| 3.6
List some possible practical strategies that you can use
when helping a person be more independent at home and in the community |
There are three common types of strategies you can use to help
a person with a TBI to be more independent at home and in the community:
- Teaching strategies
- Managing fatigue
- Memory
Teaching
strategies
1.
Demonstration
- Try to demonstrate/
model how you would perform the activity
- You may need
to demonstrate a number of times so that the person understands
- Get the person
to practice the actions or repeat the steps verbally to you
- Use a written
checklist to help the person remember the steps they need to perform
Eg A written checklist
for using the telephone may look like this:
Check you
have enough coins
Ask someone if there is a public phone close by
Find your friends phone number in your diary
Lift the receiver and wait for the dial tone
Insert the money then dial the number
2.
Instruction
- Try to use as
many methods of instruction as possible eg written checklists, photos/pictures,
demonstration, voice recorded on cassette tape
- