Holiday Adjustments-Part 2: Participation

This is part 2 of a series on holiday adjustments.  As mentioned in part 1, deficits suffered in the wake of a brain injury may impact brain injury survivors’ ability to participate in holiday celebrations to the degree that they had in previous years so adjustments may need to be made in order to provide a greater likelihood of those survivors enjoying a successful holiday.  Part 2 will be focusing on some thoughts regarding participation in holiday celebrations.
One of the most difficult aspects of having a brain injury at holiday time is changes in the ability to participate in the holiday celebrations.  For instance, a brain injury survivor may have been the main cook for Thanksgiving but can no longer do so due to memory deficits or newly acquired physical disabilities (such as losing use of the entire right side of the body).  This can serve a tremendous blow to the survivor’s self-esteem and pride.  Family members may try to be helpful by telling the survivor to “not worry” and that the family members will “take care of everything.”  Many survivors will appreciate this effort at mitigation, but unfortunately some survivors will receive such an effort as an even further attack to their self-esteem.  If we were to choose a single most important guideline governing brain injury survivors’ participation in holiday festivities, rehabilitation therapists and professionals would encourage brain injury survivors and their families to find tasks contributing to holiday celebrations in which the survivor can fully participate.

 
The first part of identifying holiday tasks that the survivor can participate in is to take a realistic assessment of the survivor’s skills and deficits.  Safety concerns should always be held in priority, but they should not be allowed to unnecessarily overshadow consideration of reasonable options.  If a survivor has ataxia (inability to fully control muscle movement) in his or her arms, the survivor should not be lighting menorah candles for Chanukah.  Similarly, a survivor with balance issues should not be climbing on to the roof of a home to put up Christmas lights.  With this in mind though, a survivor will always have some form of identifiable strengths.  In fact, it is incredibly rare that a survivor would be unable to contribute anything at all to holiday celebrations.  For instance, though a survivor in a wheelchair may not be able to put up all of the decorations on the Christmas tree, he or she may be able to put up the decorations on the lower part of the tree.  A survivor may not be able to be fully responsible for the cooking of a turkey, but perhaps he or she could cut some of the vegetables for a salad or help set the table.  Even if a survivor cannot use his or her arms or legs, perhaps a role can be found such as leading the family in a prayer before eating or giving recipe directions to family members that are cooking.  Survivors with aphasia can sometimes sing, with help, familiar songs as the songs are so familiar that the action of singing them can have become almost automatic.  For example, many aphasic survivors that struggle to name a common item like an apple can sing a holiday tune like “Jingle Bells” or “We Wish You a Merry Christmas” if given extra time and if someone sings with them.  If survivors and their family members look closely enough, there is almost always something the survivor can do or help with.  Even a small task will help boost the survivor’s pride and self-esteem.  Moreover, injury or no injury, working together on holiday celebrations brings family together for a joyful opportunity to bond.

 
Many survivors struggle with the tradition of giving gifts at certain holidays such as Christmas and Chanukah, since they often find themselves contending with greatly worsened financial status in the aftermath of the injury suffered.  They have often lost jobs and can have high medical expenses which dramatically sap their funds.  Many now rely on financial support from family members.  Usually, families and friends understand that the survivor is in a different financial state but the survivor may still feel significant guilt over the inability to purchase gifts as he or she once did.  Simply reassuring a survivor that the family members and friends understand the changes and are not worried about not receiving a gift or are perfectly fine with receiving a smaller gift can help alleviate concerns.   Alternatively, a survivor could always put together a handmade gift or card with the help of a family member as necessary.  Everyone appreciates a homemade gift or card.  Families may choose to switch to a gift exchange in which everyone buys just one gift, places that gift in a bag, and then randomly chooses a gift from those assembled.  One gift is far less costly than multiple gifts.  A limit on the cost of gifts purchased can also be placed so as to further make participation easier and to help make the survivor feel less left out due to costs.  If an effort is put into de-emphasizing the role finances play in holiday celebrations, the survivor is often better able to focus on those more essential and meaningful aspects of the holidays.

 
Another consideration regarding holiday celebration participation is fatigue.  Holiday celebrations often go quite long and brain injury survivors may find that they become fatigued more easily than they did previously.  This is a particularly common issue during New Year’s celebrations.  Survivors who have grown accustomed to staying up until midnight to celebrate the new year may find that they now are exhausted by 8 p.m.  Sometimes, shifting the length of time that the survivors will be attending the celebrations in question can increase opportunity for participation.  Three good hours of participation is better than five hours of exhaustion.  Moreover, some families change the time of the celebrations entirely to make it easier on the survivors.  “Early” New Year’s eve celebrations are relatively common.  After all, it’s midnight somewhere.  Instead of a late Thanksgiving dinner, a survivor’s family might find that a Thanksgiving lunch is more feasible.  Perhaps gift opening can be done prior to a holiday meal rather than after the meal, which would speed up the main parts of the holiday celebration considerably.  These are just a few of the ways in which post-injury fatigue can be better managed at a holiday celebration.

 
Hopefully this post was able to raise awareness of adjustments in participation that can be made in order to increase a brain injury survivor’s enjoyment of the holiday season.  The next part of this series will focus on holiday adjustments that may need be made related to social interactions and attention.

 

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

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