With three growing boys, Jeanne Gin’s household sees a lot of wrestling and tackling. But after her youngest son, Austin, suffered five concussions ─ four of them within two years and several from roughhousing with his older brothers ─ the boys learned to take more care in how they play. Furniture and obstacles are moved. Tackles are gentler. And a quick “are you okay” follows any bumps to Austin’s head… no matter how mild.

As with other families who have gone through the recovery of a child with concussion, the Gins have learned traumatic brain injury is a matter that concerns everyone in the household and how helping someone heal has multiple impacts on family life.

Adjusting to a New ‘Normal’ 

Often the biggest surprise when a family member suffers a concussion is the disruption to everyday life. Culturally we tend to look at concussion as a bump to the head requiring a few days break from contact sports. But in recent years new findings about the condition have prompted stricter protocols, most notably in the area of promoting brain rest.

Common life changes for recovery include reduced or halted school attendance, avoiding screen-based activities, and keeping the house quieter for the injured child’s sake. It quickly becomes evident to siblings that some restrictions have to apply to them too. They may also miss out on having the injured child as a playmate while he/she rests and refrains from symptom-provoking activities. Even family time tends to look different.

“Because we’re a very active family, it’s challenging to find fun activities to do together when a kid is concussed,” says Gin. While in the majority of cases the disruption lasts only a few days to a week, in some instances recovery drags on, taking a toll on everyone involved. “Families are really blindsided when suddenly somebody has symptoms lasting months and accommodations that have to be put in place for [a duration],” says Dr. Robert Cantu, clinical professor of neurology and neurosurgery at Boston University of Medicine and author of Concussions and Our Kids.

For parents, the new normal requires energy and flexibility, between maintaining the healing environment at home and providing their child with the medical attention they need, such as visits to neurologists and physical therapists, while still caring for the rest of the family. When the recovery progresses smoothly, the slow return to a regular routine can still be draining. “It really affects the parent’s schedule,” says Katherine Snedaker, executive director of Pink Concussions, an organization focused on female head injury. “Even though your child is back at school, you’re still ferrying them back and forth.”

Increased Anxiety 

Currently the field of concussion care is undergoing rapid change. Treatments that doctors suggested a year or two ago have been replaced. Parents may find one doctor recommending one protocol, while another takes a different stance; all of which can leave parents unsure of what to do and second-guessing their own actions. The anxiety of a brain-injured child becomes compounded by a lack of security in medical treatment. “There is no definitive timeframe, no definitive treatment,” says Snedaker. “Parents are lost.”

The stress of not knowing how long recuperation will take, due to the variability of each brain’s response to injury, makes coaching siblings on how to cope with changes in family life difficult. Parents cannot offer an end-point as motivation. And when the symptoms last for weeks, it can be disheartening. However, Cantu encourages families to remember that, even if it takes a long time, the child will recover completely. “It’s hard to believe,” he says, “when it’s lasting 6 months or more.” Living under the specter of such anxiety can lead to worries concerning re-injury. This adds another layer of tension to day-to-day life. Gin notes, “I’m not sure parents ever recover from that trauma. I’m always nervous about any hit Austin takes.” She adds that the concern about re-injury extends to the rest of the family too. “I often feel like we’re walking on eggshells during a concussion recovery.”

Going it Alone 

Concussion is an “invisible injury,” in that it is not readily noticeable. The child looks the same and may be able to engage in some activities ─ which can lead others to believe life for the family is fine; or worse, the injured child can be perceived as faking it. Rarely does a concussion draw the attention and support other medical conditions do. Snedaker believes the lack of awareness about the effects of concussion puts families at a disadvantage, in terms of support. “People don’t know how to respond,” she explains.

A child with a concussion and a busy environment do not mix, which means families often have to pull back on their social calendar during recovery. When they are able to go out, families find themselves having to leave early because their child’s symptoms become exacerbated. “We’ve made the mistake of going to church [as usual], forgetting that lights, noise, and commotion aren’t well tolerated by a concussed child,” says Gin. This adds to the sense of isolation experienced by the whole family. Leaving the child at home can open up social opportunities, but comes with a feeling of loss or even betrayal. Many families are left doing a delicate dance to balance social needs with the health of the injured member.

On the Bright Side  

Not everything in family life is negative during a concussion. Families find it provides bonding opportunities where they can engage in quieter activities that usually get pushed aside. A parent might read aloud to their injured child. Siblings may spend an afternoon fishing together. As a child waits to be allowed to return to school or play sports, life often becomes simpler. “It forces us to say no to things which aren’t conducive to recovery,” says Gin.

A concussion may happen to an individual, but the whole family feels the effects. It can be a time of drawing inward and pulling together. Ultimately though, everyone emerges from concussion recovery with a renewed appreciation for each other, the family’s health, and the seriousness of brain injury.

To learn about concussion guidelines, visit the website of the American Academy of Neurology (aan.com).