Cognitive outcomes and strategies after brain injury
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Celebrations after brain injury can be tricky. This article is updated and reposted each year before the end of year. Timed for when Christmas, Hannukah, New Year and other celebrations abound. It acknowledges that managing celebrations after brain injury can be difficult. Filled with expectation and anticipation - it does not always deliver on the promise. It would be great to hear from you about your own experiences and strategies. Managing Celebrations after Brain Injury 2015 I do not want to be accused of being the Grinch who stole Christmas, so please let me start by wishing those of you celebrating Christmas a very special time. And for everyone I hope it is a wonderful new year. Why am I in danger of being called the Grinch? Well, in the middle of a major holiday celebration, I am about to suggest that birthdays, anniversaries, Christmas, and celebrations after brain injury do not always go so well together. Expectations can be high and…
Difficulties with organizing, starting things (initiating), putting things in the right order (sequencing), making plans and sorting out priorities are common cognitive outcomes of brain injury, particularly when the frontal lobe is damaged. I recently received a letter asking about strategies for organisation planning and problem solving. How can you organize your own life, and that of your family, when you have trouble with planning and organizing after brain injury. This question inspired this series of articles. Last week Brain Injury Difficulty Problem-Solving and Planning looked at what can happen after brain injury. Today tips and strategies for organisation planning and problem solving that might be useful after brain injury. These functions are what you might see termed as “Executive functions”. (brief explanation near the end in “What Does Cognitive Mean”) All this sounds sort of business talk and that is kind of what executive functions are really – the business end of the brain, figuring things out, making things happen. We…
Most of us at some time have trouble trying to work out how to solve a problem. Or maybe we can’t seem to make a decision, or we make a decision and then think “Why did I ever do that”. Brain injury, particularly when it involves the frontal lobe, such as after trauma, stroke, dementia, tumour, commonly results in similar difficulty with working through a problem, planning, organizing and putting steps in the right order. After brain injury it is different - it might not go away. Today a look at what happens when planning, organization and putting things in the right order are not happening as they should. Next week some strategies that might be helpful to work around planning and organization issues after brain injury. Definitions What is planning? "“Planning” is the ability to choose how to do a task, and to list all the steps of the task. Planning also requires the person to decide what they will…
Fatigue after brain injury: Cognitive fatigue, Brain fog, Mental fatigue, Brain fatigue, Brain exhaustion, Mental tiredness, Foggy brain. I love the last one! All terms that can mean "I'm so tired my brain hurts". Please Remember This: To begin here is the key message I want to make – We can all get foggy brain. Most of us recover quickly and it doesn’t happen too often. After brain injury - foggy brain is not cute, and it is often not a temporary thing. After brain injury 'foggy brain', is more professionally called cognitive fatigue. It does not go away without paying it attention and it can come back over and over again. Introducing Cognitive Fatigue After Brain Injury A few years ago (I just realised - 3 years ago almost to the day!) I wrote a post “I’m So Tired My Brain Hurts.” This has been the source of many letters, and one of the most read articles. Recently it was suggested…
"LobesCaptsLateral" by Sebastian023. Licensed under CC BY-SA 3.0 via Commons
Have you noticed the Parietal lobes tend to receive less attention than their flashy neighbour the Frontal lobes and other lobes of the brain? Maybe it’s because they tend to be more on the touchy-feely side of life. That softer sensory side we don’t like to talk about. We tend to prefer those flashy intellectual functions other parts of the brain are better known for. Or maybe it is because what they do is tricky to explain. Or maybe they just sit up there on top of our heads, doing their job, forlorn and forgotten until something goes wrong. Today we give the Parietal Lobes their day in the sun. An attempt at a simple rundown on what they do, and what happens when they are damaged. Quick Parietal Lobe Anatomy Lesson A couple of basics before I launch into the detail: There are two Parietal lobes – a left and a right. They have…
Concrete thinking is a descriptive term for this kind of thinking. Factual. What you see in front of you is what you understand. You take what is said to you, as it is said. Concrete thinking - being less able to generalise. Less able to think in the abstract. A person is likely to see and take things as said. Thinking about information and understanding information in a “concrete” way; taking things literally. What Would Concrete Thinking Look Like As with many cognitive (thinking) outcomes; concrete thinking can be difficult to understand, and to accept as a result of damage to the brain. You might see the following: [unordered_list style="green-dot"] Taking things literally. “Hop over here” would see you doing just that – hopping. Difficulty understanding abstract language such as metaphors, proverbs, humour and sarcasm. Proverbs are good examples of how concrete thinking can occur. Proverbs need you to be able to interpret the meaning, it requires abstract thinking.…
A neuropsychological assessment after brain injury is often recommended. In my experience this can be a source of worry to people living with brain injury and their families. Concerns include how this will be done and what the benefit will be. A support worker recently asked me how they could support a person who was about to have a neuropsychological assessment after brain injury. This lead me to try and answer some common questions here. This article will briefly look at: [unordered_list style="tick"] Why Neuropsychological assessment might be done. Steps that might be taken to prepare for the assessment. What is likely to happen in the assessment. What is assessed. What a person living with brain injury, and their family might get from the assessment. [/unordered_list] Why Undertake A Neuropsychological Assessment After Brain Injury? To provide information to people involved; For the person with the injury, their family and supporters such as where damage might have occurred and its impact on…
Reduced speed of information processing: I have a picture of an information superhighway with information flying along at great speed. Suddenly it is thrown into chaos because some stuff begins to slow down and not follow the rules. These slower pieces get in the way of other information whizzing along and the information superhighway is disrupted. What does information processing look like? How does it affect the function of the brain? What Is Information Processing? Let’s start with a challenge: Can I write a very simple description of ‘Information processing’ that is able to be understood? Here goes: 'Information processing' is part of what the brain needs to do so we can function efficiently: The brain needs to quickly sort out, and prioritise all the millions and millions of inputs it receives, from all parts of the body, every second of every day. It then has to decide on the spot what to action now, what to keep for later,…
Flickr Image by Spencer Finnley
A simple definition of impulsivity after brain injury: Talking or acting without thinking. For a fun kind of explanation the cartoon above might help. A reminder of the impact of acting without thinking. For more detail and suggested strategies read on. What Is Impulsivity After Brain Injury? As the cartoon above demonstrates impulsive actions are those made without taking into account possible problems, and not thinking about possible consequences. While we can all be impulsive at times, impulsivity after brain injury is caused by damage to the brain, specifically the frontal lobe and it does not just go away. The mechanisms that control our ability to stop and consider, and to filter what we pay attention to, are damaged. It is important to remember the impulsive behaviour you see, is related to the damage to the brain [unordered_list style="green-dot"] it is not deliberate it may not be apparent to the person themselves it is unlikely to go away it can fluctuate,…
Not being able to initiate activity and a change in levels of motivation after brain injury can be a challenging and sometimes life limiting outcome to live with. During a training session for community support workers I asked the group for the number one issue they struggled with, assisting a person living with brain injury. I had jumped ahead and assumed that number one would be either finding meaningful stuff to do, or challenging behaviour. Surprisingly, the number one issue was neither. It was the ethical dilemma of getting someone to do something they did not seem to want to do. Commonly termed lack of initiation and motivation after brain injury. How do you push someone to do something if they are not really willing to do it? How do you know when it is OK to push someone and when it is not OK? I use the word “push” here because this is how it can seem to a…
