One of the most unsettling things I see in the TBI community is when survivors feel isolated and lonely. There have been heart-wrenching posts and comments on our blog site about families that shun (or brush off) their own family members that have experienced a traumatic brain injury. Worse yet, I’ve heard people say that they are totally on their own because they just don’t have emotional support from family (or friends). There is no way that I can offer a solution that will work for everybody – for that matter, even for one survivor…but I’m gonna try to give some pointers that can alleviate some of the frustration and hurt that’s caused by loneliness and the things that can make it feel even worse.
It’s hard work
The very first thing I’ve recognized as the rallying cry of survivors is “you don’t know it unless you’ve experienced it” – and that surely is true. Letting people know how your brain injury feels is like describing the color and texture of an abstract painting to a blind person. They have no point of reference to even work with. To many, the conditions, effects, and feelings experienced by a TBI survivor are inexplicable in words…although some are able to do it. I will be referencing a book offered by Lash & Associates Publishing to help find ways to combat the depression and anxiety that survivors experience, to find ways to cope, and to encourage caregivers as well.
In the book titled “Lost & Found” – a brain injury survivor herself, offers these succinct nuggets of wisdom: “Healing and rehabilitating from a brain injury takes a long time. It continues long after formal rehabilitation has ended. It is the hardest work I have ever done. It requires endless courage, determination, motivation, and
support. It usually involves rebuilding multiple areas of not just your life but also your being – all at once. How could there be an easy solution for all of that!
Brain injury doesn’t have to be a destination. It is a journey. Let it be only part of who you are to become. “Don’t accept timetables for recovery.”
— Jill Bolte Taylor, Ph.D., Neuroanatomist
The Key is Incremental Strategy
Follow your heart…and find progress.
Strategies are key in making “baby steps” toward better cognition, a better mood, a better outlook, and a better life. Much progress can be made with encouragement from friends or family…but what about those that don’t have that kind of social “safety net”? Be encouraged. Your will to improve is the key to doing the right things and working to get the right results. As always, there will be naysayers that will immediately point out that “you’ve been this way for a long time” or “you’re wasting your time.” Well, with that kind of encouragement, you’ll be better off doing your best – one step forward at a time. Don’t even consider the steps backward…life hands those to everyone anyway!
Incremental strategies are the ticket to incremental change. Biting off more than you can chew is not a good plan! Start off small, find strategies that work for YOU, and repetition is a good thing. If you’re repeating a step, and you know that you are…that’s a great thing! If you recall how your brain used to process information, but you realize that it has changed…good for you! That is a baseline for working on your cognition. Remember, working in tandem with your doctors, therapists, caregivers, etc. is also very important. You’re not going to make measurable progress without someone that can see your “mile markers” and take note of them. Caregivers can also help with that.
Here’s an excerpt from Lost & Found that is a prime example of working toward healing: “Know that in time, as you heal, it won’t always be this hard. You won’t have to plan and strategize each and every little step you take. So remember you are healing, imagine yourself with a cast on your head and be kind to yourself. Treat yourself like you would any loved one with a serious health issue.
Remember to reward yourself for every successful task and effort, no matter how small. Pat yourself on the back and take a break doing something that will make you smile. We have to be our own cheerleaders now, like the supportive people in our lives were when we were growing up.”
Wow…that’s powerful, but also takes grit and determination. Believing in yourself is always easier when you have cheerleaders – but for those who don’t, that excerpt makes a lot of sense.
Emotional healing can come through a combination of things – here are a few (a more detailed version is available in the book, Lost & Found), but here’s a brief overview… Keep a grateful journal or victory log; Discover your “inner poet” by writing phrases that are meaningful to you; Journaling about your day can help you build confidence and see progress; Keep your perspective by noting improvements on a calendar; Challenge and learn from negative thoughts; Take time to smile; Forgive yourself – can’t do what you used to do? You’re only human! Remember that you’re still the same unique and valuable person that you always were; Try to have positive people around you…that supports your life moving in a positive direction; Work with art. Creative outlets are rewarding and fun. These are things that encourage and grow you as a person – with or without others’ approval.
Many times, people in your life are grieving the loss of the “old you” and trying to establish how to interact with the “new you” – just like you are. That can also make an awkward transition for family and friends. Seeking spiritual counsel can be a huge boost as well – if you attend a church, synagogue, etc., or want to…that could be a great way to grow your positivity in life and make some new acquaintances too.
Here’s another excerpt from Lost & Found: “Keep in mind that your family members and friends may be grieving too. They have lost the person you used to be and the roles you used to play in their lives. They don’t know how much of your former self will return, or when.”
And a quote from the same book: “Honoring your feelings is what helps you move beyond the pain.”
— Janelle Breese-Biagioni
This last excerpt from the book really sums up what so many TBI survivors need to hear…
“Remember you are healing, even if you can’t see a wound! Think of your brain in a cast, as it would be if you broke any other part of your body. If you broke your leg, you wouldn’t expect yourself to run a marathon right away, even if you were previously a marathon runner. First, you would be in a cast and you would rest a lot. Then you would start walking with crutches on even surfaces. The next step might be walking with a cane. You get the idea; it would take a lot of healing before you could run again, never mind run a marathon! Most of us try to run marathons with our brains all the time!
Work to make good things happen.
You won’t be able to do everything you used to, at least not right away. Everything will be harder and take a lot longer to do than it used to. You can compensate by cutting back, simplifying and being kind and patient with yourself. Avoid the tendency to push yourself too hard. Rehabilitation is a delicate balance between challenging yourself enough to promote healing and not so much that you have discouraging setbacks.
So picture yourself with a cast on your head and remember to rest, celebrate the smallest gains and balance out all the hard work with something that makes you smile, every day. You are engaged in one of the toughest challenges of your life, if not the hardest but it will get easier in time.”
Root for the Home Team…YOU!
In closing, the hardest takeaway from all this is that “going it alone” is hard but doing it without positive people surrounding you may be even harder. Cheerleaders are great, but they have to be rooting for the home team…and you’re the captain of the home team! Make the best choices that you possibly can and be encouraged – knowing that if all else doesn’t go as planned, you can rely on yourself to try and make things better. And you can also claim all of the credit. As always, be sure to let your doctor(s) know your intentions, and hopefully, they’ll be excited for your long-term efforts to improve. TBI is tiring, overloading, depressing at times, and can cause irrational behavior. With all that said, there’s always room to plan for incremental change.
