Sixty nine primary caregivers of adults with a severe traumatic brain injury TBI were assessed at 1 year post injury. Caregivers completed questionnaires on the physical, cognitive, emotional, beha vioural, and social functioning of the person with TBI. Caregiver objective burden, psychosocial functioning, and subjective burden were also assessed. Clinically significant levels of anxiety and depression were evident in over a third of the caregivers. Similarly, a quarter of the caregivers reported poor social adjustment. There was no consistent relationship between the prevalence of various types of objective burden and the level of subjective distress that resulted from these changes. The person with TBI s emotional difficulties, in particular their anger, apathy, and dependency, caused the greatest distress for caregivers. With regard to the impact that caregiving had on their own lives, caregivers were most distressed by the loss of personal free time. Results from a regression analysis indicated that the person with TBI s physical impairment, number of behavioural problems, and social isolation were the strongest predictors of caregiver burden. The impact that caring for a person with severe TBI can have on the extended family unit is discussed.

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Sixty-nine primary caregivers of people with a severe traumatic brain injury (TBI) were assessed at 6 months post injury. Caregivers completed questionnaires on the physical, cognitive, emotional, beha vioural, and social functioning of the person with the TBI. Caregiver psychosocial functioning and levels of subjective and objective burden were also assessed. Clinically significant levels of anxiety, depression, and impairment in social adjustment were evident in over a third of the caregivers. The frequency with which various changes in the person with the TBI and types of objective burden were reported had little relationship to the degree of distress caused by these changes. The person with TBI s social isolation and negative emotional behaviours caused the greatest degree of stress for caregivers. Caregivers were also most distressed by the impact that caregiving had on their personal health and free time. The results from a multiple regression analysis suggest that it is the presence of behavioural problems in the person with the TBI that has the most severe and pervasive impact on all aspects of caregiver functioning. It is suggested that these findings be taken into account when providing rehabilitation services to people with TBI and their families.