move forward supporting one another and creating new memories. It is also possible that your friend may continue o recover and regain skills over time. The first few weeks or months may therefore be difficult, but things might gradually improve.
Continuing to support, check in and and caring for your friend can help them to feel more positive about themselves and their circumstances. This might in turn have a positive impact on their overall recovery and general well-being. Do therefore try to stay in touch and support them, even if this is difficult at first.
Tips for supporting your friend
Below we offer some tips for supporting your friend with brain injury.
Learn about brain injury
Read about the effects of brain injury and speak to your friend about which effects they personally experience. Our website has lots of information on the effects of brain injury on Living with brain injury, where you can also learn about coping strategies that you can support your friend with using.
Be aware that the effects of brain injury can fluctuate on a daily basis, so while your friend may appear to be well and functioning on one day, they might struggle the next day. Issues like fatigue can be particularly problematic after busy periods. So if you have been socialising with your friend the evening before, be aware that they may experience fatigue the next day.
Try to avoid drinking alcohol with your friend, as this is generally discouraged after brain injury. Find out more about this on Alcohol.
Memory problems are particularly common after brain injury and can often cause misunderstandings. For example, a person with brain injury may forget their friend's birthday or an important social event. Try not to take such incidents personally and learn more about how you can help your friend with memory problems by visiting Memory problems.
Remember that no two brain injuries are exactly alike. Therefore, even if you know someone else with brain injury, remember that your friend's experience will be unique.
Encourage your friend to get support
Explore what services your friend's local Headway can offer and share this information with them. If helpful, consider joining them at a first visit.
If you suspect that your friend is feeling depressed, gently encourage them to talk about how they are feeling and to seek support, either from yourself, other friends or professional services. Information on the signs of depression and how to help are available on our Depression, including what to do if you have serious concerns for your friend's well-being.
If your friend needs support with activities such as washing and dressing, and no existing provision is in place for this, encourage them to contact their local adult social care team. Information about the services that social care teams offer, and the process of making a referral, are available on local council websites.
If your friend is experiencing ongoing effects of their injury that are affecting their quality of life, encourage them to contact their GP, who may be able to refer them onto helpful services.
Look out for your friend
Don’t assume that just because your friend appears to be coping or does not take the initiative to contact you, they do not need help. Rather, ask after them and offer to help out where needed. At the same time, respect your friend’s independence and do not assume that they cannot do things by themselves, as many survivors learn ways of adapting to their injury over time.
If appropriate, ask rehabilitation staff involved in your friend’s rehabilitation whether there are any activities such as cognitive exercises that you can help your friend with. There may be activities described on Redeveloping skills that can help.
Offer practical help
If appropriate, consider offering support with childcare if your friend has children. There may be particular activities that your friend now struggles to complete as a parent that you can offer to help with, such as taking children out to the park or helping them with homework.
Shopping can be a particularly difficult activity for some people after brain injury due to overstimulation and increased sensitivity to noises/lights. Ask your friend if they need any help with shopping, and if so, offer to pick up items while out doing your own shopping.
Some brain injury survivors are no longer able to drive safely after injury and may therefore have their driving license either temporarily or permanently revoked. If your friend is no longer able to drive or safely use public transport, offer to drive them to places such as social events, the shops or appointments.
Offer to bring your friend healthy meals if they struggle with cooking for themselves. If your friend has problems with their taste or smell, consider using a variety of colours and textures instead - more tips for this are available on Taste and smell problems.
Try to offer help with any forms your friend has to fill in, for instance if they are applying for welfare benefits. These forms can often be lengthy and complicated, and may require information that your friend struggles to remember or find the correct words for. Remember to only help with information that you are sure of or can verify.
When buying gifts for your friend, consider selecting practical things that can help them on a regular basis. For example, if your friend has memory problems, consider getting them a journal or personal organiser.
Help your friend during outings
If your friend struggles with fatigue, try to keep outings short, and encourage them to rest beforehand and afterwards. Do consider that for many brain injury survivors, even a considerably short outing can cause them to experience fatigue the next day.
If your friend struggles in busy, noisy environments, consider meeting with them somewhere quieter or visiting one another’s house.
Alcohol can worsen some of the effects of brain injury. While you cannot tell your friend whether or not they can drink, do remind them that alcohol can have a negative effect, and consider going alcohol-free yourself to support your friend.
Ask your friend whether they would like you to explain that they have a brain injury to others while you are out together. This can make social situations easier, as others may be more understanding of their behaviour.
Encourage your friend to use their Headway Brain Injury Identity Card when they are out, if they have one.
If your friend prefers to keep to a routine, try to set a recurring day and time for activities that you do together. This can help if your friend has memory problems or difficulties with organising and planning. Ask if they would like you to send reminders the day before, and an hour before you are due to be seeing them.
If your friend is unable to safely do activities that you both enjoyed before their injury, or they are no longer interested in those activities, try to find new or modified things that are safe and enjoyable. Remember that there are organisations that offer disability friendly sports, outdoor activities or holidays, so explore these options rather than excluding your friend from group outings.
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Need to talk?
Contact our nurse-led helpline for further information and support
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