Tag Archives: survivor

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/

 

How Can I Support A Caregiver?

As modern medicine improves and our population ages, more individuals are able to live longer with serious health issues including permanent deficits resulting from a brain injury.  This notable demographic shift places more loved ones in the position of serving as long-term caregivers.  These caregivers need all available support from those around them but many of those capable of offering assistance are simply unaware of how best to help.  Here are a few quick suggestions on how to support caregivers:

1.     Call them and ask how you can help.  Caregivers may feel shy or embarrassed to initiate requests for help but are often far more receptive to assistance if it is offered.   This gives caregivers opportunity to request specific aspects of help most needed at a given juncture, and they will certainly be grateful for all help shared.

2.    Offer to have the caregiver and survivor over for a meal or to deliver a meal to them.  With all of the responsibilities that caregivers meet on a daily basis, having someone else take care of even a single meal can be a source of welcome relief.

3.    Be there to listen.  Many caregivers feel overwhelmed by their experiences.  A friendly phone call or visit with a supportive ear helps relieve some of this emotional burden.  Knowing that others care about their well-being is very important for caregivers in maintaining their own emotional health.

4.    Be a friend to the survivor.  After their injuries, many survivors find that their social circles quickly shrink.  Some caregivers can find themselves serving as the only social outlet for the survivors in their lives.  This can be a source of tremendous additional stress in the life of a caregiver.  Being a part of the survivor’s social circle reduces the need for the caregiver to fill all of these social roles.  Moreover, the survivor is sure to appreciate this as well!

5.    Offer to spend time with the survivor so the caregiver can spend a little time tending to his or her own needs.  As a result of devotion to meeting needs of a survivor, it’s all to easy for caregivers to end up neglecting their own.  A few brief hours just to cover an unhurried trip to the grocery store, hair salon or doctor’s office (or simply to enjoy a quiet cup of coffee on their own) can do wonders for a caregiver’s quality of life.

6.    Take a moment out of your day to send a card, e-mail or flowers.  Sometimes we don’t have a lot of time to spare for lengthy calls or visits but a quick note to say “hello” tells the caregiver that they are not forgotten.

Hopefully this list will give you ideas to start reaching out and supporting caregivers!

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

Life, Brain Injury and Repairing with Gold

There is a fascinating art form originating from Japan called “kintsugi” (a name formed from the Japanese root words meaning “golden” and “joining”).  In this form of art, broken pottery is repaired by using lacquer mixed with gold, silver or platinum.  Rather than being hidden, these cracks are instead highlighted, enhanced and made to reveal an entirely separate and distinct beauty.  Kintsugi is connected to the philosophy of “wabi-sabi” which means “finding beauty in broken or old things”.  This is not really a philosophy of items but a deeper spiritual concept informing a healthy approach to the world around us.

This idea of making the cracks more beautiful rather than trying to hide the break is an amazing metaphor for post-injury growth.  Survivors should not feel the need to hide or be embarrassed by their injuries.  Survivors never asked to have brain injuries, the events simply happened.  But there is a great deal of opportunity to use an injury and the rehabilitation process to take beautiful steps forward in life.  Some TLC patients have taken their experiences and used them to educate others about brain injuries.  Rather than shying away, they put themselves out front and center so as to benefit others in a powerful way that typical rehabilitation professionals do not have access to.  These survivors can speak from the authority conferred by actually having lived through the injury experience, lending their words an innate credibility that similar statements from health care and rehabilitation professionals can sometimes lack.  Other TLC patients have used their injuries as impetus to reach out to family and rekindle strained relationships.  Relatives who had not spoken for years were able to be reunited through response to these injuries.  Still other TLC patients have used their injuries to take their lives in healthier directions, such as returning to school, getting better jobs or cultivating sobriety.  Each of these steps forward is a way of taking the breaks in life created by brain injuries and repairing them with a “golden joining”, so that the survivors engage the world in an undeniably changed but potentially more beautiful and impactful way than before those changes wrought by their injuries.

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

 

Utilizing Music For Mood

Music has the amazing power to touch our hearts and souls.  The right song at the right time can move us in powerful ways, eliciting emotions ranging from brightest joy to deepest sorrow.  Harnessing the power of music can also help brain injury survivors (along with the rest of us) make it through their days more successfully.

It is a common sight at a gym to see the majority of participants working out with music in the background to help keep them motivated and driven.  This music tends to be upbeat and intense.  This workout music highlights the ability of music to boost our performance.  Survivors may want to consider using similar energetic background music while they are working out, whether in a gym or in therapy, to help them when they might be feeling low in energy.  However, it is important to ensure that the music does not distract the survivor.  An example of this pitfall to be avoided can be observed in a survivor suffering from substantial deficits in the arena of attention.  A catchy song could cause this survivor to sing along and devote a disastrous lack of attention to foot placement while practicing walking.  Finding the balance (whenever possible) between drive and distraction is important.  Energetic music may also help mitigate general fatigue that can occur at any part of the day.

