My sister..

Marty, I have 2 brothers one older by a year, one younger by several years. I very rarely see them. Both are well adjusted individuals.

I very rarely see them, maybe once in every 2 years.

I don't see why you should feel guilty if you don't want to spend time with your sister.

if she asks why Just be honest. Ie "your behavior in public embarrasses me." Siblings should be able to be a little blunt with one another.

If I were blunt with her she'd cry. I feel badly because no one likes to be around her. She is so desperate for companionship. I agreed to this vacation and now she is planning two weeks for next summer. I told her there's no way I can commit to something so far in advance.
She is in total denial that something is not right with her. She doesn't see it and can't understand why she is so alone. She has 3 sons and one will not speak to her.

Does she drink?

No drinking or drugs. Goes to church regularly. But she is obviously depressive.

But you cant help her on your own. It sounds to me like she needs professional help.

Too often friends pussyfoot around issues, dropping subtle hints that the other party just doesn't pick up on instead of coming right out and saying it. Just lay it out for her and tell her if she can see someone you'll support her.

I assume it was a frontal injury?


If her frontal lobes are affected, this, indeed, can lead to irritability, loss of behavioural inhibition, angry outbursts, poor social judgment etc.


However, she sounds as though she is deteriorating?


Am I right?


I assume there is no way she will agree to assessment by a doctor? Sigh.

Do you know if she was properly assessed after the immediate head trauma had resolved re brain damage? I am wondering if some mental/emotional illness is complicating any physical problems.


Anyhoo, other than a proper assessment, neurologically and psychiatrically, (I am wondering if there might be some medication to make her less irritable, or some other treatment that might help...or just some acquired brain injury agency which might be able to offer support) which your post makes me think she won't agree to.....the only way I can think of to balance your compassion and love with your sanity, is to make your two week visit impossible, but make briefer visits that you can handle, and phone contacts. Would this work at all?


The only other thing is, indeed, to discuss her behaviour with her, if you think her capable of benefiting....


Also, you CAN sometimes affect these folk's behaviour via conditioning.....even if only around you.


It seems sneaky and awful, but if it allows you to be able to be more supportive to her, I'd see if it has any effect.


She has no need to know what you are doing, OR, if you think she might benefit, you can tell the truth...ie that you sometimes find her behaviour distressing, and while you love her and want to have contact, you will not interact with her when she distresses you.


Examples of the sort of thing I mean:


If she answers the phone appropriately, be very interactive and chatty and make it a longer call. If she answers inappropriately, be more muted in your response, and terminate the call very quickly....or terminate the call when she becomes inappropriate. Depending on whether you are telling her what you are doing or not, you make a polite excuse, or you say calmly that you are finding her manner distressing, and you will terminate the call now.



When you see her, you can be very socially reinforcing when she is appropriate, and much less interactive when she is not, or leave.


There are lots of other ways of being reinforcing, or not reinforcing, but I imagine you get the idea?

My other sister and I agree that she needs professional help. They've talked before but like I said she is in total denial.
I wonder though, if this is all related to he brain injury if there is anything that can be done or if we as a family need to just accept that she is different.
I had friends with a highly autistic child. In public, his outbursts would attract attention but it was obvious that he had a handicap. With my sister, her inappropriate behavior isn't obvious. So being with her is awkward.

She has extensive scarring to her face so yes, I assume it was a frontal injury. And the symptoms you describe are on the mark. As far as deteriorating, I'm not sure because when I lived back home I was around her regularly and became accustomed to it. Now, after spending a solid week basically living with her it became so apparant

Dunno...I don't work a lot with brain injury.

Here's some stuff I found, though (remember, we don't know what is brain injury and what may be something else, though)



Just in case you're interested....


http://www.biausa.org/publications/roadToRehab6.pdf



http://www.braininjuryfacts.com/traumatic-brain-injuries.html



http://www.bisociety.org/med.cfm




Seems to be a passel of info and support sites for relatives/friends.



Never know how good web info is, thoiugh.......

