Tag Archives: focus

Give Me Your Best 40%

Good days, bad days.  Everyone has them.  No one minds the good days, but those bad days can be such headaches.  Maybe you didn’t sleep well the previous night.  Perhaps your children were sick and were thoughtful enough to pass their germs on to you.  Those bad days pose a regular struggle that we can only push through.  However, sometimes bad days have potential to knock traumatic brain injury and stroke survivors to emotional low points markedly lower than anything experienced in their lives prior to the injury experience.

Often, patients will apologize to their therapists when they are having bad days, even though they would not feel the need to do so when going through a similar bad day at a job in their pre-injury lives.  In reality, no apology is truly necessary.  Having good days and bad days is not only a natural part of life, but is just as natural a component of the journey to recovery.  The progress of a healthy recovery can usually be observed to resemble that of a healthy stock market.  We can track plenty of ups and downs, but a general upward trend is just as persistently evident.

On rare occasions, a patient may ask a therapist if he or she can skip a session because he or she is having a bad day.  Unless the patient is deemed unable to participate in therapy by a facility nurse or doctor, the patient will be strongly encouraged to engage in therapy.  This can be a bit confusing for patients.  After all, why shouldn’t they be able to skip rehabilitation when having a particularly bad day?  I will explain some of the logic involved in having patients stay in therapy even on those bad days.

First, as stated earlier, bad days are a natural part of life.  Therapists know that on some days a patient will simply be unable to contribute that normal 100% effort.  This is fine.  Advances in therapy can be made even on bad days.  A therapist will always take a patient’s best effort, whether it be that patient’s best 80%, best 60% or even a 40% effort.  Every step forward in rehabilitation is a step in the right direction.  Second, it is important to remember that every activity in rehabilitation is aimed at facilitating success following discharge.  At home, just like in rehabilitation, there will be good and bad days.  Survivors need to be just as prepared to handle bad days at home as they are to handle the good ones.  For example, a patient may not want to work on hand skills necessary to use adaptive flatware on a bad day.  But what is that patient going to do when he or she is hungry at home on a bad day?  Will the patient not eat because he or she is having a bad day?  Good day or bad day, the same skills will be used to succeed at home and therefore they need to be practiced both on good days and bad days in therapy.

So don’t worry about having a bad day.  Just give therapy your best effort, even if on that day your best effort is only 40%!

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

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Tips for Improving Attention

Attention is an important skill. It plays an integral role in almost everything we do. Attention is vital when we engage in daily activities such as paying bills, driving a car and safely walking through a busy parking lot. After a brain injury, many survivors notice significant challenges in the realm of attention.  Their attention spans may be much shorter, they may find themselves now to be far more easily distracted than they once were, and multitasking may no longer be in any real way feasible. Here are a few tips to help improve attention:

1.  Find a quiet location to work on activities. The more quiet the surroundings, the less likely distraction is to present as a significant factor while completing those activities.

2.  Remove all distracting items such as cell phones, Ipads and radios while involved in activities.  One should also silence ringer/alarms on phones and watches.

3.  Let other people in the vicinity know that silence is needed when working on an activity so as to minimize likely instances of disruption.  Often, a “Do Not Disturb” sign works well to notify others to be quieter.

4.  Break down activities into smaller, simpler tasks. It is much easier to pay attention to smaller, simpler tasks than it is to contend with larger, more complex activities.

5.  Do one activity at a time.  All people, whether they have a brain injury or not, are better at focusing on a task if they tackle just one activity at a time rather than make an attempt to multitask.

6.  Organize activities before starting them. It is far easier to focus on organized activities than it is to grapple with disorganized ones.  Good organization also provides a road map for how one can most successfully approach a task.

7.  Schedule regular breaks during activities. Most people can only pay attention effectively for a limited period of time until they need a rest and that already limited period may be significantly diminished following a brain injury.

8.  Set up a reward to accompany completion of an activity so as to help with motivation and focus.  For instance,  watching a favorite movie or eating a favorite snack could be arranged as a reward to be enjoyed upon conclusion of a task.

9.  Make sure to eat well, stay hydrated and get plenty of rest. If a body is not functioning at its top level, attention skills will often be the first cognitive skills to suffer.  Many brain injury survivors find that strictly adhering to a well-considered health regimen is far more important to success after an injury than it was before.

10.  Ask people to speak slowly or repeat themselves if paying attention when they are speaking proves difficult.  People get far more upset if their audience misses what they are saying than if they have to repeat themselves in order to ensure that they are fully understood.