Music has the ability to lift us when we feel down.  Following a brain injury, many survivors will display acute symptoms of depression or at the very least be significantly (if understandably) sad about their situations.  Survivors should identify songs that lift their moods and listen to that music when they find themselves feeling low.  These songs often tend to incorporate themes of hope and joy.  Religious music is also a very popular and effective source of this helpful form of mood modulation.

Many survivors also face serious difficulties with stress and anger.  Certain music can help individuals to relax and stay calm.  Soft, classical music tends to be popular to ease stress and anger though other types of music can do this as well.  Some individuals prefer listening to sounds of nature (such as waves lapping upon a beach) to reach a more calm state.  Meditation music is a hot market and there is a huge amount of excellent music available both in stores and online.

Not every song will help with every mood and sometimes the music that is most helpful may not be the survivor’s favorite song or from a favorite band.  What is most important is that the music in question leads to the emotional experience that the survivor would like to cultivate.  Technology has advanced exponentially over the last few years, and survivors should take full advantage.  A survivor can keep a playlist of songs to help influence his or her emotions on a smartphone, Ipod or other similar device that can then be accessed throughout the day.  Remember that music can be an important part of any recovery process!

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

 

 

 

It’s Ok To Do It Differently

When I was a senior in high school, I had a physics teacher whose outlook differed from that of most science teachers.  Early in the year she told us that when we answered questions on her tests, she did not care about how we came to a given answer.  As long as that answer was correct, the method by which it was arrived upon did not matter.  Work did still have to be shown as in any other science class.  Even if that work bore no resemblance to that which she had prescribed though, a result was perfectly acceptable provided that the answers matched.

In many ways a healthy approach to rehabilitation is similar to this outlook championed by my former physics teacher.  Due to their injuries, rehabilitation patients are often unable to complete tasks in the same manner as they did before.  For instance, a patient with only one functioning hand will not be able to cut vegetables for a salad as he or she did prior to the injury but utilizing a one-handed rocker knife produces the same results.  A patient who has trouble speaking may not be able to verbally place an order at a restaurant but typing the order into an Ipad speech app produces the same results.  As you can see, there are often multiple methods by which to accomplish a given goal.  Effectiveness is the most important measure of a method’s worth, not whether it is identical to a previous method.

The idea of reaching the same goal through different methods sometimes bothers patients and their families.  In some cases, patients and their families refuse to use alternative methods because they are focused on doing things in exactly the same way as they have in the past.  A patient completing minor tasks just as he or she did prior to an injury holds strong appeal as a signifier of a return to normalcy.  However, due to the injuries this may not be realistic either at this stage of rehabilitation or for the foreseeable future.  Accepting alternative methods consistently allows patients to be far more functional in both work and home environments.  These alternative methods often allow patients to be more independent whereas insistence upon pre-injury methods can  bring with it a dependence on others.  It is important that patients and their families embrace alternative methods of accomplishing daily goals so that patients can achieve at their highest levels.  This open-minded attitude often yields the best long-term therapy results.

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

Quick Points on Wheelchair Safety in Parking Lots

Following their injuries, many brain injury survivors are left depending upon wheelchairs to meet basic mobility needs.  This change in mobility creates new safety considerations that must be taken into account on a daily basis.  One of these considerations surrounds strategies for safely navigating a parking lot while in a wheelchair.

Most adults are between 5 and 6.5 feet tall.  They are accustomed to being easily visible to drivers distractedly circling a parking lot and through rear windshields as drivers back up vehicles out of parking spaces.  When sitting in a wheelchair though, normal adults are often effectively no taller than  young children.  Even the most conscientious driver can struggle while exiting a parking space to see a pedestrian in a wheelchair.  These survivors are also often harder to see by a driver making the turn from one parking lot lane on to another.  Due to this change in baseline visibility, survivors in wheelchairs and their families must be more vigilant of vehicle activity and the abilities at every identifiable moment of drivers to see the survivors.  They must spend more time looking around to observe vehicle activity, just as they would when in the presence of a small child who may slip the notice of nearby drivers.

