Tag Archives: aneurysm

Post Injury Humor

Many brain injury survivors struggle with humor after their injuries.  Survivors who were quite socially skilled prior to their injuries often find that they make jokes which are deemed inappropriate or insulting by others, even though these jokes were made with the best intentions in mind.  These difficulties tend to be accompanied by social skill or interpersonal deficits in other domains.  The following are a list of suggestions to help ensure that jokes are made in the right situations and in the right manner, to minimize the chance of a joke backfiring.

  1. Prior to telling a joke, check to see if it is a good time to tell a joke. For example, if someone is in a good mood and is smiling then it is probably a good time to tell a joke. If someone has just returned from a funeral then it is a poor time to tell a joke.
  1. Pick a topic that you know that your audience will find funny. For instance, if your friends usually joke about traffic, you know that they will probably like a joke about traffic. If your friends usually joke about sports, you know they will probably like a joke about sports.
  1. It is always better to make a joke about a situation than about a person. A person can get insulted even if he/she is not around when you make the joke. After all, someone could always tell the other person the joke later. Situations (traffic, long lines, bad weather) have no emotions so situations cannot get insulted. If you do make a joke about a person, it is always safest to joke about yourself.
  2. Keeps jokes short. The longer the joke, the more possibilities for mistakes to occur and someone to get hurt or offended.
  1. Never make jokes that involve sex or someone’s physical appearance (“you look really beautiful”).  These jokes are tend to be taken badly.
  1. Never make jokes about safety (“someone ran away”), danger (“the car is unsafe”), health (“someone had a heart attack”) or important personal issues (“your friend’s marriage”). These issues are so important that many people are uncomfortable with any jokes about these issues.
  1. Do not embarrass someone else with your joke. The audience who heard the joke may only remember the joke for a minute, but the person who was embarrassed will remember the humiliation for a long time and consequently, may be upset with you for a long time.
  1. Look for nonverbal signs that indicate whether the person found the joke funny or not. For example, if the person is laughing then the joke probably went well. If the person is frowning then it is important to check on how the person received the joke.
  1. If you make an error or upset someone with a joke, remember to apologize. You are the one who said the joke therefore it is your fault. Never make excuses (“You need to have a better sense of humor”). Excuses push the blame on the other person and may make him/her even more upset.

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Free Webinar on Social Security Disability

The Brain Injury Association of America will be hosting a free webinar titled “Understanding Social Security Disability” on Thursday, October 9th at 2 pm CDT.  As many brain injury survivors are unable to work following their injury, whether temporarily or permanently, they often apply for Disability.  The Social Security Disability process can be long and confusing so this webinar is a great opportunity to learn about the rules and expectations of this process.


Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org


It is common for brain injury survivors to become more fatigued, and to become fatigued more easily, after their injury.  For many survivors and their family members, this increase in fatigue comes as a bit of a surprise.  Why am I (or my loved one) exhausted by 6 p.m. when I (or my loved one) used to be active throughout the evening even after a long day of work?

Below are just a few of the reasons why brain injury survivors may be experiencing this greater post-injury fatigue:

1.  Survivors may still healing from the injury.

2.  It takes far more effort to do basic activities, like walking or speaking, than it did pre-injury.

3.  Survivors are often under more stress than before.  This can be the stress of trying to get better or stress from other issues such as financial loss due to losing their job after their injury.

4.  They may be experiencing significant post-injury pain and prolonged pain tends to cause fatigue.

5.  The survivors’ medications may be causing fatigue.

6.  The survivors may not be sleeping as well due to the injury.  Many brain injury survivors experience a change in sleep post-injury.

7.  The survivors may be feeling depressed, anxious or angry, all of which can cause fatigue.

8.  They are still getting used to the “rehab” or “post-injury schedule”, which may be quite different than their pre-injury schedules.  For instance, a night shift worker may find that it takes some time to get used to the daytime hours of rehabilitation.

9.  The greater fatigue may simply be part of the brain injury itself.

Depending on the cause of the fatigue, brain injury professionals may manage the situation in different ways.  For instance, if the issue is due to depression, then the survivor would be encouraged to talk about it with a staff psychotherapist.  If it due to medication, a staff doctor may adjust the medications.  In all cases, patience and understanding go a long way to help the survivor cope with fatigue.