11.  If in a group of people, be sure to stay facing the person who is speaking.  If there are too many people around to effectively attend to, ask the person speaking if he or she could step away from the group to make focus more attainable.

12.  If in a classroom or meeting, make sure to sit in the front of the room so as to be closer to the speaker.  This not only removes as a factor distracting people and noise along the pathway to the speaker, but it also demonstrates interest in what the speaker has to say.

13.  Place a fan or a white noise machine by doors to help eliminate distracting noise coming from the outside of rooms.

14.  Place a bright colored piece of paper under a book being read.  This helps the eyes to stay focused on the book instead of on outside distractors since our eyes are naturally attracted to the bright color. Also, one can place a brightly colored ruler, index card or piece of paper under the line being read so as to help keep eyes focused on that line.

Hopefully this provided a few ideas on how to help improve attention!

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

Focusing on the Positive – Part 2

Brain injury survivor Michael Segal often tells a funny story about his injury.  As a teenager, Michael Segal had been shot in the head.  Years later, he was married and had a daughter.  One day he took his young daughter to a local amusement park.  They waited on the hot, sweaty summer day in line for a ride and after 45 minutes they finally made it to the front of the line.  The ride attendant then noticed Michael’s walking difficulties.  The attendant told him that the amusement park has a policy that individuals with disabilities do not have to wait in lines and get to ride twice.  He didn’t think too much of it but his little daughter looked at him and told him how glad she was that he was shot!  According to Michael, she taught him a lesson that day.  Namely, a person should keep a positive attitude.

Although the injury experience is hard, there are often some positive aspects to the resultant circumstance.  It is well worth a patient’s time to identify these positives.  Making a written list is the best way to avoid positives being forgotten later.  Here are some examples of such positives given by Transitional Learning Center patients:

Learned that my family truly loved me

Found out that my friends will stick by my side through anything

Get to use handicapped parking stickers and have the best parking at the store

The injury gave me time to review my life goals

The hospital found other health problems that I was unaware of and now I can get those problems treated

Lots of people willing to open doors for me

Able to receive accommodations to better succeed in the classroom

Can now be a role model to others in recovery

Decided to become sober

Get to use the elevator instead of the escalator at the stadium and avoid all of the   lines

Here is a link to a promotional video in which Michael Segal talks about his injury, including the aforementioned story:

http://www.youtube.com/watch?v=hNeRqpaoNpQ

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

Focusing on the Positive – Part 1

All people are inherently programmed to notice and immediately form lasting and indelible memories from having negative experiences more so than they will from having positive experiences.  For instance, if someone cuts you off in traffic, you are more likely to remember that event than if someone allowed you to merge into traffic.

Generally, our lives are filled with considerably more positive than negative events so our moods tend to be good.  However,  a brain injury invariably brings about a noticeable increase in the number of negative events in a survivor’s life.  These negative events can include such things as the loss of a job, physical pain or a decline in mobility.  As the ratio of positive to negative events shifts, many survivors see a decline in their emotional well-being.

One of the methods that can help improve mood is to deliberately focus on positive events.  A simple way of accomplishing this is by writing down at least five positive things that happened during the day.  This should be done on a daily basis.

Positive events do not have to be large accomplishments such as walking for the first time post-injury.  They can be (and usually are)  smaller events such as having a nice conversation with a spouse or working hard in speech therapy.  Moreover, if the same positive events happen each day, they can be written down each day.  You do not want to ignore positive events just because they happen regularly. The events should  be documented and kept in a format that can be easily accessed and reviewed.  A clear and concise diary-style list is suggested, and survivors with visual deficits may benefit from making a voice recording of events.  This activity should not be done only in one’s head.  When we leave the positive events in our head, it is all too easy to forget or discount them.  As such, it is preferable to have them available in a concrete visual or auditory format.

Here are some sample entries of daily positive events:
11/25

1.  Went out to eat for breakfast

2.  Enjoyed reading a book

3.  Transferred from my wheelchair without help

4.  Showered with only 25% assistance

5.  Had a nice conversation with my mother

11/26

1.  Was complimented by my physical therapist for giving great effort

2.  Was able to share my feelings with my counselor

3.  Conducted a cash transaction without assistance

4.  Told a joke that made everyone laugh

5.  My wife served my favorite dish for dinner

11/27

1.  Woke up without needing my alarm clock

2.  Followed my daily schedule without errors

3.  Received a card from a friend

4.  Found out that I gained 5% range of movement in my right arm

5.  Finished reading my book

By doing this activity every day, it is easier to notice and focus on positive events.  Consequently, many people who engage in this activity experience an improved mood and an expanded appreciation of daily life.

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