This is part 3 of a series on holiday adjustments. As mentioned in parts 1 and 2, brain injury deficits may impact the ability for a brain injury survivor to participate as in previous years in holiday celebrations so adjustments may need to be made for the survivor to have a successful holiday. Part 3 will focus on issues regarding social interactions and attention during holiday celebrations.
Our social skills are at the heart of what it means to be a connected person in our society and holiday celebrations tend to be key social situations. Thus, holiday celebrations can be tricky for brain injury survivors to negotiate. In many cases, holiday celebrations are the first time that friends and family members have seen the survivor since his/her injury. In other cases, holiday celebrations are the first time that friends and family members have seen the survivor since he/she was in the intensive care unit of the hospital since people are most likely to visit in the initial period following the injury. Often, holiday celebrations have dual areas of stress for a brain injury survivor. The survivor is learning how to negotiate life with new deficits while family and friends are trying to spend extra time or give extra attention to the survivor.
Near death experiences catch our interest and spark our concern. As such, friends and family often give survivors far more time and attention than previous holiday celebrations. After a brain injury, many survivors are surprised that they are now the most popular person in the room. Each family member comes by and asks what happened, how are they doing, how is therapy, etc. Even one family member was standing right behind another family member who just asked these questions, the second family member may have the exact same questions as the first. These queries are generally made with the best of intentions. Family and friends want to show their concern and caring for their injured loved ones. However, many survivors find this to be a frustrating and annoying experience. For survivors, it is important to know that some version of this experience will occur at the holidays, particularly if many people have not seen the survivors since the initial injury and to remember that this is a reflection of caring. Family and friends are often searching for a way to show their feelings to the survivor. Having a good brushoff line can often be helpful (For example: “Thank you for asking about my health. I appreciate the questions but it seems like that is all I have been talking about lately. Can we talk about something else?”) Family and friends need to remember that constant questions can be stressful. If the questioning goes well, the questions can be experienced like an interview. If it goes poorly, like a police interrogation. They should consider talking about other issues as, such as the Thanksgiving football games or favorite music. Some survivors and/or their families will send an e-mail or some similar communication updating everyone on the latest information and requesting that brain injury questions be kept to a minimum.
A more positive aspect of this extra attention is that brain injury survivors may find that they receive more phone calls, cards and gifts at holiday times than previously. Sometimes these come from people who are not close to the survivor but are more distantly acquainted with the situation, such as a congregant at a family member’s church. Again, though this may feel weird it still represents someone trying to reach out and show that he/she cares.
Changes in social skills can create big hurdles in social interactions at holidays. Survivors and their families must keep in mind potential problems due to changes in social skills. For survivors with difficulties that impact social skills, it is important that friends and family members at holiday parties know the best ways to interact with the survivor. For survivors with language difficulties, this may include giving extra time for the survivor to speak, having the conversation partner slow their rate of speech, writing important words down for the survivor, pantomiming words or having the survivor use an augmentative communication device such as a speech program on an Ipad. For survivors with impulsivity issues, family and friends may need to cue them to slow down and maintain the topic of conversation instead of going on tangents. For survivors that have difficulty with nonverbal skills such as making eye contact or reading social situations accurately, family and friends may need to cue them for proper nonverbal skills such as looking at the conversation partner’s face while speaking. For survivors with inappropriate behaviors, family and friends may need to cue them for issues such as cursing and sexual jokes. It is important in all cases that family and friends who will be interacting with the survivor be given adequate information to best help the survivor succeed in their social interactions. This can be via e-mail, phone call or personal discussion. If a family or friend is caught unawares of social deficits, this can lead to a strain in relations. For instance if a survivor’s friend does not know that the formerly soft-spoken survivor now needs help to reduce foul language, the foul language may be taken as a personal insult rather than a function of the injury.
Survivors and their families should also consider whether the survivor will do better in a smaller holiday celebration rather than a larger one. Some survivors find that larger parties lead to more stress, agitation and/or social errors. Also, the noise and activity of larger parties can become overwhelming for some survivors. Certain survivors find that young children, with their noise and activity, can be quite problematic. Further, some survivors would rather have a small celebration, especially in the early stages of recovery when they are not yet comfortable with their injury in public. They may feel embarrassed by their deficits and would rather not have large number of individuals learn about the depth of their struggles.
It is often helpful for survivors, families and their therapists to try to problem-solve potential pitfalls and practice skills such as how best to talk to others about their injury experience.
Hopefully, this post provided insight on holiday adjustments due to attention and social interaction issues.
Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org