A work culture that allows functions of support to operate
If a workplace is able to incorporate the support structures that work for the injured person into the person’s working life, it can make a big difference to recovery. Not all work conditions are as conducive to recovery as others. For example, it can be more difficult in work roles where the person has to do varied, intense or specialised work, or if they work on their own. A supportive workplace includes the work environment, company culture and also the attitudes of management and colleagues. Sometimes the priorities of the workplace conflict with the priorities of recovery – e.g. when people are required to return to full hours or duties while they still need lots of rest and/or are learning how to manage changes in what they are able to do.
Ability to do meaningful things
After the injury some activities that were meaningful to the person can become too difficult to do because of the symptoms of TBI. This can mean the person feels frustrated, stressed, bored or depressed. For some people, this experience is a motivation to find a way back to those activities (e.g. return to work or sport). For others, they may feel they only have time to cope with the recovery and that they need to be recovered before they can do these other activities. Even if there is a change to what these meaningful activities in a person’s life are, it is important to have the opportunity to do things that are meaningful for that person. These activities may also be linked to social connections.
Ability to change normal ways of doing things to help with recovery and adaptation
In order to prioritise recovery, it can be necessary for a person and their family or whanau to change their routines and ways of doing things. This might create tensions if the changes feel like a nuisance to others. It can be helpful to feel supported with these changes and that whanau are on board with the strategies.
Allowing self to rest
Rest becomes an important thing that often has to be actively managed after TBI. Ability to allow the rest that the person needs means that they need also to understand how to rest, eg not just sitting down, but reducing distractions. If a person feels busy or is in the middle of something, it can be hard to allow that rest until it is too late and they are already exhausted. Allowing themselves to rest may be at odds with wanting to function as normally as possible.
Family and others having to adapt routines and behaviour to accommodate brain injury needs
Because of the symptoms of TBI, family and others often have to adapt their own routines and behaviours to help the injured person. For example, learning not to take angry outbursts to heart, or making changes to how they act in order to help the person cope with emotional changes or fatigue. The way the home is run may have to change. For example changes to the type or amount of planning that needs to happen, a change in what activities each person does, allowing more time for the injured person to complete tasks, or planning for rest periods for the injured person can all be aspects of this change. It can feel like a strange or frustrating disruption at first, but it can become a new rhythm to home life over time.
Keeping occupied can help
Keeping occupied can distract from negative thoughts and feelings. Because of this, some people use it as a strategy to help them cope. This may include doing chores etc which need to be done, or getting out of the house to do other things.
Knowing when to push
Working out when to push the limits of what seems possible to help reach goals and when to allow rest can be difficult following a TBI. People describe it as a balance that is tricky to get right. Pushing too far can result in an exacerbation of symptoms. Frustration with how long recovery is taking may lead to a desire to push to try and speed up recovery even if it is not the right time to do so. Some people are able to learn how much they are able to push through trying and observing what happens.
Pros and cons of the recovery environment
Any particular environment (e.g. care facility, home, work) has things that both help and hinder recovery. For example, a quiet environment might be peaceful and help with managing symptoms, but feel isolating. Home may be with loved ones but have lots of stimulation that is difficult to control. A care facility may have a lot of rehabilitation opportunities, but feel far from home.
Trying to find ways of managing that work for me
Not all advice or strategies for managing TBI symptoms and changes is helpful for each particular person, and they may have to try lots of different things to find what works. What works may also change over time and therefore require ongoing attention to keep finding what works best right now. People talk about this requiring effort to maintain.