Here’s a great and inspirational quote from Beverly Bryant:
“Being a brain injury survivor = Being a stranger in a familiar place.”
Shuffled Neurons & Other Speed Bumps…The Search For Self-Awareness
By Bill Herrin
Experiences in life make us who we are – they can intrinsically change who we are for better or worse, sometimes in a temporary way, and sometimes for the rest of our lives. There are things that happen that we’ll cherish, things we look back on and laugh about, things that we’d rather not think about…and then there are things that we won’t even recall. TBI can be like a thief in the night…slipping away with treasured memories and leaving us with little to work with. But take heart, because as the old saying “time heals all wounds” actually rings true, especially in the realm of brain injury. When a brain is injured, the severity really depends on where the injury occurred, the level of the impact, and to some degree – whether the trauma was over the line of being able to overcome or not…not to mention that every person’s brain is as different as their TBI.
Every TBI is Personal
The different levels of self-awareness that arise from having a TBI can spark debate because everyone’s TBI is personal to them, but their self-awareness will never be exactly like someone else’s…although there will be common similarities. That’s where we should focus – on the broad similarities that we can all relate to, and support each other in. For survivors and their friends, families and beyond, there can be friction – often caused by the survivor saying “I don’t need help, I’ll be fine” to someone telling a survivor “you don’t look injured, you’ll be fine.” That’s a hard pill to swallow, especially when the survivor has isolated themselves or if their family has withdrawn from trying to encourage or help them because of previous resistance.
Self-Awareness Doesn’t Come Easy
Awareness of how you’ve changed after a TBI may be harder to do than many realize. I’ll be referencing some points regarding self-awareness from a Lash & Associates “tip card” (an 8-page brochure that they sell) that is packed with great advice for survivors, therapists, clinicians, families, and caregivers. These excerpts will be highlighted in italics.
The struggle is real
“Why is Self Awareness Important?
Self-awareness is the ability to view ourselves somewhat objectively. It is also the ability to see ourselves
from the perspective of other people. It allows us to use feedback from others as we develop our personal identity. We rely on self-awareness when we…
interact socially with others
decide what situations or information to share
make judgments about ourselves, and
act in ways that ensure our personal safety.
Brain injury can impair the critical capacity for self-awareness.”
The previous sentence says so much because impairments in self-awareness come from different causes, and can show up at any time – and every person with a TBI will have different impairments or limitations of varying degrees. Hence, their own ability to assess their self-awareness is negligible in many cases. Damage in different parts of the brain can impair self-awareness in ways other than judgment – such as awareness of paralysis of certain parts of the body, awareness of loss of memory, problem-solving skills, reasoning, or being unable to anticipate consequences of decisions (based, in part, by lack of recall of it happening at a prior point in time, etc.)
“What Helps Unawareness?
Working on awareness can help people make better decisions. Efforts to increase a person’s understanding of abilities/disabilities must be done in a manner that preserves self-esteem. A healthy sense of self is critical for recovery. The two primary methods to address impaired self-awareness are education and structured feedback.
Both require an interpersonal bond between the person delivering information or feedback and the individual with impaired self-awareness. It is also important to have an environment that helps the person learn about strengths and weaknesses while still maintaining hope.”
Self-awareness is a process
The deficits of self-awareness can be obvious to family, friends, caregivers, and clinicians, and many times be quite frustrating. Helping a survivor to have a clear vision of their actual cognitive and physical abilities should be addressed with patience, positivity, and prudence.
“The goal of feedback is to orient individuals to the aspects of their performance that they do not accurately perceive. It is very important to balance feedback for problem areas with feedback for strengths.
Regardless of the approach used to help someone increase self-awareness, the person in the role of therapist, coach or caregiver needs to have a positive bond or connection with the individual. In order for a person to accept feedback, the person needs to feel that there is a partnership. The clinical term for this partnership is therapeutic alliance.”
In closing, it’s important to realize that everyone has the potential for unrealistic self-awareness – it’s what the long-running TV show “American Idol” was built upon…people whose self-awareness about their vocal abilities may have been bolstered by false praise, or just delusions of grandeur…many times, the people that go on the show with a humble approach are the ones that blow the judges away!!
Help your friend, colleague, partner, family member achieve a realistic understanding of where they are, but help foster a vision for them that will lead them to further improvements through encouragement, suggestions, positivity, strong communication, realistic goals, and love. Dealing with a huge change in self-awareness is complex and there is no “set route” to get to the next level. Understanding this helps both the caregiver and the survivor to make progress on the best terms possible.
This is just my experience. Every concussion is different and the things that worked for me may not work for you. Laughter is great medicine. I laugh often at my misadventures. It is how I deal with challenging situations. I am also aware that dealing with a concussion is not a joke.
Valentine’s Day, February 14, 2019, was the fifth anniversary of the “cracking of my head”. In 2014 I slipped on ice and fell, knocked myself unconscious and woke up on a stretcher as they were loading me into the ambulance.
Stroke of luck #1
I fell at work which qualified me for worker’s compensation. In the ambulance, my head ached and I was in a world of pain. Not thinking clearly I announced to the EMT’s and subsequently to every new medical professional I met that I was in pain and was going to need drugs. I am convinced they thought I had an addiction and was looking for my next high. At the hospital, the scan showed I had cracked the back and the left side of my skull but had no internal bleeding.
Stroke of luck #2
There were no empty beds in the regular rooms and I was placed in the Intensive Care Unit. They checked on me very regularly, I had excellent care – and I finally received medication for the pain that lasted the next eight days.
Everyone kept telling me that I was doing great. “It might take a couple of weeks to recover.” I did discover on the fourth day that care in regular rooms was more “scaled back”.
Stroke of luck #3
When I was first admitted, because of the cracks to my skull a surgeon experienced in concussions was called in to check the scans and monitor me for any signs of internal bleeding. This was the only doctor in the course of my care for the next year that spoke to me with any understanding of concussions. He continued to see me because no other doctor that saw me thought I needed any follow-up. I was released to go home on day 5.
On day eight, as if a switch was flipped, the horrible pain in my head just stopped. I had vertigo. If I rolled to my side in bed it felt like I just kept rolling and rolling. Bending over or riding in a car would set it off. That gradually subsided over the next nine months. A neighbor would come by each day to take me on a walk to build back up my strength. I used a walking stick to help with my balance.
A neighbor told me to keep a diary of my days, by noting what challenges I was having, any symptoms or misadventures, dizziness, how long I slept, how many naps, and also any improvements. If I did not eventually significantly improve, I would need to document my disability. Incapacity due to a concussion is hard to prove and scam artists will fake these symptoms, so I might have needed my diary later on.
