Diana and Ralph Landwehr were married for eight years when he suffered a traumatic brain injury after the 18-wheeler he was driving became involved in an accident on the Grand Island Bridge. Diana and Ralph, both 65, met in the late 1960s shortly after Ralph returned from serving in the Vietnam War. They married within a year, and had two young children when the accident in 1978 changed their lives forever.

Ralph’s injury damaged his brain’s frontal lobe and resulted in a loss of short-term memory so profound he forgets things in less than 10 minutes. He is able to live at home because of the support of Diana and her involvement as director of support and advocacy for Headway of Western New York, an agency she helped establish for people with brain injury and other disabilities.

Headway, formerly called Headway for the Brain Injured, was founded in 1985. It is an affiliate of People Inc. and serves 2,000 people each year through its resource development center located at 2635 Delaware Ave. A major fundraiser is planned for 5:30 to 9 p.m. May 16 at Windows on the Green, 722 N. Forest Road, Williamsville.

People Talk: How was your husband injured?

Diana Landwehr: He didn’t have his seat belt on and he slid out of the truck’s cab and fell into the ice below the bridge. He was in the hospital for six months, and when he was released we thought: Now what? Physically he was stable but his memory was impaired. Cognitively he didn’t know where he lived or who I was. He knew the children meant something to him, but he couldn’t figure out who they were – their names.

PT: How has the brain injury impacted your marriage?

DL: I really don’t have a marriage. I really feel like I’ve just been a caregiver for the last 30 years. I don’t have that companion who I can rely on. I don’t have that intimate relationship anymore. My children also express sadness. The man we knew prior to the injury is different now. He doesn’t think right. He doesn’t do the things he did before. He wasn’t able to drive anymore. So we know a new Ralph.

PT: What can you still do together?

DL: He loves to go out and eat. He likes country western music so we’ll go out to hear that. I don’t like bingo, so we don’t do that. We just went to Vermont to visit our little granddaughter. I go skiing and he sits in the lodge and plays solitaire. And he will pick up a conversation with people. Physically to look at him you would never know anything is wrong, but after a while you realize he is having trouble relating to the conversation. Everyone thinks he’s charming, and he can be but at home he is not always so charming.

PT: What does he do during the day when you work?

DL: He attends a senior day program three days a week. The other two days I have an aide. They go to bingo or out to lunch or clean his room. He has problems remembering whether he took a shower, so we keep a schedule. Tuesday and Saturday are shower days. It’s very hard for him to pull out what he did for the day, so I sit there and give him clues.

PT: When he first was injured, what was the level of services available?

DL: I didn’t have any knowledge of any services, and I thought he should get occupational therapy, speech therapy. I went to the VA Hospital, and at that time they were not well-equipped either to help somebody with brain injury. Therapists didn’t know how to approach someone with a brain injury. It was a new field, and it still is. We’re still in our infancy. We still don’t know the best therapy, medicine, counseling. I think they’re starting to find answers. The brain is complicated.

PT: Why are brain injuries so misunderstood?

DL: For one, because a lot of our folks look like nothing is wrong, but they’ll have problems. Their understanding of reality is awkward. It’s your brain. It’s who you are. Once the brain is injured the damage never goes away. You’ll have an injury for the rest of your life.

PT: How prevalent are brain injuries?

DL: An estimated 5.3 million Americans are living with disabilities resulting from brain injury.

PT: Can brain injury occur without one realizing it?

DL: Yes. You don’t have to hit your head on anything. Whiplash causes brain injury. It also depends on how hard you hit and where on your head you hit. If you get a severe headache or blurred vision or if you find your speech is maybe slow, that would indicate that something happened. I would seek emergency medical care.

PT: How important are helmets?

DL: Very important. They may cut down on the severity of the injury, especially on bikes. You hear a lot about motorcycle, bicycle and skiing accidents. Not everyone knows that if you have a heart attack and you lose consciousness, it could be significant enough to cause problems with your brain and its abilities. A tumor is a brain injury.

PT: What are the chances of a lifelong disability?

DL: My husband has one, and it’s been 30 some odd years. The first two maybe three years after an injury, you’ll see the most rapid growth. After that, growth may decrease and you will know exactly how the injury will change your life. I have folks who were executives in their field, and they try to go back to work and they can’t because they can’t recall anything. A lot of people with brain injuries come up with their own remedies. One woman who doesn’t have a sense of smell will put a jar in the middle of the kitchen floor to remind her there is something in the oven and not to leave the house.

PT: How do you unwind?

DL: I find that coming here to the office – helping other folks – helps me to better understand what Ralph is going through. I feel then that I am able to help someone else. I enjoy what I do. I get tired. My relaxation is I like to ski, bike, walk – things of that nature.

PT: Where can people get help locally?

DL: ECMC offers rehab, but there is nothing in the area for long-term care. Some of the problem is insurance. You always have to negotiate, explain that a person would be able to do better if their care were covered longer. Many patients only get 30 or 90 days.

PT: Tell me about the stigma of brain injury.

DL: It’s a disability and people are ashamed because they are not able to think like they used to. The stigma is what holds some of our folks back. One of the things Headway would like to do is help our veterans who are coming back home injured. We would hope that the veterans and their families contact us. (By calling 408-3100, emailing or through the website,