There is a chain of events that happens with an auto accident that involves serious injuries, polytrauma, or death. A ripple effect that swirls and snatches and seeks to destroy not just the patient, but the family, the spouse, and friendships of that patient as well.
First, there is the initial accident. This not only causes the injuries, but causes a multitude of mental stressors as well. Fear, anger, shock, disbelief, numbness, sadness, enormous helplessness and grief. If the person survives there are things that help relieve those stressors – such as gratefulness, happiness, apprehension, confusion, hope, and for some, a distinct solidification of their spiritual base.
The stressor for the patient is that the accident itself has happened to begin with; thus causing a multitude of injuries that may affect more than one aspect of their life. They may have memory and cognitive issues in addition to orthopedic injuries. They may have behavior changes and appear to be a different person than they were before the auto accident.
The person may or may not have support and help from a trusted circle of family or friends as they fight to survive, exist, and recuperate. After a while though, often times, friends disappear. Sometimes, the burden is too big to understand or absorb for family as well. A catastrophic injury absolutely shows you the genuineness of the people around you. Life continues to move on without you and you become acutely aware of this. The relatives, coworkers, friends who were supportive at first…eventually go about their lives and forget that you are there….still struggling. The patient is left circling in the same spot, sometimes for months at a time.
Every stressful event that happens AFTER the accident compounds and slows the recovery process and adds to the mental and emotional stressors in the patient and their relationships with others. Any delayed treatments, or misdiagnoses, or haggling over care of the patient (whether by the family or the patient themselves) causes additional added stressors, which impacts the ability to heal in a timely fashion.
Something not often talked about or studied is the real impact that Polytrauma and Traumatic Brain Injury has on the spouse or children of the patient. There are changes that happen in those relationships. The household dynamics may change significantly leaving the family feeling disorganized and broken.
Children may feel insecure, may blame themselves, feel helpless and hopeless about their parent’s recovery or their parent’s relationship. They may act out in ways they did not used to. They may regress in their development, they may become isolated or clingy. They may try to act in a parental role with siblings themselves.
They may find ways to cope that are not healthy. Some kids are able to adjust to the changes going on with their parents with lots of support, education, explanation, and patience. Some are not able to adjust. Sometimes the injured parent is too different for them to understand. Sometimes witnessing the changes in their parent is too painful. Sometimes a spouse or child can incur secondary trauma/PTSD as their loved one recovers.
The dynamics in a marriage are also hit with one wave after another depending on the level of injuries a patient has and how severe they are. In a polytrauma or with a traumatic brain injury, often times spouses are forced to take on the previous responsibilities of the patient (household duties, scheduling, transportation, budgeting, cooking, cleaning). This may overwhelm the spouse if they previously depended on their now injured spouse to handle those responsibilities. The financial stress will compound quickly. The person injured, if a working parent, may be unable to return to work for a period of time…if ever. This creates a massive financial dynamic shift for the whole family. If insurance is not available, or does not cover all of the medical bill this can spell financial ruin for a family. Not many individuals or families are in a financial position to endure a catastrophic injury/event. This is only compounded when the parent that is left working loses their employment because they are taking too much time off work to care for their spouse/family member. This can exponentially compound the stressors in the household.
Even the kids can be affected by the financial changes both directly and indirectly. A family may have to go to food banks, acquire assistance from agencies for bills, food, utilities, transportation, etc. Some may end up losing their homes and become homeless. This is a dynamic ripple affect that goes beyond the initial injury at the time of the accident. This ripple affect can continue for weeks, months, or years.
Brain injury often brings on drastic personality changes, which may include irritability, depression, limited awareness of injury-related changes, and argumentativeness.
Some spouses may feel like they are married to a stranger.
They become concerned about whether their spouse will ever be the same again. The reality is, they will not.
The working spouse may feel alone in the marriage or like a single parent (if they have kids) due to the inability of the patient to take on the same responsibilities and roles as before. The non-injured spouse may also lose their marital benefits for an undetermined amount of time. The loss of a partner that they previously shared comfort, affection, mental support, and did activities with. This can put another layer of strain on the marriage, which is now no longer, a normal marriage.
While most people, in an ideal environment without financial devastation and strong support systems in place, progress in their healing over time in a seemingly more timely fashion; a patient with all these added stressors can actually see a delay or lengthening of their recovery period, an exacerbation of some of their symptoms and the real potential for more permanent disabilities. Some patients may even develop mental health challenges in relationship to adjusting to their life of “new normals”. Coming to grips (acceptance) of their injuries, limitations, and the domino affect of seeming losses from their injuries, can be crippling and make the patient and their caregiver feel isolated and in a constant “survival mode” state.
The team in place to help the person recover should absolutely include their providers, and include the insurance company handling their claims as well. Any delays or standoffs regarding reasonable and necessary patient care only seeks to elongate and sabotage the patient’s recovery and future progress.
The ripple affect continues. The waves of pain also continue, yet the tsunami of numerous medical appointments lessen as time goes on. The relationships the patient is left with will continue to shape the shores of their life as they now know it. Some relationships will erode over time, some will get swept away by the current of recurrent trauma’s, some will stand the test of time and hold strong and true.
These moments. The moments that are not measured by the number of breaths we take, but rather the moments that take our breath away are the ones that leave us grateful for being able to wake up to the ripple of a brand new day.