Now, two weeks after release from the hospital, and having only minor improvements I wished that some smart person had stepped in. My opinion of my ability to intelligently make decisions was rooted in my pre-concussion abilities. The “cracked-head me” was not making informed decisions. I looked fine on the outside. I could even form some good sentences, hold conversations, move around, and my appetite was fine.
To many people, including some caregivers, I looked and sounded normal – BUT areas of my brain were not showing up to participate. I had injured the part of my brain that handled memory, reading, and writing (my day job skills), and I had trouble staying focused. One day I was going to clip my fingernails and was distracted by an email. Later, while showering, I discovered I had clipped just one fingernail. When I started driving, I kept repeating over and over “Watch the stop light.” I was afraid some distraction would pull my attention away from driving. I had trouble producing the names of close friends and relatives. As I would read a paragraph, each new line would remove my memory of the previous line. I couldn’t process a paragraph! If you were giving me a phone number, I had to receive one number at a time, say it out loud as I wrote it, and then receive the next number.
I went to my appointment with the surgeon, I stated that I thought I could go back to work. After all, everyone kept telling me I was doing great and would be feeling better in a couple of weeks. He reluctantly agreed, but only for half days. This was too soon, and it seriously slowed down my recovery. He later apologized and said that he never should have allowed me to go back to work so soon with the problems I was experiencing. I stayed on half days for months.
Early on, the calls from the worker’s compensation insurance nurses began. They were friendly and supportive at that point, however, they are not on your side. They sound helpful and steer you towards lower cost options. When I started asking for things like follow-up appointments, they started to get angry and short with me. Except for the surgeon, I had no follow-up appointments. The workman’s compensation contact had made an appointment with a sign-off doctor. He gave me a test and I passed with flying colors. He had tested me on things that I was able to handle and ignored the problems I told him I had. He told me I was probably creating a self-fulfilling prophecy.
The reason that was not likely is that my awareness was totally in the moment. I wasn’t anticipating any future moment. My only thought was the thing in front of me. When I was entering a grocery store, my only thought was “I’m here for bananas” (It was also written on a piece of paper in my pocket). There is the door. Go in. One of my triggers were when too many things would happen. My brain freaked out with multiples. What to look at? What are all of these things? Where is the thing I need? I can’t tell you exactly why but it made me extremely anxious and freaked out my brain. I would be fogged in for days, and it caught me by surprise every time. My “cracked head self” kept forgetting my new situation and defaulted to how I perceived myself before my fall.
On July 4th we went into Trader Joes…it was deserted. We walked to the vegetables, and Ron asked what I would like with dinner. Two things happened. At that point in my recovery, I had no opinion on what I wanted for anything. Beans or ice cream or prune juice were equal, and I would randomly spew out a choice. Second thing, my brain just freaked. Too many things, and a choice to make. It had to show on my face because immediately Ron said, “I’ll pick” and I waited outside.
I realized the doctor was a sign-off doctor when he refused to see me a second time because he “could not help me, he thought I was fine.” And the Insurance contact would not agree for me to see anyone else. I later discovered you have to request a second opinion from a different doctor in writing (an email counts) for them to be required to allow it.
Rick doing what he loves…plein air painting!
At six months I stopped pursuing the search for a doctor because I starting to improve. It was in stages, and there were setbacks…but function improved. At two years, I reached a point that I felt that if I never improved more than this I could live with it. On one of my walks, I was really down. I had had a setback and was having a major pity party. Then I looked up ahead, and there was a lady in a wheelchair. I thought, “I know it could be worse, but it has been really hard. I can have a pity party.” So, I continued my walk and along came a gentleman in a wheelchair taking his dogs for a walk. He was a very engaging person and we talked about his dogs. I thought “Well crap! God is going to keep putting wheelchairs in front of me until I stop feeling sorry for myself.” The very next day on the same block there was a group of teenagers across the street, cutting up and having fun. One young man was wearing shorts and had a prosthetic leg. I said to myself, “I get it. I get it. No more pity parties.”
I have a wonderfully supportive partner and some great friends. I don’t know what I would have done without them. I didn’t access support groups but would have if I had been going it alone. I didn’t access legal help, and it could have been a mistake. Early on I didn’t know how much I would recover or how slowly. I didn’t have the know-how to navigate the system to get good care. Today’s “clearer thinking me” understands if things had gone differently in recovery it would have been a big mistake.
Five years later I still have occasional trouble with my memory and with writing. Music is still not enjoyable. Reading tires my brain, but I keep pushing to regain that. I occasionally see some things improve – even at five years. I have “tired brain days” especially after a hard week at work. I keep a calendar of commitments and appointments. I am organized and know where to find information that I need to know. I still am very much “in the moment.” I must consciously think about planning, make a list and note it on my planning calendar for it to happen. An upside is that my challenging day job used to cause me anxiety. But because of my concussion, I’m in the moment, and not as worried about things.
Rick’s rendition of a classic hot dog joint in Raleigh, NC
I am long past the worst and take joy in the good things. I am at peace with my new normal.
The best thing is that my watercolor painting is better than ever! It was located on the undamaged side of my head. It was like my brain said, “this side is just fine, so let’s use this for a while.” Very early in my recovery, I tried painting again, and was as good as ever. I also saw great growth during that time. I think my brain is at ease in the undamaged area and likes working there. You can check out my watercolor paintings at RickBennettwatercolors.com
Rick lives in Raleigh, NC and actively participates in the arts community, doing plein-air painting, teaching watercolors workshops, and more. Many thanks to Rick for taking the time to share his story with us!
Finding your way after a stroke, ABI, MBI, TBI, Concussion, and related conditions is uncharted territory in every sense of the word. Intentional living not only defines the attitude that will help you work toward improvement, it also defines how you will continue to live going forward.
For every case that takes a definitive route, and a measurable outcome, others can spend a lifetime making even a portion of headway that others may achieve.
When anyone claims to know the way, it’s only because that’s the way that works for them. There’s no other way to say it. Rehabilitation after a TBI (no matter what variety) is always on a case-by-case basis, with progress being made according to many variables and factors.
Cognitive rehabilitation should be left to professional clinicians, and follow-up cognitive growth can be an independent venture – and best if applied in line with your doctor’s overall plan. I’ll be excerpting some information from the book “Brain Injury – It is a Journey” that is an excellent resource for families of TBI survivors that are helping someone they love to begin their journey.
