Where there has been a serious injury and one partner is unable to return to work, the financial situation in the household most likely will change.  A stay-at-home mom may have to shoulder the responsibilities of working, often at a low-paying job.  That person may possibly have the additional responsibility of looking after a family if there are children still living at home, as well as looking after the injured survivor.  When the main wage earner is no longer able to work, there is often a financial hardship placed on the family.

All of the household responsibilities may now have to be assumed by the 'healthy' partner and all decisions may also have to be made solely by that person.  It may no longer be a joint effort or an equal partnership.  'What do you think' questions may no longer be able to be asked - or answered.  The strength and coping abilities of the 'healthy' spouse will be important during this difficult period.

The injured survivor may no longer be able to parent as he/she once did.  Anger, irritability and frustration may be the dominant issue and may cause problems where young children are concerned.  This puts an additional burden of responsibility on the non-injured partner and can create a domino effect within the family structure as more and more stress is placed upon the 'healthy' partner.  For the non-injured spouse, it may appear as if there is now an additional child to care for.  This is especially true if there is not a large family support system or if no insurance is available for medical, therapeutic and other assistance.

Their relationship as a couple may also have changed.  The survivor very often will lack empathy and may have become self-centered.  He/she may, as a result, live in a 'me' world with little concern for his/her partner's problems.  The brain-injured person may have difficulties showing affection.  These issues will almost certainly have a detrimental effect upon their relationship.  But at the very least, the onus is placed almost entirely on the shoulders of the non-injured partner regarding the health of their relationship.

The above instances are mainly where roles may change - possibly only for a short time or maybe forever.