After any visible bumps, bruises and scars have healed, the effects of a brain injury may linger much longer.

Long-term health challenges may be manifested in the form of cognitive challenges, communication problems, lack of short-term memory and inability to figure out the "how" of getting things done, among other things.

And those are apt to be permanent.

The best thing that family members can do for someone who has suffered a brain injury, whether from a tumor, stroke or trauma, is to recognize that person's life has been changed and he or she can no longer do things the same way as before.

"It does no good to tell someone to try harder — they can't," Mark Fox said during Saturday's Deseret Morning News/Intermountain Healthcare Health Hotline. They have to find different ways to deal with their new limitations, and with help, hard work and patience, as well as strategies to compensate, people can reclaim their lives.

During a busy hotline, Fox, a speech-language pathologist, and Barbara M. Bills, certified employment specialist, both of Intermountain Outpatient Neuro Rehabilitation, took many calls from family members and loved ones of someone with a brain injury. Both noted that differences are most noticeable to those who live and work closely with affected individuals. To others, they seem fine.

"It's common for everyone else to think they're normal, except the family," Fox said. And a lot of people mistakenly believe the individuals should just "pull herself up by the bootstraps and get on with it."

It doesn't work that way. Besides bringing its own long-term disabling challenges to the individual, brain injury also has an impact on long-term brain issues. It can accelerate the decline of cognitive function as someone ages, Fox said. And it's often not a single brain trauma or event, but a series of little knocks that add up to a lot of damage.

Bills and Fox said people expect their bodies to change and weaken in some ways over time. They're not surprised they can't do the same physical activities they were doing when they were younger.

But they hold high — and unrealistic — expectations of their brains. And they're often reluctant to ask for help when something doesn't seem right. But Bills says there are strategies and tools that help overcome many of the challenges a brain injury presents.

The hotline tackles a different topic the second Saturday of each month.