Emotional, personality and behavioural changes

• Acting on impulses without thinking of the consequences of an action
• Appearing to speak rudely to others or not consider their feelings
• Spending large sums of money, or making uncharacteristic purchases
• Increasing or starting to engage in risk-taking behaviours
• Difficulty interpreting social cues (e.g., standing too close to others, making inappropriate comments/jokes, not taking turns in conversations, speaking over the top of people)
• Walking off and starting to do something else in the middle of activities or conversations

Rude of inappropriate behaviours

• Your loved one will likely not know they are being rude or acting inappropriately, so it is important to gently tell them that their behaviour was not appropriate.
• Try to talk with your loved one prior to important events/appointments about what would or would not be appropriate behaviour in that circumstance
• Inform friends and relatives that your loved one is having difficulty in controlling their impulses so that they are not offended by rude/inappropriate behaviours
• Try to limit situations in which inappropriate behaviour would have very negative consequences (e.g., attend events where work colleagues and acquaintances are for shorter periods)

Uncharacteristic or reckless spending

• Discuss with your loved one about how to best manage finances.
• Try to get them to agree to a set budget each week and transfer the rest of the money into a savings account.
• Your loved one is acting as soon as they get the impulse to do something without consideration of the consequences, so sometimes distraction can be a helpful strategy.
• Try to get them to agree to a set budget each week and transfer the rest of the money into a savings account.
• In severe cases of financial mismanagement, you may need to seek guidance around your loved one’s financial decision-making capacity. However, the best outcomes generally result from your loved one retaining their independence with appropriate strategies/solutions put in place

• Snapping at you or others and having a “short fuse”
• Being impatient and intolerant of delays or unexpected events
• Yelling, swearing, insults or other verbal aggressive behaviours
• Sometimes anger/irritability can lead to physically aggressive behaviours (e.g., hitting, pushing or shoving). While strategies can help to reduce these behaviours, your and others’ safety should be the primary concern if your loved one is showing aggressive behaviours.
• Encourage your loved one to have patience with themselves. Anger and irritability can also be the result of frustration at not being able to find the right words to say or to do the things they used to do at the same level as before.
• Overall, the most important consideration is your and your loved one’s safety. It is important to get help if you feel that your loved one’s behaviour is putting themselves or others at risk of harm

• Remember that the anger is not the result of something you have done, it is caused by changes to their brain that make them less able to manage their emotions in the way they previously could
• Try to identify any triggers your loved one has that lead to anger or irritation. It can be helpful to write down what happened immediately prior to an outburst of anger to avoid or decrease these triggers in the future
• Try to avoid environments where your loved one will be overstimulated. Following a brain tumour and treatment, the brain is in recovery mode and devotes a lot of resources to trying to heal as much as possible. Because of this, the brain can have a sensory overload with too much sound/light/information. Because of this, over-stimulation is a common reason for anger or irritability. This can be stimulation by bright lights, loud noises, constant noises, more than one person talking at once, or large or continuous movements (e.g., like children jumping around/playing)
• Fatigue can also play a role in anger or irritability. Ensure your loved one has a quiet place where they can have “down time” when needed. You may need to help them in scheduling “down time” each day.
• Don’t try to argue back or reason with your loved one when they are displaying anger or aggression. Try to distract your loved one with something they enjoy or remove yourself from the situation until they have calmed down.
• Listen to your loved one when they tell you why they feel angry and try not to discount their feelings. If you show interest and understanding it can help to calm them down.

• Exaggerated emotional responses, or emotional responses that don’t match the circumstance (e.g., crying/laughing at inappropriate times or without a cause, difficulty stopping crying/laughing once started)
• Your loved one may find it difficult to see other people’s perspectives
• Increased fear/worry that is disproportionate to the circumstances

• Uncontrolled or inappropriate laughing/crying can cause embarrassment and concern for your loved one. Because of this, try to ignore episodes as much as possible.
• Just like episodes of anger, uncontrolled or inappropriate laughing/crying can have triggers. Try to look out for and avoid triggers (e.g., fatigue/tiredness, stress, worry, overstimulation, pressured situations) where possible.
• Sometime a break from whatever is happening at the time of the uncontrolled laughing/crying is enough for your loved one to reset and regain control of their emotions. You could suggest a brief activity to distract them (e.g., getting a glass of water, washing their face, going for a short walk).
• Schedule more demanding appointments/activities at times your loved one is more alert or try to encourage rests before them.

• Loss of motivation to engage in previously enjoyed activities
• Lack of energy to do everyday things
• Decreased hygiene behaviours (e.g., not showering, brushing teeth, wearing soiled clothes)
• Staying in the same place for extended periods of time (e.g., watching television or not getting out of bed)
• Difficulty identifying emotions in others (e.g., not noticing if others are becoming upset, not picking up cues)
• Expressing no or little emotions when good or bad things happen
• Difficulty with making decisions or coming up with ideas
• Difficulty thinking of things to say in conversations

• Incorporate routines into the everyday. If there is a morning routine, your loved one is more likely to engage in activities. Start slowly, set up one routine (e.g., brushing teeth after the morning coffee) until it is well established and then incorporate another. Talk with your loved one about which task they would like to build a routine around to ensure it happens more frequently.
• Develop checklists with your loved one to list the tasks they would like to achieve in a day. To avoid a sense of failure, it will be important to keep these lists short (i.e., 2-3 tasks maximum) and reinforce/praise any steps towards achieving each task.
• Bigger tasks (e.g., getting ready to go out) can feel overwhelming. Break these tasks into small steps to increase the likelihood that they will be achieved.
• If you are trying to get your loved one to make a decision, make suggestions with either/or options
• Gently encourage engaging in previously enjoyed activities and be happy to accept ‘no’ as an answer. Your loved one may or may not return to enjoying these activities.