*In the book, there are tons of resources, but one of the most poignant points are in these simple checklists:
Changes After Brain Injury
Changes in a person after a brain injury depend on which areas of the brain are
affected and the severity of the injury. Use these lists to check mark affected areas.
These will change over time as the person progresses. Possible consequences of a
brain injury includes:
– Muscle spasticity
– Weakness or paralysis
– Balance and coordination difficulties
– Changes in vision or hearing
– Loss of smell or taste
– Difficulty swallowing
– Changes in appetite
– Increased sensitivity to smells, light or sound
– Changes in sensitivity to touch
– Fatigue, increased need for sleep
– Changes in sleep patterns
Cognitive (thinking and learning) consequences
– Short-term memory loss
– Long-term memory loss
– Slowed ability to process information
– Difficulty organizing and planning ahead
– Poor judgment
– Inability to do more than one thing at a time
– Lack of initiating or starting activities
– Easily distracted
– Disoriented or confused to surroundings
– Shorter attention span
– Repeatedly says or thinks same thing
– Slurred or unclear speech
– Difficulty finding the right word
– Difficulty staying on topic
– Trouble listening
– Dominating conversations
– Difficulty reading
– Rate of speech too fast or too slow
– Things taken too literally
– Difficulty understanding what is said
– Increased anxiety
– Self centered behavior or thinking
– Easily irritated, angered or frustrated
– Overreacts, cries or laughs too easily
– Different sexual behavior
– Impulsive, acts or talks without thinking
– Mood swings
– Dependent or clinging behavior*
Having a full understanding of Brain Injury Rehabilitation and how it’s tailored to each survivor is critical. Clinical care managers and social workers help evaluate a survivor’s needs (as well as their family, caregivers, friends, etc.), and can help connect them to the proper resources in their own communities.
When the TBI survivor is still in school, a cognitive education specialist will help navigate their continuing education challenges through meeting with the educators and staff, as well as compensatory strategies for learning after TBI.
Occupational therapists can help a survivor get back on track with their personal lives to maximize their independence and ongoing improvements with cognitive, sensory, mobility, and other challenges. Their goal is to get the TBI survivor on the right path to independence and handling the challenges of daily life.
Pastoral care can provide comfort, counsel, prayer and encouragement to the TBI survivor, as well as their family.
A Physiatrist is a specialized doctor whose primary focus is on physical medicine and rehabilitation. They lead and monitor rehabilitation treatment programs and make referrals to specialists as necessary. Besides monitoring the survivor’s medical status, ordering tests, and providing prescriptions, the physiatrist provides followup to assist the survivor with inpatient or outpatient rehabilitation.
Physical therapists evaluate and work to improve physical issues such as strength, endurance, pain, balance, mobility, and more. They also teach “at home” exercise programs for safe transferring techniques.
Psychologists can provide education and therapy to survivors and their family members, especially when dealing with adjustments after a TBI.
Neuropsychologists provide additional help by offering expertise regarding the relationship between the brain and behavior – and may include testing to better understand the TBI survivor’s specific needs.
Dieticians provide nutritional counseling for TBI survivors regarding their best diet options for the specific needs and to enhance their health/weight.
When needed, as respiratory therapist works to stabilize a person’s lungs as a result of trauma or disease. This therapy is aimed at getting the patient’s function as close to normal as possible, and to lessen the complications of respiratory impairment. Respiratory therapists primarily work under the direction of the TBI survivor’s physician.
Speech and Language Pathologists evaluate speech, language and cognitive deficits – along with communication, swallowing issues, and more. The goal is to provide cognitive retraining for compensatory strategies and to make improvements for better communication, independent living, and activities. If a TBI survivor is unable to speak, a speech pathologist can also assist with alternative forms of communication through technology, and other various approaches.
Therapeutic recreation specialists, vocational rehabilitation counselors and vocational services are three other targeted types of professional help that can greatly improve a TBI survivor’s quality of life ongoing.
These pointers are excerpted or referenced from the aforementioned book titled: Brain Injury, It Is a Journey – published by Lash & Associates Publishing. The book is a great find for survivors and their families and offers some keen insights and advice for making the most of life after a TBI…and how to approach it with the full intention of prevailing over TBI. Written by professionals with many years of experience in the field of working with survivors of traumatic brain injuries, aneurysm, stroke, concussion, and more, this book is well worth the investment!
As we’re now in 2019, many of us reflect on 2018 with good and bad memories – with grateful hearts, we recall the good times – and with heavy hearts, we recall the difficult times. Life (in general) can be a rollercoaster ride of events and emotions, but especially when you’re a survivor of TBI, stroke, concussion, ABI, PTSD, etc.
New Year…New approach!
In many instances, discussing “New Year’s Resolutions” may feel like an exercise in futility. I’ll be the first to point out that I have gotten a lot of strong, and positive feedback on previous blog articles, and I’ve gotten some that were heart-wrenching. The things that people endure, and how they see the world after TBI can be so different – because, like our own fingerprints, every brain injury is different. Period. End of story.
One of the first things I try to say “right up front” when discussing any sort of brain injury, is that for every person you may encourage or inform, there will be others that don’t see things the same way. With that said, I’m not quitting! Feel free to share your feelings, no matter what they are, but know that my intentions are to enlighten, inform and inspire. Maybe not all three in every blog post, but with TBI and related subjects, you really do have to take the good with the bad.
New Year – new possibilities!
You have to play to win!
Lets’ get back to the topic of New Year’s Resolutions – I’ve thought about it, and many times, resolutions are made to be broken…or at least, it feels that way. Why not plan to fight for the things that we truly want to try to change with all our might? Even if it’s something small? Making small strides may not even be on your agenda, but maybe if you are a caregiver – you can put it on your agenda to help your loved one make small strides. If they achieve one, or more than one, you can use that to encourage a TBI survivor on to further goals throughout the new year!
The point here is to resist making half-hearted New Year’s resolutions, and plan for a New Year’s Revolution! A revolution can be big or small, but they both revolve around making changes with intent and purpose…to work toward change. Revolutionary thinking has a tactical approach, a fierce agenda…and a targeted result in mind. In other words, it can end up being half-hearted goal-setting.
How do you go about this? Here are some ideas that may help you work toward your goals.
1) If you feel that setting goals are a wasted effort, then setting a small goal may be the perfect solution for you! Baby steps are how progress often starts! If you have a friend or relative that can help you toward your goal, that’s even better. Accountability and encouragement can make a huge difference.
Setting goals is planning.
2) Be realistic when setting a goal – as an example, maybe you have trouble with your balance – don’t expect to overcome that quickly, and there may be other ways to overcome it that are outside of just having the desire to do it, such as therapy, certain medications, etc.; Keeping up with your doctor, and working with clinical professionals would be the best route for something like that.
3) Journaling. Write daily (or as often as you can) for 2 reasons…one is for a point of reference for where you are starting from…and the other is to show yourself (and even others) how far you’ve progressed. Journals that start off early in the year can show the progress toward your goals, one post at a time!
4) Besides journaling, a personal history log can be used to record one or two significant events that occur each day for a month. It may be especially useful for individuals who have difficulty remembering dates, being aware, or being oriented to time. Writing information down and seeing it can help a person understand the passage of time, what has happened over time, help organize daily activities into logical sequences, prioritize assignments, errands & appointments, etc.*
5) Daily living checklists are designed to help the survivor with personal hygiene, meal preparation, maintaining a household, driving, and taking medication(s) as prescribed. The Employment Checklist emphasizes the skills necessary to function in the workplace.*
6) Visual Reminders are designed to minimize the survivor’s reliance on memory. They may be copied and posted in useful places where the survivor lives. Suggested locations include near the door most often used to enter or leave the home, near the kitchen stove, and/or on a bulletin board.*
7) Treatment tasks and goals are designed for use primarily during rehabilitation sessions with the assistance of a cognitive therapist, counselor or therapist. These aids are particularly useful for periodic patient self-evaluation. They also help the survivor and family focus on issues that are essential to cognitive recovery.*
8) Personal and household information, such as phone numbers, addresses, and other important personal information that might be needed daily can be kept in a visible place. Financial management and budget worksheets help the survivor keep track of information that might be lost due to impaired organizational skills.*
Application of some (or many) of these techniques can help a TBI survivor simplify daily tasks, communicate effectively, and cope with difficulties experienced as a result of memory loss or attention deficits.*
Stay the course!
Envision a better year ahead.
Keeping your focus on your “New Year’s Revolution” can help you make change happen – at whatever rate your personal situation will allow. Resolutions are often dropped as their immediacy fades with time…a “revolution” is a stronger approach because it’s a plan! Incremental steps, along with a plan in place, can produce marked and measurable results – and as I had stated earlier, your results will vary, as every traumatic brain injury (TBI) is as individual as your fingerprints…no two TBIs are the same. My most sincere suggestion of working along with your clinician, family member, caregiver, friends, etc. in doing this is the best approach – everyone needs a sounding board…and a cheerleader! There is a proverb that says, “The journey of a thousand miles must begin with a single step” – that’s a revolutionary approach. I wish you much success in this new year!
(*Referenced from Lash & Associates’ book (by Debbie A. Leonhardt, M.A., NCC, LPC), titled “Survival Kit” – a great resource for planning, goals, and progress after TBI)
Rebuilding Your Life Year-Round Makes For Better Holidays
By Bill Herrin
Is your glass half full or half empty?
I once heard the radio legend Paul Harvey say that life is a “do-it-yourself project.” It always stuck with me, and I saw many folks through the years that didn’t seem to grasp this simple, yet truthful mantra. I’m certain that Mr. Harvey wasn’t referring to survivors of TBI, but even they have a stake in what ends up happening in their lives…even when so much of their lives may feel out of control. Since every brain injury is completely different, one survivor can be social and fully aware of how they interact with others – where another may be dealing with more severe issues, and would rather be left alone. That’s understood, and for that reason, this blog article is meant for folks to be able to “cherry pick” the things that suit their situation, their needs and their desires best. There is no “broad brush” approach implied or intended here! One size does not fit all.
Interaction Doesn’t Always Come Easy
I think the one thing that could be agreed upon is this: if you want interaction, conversation or inclusion – you need to be willing to make some effort. As if making a friend isn’t hard enough in this world, the complications of TBI make it more complex. Depending on your TBI, you will have different options, but here are some suggestions for starting to build a more rewarding life.
Find a support group that includes people with similar lives – a TBI survivor group, brain injury group, etc. If there’s no such thing where you live, then guess what – support groups are also a “do-it-yourself project”! If you dare to start one, you’ll officiate the meetings (consider sharing the responsibility with others, too), and possibly get the group going. Not only is it an achievement for you, but it’s also a blessing to all involved. This can build a small (or growing) circle of friends that have something in common. You’re on your way to building a portion of your life that is
Connect with others that have similar interests
missing, and you will all have a sounding board, an outlet to discuss things in common, and just some fun time together. Be prepared in advance for any issues that may arise, as people are not perfect, and some may speak before they think…such is life.
Use social media to interact with others, especially those who have TBI in common. The safest way would be through moderated forums that are based around life with a TBI, etc. This keeps conversations on track, eliminates any bullying or threatening behaviors, etc. The best rule of thumb for social media is that it’s social, and society brings a huge variety of people with it! LOL
Find a church or synagogue that you like – maybe go to one you’re familiar with, or maybe you already attend one – either way, the other members can feel like
Strive to be more social!
family! You just may find some ways to get involved, as well as ways to have fun together. Churches and synagogues often provide great social inclusion, and acceptance of others…find your place among some encouraging folks, and you’ll be able to encourage them as well. That’s a nice payoff.
Find a coffee shop, library, bookstore, restaurant, etc. that you really like (or more than one!) and go there on a regular basis. If you go on a consistent basis (once or twice a week) you’ll start being recognized, and you’ll get to know others as well. If you’re shy, don’t rush things…sometimes it’s best to just show up, and the rest will take care of itself. If you’re not able to drive, see if someone you know can take you, and hang out with you for a bit. Two people together are safer and can start a conversation more readily. This is just for fun – so let things happen and enjoy the time away from home!!
If you’re physically able to go walking, or if you need a wheelchair, etc. – either way, get outside! There’s nothing quite like being out and about. As mentioned above, find a friend or relative that can go with you. If not, maybe in due time you’ll be able to be involved with a group that has the same goals of rebuilding their lives…and you can make a day of it together. The main thing is to think about doing things and look for the best opportunities to make them happen. Life is a do-it-yourself-
Balance your thoughts and feelings
Find a job or volunteering position that suits you. These are great, and can benefit in more than one way. With a job, you’ll interact with people on a personal level, and you’ll also get paid! That’s a win-win! Volunteering for a cause that is near and dear to your heart is a good way to make a difference in your community too, and to make change in yourself. It may not pay, but the end results will be positive – social benefits, and sometimes volunteering can lead to part time work. As stated earlier, these may or may not be an option, as it will depend on your own situation. If it’s something you can do, it’s a great step to making friends that live in your home area. Work it!