Another issue regarding parking lot safety is that survivors in wheelchairs are generally slower than the average person would be while moving across the same parking lot.  Since it takes more time to traverse any distance, survivors and their families must add extra time in their calculations as to whether there might be enough time to safely cross in front of an approaching vehicle.   If the result of such calculations inspire even the suggestion of doubt, erring on the side of patience is always the best policy.  Sometimes, family and friends may need to push the survivors’ wheelchairs to help move quickly enough to safely avoid traffic.  Additionally, typical adults generally can step up onto the curb from the parking lot at any location they choose.  Survivors in wheelchairs must use curb cut ramps which often means that they have to take a longer route to get onto the curb and consequently spend more time in the path of vehicles.  Again, survivors and their families must be aware of this additional urgency when choosing a path across any parking lot.

These are just a few quick points on wheelchair safety in the parking lot.  I hope everyone has a safe time in their travels, particularly in parking lots!

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

 

Why Are We “Suddenly” Hearing About Brain Injuries

Brain injuries are a hot topic in today’s media.  Whether it be football players with lasting damage due to concussions, soldiers suffering from brain injuries due to overseas conflicts or the latest youth sports concussion protocols, it seems that there are suddenly many news stories on brain injury that simply were not around just five or ten years ago.  Some individuals may be cynical and wonder whether brain injuries are simply the “diagnosis of the moment”, one of the many diagnoses that are suddenly “hot” but will disappear over time.  To those individuals, I would like to offer several rational reasons why brain injury stories have become more prominent over the last few years.

First, many people are now living with brain injuries who would have died from their injuries in previous eras.  The medical world has advanced significantly over the years and now doctors are able to save the lives of people who would have otherwise died. However, just because their lives were saved does not mean they emerged from their health emergency unscathed.  These survivors often have brain injuries which require treatment.  Please allow me to give an example of this change over time.  I once was talking over lunch with an older rabbi about Transitional Learning Center.  He relayed a story about his time at a synagogue many decades ago in Indiana.  A young man in his community had a serious motorcycle accident and as his rabbi, he visited the young man in the hospital.  After conversing for a while and finishing his visit, the rabbi exited the room.  As he left, the doctor pulled him aside and said “You know he will be dead in three days”.  The rabbi was shocked, having just had a full conversation with the young man.  But the doctor was correct.  The hospital had no means to manage his brain injury.  Due to either brain swelling, bleeding or both (the rabbi did not know the details), the young man passed three days later.  Today, a person with a similar motorcycle accident would have a surgery and other potential procedures to manage his injury and would stand a good chance of living, albeit with a brain injury.  Similarly, improvements in military field medicine are allowing many soldiers to survive blasts and other dangers that would have killed them in previous battles.  Thankfully, these soldiers still have their lives, but often struggle with long-lasting brain injuries suffered in their military service.

Second, it is important to acknowledge the active suppression of information regarding brain injuries in certain circles that is only recently coming to light.  Most famously, the NFL actively denied and hid data on the long-term brain injury effects of concussions to former football players.  Through a series of lawsuits, the NFL opened up about brain injuries and is now acknowledging the long-term injuries that many former players have suffered.  This has led to a complex $1 billion settlement for players with long-term effects of brain injuries.  Following these court cases, many other lawsuits have been filed against other professional and amateur sports, leading to further agreements and new safety protocols.  The suppression in the past contributed to an artificial perception that brain injuries were less common than they actually were.

Third, we are in an age of information so it is much easier to learn about what is happening to people across the country, and even across the world.  Just think about how often you hear or read stories about a robbery or kidnapping occurring hundreds of miles from where you live.  Until the age of the internet, most of those stories would be confined to local media.  Now, stories can go “viral” and suddenly everyone knows the details.  This phenomenon is equally true in the realm of brain injuries.  A simple keyword search of “brain injury” will bring up a plethora of local stories that prior to the age of the internet would have been hidden from most of the world.  These local stories existed in the past but only now d0 we have so much access to them.

Fourth, we are now having a more honest conversation about brain injuries.  In the past, people generally did not talk about brain injuries.  Athletes and soldiers rarely mentioned their deficits due to fear of sounding “weak”.  Individuals with brain injury deficits from car accidents, strokes or other methods were often afraid of negative views and discrimination if others knew about their deficits.  We are now coming to an age of sharing without fear.  It may be hard to believe but the Americans With Disabilities Act (ADA), the civil rights legislation that has allowed for a greater involvement of people with disabilities in the workplace without fear of discrimination, was only passed in 1990.  In comparison, the Civil Rights Act, which blocked discrimination due to issues such as race, gender, and religion, was passed in 1964.

Fifth, we are much more able to diagnose and treat brain injuries than in the past.  Technology such as MRI and CT exams to scan the brain and locate injuries are relatively new.  Moreover until fairly recently many people, even health professionals, did not even know the right questions to ask to identify a potential brain injury.  For instance, if a high school athlete is concussed in a game today, the coach and athletic trainer often have a protocol to follow to ensure proper health management.  Twenty years ago, the player would likely have been just given smelling salts, asked if he or she felt “okay” and sent back into the game.  In fact, many states now have mandatory concussion training for coaches and athletic trainers.  This was unheard of just a few years ago.  In the past, people with brain injuries were forced to suffer in the silence of unrecognized deficits.  Now, these brain injuries and their concomitant deficits are more likely to be accurately diagnosed.

Overall, there are many rational reasons why we are “suddenly” hearing about brain injuries in the media, despite these injuries having been an issue in the past.

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

 

 

Just Be Grateful

“Just be grateful you are alive”

“Just be thankful you didn’t die”

“You should just focus on the fact you survived”

Brain injury survivors hear these types of well-meaning lines all the time.  They are used by family members and friends to help survivors see the “brighter side” during their recovery periods.  There is undeniable truth in each one of these statements; traumatic brain injuries, strokes and other forms of acquired brain injuries lead to death for millions of people worldwide every year.  It is worthwhile to be thankful for life.  But these well-intentioned statements can all too often serve as double-edged swords.

Taking a step back for a moment, most survivors are truly thankful to be alive following their near-death experiences.  But that does not mean that they have not suffered real, painful losses.  While one may feel the commendable impulse to encourage and support survivors, it is also important to allow them to mourn these losses.  There is nothing inherently wrong with lamenting loss of arm function or fluid speech, as long as this does not lead to a serious decline in mood or performance.  For instance, wouldn’t any person be upset if, after decades of normal walking, he or she would have to suddenly learn how to walk all over again because of a stroke?  A balance has to be struck between fostering positive mood and allowing for reasonable mourning of loss.  “Just be grateful you are alive” is clearly not an inherently harmful statement, but it can still nonetheless be overused and thus inhibit healthy adjustment to change.  Excessive  repetition of such a statement can often cause survivors to be frustrated and feel as if they are being discouraged from expressing their feelings.  Though it may be difficult for family members or friends to witness as survivors experience sadness or anger, this is often one of the steps necessary while making a successful transition into post-injury life.

 

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

 

Give Yourself Permission

Brain injury survivors and their loved ones often try to approach life after an injury as if it is a fight.  Battle hard, stay strong and never let your enemy see your weaknesses.  But in truth, though there are some similarities in this analogy that are appropriate, life after an injury is not an actual fight.  In fact, by treating it as a real fight survivors and their loved ones can sometimes hurt themselves by not allowing themselves to feel and process certain emotions in a healthy manner.  By not processing emotions, individuals may allow these emotions to fester inside and come out at the wrong time or in the wrong situation.  Not processing emotions can lead to difficulties such as depression, anxiety and relationship stress.  I would like to encourage you to give yourself permission to feel these emotions.

Give yourself permission to get angry at the injury.  It truly is a frustrating and unpleasant experience.

Give yourself permission to cry.  There is no weakness in crying.  This is an appropriate reaction to a painful situation.

Give yourself permission to mourn.  There may be parts of you from the past that will no longer be part of your post-injury future.  It is okay to mourn their passing.

Give yourself permission to laugh.  Laugh at the moments of oddity.  Laughter, in measured amounts, is a reasonable coping technique during times of distress.

Most of all, give yourself permission to experience and value the full range of your emotions.  After all, our emotions are important aspects of who we are as people.  They are a central part of simply being human.  So please give yourself permission to be the complete person that you are, despite your injury.

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

 

 

 

 

Doing It Best

Jahvid Best appeared to be on the road to football stardom.  Drafted in the first round by the Detroit Lions, Best possessed blazing speed that was the envy of other running backs.  Unfortunately, his professional football career met a premature end during it’s second year due to the effects of concussions.  Best put forth great effort to get back into the NFL but ultimately doctors ruled against his return.  For many people, this would be the end of the story.  For Jahvid Best though it was the start of something new.

One of the key tasks that brain injury survivors must navigate is assessing their retained abilities so as to identify what they can still do best in spite of their injuries.  Best understood that though his body was not ready to be tackled by 300 lb linemen, he still had his speed.  Best worked tirelessly at his skills on the track.  The hard word paid off.  Best qualified for the 2016 Olympics in Rio, where he will be representing the island nation of St. Lucia.  Best demonstrated how to thrive and succeed in spite of an injury!  Though he was not a TLC patient, we certainly think he is a true hero for the brain injury community.  Identifying a survivor’s skills and choosing activities that match those skills is a key part of the rehabilitation process.  For more reading on Jahvid Best’s journey, click on the link below:

 

http://olympics.nbcsports.com/2016/07/16/jahvid-best-olympics-detroit-lions-nfl-football-track-and-field-st-lucia/

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