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

CARF Certification

The Commission on Accreditation of Rehabilitation Facilities, also known as CARF, is the primary certification body for brain injury treatment facilities.  CARF assesses the standards and quality of rehabilitation facilities both in the United States and Canada.  The Transitional Learning Center recently went through a site evaluation by CARF and was re-certified for 3 years, the longest period that CARF will certify a facility.  TLC is proud of CARF’s recognition of the excellence of our program!

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Featured in the News!

The Galveston Daily News recently did an in-depth story on Transitional Learning Center therapist Lauren Mitchell’s work on community integration of patients at TLC and Tideway.  Lauren has previously written for this blog about  the purpose and design of a community integration experience.


Below is a link to the article, which is available to subscribers to the Galveston Daily News:


For those who are not subscribers, here is a photo of the article from the front page of the newspaper.




Great job, Lauren!

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org


2014 Forum on Traumatic Brain Injuries

Attention Healthcare and Rehabilitation Professionals!  On September 19, the Transitional Learning Center in Lubbock will be hosting a special conference on traumatic brain injuries with experts covering topics such as managing spasticity, visual impairments and the effects of mild traumatic brain injuries.  This is a unique opportunity to learn from clinical experts from the field of brain injury.  Free CEUs are available for nurses, case managers, social workers and counselors.  Click on the link below for more information on registering for this wonderful event.


Learn about brain injury treatment services at the Transitional Learning Center:


Visual Scanning with Telelphone Books and Circulars

As I have talked about previously in this blog, many brain injury survivors recovering from traumatic brain injuries will experience visual scanning difficulties as a result of those injuries.  This can be due to a direct loss of visual ability (often called a visual field cut) or due to an attentional issue such as left neglect.  One convenient and practical way to work on scanning is for the survivor to practice with a telephone book or supermarket circular.

The idea is pretty straightforward:  the survivor is tasked with locating various items found in the advertisements of the telephone book’s yellow pages or in a supermarket circular.  You’ll want to pick items in a random order so as to prevent the survivor from figuring out where each correct item is without really working on the skills.  For example, if you are using restaurant ads in the yellow pages, you may first have the survivor find the hours of operation from an Arby’s ad in the top left corner, then the address of a Taco Bell advertised on the bottom left of the page, followed by the Domino’s Pizza fax number down at the bottom right. The supermarket circular can be used in the exact same manner.  As example, you could ask the survivor for the cost of the Oscar Meyer bologna in the top right corner of the page, then the size packaging of the Frosted Flakes cereal in the bottom left corner, followed by having the survivor point to the Hebrew National hot dogs back up towards the top right.

You do not want to tell the survivor where on the page each item is located, but allow the survivor to naturally search on his or her own.  All parts of the page, including the center, should be used during this activity.  If the survivor cannot find the material, the survivor (often with the help of a loved one) should be prompted to conduct a slow, organized search for the item in question.  If the survivor has left neglect, such a search should always begin on the left side, using a slow up-down search rather than side to side.  If the survivor has a visual field cut, the search should always begin on whichever side has suffered the cut, again using an up-down search.  If the survivor is missing the right visual field in both eyes, the search should always begin on the right side and if he or she is missing the left visual field in both eyes, the search should always begin on the left. Missing both the right or both the left visual fields is known as homonymous hemianopsia.

There are a few things you want to keep in mind to help this task go smoothly.  You will want to check and ensure that the information can be easily seen by the survivor.  Sometimes the writing in phone books and circulars may be quite small and the survivor may need to use reading glasses or perhaps need only to work with the bigger items on the page.  When working with the yellow pages, it is generally better to pick pages with lots of display ads rather than just listings.  I do not advise using the white pages since the writing is small, placed very close together and is always in an obvious alphabetical order.  Supermarket circulars are generally much better for this task than department store circulars since they will tend to list more items.

Here are a few previous blog posts on home-based visual scanning activities:



Learn about brain injury treatment services at the Transitional Learning Center: