Traumatic Brain Injury A to Z - Visual Spatial Problems

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Dizziness

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It’s not unusual for patients to feel dizzy during TBI recovery. Watch as Tracy and the group explore strategies for managing dizziness.
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Dizziness

Julie
You know Michelle, now that Tom’s awake he’ll probably be moving around more. You may find that he complains about dizziness.

Tracy
That’s right, Julie. Dizziness is a very common effect of TBI. Tom may complain that the room is spinning, moving, you know causing that sense of vertigo. So if that happens, he could lose his balance, he could fall. You just want to “fall-proof” the house.

Carl
Julie had me get rid of all her area rugs and electrical cords, things that Sam could slip or trip on. We also put on non-slip mats on the shower and bath floors.

Tracy
Good idea, Carl. Good idea. Also, you want to make sure that the room is well lit. That Tom is encouraged to use any of the assistive devices that his team might’ve provided for him.

Travis
What’s an assistive device?

Tracy
Oh things like canes, walkers…equipment that may help your Dad get around when he comes home.

Okay, just a few more things… You’ll want to remind your Dad to avoid sudden movements. It can also help to sit for a few minutes before walking. You know it just gives the brain time to adjust. So encourage him to sit or to lie down as soon as he feels dizzy.

Julie
Sam didn’t seem to get dizzy very often at first, but once he started walking again, he couldn’t seem to keep his balance. They had this kind of belt like contraption that Carl would hold onto while Sam walked up and down the halls in the hospital. It was a good part of Sam’s therapy.

Carl
Heck, it was good therapy for me, too. At least I felt like I was doing something.

Tracy
Something very helpful, Carl. Sam’s lack of balance is pretty common. Our brains control our physical movement, our balance, so obviously a TBI can cause problems with that. Now fortunately, those problems usually go away over time and with physical therapy.

In fact, many of the effects that you see may improve over time. Some of the others might be sensory changes, spasticity, vision problems, seizures, a variety of cognitive effects are some of the possibilities. So you’ll find a description of what to expect, along with those tips on how to manage those conditions, in the Managing Less Common Effects of TBI in your Guide for Caregivers.

Okay, I think this is a good point to take a break.

This week please take some time to write in your journal. It’s important. If you haven’t started one yet, you’ll find a template in your Guide for Caregivers. Keep track of the progress that your family member is making - - even those… those small steps. And write down your experiences, your feelings. But do take time for yourself.

Julie
Along that line, Tracy, we use a website called caringbridge.org. When Sam first got hurt, everyone in our family was calling every day, trying to get information. And it was just too much; it was overwhelming. Carl and I couldn’t keep up, and stay with Sam at the same time. Then the people at the Fisher House in Landstuhl, told us about caringbridge. It’s great. You can download pictures, and create a website for your injured soldier, and keep everyone posted. Every day I go on there and write in my journal. It’s good therapy for me, and our entire family can check up on Sam’s progress.

Tracy
That’s terrific, Julie. Yeah, I’ve met many people who’ve used both caringbridge and another website, called caringpages.com. It’s really helped in a couple of ways - - keeping family and friends updated, serves as a journal for the caregiver. You know if you have a chance, check the sites out. I think they’ll help.

So next week lets talk about taking care of yourself, which is key to being an effective caregiver. Okay. Thanks everybody for coming. And remember, I’m here for you if you need anything, you know where to find me. Okay.
 

Visual Spatial Problems

Visual spatial abilities begin in the brain. They include blind spots and/or changes in the brain’s ability to understand what the eyes see.

The ability to perceive where you are in space and in relation to other items in the environment may also be affected by TBI. This is called spatial awareness.

Injury to the right side of the brain in particular can lead to difficulties in these areas.

What you might see:

  • Tendency to ignore things on one side of the body
  • Bumping into things on the affected side
  • Difficulty finding his or her way around, especially in new places
  • Difficulty recognizing shapes and telling the difference between shapes
  • Turning head towards the unaffected side
  • When reading, cutting words in half or beginning to read in the middle of the sentence or page
  • Mistaking the location of a chair when sitting down 
  • Misjudging distance; for example, missing the cup when pouring 
  • Standing too close or too far from others in social situations 
  • Confusion between right and left 
  • Reports of impaired vision

How you can help:

  • Ask for a neuro-ophthalmologist to identify your service member/veteran’s specific visual and/or visual spatial problems.
  • Stand on and place objects on the affected side. Encourage your service member/veteran to look to that side (this is called visual cueing).
  • Remind your service member/veteran to frequently look around the environment, especially toward the affected side (this is called visual scanning).
  • Use visual cues (e.g., a dark line) on one side of a page to encourage visual scanning of the entire page.
  • Arrange your house to make tasks easier. For example, have items to accomplish a task organized in one place.
  • Show your service member/veteran around new places several times. Avoid sending him or her to new places alone.
  • Limit clutter in the house. Try not to move items around.
  • Remind your service member/veteran to use handrails when available.
  • Provide gentle reminders that he or she is standing too close or far away during social encounters.
  • Seek professional advice about whether or not it is safe for your service member/veteran to drive.
Related Information:
Dizziness
Other Physical Effects
Glossary
Frequently Asked Questions
"He really won’t tell me the whole story because I think he doesn’t want to scare me. But, he brought me a piece of metal back home that was embedded in the wall right behind him. He said it missed his head by a few inches. He said that he thanks God every day that he’s still alive, and that’s why he brought the piece of metal home, to show me that that’s how close he had come to dying." -  Lynn C-S.

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