It has been said that humor is the best medicine, and even though it might not be an actual cure for most ailments, I think that this saying is quite true. Humor is an important part of most people's lives, and people with traumatic brain injuries are no different. That's why we try to include fun and funny things in their daily lives.
This week I took some clients to the movies to see You Again. While some of the clients tend to have trouble focusing on one thing for an extended amount of time, most of them enjoy going to see a funny movie. However, I have a feeling that some jokes go over their heads, but they all enjoy a good laugh. In fact, many of the clients respond best to humor in stressful situations. It can divert their attention away from the bad things they're thinking about and get them started on something else in a better mood.
The kinds of jokes and humor enjoyed varies widely from client to client, and it can be really important to know what type of humor is appropriate and what is not. While some clients enjoy the dirtiest of jokes, others might be deeply offended by them. So it can be a good idea to stick to the general types of jokes until you really know what will fly. When you get familiar and comfortable, you can really joke and have a good time.
Sunday, September 26, 2010
Sunday, September 19, 2010
Age is only a number.
So my last entry focused on short-term memory loss, and I got some comments I wanted to address.
I work with a lot of different types of traumatic brain injury patients, from about the ages of mid-thirties all the way to about 70 years old or older. Some of these patients were injured before their tenth birthday, and some as late as their late thirties, and some even before or after that. The vast majority of these TBIs are a result of motor vehicle accidents: car collisions, motorcycle accidents, cars striking pedestrians, even tractor trailer accidents. I would say more than half of these accidents involved driving under the influence of alcohol. We have a couple of more unique accidents, one client was thrown from a racehorse, another client had a roofing accident, another accident involved a loose manhole cover.
Because of the varied ages that these accidents have happened, we end up with clients in every stage of life. Some clients are 'stuck' in their teenage years, with all the characteristics of a 17 year old, including the attitude. Some clients are married with children, and some are divorced (which unfortunately happens often when a spouse becomes brain injured). Some are more childish and have limited communication ability. Also because of these varied ages, among many other factors of course, memory loss presents itself in each client uniquely. Those clients that were injured at a very young age did not have much opportunity to experience life and therefore have limited long-term memory in addition to short-term memory loss. Most of their memories consists of parents and siblings, and some can remember events and things they've done since their accident. Clients that were injured later in life often have uncanny long-term memory, much better than I feel I would have myself. A client that was injured at 17 can remember many details about the night she was injured, like where she went, where she told her parents she was going, who she was with, and even the "heaven" that she remembers being in while she was in a loooong coma. Other clients can tell stories of family members and events (although the short-term memory loss kicks in here because I have been told these stories so often I can now repeat them verbatim). In some cases, clients can remember important events that have happened since their injury, like a particularly memorable vacation or the day they got married (but on bad days, they can't recall the exact date).
Many clients do seem to be, in a way, stuck in the time period their injury occurred. Like I said before, pretty much whatever age they were injured at is the age they perceive themselves as for the long haul. We have 50 year old teenagers, 40 year old children, and plenty of other people who just don't act their age. This can be at times refreshing, and at other times, just plain challenging. When a past-middle-aged woman wants to 'make out' with the men she works with like she was a hormone-driven teenager... sometimes you just have to remind them that somethings aren't age appropriate.
I work with a lot of different types of traumatic brain injury patients, from about the ages of mid-thirties all the way to about 70 years old or older. Some of these patients were injured before their tenth birthday, and some as late as their late thirties, and some even before or after that. The vast majority of these TBIs are a result of motor vehicle accidents: car collisions, motorcycle accidents, cars striking pedestrians, even tractor trailer accidents. I would say more than half of these accidents involved driving under the influence of alcohol. We have a couple of more unique accidents, one client was thrown from a racehorse, another client had a roofing accident, another accident involved a loose manhole cover.
Because of the varied ages that these accidents have happened, we end up with clients in every stage of life. Some clients are 'stuck' in their teenage years, with all the characteristics of a 17 year old, including the attitude. Some clients are married with children, and some are divorced (which unfortunately happens often when a spouse becomes brain injured). Some are more childish and have limited communication ability. Also because of these varied ages, among many other factors of course, memory loss presents itself in each client uniquely. Those clients that were injured at a very young age did not have much opportunity to experience life and therefore have limited long-term memory in addition to short-term memory loss. Most of their memories consists of parents and siblings, and some can remember events and things they've done since their accident. Clients that were injured later in life often have uncanny long-term memory, much better than I feel I would have myself. A client that was injured at 17 can remember many details about the night she was injured, like where she went, where she told her parents she was going, who she was with, and even the "heaven" that she remembers being in while she was in a loooong coma. Other clients can tell stories of family members and events (although the short-term memory loss kicks in here because I have been told these stories so often I can now repeat them verbatim). In some cases, clients can remember important events that have happened since their injury, like a particularly memorable vacation or the day they got married (but on bad days, they can't recall the exact date).
Many clients do seem to be, in a way, stuck in the time period their injury occurred. Like I said before, pretty much whatever age they were injured at is the age they perceive themselves as for the long haul. We have 50 year old teenagers, 40 year old children, and plenty of other people who just don't act their age. This can be at times refreshing, and at other times, just plain challenging. When a past-middle-aged woman wants to 'make out' with the men she works with like she was a hormone-driven teenager... sometimes you just have to remind them that somethings aren't age appropriate.
Sunday, September 12, 2010
A Bit of Calm, and a Bit on Memory Loss
So this week at work was one of those infrequent calm weeks, leaving me nothing of interest to write about in only my second post. I say calm in the sense that there were no fist fights, violent outbursts, ER visits (with one minor exception), seizures, missing clients, power outages, and/or vehicle breakdowns. That said, I have had to deal with all of these situations, minus a seizure (knock on wood), in the whole 4 months that I have had my job. I have a feeling that if I were to give a complete recap of the two days I spent at work this past week and explain them as calm, one would look at me like I am the one with a brain injury.
I'm going to try and avoid having this blog as just a rant of all the insane things that can happen at my job, and try to take a more 'health psychology' point of view (whatever that may be, I think I may have made that up) to the events I encounter, but it might end up being a little bit of both from time to time. In any case, I think this entry might be a good one to start covering the topic of memory loss. Specifically, short-term memory loss. Now, I know more than anyone, that we all have those moments of "oh, what did I come in here for?" but trust me, that's nothing.
I have often been asked by clients, "excuse me, do you know what day it is?" And perhaps just as often, "how old am I now?" With September 11th passing recently, everyone's facebook status was 'Never Forget.' When I was asked what day it was on Sept. 11th, and I stated the date and followed with the question "does that mean anything to you?" I did not get the answer one would expect to hear from someone who lived through that day in September 11th, 2001. I give them credit for trying though.
Short-term memory loss from TBI can be an interesting thing, and will try your patience probably the most out of all the symptoms of TBI. I have good reason to believe that if you spend too much time around someone with short-term memory loss, you could easily lose your mind. I have always been a very patient person, but when asked a question for the 37th time (not kidding), even I can lose it. Especially when it's a conversation like:
"Excuse me, but can you get my slippers? My feet are cold."
"Your slippers are on your feet."
"Well then why are my feet cold?"
"Because you have bad circulation..."
"#!&* @%*&!@("
(3 minutes later)
"Can you get my slippers?"
In these situations, all one can do is think 'it's not their fault, they have a brain injury, they just really can't remember.' More on this in my next entry, I think...
I'm going to try and avoid having this blog as just a rant of all the insane things that can happen at my job, and try to take a more 'health psychology' point of view (whatever that may be, I think I may have made that up) to the events I encounter, but it might end up being a little bit of both from time to time. In any case, I think this entry might be a good one to start covering the topic of memory loss. Specifically, short-term memory loss. Now, I know more than anyone, that we all have those moments of "oh, what did I come in here for?" but trust me, that's nothing.
I have often been asked by clients, "excuse me, do you know what day it is?" And perhaps just as often, "how old am I now?" With September 11th passing recently, everyone's facebook status was 'Never Forget.' When I was asked what day it was on Sept. 11th, and I stated the date and followed with the question "does that mean anything to you?" I did not get the answer one would expect to hear from someone who lived through that day in September 11th, 2001. I give them credit for trying though.
Short-term memory loss from TBI can be an interesting thing, and will try your patience probably the most out of all the symptoms of TBI. I have good reason to believe that if you spend too much time around someone with short-term memory loss, you could easily lose your mind. I have always been a very patient person, but when asked a question for the 37th time (not kidding), even I can lose it. Especially when it's a conversation like:
"Excuse me, but can you get my slippers? My feet are cold."
"Your slippers are on your feet."
"Well then why are my feet cold?"
"Because you have bad circulation..."
"#!&* @%*&!@("
(3 minutes later)
"Can you get my slippers?"
In these situations, all one can do is think 'it's not their fault, they have a brain injury, they just really can't remember.' More on this in my next entry, I think...
Saturday, September 4, 2010
Difficulties in Dieting
This blog is mostly going to cover the experiences I have working with traumatic brain injury patients and their specific health and psychological issues. Each week I will try and base my topic on an event that has happened at work that week and has some aspect of health psychology involved.
With TBI, we often see clients who are overweight and some who are obese. This is often a direct result from the brain injury, sometimes from a lack of exercise due to physical limitations, sometimes from a neurological problem, or perhaps even an emotional problem. My goal, as a facilitator, is to help our clients stay healthy and encourage them to make the proper nutritional choices. A few of our clients are on special diets, which can certainly complicate dinnertime. In addition, as part of the rehab process, we will take our clients out to eat at their favorite restaurants.
I should probably take a moment to explain that, if it's not well known in the real world, TBI patients are usually a bit different than the rest of the population. Characteristics can include social disinhibition, memory loss, emotional outbursts, psychological disorders, and a general "wearing of the emotions on the sleeve," among many other things. Our clients can be quite frank with us, and they will never hide their true feelings and frustrations.
Special diets with TBI patients can be particularly tricky because of some of these traits. When going out to a restaurant with a client on a low-carb diet who doesn't really enjoy low-carb food items, it can be a challenge to keep them happy and have them stick to their diet. It's also a delicate balance between suggesting healthy food items and not just telling them what they are "not allowed" to order, as we aren't able to stop them if they make a bad decision, just guide them in their choices. However, clients will often be defensive about our suggestions and become easily frustrated that they "can't" order what they want. Outbursts are typical in a situation like this, and can escalate quickly.
Dieting can be such a complicated and involved process for individuals with TBI, it's no surprise to me that so many struggle to lose weight or just give up altogether. Those who do lose weight have to work just as hard to keep it off. The benefits of losing weight are worth the struggle for some clients, though. Not only the health benefits, but just being more comfortable sitting in a wheelchair, or being able to fit in an specialized airplane seat so that they can finally go visit their family.
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