Inclusion and Exclusion
The final part of this article (which actually was the intended goal) is that if you work at making your life well-rounded, work to meet people (and make a friend, or friends), strive to be more social (even if it’s scary), and find some places to find inclusion, inspiration, and socialization…you’ll have folks that you can call on via phone, texting, through social media, at your church or synagogue, at places you frequently visit, at work/volunteering, and also other friends & family members…all of these combine into making up your new normal. Your new Life 2.0!
The Holiday season is one of those times of year when people can feel down, forgotten, maybe they really aren’t included. When you work on being more social, encourage those who need it (and in turn, you’re encouraged too), and work to be more active in your community (church/synagogue, volunteering, etc.) …the Holidays will be much brighter, as well as your life throughout the year! Be encouraged. Be encouraging. It’s funny how those two go hand in hand. It’s my wish that you have fun this (and every) upcoming Holiday season. Make the best of it and work your plan year-round to build the life you deserve. It’s a do-it-yourself project, and with determination, you can make it better and better…and always remember, there’s always someone that needs love and encouragement more than you do. Be an encourager to others. You’ll find there’s nothing that feels better than being the light in someone’s life that truly needs it! Happy Holidays!
I’m always careful to keep in mind that there are TBI Survivors who will never fall into certain categories – this is one of those times. Although there can be creative outlets for a large percentage of Survivors, there will always be limitations for some. Since every brain injury presents its own challenges, I wanted to acknowledge that first and foremost. Let’s explore how art and music therapy after tbi can make a difference!
Music is a powerful healer
Creative music and art therapy provide help for recovery, recuperation and cognition through listening to music, learning to play an instrument, or through creative art and writing. Music is powerful in the way it can conjure memories of a certain time or place in a person’s life. It also can stir emotions through the song’s structure and words. Learning to play music can create a free flow that comes to a person effortlessly (it seems, at least), or it can be tedious and frustrating to others. Either way, it builds memory in different ways – either by repetition and learning, by building retention and memory capabilities…or by listening to music. This can bring a feeling of “knowing” that is like no other – knowing the song, or knowing it sounds familiar, knowing the words, and also having memories flood back that may relate to another time in a survivor’s life. All of these things can be helpful, but all may not bring positive memories. Nonetheless, remembering things can bring a certainty that “all is not lost”, and can provide a foundation on which a new life can be built, and new memories can be made and added in the days ahead.
The Department of Defense website offers information from the Centers for Disease Control and Prevention saying that about 1.5 million people in the United States have a TBI each year and that 85,000 people have long-term disabilities. That’s a lot of people, and in turn, a lot of rebuilding of lives.
“The Creative Forces music therapy program assists with the needs of military patients and veterans who have been diagnosed with TBI, as well as their families and caregivers,” said Danielle Kalseth, 673rd Medical Operations Squadron creative arts therapist/music therapist. “Not only do we provide clinical services, we want to provide patients and their families access to the arts in the community.”
The music therapy program currently helps 30 patients rehabilitate from TBI, with new referrals every week. Patients who receive music therapy can participate in group or individual sessions, or a combination of both.
The program enables TBI sufferers to engage in a meaningful activity with others who are experiencing the same issues.
“Music therapy helps with more than just my memory; it helps with my mood too,” Young said. “On days when I’m in a bad mood, playing the guitar is a great way to change that.”
Art therapy is one of many treatment modalities used daily with brain injury patients throughout Brooks’ continuum of care. Art aids in the recovery process by allowing survivors to do something they enjoy. When utilizing art therapy as a treatment intervention, Brooks clinicians are working on various functional skills such as fine motor skills, gross motor skills, standing tolerance, endurance, communication, expression of feelings, relaxation, socialization, memory and problem-solving skills. (*end of excerpt)
You Gotta Have Art
Creating art can be relaxing
Using art as therapy is also a great way to treat the effects of TBI and helps fuel recovery. When used as a therapeutic approach, it…
helps eye-to-hand coordination (motor skills),
strengthens a person through standing or sitting up,
improves communication through personal interaction with others,
helps memory and expression of thoughts/feelings.
Creating artwork also can be rewarding – bringing a feeling of accomplishment, and even relaxation. In short, it’s just a great outlet for sharing thoughts AND feelings in a creative way that builds coordination, self-awareness, and confidence.
Music Strikes A Common Chord For People
When it comes to music, it turns out that you don’t have to play an instrument to reap the benefits of cognitive improvement. Listening to music as therapy creates positivity, an improved mood, better focus, and better behavior.
From a neuroscientific perspective, indulging in music is considered one of the best cognitive exercises. With “plasticity” as its veritable nature, the brain engages in producing music indulging an array of cognitive functions and the product, the music, in turn, permits restoration and alters brain functions. With scientific findings as its basis, “neurologic music therapy” (NMT) has been developed as a systematic treatment method to improve sensorimotor, language, and cognitive domains of functioning via music. A preliminary study examining the effect of NMT in cognitive rehabilitation has reported promising results in improving executive functions along with improvement in emotional adjustment and decreasing depression and anxiety following TBI. (end of excerpt)
Don’t Write Things Off – Write Them Down!
Writing strengthens a survivor’s resolve
In the world of a TBI Survivor, one of the most personal and reflective ways to share thoughts, feelings, desires, goals, progress, concerns, hopes, dreams (and more) is through writing and journaling. By sharing their thoughts through writing, a TBI Survivor can make huge strides toward healing (physically, mentally and emotionally). It brings self-awareness, self-expression, and can help rebuild after “loss of self” through reinvention and creativity. Journaling can be done individually, in a group or with assistance from caregivers or family. (Here is an excerpt from Journaling After Brain Injury, Written by Barbara Stahura, CJF)
Some good ways to start off writing a journal can start with these basic prompts:
Today I feel…
I feel stronger when…
I’m proud of myself because…
If I could change…
Even though now I can’t (fill in the blank),
I can still…
I am grateful for…
I feel powerful when…
I want my life to include…
One year from today…
When I was 10 (or some younger age), I…
When I am 60 (or some age older than you are now),
Remember, don’t worry about the “rules” of writing.
Just let your pen move across the page and let the words
flow. Be kind and don’t judge yourself or what you write.
