A brain injury can have an impact on a person’s emotional, behavioural, physical and cognitive abilities, which can affect current and future relationships. Family members and carers often face significant challenges and must make adjustments in their roles and relationships as a result of the brain-injured person’s condition. Some relationships with friends or family members can strengthen as a result, whilst others may become strained or even break down completely.

Partner

Couples often spend significant periods of time together, and consequently, the affected person’s partner is often most aware of the effects of the brain injury. This includes the ‘hidden’ effects that others may not see.

If the brain injury has significantly altered the person’s personality, a partner may feel like they are no longer in a relationship with the same person, leading to feelings of confusion, loss and sadness. Similarly, the injured person may also feel differently about the relationship as they come to terms with how their injury has changed them.

Partners may also take on caring responsibilities following a brain injury, which can lead to a change in the dynamics of the relationship and a blurring of the boundaries between carer and partner. Additionally, significant changes and challenges in the sexual relationship can arise, and require understanding and adaptation in this area on the part of the couple.

However, enduring challenging experiences such as a brain injury can strengthen relationships and bring couples closer.

Parents

Regardless of age, the bond between a parent and child is one of the strongest a person will experience. Having a child sustain a brain injury can have a devastating impact on a parent as they often feel helpless to alleviate the hardships their son or daughter will face following the injury. In the early stages, parents face significant challenges as they adapt to their child's new needs and the uncertainty of their roles and responsibilities. Whilst it is normal for parents to be concerned about their children’s futures, parents of children affected by brain injury can feel further fear about their child’s prospects.

Changes in personality and behaviour can alter the dynamic of a parent/child relationship and in severe cases, a parent may have to adopt caring responsibilities for a child who was independent prior to the injury. This can lead to feelings of stress, resentment and concerns about money if the parent can no longer work or undertake some of the activities they enjoyed before.

Children

A number of factors will determine how a brain injury to a parent will affect a child. Their age, temperament, the impact of the injury on the parent, and what their relationship was like with the parent will all play a part in how they cope. For some, it may create distance between them and the parent as the changes in personality make them feel like they are a different person. For others it may bring them closer together, as they play a more supportive role in their parent’s lives - for example, children may take on additional household chores following a parent's brain injury.

Siblings

A person sustaining a brain injury is often hard on the whole family, but especially the injured person’s siblings. Other family members experience significant challenges and adjustments, which impacts the broader family dynamics. The focus is often on the injured person and siblings may sometimes feel ignored. They may struggle with emotions such as concern for the person with the brain injury, guilt, frustration and sometimes grief when the sibling’s personality and behaviour have changed. Intervention is often required to support siblings so that they can come to terms with their new life. Education and therapy is often key to a successful outcome.

Friends

Friends tend to have less of an understanding of the impact of a brain injury than close family and can therefore be less accommodating of the effects, especially when they are less obvious. Friends may trivialise issues or even make a joke about the situation, and fail to understand the impact this may have on the injured person. This can lead to social isolation as some friends may drift away as they become less comfortable in the company of someone affected by brain injury. Meanwhile, others will strive to learn more about the impact and relationships may strengthen as a result.

Work Colleagues

Relationships with work colleagues play an important part in our social network. Some develop into friendships outside of the workplace, while others remain part of the work environment. For those able to return to work, colleagues may not understand the impact of a brain injury or how it affects their colleague. Expectations about work output may have to change, as the person may not be capable of working at the same pace, or in the same way as before.

For those unable to return to work, they may not be able to maintain the relationships they enjoyed in the workplace and, as a result, an important part of their social network is lost.

Changed Relationships

When any type of relationship changes, it can bring with it feelings of loss, sadness, hurt and confusion. For survivors of a brain injury, this can lead to them becoming more withdrawn and socially isolated. Within the family, the impact of a brain injury necessitates flexibility and open communication to cope with the changes and challenges in adjusting roles and responsibilities.

Those affected can feel like their loved ones do not understand what they are going through, leading to increased levels of frustration. Similarly, family members and friends may also feel frustrated and helpless if they cannot understand how the injured person is feeling or how they can help.

A brain injury impacts the individual and the family and friends closest to them. It is important that everyone affected has access to support to ensure relationships remain positive and healthy.