Objectives: Traumatic brain injury (TBI) has a substantial impact on caregivers, and the effects of moderate to severe TBI can be long-lasting or even permanent. This study describes the burden experienced by family caregivers of 344 patients who had suffered traumatic brain injury over 10 years previously. 
Methods: Family caregivers of the 344 patients who suffered traumatic brain injury 10 years or more previously were asked to fill in an unpublished self-report questionnaire in order to explore their burdens and the patients’ records.
Results: In 313 patients (91.0%), loss of consciousness after injury continued for over 4 days. Of the total 344 patients (289 male and 55 female; current age: 43.6±12.3 years old; age at injury: 24.0±13.3 years old), 296 (86.0%) lived with a parent. Family burden was found to be associated with increased cognitive, emotional, and behavioral disorders of TBI patients (correlation coefficient = 0.61). Most patients (78.5%) were independent in the activities of daily living (ADL), and no statistically significant difference was found between family burden and ADL abilities of TBI patients (correlation coefficient = -0.18). Of the 344 patients, 220 were employed, including welfare employment (53.6%). The non-employment group demonstrated more considerable feeling of burden to family than the employment group (p<0.01).
CONCLUSIONS: The feeling of burden to family is immense even now, after more than 10 years since the accident. The feeling is much influenced by cognitive, emotional, and behavioral disorders as TBI sequelae that are caused by frontal damage, and psychosocial problems after injury. Furthermore, the employment situation of patients is also an important factor for the feeling of burden of long-term care. In Japan, the length of hospital stay cannot exceed more than six months after injury by law. Therefore, it is necessary to focus medical intervention for an outpatient on psychosocial problems, and if possible, vocational rehabilitation is necessary for moderate to severe TBI patients, as part of community rehabilitation.

Family burden of patients 10 years or more after traumatic brain injury