Journaling is a very helpful practice after a brain
injury, both for the person with the injury and family
caregivers and members. Writing down your thoughts
and feelings about what is happening in your life can help
you develop safe ways to cope with change and create a
healthy new life.
(Excerpt from Journaling After Brain Injury, Written by
Working To Find Therapeutic Healing Through Art and Music
Visual/Fine arts can be quite rewarding and can bring out the best in a person’s creative expression. It can help a TBI Survivor in many different ways, including the development of creativity, dexterity, motor skills and coordination, technique, and self-expression. In the book “Reinventing Oneself After Loss,” by Hilary Zayed, the author explores her meaning of loss, her search for a new identity, and the reinvention of her “new self” with her new self-awareness. Art became her vehicle for self-exploration as she struggled to build a new identity and move forward.
Hilary is a great example of a person who was quite different after her TBI, and her motivation and determination to take her life in a new direction resulted in finding a new passion for writing and art. Working primarily as a painter and mosaic artist, Hilary found that her new direction was a natural fit and that it was rewarding in many ways…although it was completely different from her previous life as a teacher, horseback rider, and accomplished flute player. She had lost a lot of memories of her life before TBI. She struggled with loss-of-self but decided to forge ahead and pursue what she felt were the gifts that had replaced her former abilities. Her journey took her to a new place, with a better sense of self – and a new identity. One that brought her joy and a sense of accomplishment. Although this is a best-case scenario, many Survivors can take Hilary’s lead, and find things that help complete their lives – even small things that make them happy, such as journaling, poetry, socializing, board games, crossword puzzles or word searches, etc. It all depends on what appeals to them! If they find that art is an interest, adult coloring books are fun and relaxing. If they want to draw, a sketchbook and pencils (or colored pencils) is an inexpensive and easy way to see if that’s their strong suit. The point is to help them search for the thing(s) that suit their desires, talents, and abilities. Creating art, writing and music can propel people to new heights of healing and cognition.
Maybe this will inspire you (as a Survivor) or as someone who loves and assists a TBI Survivor…find inspiration, and in turn, find your new self, or inspire someone to aspire higher!
One day at a time. Cognition and Caregiving after a TBI.
By Bill Herrin
Better cognition takes time
Thinking comes so naturally that most people take it for granted, but after a traumatic brain injury – many times, thinking can be more of a deliberate action. It takes focus and effort to put a series of thoughts together after TBI, to speak clearly, or to even move. Simply put, the brain (like the body) takes time to heal. Since no two brain injuries are identical, there is no clear path to better cognition. There are, however, certain broad directives that can get you moving in the right direction in most situations. The hardest part of this is to accept your “new normal”. Acceptance, once you come to terms with it, gives you the desire to work toward the goal of better cognition, coordination, memory, anger management, judgement, attention, and other challenges. Once you accept your situation isn’t going to change overnight, you can start the process of healing, along with testing your limitations. Although finding your limitations is difficult, knowing what they are is a huge step towards improvement in areas that need changing. When a person lacks enough cognition to be self-aware or to strive towards improvement, that’s a test for the caregiver’s guidance and patience. Sometimes just being there for your friend, spouse, or loved one is all you can do.
As a caregiver, high expectations from a TBI survivor shouldn’t be overly discouraged, as they can bring progress through their desire to improve. They may not reach the goal they wanted to, but they’ll make strides towards it! That is positivity in its purest form. Nobody wants to be working through such a huge change in their life without encouragement – cheer them onward and upward! Even if they fail, they are trying, and that shows initiative. Their desire to improve should never be underappreciated.
Change after TBI is incremental
When cognition is in the early stages of improvement, the changes may be noticed more by the family or caregiver than they are by the survivor. Sometimes incremental change is just too subtle for survivors to realize, but pointing out the changes to them is incredibly positive reinforcement. The following tips on cognition are excerpted from Lash & Associates’ tip card titled “Cognition – Compensatory strategies after brain injury”
Cognitive fatigue is one of the most common consequences of brain injury. The survivor’s brain is simply working harder to think and learn. Cognitive rest is just as important – maybe even more important – as physical rest after the brain has been injured. Cognitive fatigue can have a ripple effect. You may have a shorter temper, find it harder to concentrate, make more errors, misplace things or forget appointments. You may feel like you can’t think straight no matter how hard you try. Many survivors describe cognitive fatigue as “hitting the wall”.
• Feel tired after mental exertion?
• Have a harder time thinking after working on longer or more complex tasks?
• Need more sleep than usual?
• Find it hard to get through the day without napping?
Tips on compensatory strategies…
• Take breaks.
• Schedule rest periods.
• Stay organized.
• Use a daily planner.
• Use time management strategies.
• Eat nutritious meals on a regular schedule.
• Go to bed at a consistent time.
– Create a weekly exercise routine.
• Request a medical evaluation.
• Discuss medications that may help with a physician specializing in brain injury rehabilitation.
There are a plenty of great suggestions for compensatory strategies for survivors and their caregivers in the tip card referenced above. Here’s a link to it here!
When it comes to cognitive functional rehabilitation – seek professional advice first (of course), but when the TBI survivor is at home with a caregiver, clinician, friend or family member, there are some great approaches to working on communication, social interaction, organization, reading, attention, problem solving, and rebuilding other deficits through consistent application by any or all of the people involved in the care of the TBI survivor.
Referencing the book titled “Cognition Functional Rehabilitation Activities Manual” (Developed by Barbara Messenger, MEd, ABDA and Niki Ziarnek, MS, CCC-SLP/L), I’m sharing an excerpt that provides a glimpse into the workbook’s approach to helping a person with cognitive challenges. Many of the exercises use interaction and documentation to assess where the TBI survivor is at (cognitively speaking) on an ongoing basis. Remember, this is a workbook, and there are plenty of exercises that build activities and responses ongoing. Here is the example of how the manual challenges a TBI survivor with structured and specific activities:
Task: Provide awareness training.
Prompt participant to work on awareness training.
Ask why participant is here receiving rehabilitation.
Ask what skills/activities are harder since the brain injury.
Ask what participant does to compensate for these difficulties and which therapies address them.Ask what participant’s strengths are (what is participant good at?).
Ask the participant how the brain injury and difficulties affect daily activities.
Provide answers and examples when needed.
Provide positive reinforcement for strengths, being receptive to information regarding brain injury, for participating in the task, and for being motivated to participate in rehabilitation.
Provide a complete description of this activity in the Functional Rehabilitation Documentation Form.
