Preventing Traumatic Brain Injury in Older Adults

Information for Family Members and Other Caregivers

If you are one of the millions of people in this country who provides care for an older adult — a parent, grandparent, other family member, professional caregiver, or a close friend – you should learn about traumatic brain injury or TBI. A TBI is caused by a bump or blow to the head that affects how the brain normally works. TBI is a special health concern for older adults. People ages 75 and older have the highest rates of TBI-related hospitalizations and death. They also recover more slowly and die more often from these injuries than do younger people. Falls are the leading cause of TBI.

What are the signs and symptoms of TBI?

Symptoms of mild TBI include:

• Low-grade headache that won’t go away
• Having more trouble than usual remembering things, paying attention or concentrating, organizing daily tasks, or making decisions and solving problems
• Slowness in thinking, speaking, acting, or reading
• Getting lost or easily confused
• Feeling tired all of the time, lack of energy or motivation
• Change in sleep pattern — sleeping much longer than before, having trouble sleeping
• Loss of balance, feeling light-headed or dizzy
• Increased sensitivity to sounds, lights, distractions
• Blurred vision or eyes that tire easily
• Loss of sense of taste or smell
• Ringing in the ears
• Change in sexual drive
• Mood changes like feeling sad, anxious, or listless, or becoming easily irritated or angry for little or no reason

A person with moderate or severe TBI may show the symptoms listed above, but may also have:

• A headache that gets worse or does not go away
• Repeated vomiting or nausea
• Convulsions or seizures
• Inability to wake up from sleep
• Dilation of one or both pupils
• Slurred speech
• Weakness or numbness in the arms or legs
• Loss of coordination
• Increased confusion, restlessness, or agitation

Older adults taking blood thinners (e.g. Coumadin) should be seen immediately by a health care provider if they have a bump or blow to the head, even if they do not have any of the symptoms listed above.

What should you do if you think the older adult in your care has a TBI?

Take them to the doctor. Tell the doctor about any prescription drugs, including over-the-counter medicines, blood thinners, or aspirin that the older adult takes.

• Encourage Exercise
• Make the Home Safer
• Have Medicines Reviewed
• Have Vision Checked

Can TBI be prevented?

Yes. Here are some things you can do to help prevent falls, the most common cause of TBIamong older adults.

The most effective way to prevent older adults from falling is to do all of these things.

• Encourage Exercise. Exercise is one of the best ways to reduce older adults’ chances of falling. Exercises that improve balance and coordination, like Tai Chi, are most helpful. You should check with the older adult’s doctor about which exercises are safest and best for them.
• Make the home or surroundings safer.
  Remove things from stairs and floors that might cause tripping.
  Remove small throw rugs or use double-sided tape to keep the rugs from slipping.
          - Place items used often within easy reach, so that a step stool is not needed.
          - Install grab bars next to the toilet and in the tub or shower.
          - Place non-stick mats in the bathtub and on shower floors.
          - Add brighter lighting and reduce glare by using lampshades and frosted bulbs.
          - Be sure there are handrails and lights on all staircases.
          - Be sure the older adult wears shoes that give good support and have thin, non-slip soles.
            They should avoid wearing slippers and socks and going shoeless.
• Ask the health care provider to review all medicines. Ask the doctor or local pharmacist to look at all the prescription medicines the older adult takes as well as non-prescription drugs like cold medicines and various supplements. As people age, the way some medicines work in the body can change. This could cause a person to feel drowsy or lightheaded, which could lead to a fall.
• Take the person in your care for a vision check. Make sure an eye doctor checks to be sure eye glasses are correct and that there are no conditions that limit vision, like glaucoma or cataracts. Poor vision can increase the chance of falling.

For more information:Call the Centers for Disease Control and Prevention (CDC) toll-free at 1-800-CDC-INFO (1-800-232-4636) or visit www.cdc.gov/BrainInjuryInSeniors.