I attended an ABI (Acquired Brain Injury) workshop, and support group recently. It was new experience. I left me musing about a number of things.
Even though no two brain injuries are the same there are some common elements. Memory loss and the loss of ability to problem solve seems to be most prevalent. Loss in the area of executive functioning is a close third. The challenges surrounding these three skills can be very frustrating. Frustrating because these are some of the key skills most needed in adjusting to a post injury life. The ability to figure out, implement and remember the changes that are needed is a key part of developing a quality of life post injury.
It’s the skills or abilities that are lost due to brain injury that are most in demand to regain a reasonable quality of life.
With the loss of memory, learning to live with a post injury reality has numerous challenges. Making new procedures part of a daily or weekly routine are hard to adopt on a consistent basis. Additional demands are placed on ones memory, whether it’s dealing with additional appointments, remembering what activities to avoid or minimize, dealing with agencies such as insurance or other injury support agencies.
The need to problem solve is a skill that is in higher demand post injury. Learning how to accomplish tasks or daily activities with reduced mobility or much reduced level of energy. The reduced energy could be from loss of energy due to neural fatigue.
Strategies to the rescue
Learning new routines can be difficult. Learning new strategies to help remember new routines results in changing one’s life at two different levels of functioning.
Over the past 4 years I have gotten used to receiving two kinds of reminders. One type of reminder is a getting a prompt that it’s the time of the day that I need to do a particular activity or head out to an event.
The second type of reminder is getting a prompt about the strategy that I should be using. For example, I recently had my family doctor complete a medical examination for renewing my driver’s license. Because of the residual effects of my injury my complete form does not go through the normal route that I have done for several decades. As I left the doctor’s office he reminded me to read the instructions to ensure the form was sent to the correct place. It hadn’t crossed my mind to check the instructions till he pointed that out. Then I was surprised that I hadn’t thought of it myself.
That is just one example of how the deficits I am dealing from my injury requires new strategies in order to compensate for my injuries. I have had to apply this to various areas for which I continue to take responsibility.
To make sure bills get paid on time I take the bill as soon as it arrives and open my online banking app. I will then post date the payment so that I don’t have to remind myself and risk a late payment charge. I have yet to remember to apply this strategy consistently.
Executive Functioning challenges
Some tasks I find too complicated to take on myself. The most challenging one is getting reimbursement for expenses covered by more than one insurance company. Prior to my injury all my medical expenses were reimbursed through only one insurance company. Great. So simple.
With my injury I had the unfortunate challenge of having to deal with a two step process. I needed to first submit my expenses to insurance company A and then to insurance company B to cover the unpaid portion. It’s keeping track of the different steps along with the delay between submitting receipts to the first insurance company before I can submit to the second insurance company that things go awry. When I was at my lowest level of personal functioning that’s when I had too many of these. I finally resorted to having someone else take care of it for me.
Problem Solving challenges
Once I had recovered sufficiently from my injury to take on some projects I quickly realized that I had issues with problem solving. The problem solving issues appeared in two different formats.
- Undoing mistakes
As I was building things I found myself forgetting some of the techniques I had learned over the years. This was frustrating as I was used to going ahead with projects knowing how to do it and expecting to be reasonably successful. The errors of cutting materials incorrectly and having to redo different steps in a project was disappointing and at times frustrating, not to mention wasting good material. Also, errors in the early stage of a project would require some heavy duty problem solving to correct the situation. Needless to say, neural fatigue would set in rather quickly with that type of cognitive demand.
In order to successfully do the types of projects I had been familiar with, I realized that I needed to be intentional about the planning stage. It was no longer good enough to have a general overview of what I wanted to do. I now needed to plan each step and have a clear picture of how each stage of the project should unfold.
Recently while building props for a Medieval birthday party for my grandson I was very intentional about doing it right. I took on the challenge of building a functional catapult for attacking a castle. Every time I needed to think through a particular detail I would put the work aside and work on a different part of the party preparations. That gave me time to mull it over.
It might appear easier if I had downloaded an instruction booklet and build\t the catapult based on someone else drawings. I considered doing it that way, but that would have added a very different challenge, one of following someone else instructions. That would have contributed more quickly to neural fatigue. I chose to build my design and incorporate the materials I had on hand.
The last step in building the catapult, getting the tension tight enough was a two person operation. In the end I was able to make the catapult function well. In addition to that I was able to complete the castle to add an element of realism.
On the day of the party each guest was given a wooden sword, which my grandson had painted, and a wooden shield to decorate, which my son had made. This was greater than any ‘loot bag’ they might have gotten at a birthday party.
With building the medieval props I knew I had only one week. I was mindful to carefully pacing myself, having my grandson or son complete some of the things I had committed to but couldn’t meet the deadline.
Had I not planned and paced myself I might not have completed the props I had agreed to make. I also might not have been in a condition to enjoy the party. It’s so easy to fall into pre-injury pattern of doing things in the excitement of getting things ready for a memorable event. That would have been to my detriment.
Midway through the party I stepped away and crashed. I was helping the kids with the catapult. Dealing with groups of four or five kids and their energy level quickly drained my energy. When my part of done I walked away and crashed. I slept for an hour and a half. Success for me was contributing in a significant way to a memorable event for my grandson and the fond memories for myself of being part of the event.
Needing a day or two for recovery time following the event was not a hardship. It left me with a sense of wanting to take on something like that again… though not for a month or so.
P.S. If you live within traveling distance you are welcome to borrow the castle and catapult. You need a 16 X 16 foot (4.8 m X 4.8 m) area to set up the castle plus room to attack the castle.