Finding cognitive deficits is the first step
By asking specific questions, and recording the corresponding answers, this workbook is a great tool for tracking progress – and the exercises can be done more than once, to check and see how/if the answers have changed. So, what’s the takeaway from this excerpt? It illustrates that structure and consistency of care and treatment by family/caregivers and professionals can overlap and create a solid overview of cognitive deficits, and improvements.
In closing, the main goal of this post is to address the expectations of TBI survivors and their caregivers, to encourage them to strive for progress and to offer resources for compensatory strategies, and cognitive rehabilitation. If all parties work in tandem with the common goal of helping a TBI survivor make it to the next level, they’re all closer to the goal…and the whole team wins. That’s the goal!
My dad would often tell me not to get discouraged, and as a young man, I didn’t understand why…sometimes it made me frustrated. What he knew (that I didn’t at the time) was that he was preparing me for discouraging times in my life. This was a part of his legacy as a dad, and he was laying the groundwork for doing his best to impart positivity and hope into my character…whatever may come! Not everyone has this kind of person in their lives, but many of us can be our own encouragers through positive self-talk, thoughts, prayers, and by being encouraging to others.
There’s no magical solution for encouragement – you start by taking a situation that you’re going through, and start dissecting it. By asking yourself “how bad is this, really?”, you start to see things for what they are. If your emotions cloud your outlook, you may give up the fight, or just become tired of working to keep things positive. Let’s face it – brain injuries of any kind are no “walk in the park.” For many, progress is slow, or even elusive. Finding some redeeming things in your life is the first step to realizing that there are also things to be thankful for, despite any other negative issues that have placed you in this “new normal”.
Let’s take a look at some ways that can be encouraging for you, a person that you may take care of (as a caregiver), or maybe just to encourage a loved one or spouse. Remember that every TBI is different, as well as every personality…there are no two situations that are exactly the same. The goal is to paint with a broad brush, and point to ways of encouragement that most likely will apply to most TBI survivors, and the challenge to you is to apply them appropriately to your situation! It’s never a “cut and dried’ kind of thing when you’re dealing with TBI, and unfortunately, there will be suggestions here that will absolutely not apply to some survivors at all. With that said, let’s plod ahead, and plot our path toward being more encouraged…or being more encouraging to someone else. Let’s find some inspiration!
Negativity can easily creep in, when there’s not enough progress after a TBI. Negative attitudes can be the norm, as people wear down when they’re dealing with pain, loss, stress, impulsive behavior, lack of motivation, poor self-awareness, and their overall recovery. For a caregiver, spouse, or family member, you can reinforce positive behavior on their part by maintaining your patience with them…stopping negative behavior by modeling patience and good behavior can be tough to maintain, but it can pay off by easing the overall household stress level. If you’re on working toward increasing positivity on your own (as a survivor), one of the main things to keep in mind is that change will be incremental. Implementing total change in one fell swoop is a daunting task, and will most likely lead to failure…and more negativity. Small steps toward your goal will not only give you confidence that positive change is occurring, but others will see it as well…you’ll know that you’re making progress, and others will reinforce that by seeing it as well. Change begins with you. That’s encouraging!
Finding joy in small things can be a stepping stone to other “wins” in your journey toward a more positive outlook after TBI. Let’s say, for example, that you’re having a hard time using a TV remote – the channel select button is hard to press when you’re holding the remote. Finding a workaround sounds simple enough, and if it can reduce your stress…then try doing something differently. In this case, maybe holding the remote with both hands. The point is that trying different ways to approach everyday (small) issues can build confidence and positivity. It will give you insight into building up to working on larger items on your list that you’d like to conquer…it’s always going to be one step at a time!
When feeling irritable or stressed out (which can be a huge problem after a TBI), strive to remember that lashing out at others creates more of the same. Keep in mind that your challenges don’t have to define you as a person…sure there are issues to deal with every day, and some are huge. Pain, mental clarity, uncontrollable emotions – they all come into play, but awareness of negative thoughts that are brought on by these things can be the first step toward minimizing how you react to them – which brings more self-control. When you feel that you’re managing your actions, despite how you’re feeling (not an easy thing) – you’re going to become a more positive person, and you’ll start working your way in the “the zone” of actually being more encouraged by taking positive actions on your own. When you own your behavior, you’ll learn to control it, albeit incrementally. That’s finding a more positive you through self-change, and impacting your surroundings with behaviors that breed more positivity (from family, friends, etc.). It’s a synergy that breeds encouragement for all involved.
• When it comes to caregivers, spouses, family or friends – consequences of bad behavior from a TBI survivor will sometimes be met with more bad behavior. Negativity breeds more of the same. Outbursts from a TBI survivor, for instance, that are met with an outburst in reply, can be the rocket fuel that makes everything spin out of control very fast. As a person in the life of a survivor, you have to remember everything that the survivor is experiencing is very difficult, and weigh your responses accordingly. Sure, you can reply firmly when a behavior is totally inappropriate, offensive or even dangerous to themselves (or others), but the goal of bringing them to a point of having a more positive outlook is going to require patience from you, as well as them.
Here is a short, but excellent checklist of tips for caregivers (excerpted from Caregiving After Brain Injury, A Survivor Guide (By Carolyn Rocchio)
Tips on managing caregiving…
✓ Model behaviors you want to see.
✓ Reinforce behaviors you want to see increase.
✓ Structure the environment and use cues for positive behaviors.
✓ Plan rest periods.
✓ Ignore behaviors you want to decrease when safety is not an issue.
✓ Avoid situations that provoke behaviors you are trying to reduce.
✓ Redirect rather than challenge the person.
✓ Seek professional help sooner rather than later.
Caregiving requires lots of patience and understanding. It is normal to have many feelings of resentment, sadness, and grief over the loss of the person you knew and loved before the injury. It is not always easy to learn to love this new and different person. With time, strength and endurance, most caregivers find comfort in knowing their job is improving the life of their family member with a brain injury.
In closing, survivors of TBI have negative and positive options to approaching their recovery, and rebuilding a life is a “do it yourself project” for the most part – all other players in their lives can give care, encouragement, and as much help as possible, but in the end the survivor will determine their path to recovery (and it will depend on their outlook and overall cognition). By not focusing on the past, and living in the present (in their “new normal”), TBI survivors have a shot at making a new and satisfying life. Not necessarily the life they had before, but through encouragement and work, they can at least find as much contentment as possible. As my dad always said: don’t get discouraged. A simple, but clear statement of encouragement that can carry you through the rest of your life. Own it!