You Should Remember

“You should remember.  I told you this an hour ago!”  “You should remember.  We’ve been talking about this for the past week!”  When a family member or friend speaks in this manner to a brain injury survivor, it is often a sign of annoyance.  They are expressing frustration at the survivor forgetting what was told him or her.  However, the word “should” implies a value judgement.  The survivor “should” remember and if not, he or she failed at something that “should” have been done.

Before family or friends attempt to discuss what a survivor “should” do, the first question that needs to be addressed is whether or not the survivor CAN remember the information in question.  If due to deficits left in the wake of a brain injury survivors are simply not able to remember information, it is unfair to say that they “should” remember.  As an analogy, we would not say to a young child that he or she “should” be able to complete a calculus problem the child has worked on for a week.  We can all recognize that calculus is simply beyond a young child’s skill level.  A “should” statement does not make sense in this situation.  Similarly, we need to ask whether completing a given memory task falls within the brain injured survivor’s skill level.  If the memory task is beyond the survivor’s abilities, clearly the survivor will not remember the information.  In this case, stating that the survivor “should” remember is unfair.

The next logical question is whether anything could be done to further facilitate the survivor’s efforts to improve his or her memory.  Perhaps information needs to be written down on a note so the survivor can check the note later for the information.  Some patients benefit from constant repetition or association techniques to help bolster the memory.  There are many different methods to help memory.  In some cases though, a family member or loved one will just need to remember important information for the survivor if doing so proves truly outside of the range of the survivor’s abilities.

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

Finding Balance

There are many struggles a brain injury survivor faces when rehabilitating from a brain injury.  It is often difficult for the survivor to relearn how to walk or talk and the survivor is generally confronted with new experiences of fatigue, frustration and varying levels of physical pain. These types of struggles are relatively apparent to outside observers.  However, there is one struggle that will often go unnoticed; this is the struggle to find balance between acceptance and change.

Generally, brain injury survivors work diligently to improve their functional proficiencies.  They pour in blood, sweat and tears in the effort to regain abilities and learn new ways of performing tasks.  This is important since there is little success in rehabilitation without substantial effort.  Unfortunately, some brain injury survivors get so caught up in impending improvement that they can view themselves currently as effectively worthless.  They may think,  “As long as I am only 75% better then I am only 75% of a real human.  Until I am 100% better I am just a waste of space.”  This type of thinking  will almost invariably lead to anger, depression and despondency.
Then there is the flip side to the above problem.  Some survivors are so content with the levels at which they currently function that they see no reason to bother trying to get better.  They lose precious opportunities for improvement because they do not see any need to change.  They may think, “I accept myself and I like myself as is, why should I try to do more?”  This type of thinking leads to complacency and lack of motivation and more often than not, to eventual inconsolable regret.
The most effective strategy is to try to achieve a balance of these two approaches.  One of the major emotional challenges of brain injury rehabilitation is for the survivor to be able to fully love his or her self while at the same time still remaining fully committed to the work of rehabilitation.  This is not an easy task and often requires loved ones to help survivors recognize the value of rehabilitation while also never losing sight of  their own intrinsic self-worth.  Achieving a satisfactory balance between acceptance and change is one of the greatest struggles of rehabilitation.

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