Thanks, I'll look at those.

well, i got nothing much for you other than support.

it took me ages to realize that i do not represent my parents or friends, but i did embrace it ongoingly. if you can accept that, and not take her outbursts personally, but rather focus on calming her down in sort of a professional way at the time, that may help. it really is not embarassing, it has nothing to do with you, not even if she's your sister. if you can just focus on her at those moments without worrying what people might think, that might be liberating...sure, easier said than done. i guess i'm just trying to say don't give up on her, and support you in your finding a way closer to her.

Thanks Dag,
Can you imagine how my teen kids feel? Even I embarrass them from time to time.

OK, I'll throw out an example. Our second day in the condo, My daughter was sleeping on the fold out couch and my son on an inflatable mattress near her, I was out for a morning run and my sister burst into the room and yelled"Look what I got guys? I got us some toiletpaper!" This is what my kids woke up to. She was routinely up around 6am and used the bathroom, brushed her teeth and whatever with the door cracked open. Whistler,BC was absolutely beautiful but it wasn't the most pleasant experience for me or my kids.

Doesn't boomerang have a thread going about her neighbor with similar circumstances?

I'll see if I can find it...

Have you told your kids about her accident? It might make it easier for them to accept her behaviors as part of a 'condition'. I know that teens are easily embarrassed but they tend to be mostly embarrassed about what their friends might think. It's hard though to think of their vacation as the time when they're on guard constantly and dread what might be coming next. Can you split the time you spend on the trip? Maybe a day or two with your sister and then go somewhere else where it would be more fun for them?

I'll be back this afternoon to respond. Thanks

marty, I don't have any personal experience in this area but heard a fellow interviewed recently who is living through a similar experience. After a brain injury he became aggressive and prone to violent outbursts, eventually his marriage fell apart and he lost contact with his children. He is now in behavioral therapy and part of a brain injury support group. He speaks of his support group the way I've heard former alcoholics speak of AA -- as a life saver. Perhaps if a group like that exists near your sister it would provide at the very least friendship from people who understand what she is going through. I imagine they do not provide "blind" acceptance but would also encourage her to improve her social skills through therapy. I hope you find some answers. This sounds really tough.

Marty, boomer's discussion of her friend's accident begins here

Marty--

You've got at least two problems here because your vacation time is also your kids' vacation time.

A Slightly Peculiar Sister might be part of your burden, but your kids are carrying enough without Slightly Peculiar Auntie being their summer vacation.

As for Slightly Peculiar Sister: Mr. Noddy has been diagnosed with both MID and Parkinson's. He's always been outgoing, but lately he's more and more likely to buttonhole strangers and hold forth on cabbages and kings and his views of the universe.

I don't like this--after all, I can hear Mr. Noddy on cabbages, kings and the flaws of the universe anytime. When I'm out for Diversion, I want to be Diverted.

I don't like this--but any innocent bystander can see that I've got my hands full with a slightly whacko husband. If they think of me at all, it is with sympathy.

Right now, your kids and their needs should be more important to you than your sister and her needs. They won't be your kids much longer and you want to provide them with pleasant, sustaining memories.

Give them a day or so of Slightly Peculiar Auntie--with explanations both before and after of why she might be acting this way and the importance of loving family with imperfections within your personal limits.

I gather your Slightly Peculiar Sister lives at a distance? You're a layman--laywoman?--and you can't do much about diagnosis or treatment with two teenaged kids as an audience.

Does your sister have any physical symptoms? Headaches? Pain at the scar tissue lines? Vision problems? Does she see a doctor on a regular basis?

If your conscience is nagging you that you Must Do Something, try to get her in for a general checkup--and a mammogram and a pap smear.

Hold your dominion.

Marty
Marty, a suggested different approach to your sister. Instead of describing her as depressive or having a mental illness, you might want to try a routine physicial exam instead of a "loony" exam.

Suggest that she needs to see a Neurologist as a follow up to her brain concussion to learn if anything was missed in her original examinations and any changes that might have occurred. Stress that routine exams are a normal process for all patients and her follow up exam is overdue.
This might not be so threatening to her.

More info:
http://healthgate.partners.org/browsing/LearningCenter.asp?fileName=96747.xml&title

BBB