Assisted Healing

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Muskoka River, Bracebridge

Goal, Plan, Do, Review

Let me share one of the basic tools I have been learning to use. The tool is a very practical four step process, Goal, Plan, Do, Review, that helps me live with ABI. The real value comes with refining the use of the tool, knowing what factors to take into consideration. Just as good wine improves with age, so the tool improves with use (and guidance from a mentor).

 

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This tool reminds me of an educational tool called Action Research. Action Research…  is a disciplined process of inquiry conducted by and for those taking the action. The primary reason for engaging in action research is to assist the “actor” in improving and/or refining his or her actions. ASCD (2000)

In education the intent is to improve the art of teaching for the benefit each student. In my case the intent is to increase my mindfulness and make informed choices to help improve my quality of life

I’ve been working with an Occupational Therapist (OT) to help me better understand how my ABI affects my day to day living. A better understanding is leading to a better management of my challenges. The use of Goal, Plan, Do, Review is the key tool in the ‘detective work’ of avoiding or minimizing obstacles during the course of my day.

GOAL – Choosing achievable activities

Recently, in reviewing my schedule for the week the OT stopped me and asked, “How are you going to do all that?” She was commenting on my calendar which showed a concert on Friday evening, with a two hour trip to a wedding shower the next day, followed by an hour and a half drive to a birthday celebration. What she was alerting me to was the need to have a plan. Failing to plan would be a plan to fail.

PLAN – Figured out the necessary accommodations

There were a few obvious issues. First of all, I was reminded that driving or being a passenger creates its own set of challenges. Second, I was reminded that music, especially live music was a challenge. Right off the top there were two significant factors that needed to be addressed. How to manage the two days without experiencing sensory overload or neural fatigue.

Failure could result in having to bail part way through the day or less drastically needing a couple of days to recover. The object is to avoid the first scenario and minimize the second. Early on I depended on the help of an OT to make sure I had recognized all potential challenges. Part of the planning involved leaving some flexibility for factors I had failed to identify. Eventually I was learning to recognize more of the potential challenges on my own. The end of the process would always determine how successful I had been with the planning.

DO – following the plan work

The most important rule is to be rigorous in following the plan. The value of the planning would be seriously undermined by allowing short cuts or deviations.

For the concert I made sure I had my musician earplugs on me and a lawn chair. Since the concert was out of doors, the live music did not come with the additional challenge of reverberating off the walls. The musician earplugs would reduce the volume of the music by 15 decibels. The lawn chair would allow me to sit further back from the action and away from distractions of spectators. To create some additional resilience I scheduled a ‘rest up’ time a couple hours before the concert.

For the two hour drive to the wedding shower, (I was actually the ‘tag-along’ for that event), we made several accommodations. First of all, we scheduled three hours for the drive. That allowed for several short stops and a longer break half way there. I made sure to have a proper lunch as well as an opportunity for a ‘rest up’ time. Can’t under estimate the importance of nutrition to keep the brain fed. Since it was a ‘women only’ shower I had time alone and a chance to ‘rest up’ for a bit.

For the drive into Toronto, I am better able to handle traffic as driver than a passenger. This is even more significant when dealing with heavy traffic and traffic jams. As expected, we made rather slow progress once we reached the outskirts of the city. Since I’m quite familiar with Toronto, I had several alternate routes in mind depending on where we would encounter traffic congestion. I made route changes based on my own judgement without discussing options. Had I been the passenger and asked to give input I would have been into neural fatigue within a few minutes. That type of discussion and problem solving has too many cognitive and social layers.

When we arrived at the party I found out there would be live music. Unfortunately I had forgotten my musician earplugs. This raised the real likelihood of having to abort our time at the party. In the end it was a non-issue. The guitar music created a calm background to the party activities.

The social dynamics of large groups create challenges for me. After doing introductions and sharing birthday wishes I sought out people who preferred one on one conversations. Surprising how many people for different reasons have difficulty with large groups. Yeah, it helps to feel like I’m in familiar company.

On leaving I drove the first part till we were clear of the city traffic. After switching to the passenger seat I became aware of how tired I was. Tired is better than sensory overload. I dozed off during the last half hour of the drive home. I had followed the plan quite closely and was pleased with the results.

REVIEW – How well did I land on my feet?

The real test as to whether my participation with the Friday night and Saturday events were a success wouldn’t be confirmed till the next day. If I slept well and experienced no lingering fatigue in the next day or two I could then confidently declared the execution of the plan a success.

Had the plan not worked, I would then need to get into the detective work of figuring out what factors or combination of factors contributed to the plan going off the rails. Sometimes unexpected situations develop that create a domino effect. For example, had the weather been hotter than expected, that could have changed things very early in the ‘Doing’.  That could have required a decision to abort the second event on Saturday. Just one example of the importance of having flexibility in the plan.

In ongoing detective work of living with ABI, the main rule is don’t arrive at premature conclusions. Each ‘detective’ review following an event or series of events is to continue to build a case, to constantly work to clarify two things:

  1. When experiencing success, determine what can be added to the list of successful strategies. At times a successful experience will show a successful broadening of an activity or adding a new activity to the list.
  2. When experiencing a setback determine the possible culprits. When a culprit is suspected analyze the context and possible contributing factors. Don’t immediately rule out the activity. Certain activities create a setback only in combination with specific factors.

The more I use the Goal, Plan, Do, Review tool the better I am at realizing successful results.

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Author: Jasper Hoogendam

After 36 years as an educator my career ended due to a TBI. Renewable energy as part of 'walking lightly on this earth' has been and continues to be my interest since my teen years. Since early 2015 I have been learning to live with ABI (Acquire Brain Injury). I don't want to let my ABI limit the goals I set for myself. I'm living with a different brain, not a lesser brain. In sharing my day to day successes and struggles, I am better able to understand how my life had changed and begin to accept the change. In sharing my experiences I'm hearing from caregivers and fellow ABI's. I'm encouraged when my experiences are helping others understand some of the complexity of living with ABI.

2 thoughts on “Assisted Healing”

  1. It’s non-anonymous Betty-Anne! I love the plan, or framework you are following. We teacher types love to have a structure on which to hang the immense and often intense variables of life, don’t we? A big hug from me to you!

    Like

    1. Yes, we love structure, that’s why we also look for patterns to help understand. A ‘one off’ doesn’t give the same insights as seeing a pattern. In geometry you need a minimum of 3 points to define a plane. Two points leaves you teetering, one point leaves you hanging or blowing in the wind.

      Liked by 1 person

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