Regarding the patient with personality changes after injury...the question was is there a component of neurology to help the family deal with changes in their loved one. Gosh, I certainly hope so! These types of changes happen in many types of disorders:renal failure, cancer, alzheimer's, dementia--many chronic conditions. In Acute Care, here is the principle of Maslow's Hierarchy of Needs that states that healthcare professionals must deal with the physical basic needs of the patient first, such as ABCs, nutrition, shelter (warmth etc) and can only address higher needs after the first level is attained. This also carries over into the beginning of Rehab as the patient may not be entirely stable. One striking aspect of, say, long term care, is the perceived absence of normal family life and relationships that people are used to. It might help to look up Maslow's Hierarchy to ground yourself in what's going on. For instance, if a child is lying in the street after being hit by a car and has a broken leg, you are not going to worry about whether he has fulfilling play relationships at first. So with someone who has lost the ability to engage in stimulating discussions, etc. I think this realization may help slightly in the long road to adjustment. Nurses, being compassionate, do consider the whole family as the patient, and try to help family members adjust and process feelings. Many hospitals have spiritual care or social service or group support to help. Self help groups are invaluable, as are internet blogs and support groups. Slowly, the spouse begins to participate in the small increments of improvement that can be attained. It is part of life's journey that makes you consider the meaning of basically everything and what you believe. My heartfelt empathy for this lady and her husband and best wishes for happiness goes out to you and all who are experiencing these problems.