|
A lot of people complain that following a head injury they have difficulty getting organised. They say "I’ve got 50 projects going, but I’ve completed none of them," or "I start something, but I just can’t seem to finish it." These problems involve organisation. Why do people have a problem with organisation?
The front part of the brain is called the frontal lobe. We have a left frontal lobe and a right frontal lobe. Each is involved in planning activities, getting things in the right sequence, and evaluating possible errors. There are two types of processes that occur in the front of the brain: language and visual analysis. The left frontal lobe helps us with language. This is important because the majority of things we do in our day-to-day life are language-related. The right frontal lobe generally involves visual organisation. For example, if you’re going to take a lawnmower apart, you’ve got to make sure all the parts go back together in the right order. Having a few "extra parts" after putting a lawnmower together is not a good thing. This problem happens very frequently in head injury.
Can you get a frontal lobe injury from hitting the back of your head? Yes. If you’ve ever watched the seat belt commercials on cars, you’ll notice that in a head-on collision, the people are thrown forward in the car and then go flying backward. In a car that’s been rear-ended, the brain is thrown backward and then bounces forward. The medical term for this is contra-coup injury. That’s a French word meaning "other side". In this type of injury, the brain essentially rattles back and forth.
Many people complain that they used to be able to handle 10 things at one time but now can only handle one or two. Secretaries, for example, often have to do multiple activities. They have to type, answer phones, talk with customers, and do filing, all at the same time. In your home, you cook dinner, watch television, and maybe have a load of laundry going at the same time. But if you have problems organising and sequencing, you may lose track of one or more tasks. You may be watching TV or doing the laundry only to realise that you’re also burning the food.
SO WHAT CAN I DO?
Getting help in a transitional rehabilitation head injury program is very important. These programs have a number of activities aimed at improving various skills.
Research shows that comprehensive rehabilitation programmes greatly improve overall physical and psychological recovery provided it is done timely – quickly, within the optimum window. In one study in 2005, 89% of patients with moderate to severe traumatic brain injury were able to work or study or participate in volunteer activities following an intensive post acute interdisciplinary 6 week rehabilitation programme compared to only 55% of patients undergoing conventional rehabilitation through the general health care system [Arch Phys Med Rehabil 2005 Dec;86(12): 2296-302]
"In the UK optimal recovery is a post code lottery" and "Such post acute NHS facilities as exist are few and far between and often in less than desirable premises and woefully lacking." Professor Mike Barnes, Consultant in Neurorehabilitation at Newcastle upon Tyne.
This is not to say that excellent facilities within the UK do not exist. They do, but they are woefully thin on the ground and can only provide a small proportion of the total amount of transitional rehabilitation care that is necessary. This means that for a very large number of head injury victims no transitional rehabilitation is available and victims are left to cope with whatever services are available in their area, hence the "post code lottery".
"With head injuries a persons life can change dramatically....an individual goes from being independent to totally dependent and from being capable to being incapable... During the recovery period there is a need not only to reconnect neurological paths but at a deeper level for people to reconnect socially and emotionally with their friends families therapists and society at large ...The brain is a dynamic organ and as long as it receives repeated stimulation chemical and physical changes occur to ensure that cells will react to ensure that same stimulation in the future...The brain does not adapt or try to recover if it is inactive." Excerpt from Hansard (the official Parliamentary debate reporting system) on the 28/1/2004 – words spoken by Ms Iris Robinson MP.
If you’re not involved in a transitional rehabilitation head injury program, what can you do for yourself? Start simple, do one thing at a time. This may sound easy, but it’s hard to do in the real world. For example, if you’re home cooking a meal, family members should keep an eye on you but basically leave you to it and not bother you, unless you ask for help. You should not be doing other tasks at the same time (like the laundry or watching TV). Limit yourself to one activity at a time until you’ve mastered that task. Once you feel confident, start adding a second task. Be patient, this process can take many months.
One of the most important things to help with organisation is writing things down. Get a daily planner and write things down in the order you’re going to do them. Let’s look at a common problem. Someone with a head injury may go into town because they need to get groceries.
Afterwards, they realise that they needed to go to the post office; and now a second trip into town is needed. That’s extra work and very frustrating if it happens to you enough. Sit down at the beginning of every day or the night before (actually, you should do both) and look at your schedule. Plan what you are going to do. I know that people have very busy schedules, but taking that extra 10 minutes to organise is going to save you a lot of time and frustration.
Let’s look at another common problem. Planning a meal each day is difficult even if you don’t have a head injury; it can become a nightmare if you do have one. One solution is to sit down on Saturday or Sunday and plan out meals for the entire week. Just plan one main meal for each day. Once you have the main meal, go back and add dishes. Make a list of what you need and do your shopping in one visit. This will save both time and the daily frustration of making a decision. I know this sounds like a lot of work, but it will help stop the "brain lock" problem of not being able to make a decision.
Secondly, use a "Modified To-Do List" (This is also discussed in the Memory section). Get a dry marker board (2x3 feet) and put it up somewhere in your house. Write on it the things that you have to do and then erase them as you complete them. Sometimes people will list 50 projects and none of them will get done. If you have this problem, create a list of 5 projects that you want to do and write them on the dry marker board. Don’t add another project to the list until you completed one of the 5 items. As you add one, you have to subtract one. You may want to limit it to only 3 projects on the board; sometimes looking at even 5 things can be overwhelming. Practice organization skills early in the day. Remember, fatigue will make your ability to organise worse. Do it when you are fresh.
|