Tag Archives: goals

Open Communication

The brain injury experience is a remarkably complex one.  Overnight, so many things change and so many adjustments need to be made.  Throughout this experience, brain injury survivors have goals, concerns and aspirations.  Survivors’ loved ones will have their own goals, concerns and aspirations as well as they come to terms with their own roles in this new and dauntingly complex experience.  These two sets of expectations may or may not fully match up with one another.  Survivors and their loved ones will all try their best to achieve desired outcomes.  Sometimes  differences in respective desired outcomes can lead to conflict.  One of the most common contributing factors to such conflict is poor communication.

Family members, injury or no injury, tend to make assumptions about one another.  In fact, we all engage in some form of attempted “mind reading” in which we guess at what another person is thinking.  For instance, if one person pauses to look at a second person prior to walking through a doorway that second person may “mind read” and think, “The other person is looking at me because he wants me to enter the doorway first.”  There are no actual words spoken in this momentary exchange, only valid assumptions made.  This method will generally work well enough in simple situations, but problems  arise when we engage in such “mind reading” in place of actual open communication regarding more substantial and  important issues.  A simple look or smile does not say “I am hoping that a month or two after discharging from therapy I can return back to working and driving” or “I am worried that my son will want to return to mountain climbing where he could fall and suffer further brain injury”.

A good place to start open communication is with a family meeting explicitly organized to talk through the goals, concerns and aspirations of all involved.  The meeting should be planned in advance and all parties informed of its purpose.  This gives each family member time to organize his or her thoughts about pertinent issues.  Many survivors benefit from writing down a list of topics they’d wish to discuss at this meeting in order to ensure that they don’t forget to raise a given subject.  A meeting of this sort need not necessarily determine the final word on any topic.  In fact, it can be a good idea to state from the start of such a meeting that participants are in no way required to (and may not even be expected to) agree with what others are saying.  Particularly at the first meeting of this sort, it is not important to make decisions regarding the future.  Instead it is more important to open the lines of communication so each person can know what all others are thinking and “mind reading” can be avoided.  Opening the lines of communication in such a formal manner may seem awkward to some, but it helps ensure that the goals, concerns and aspirations of each family member will actually be discussed and addressed rather than being lost in any number of side conversations.  Once these lines of communication are opened and everyone has a chance to freely discuss thoughts and sufficiently convey perspectives, it is much easier in the future to re-visit these topics in a constructive manner.  Open communication will ultimately allow family members to walk hand-in-hand into the future with less conflict.

 

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

 

Advertisements

Setting Goals

When I first meet with brain-injured patients, I ask them to tell me about their goals.  In most cases, the patients will tell me about goals involving work and home.  These goals have to do with the long term,  future hopes of the patient.  These goals make fine targets to aim for but they often miss something important.  In order to accomplish these long term goals, short and intermediate term goals must first be reached.  Short and intermediate term goals are the important building blocks that allow a patient to achieve those hopes and desires.  I often find it useful to perform an exercise with patients in which they set short, intermediate and long term goals.  This is an easy task to do at home but can be quite valuable in assessing reasonable expectations and recognizing steps needed in the pursuit of recovery.

For the task, one simply needs to take a piece of paper and divide it into three sections.  The first section is for short term goals; these are goals that can be achieved within one month.  The second section is for intermediate term goals; these g0als should be attainable within six months.  The third section is for long term goals which the patient should be able to achieve within one year.  Sometimes it is helpful to add a fourth section for goals that can be achieved within three months.

It is generally useful for the patient to complete this task with another person.   This person should be familiar enough with the patient’s circumstance in order to be able to offer guidance in recognizing limitations in the patient’s ability to achieve a given goal within a certain time frame and also to recognize achievable goals that may have been forgotten.  Some family members may also want to complete this task for themselves as it can enhance involvement in the planning of their loved one’s treatment and can offer a better understanding of the likely path of rehabilitation.

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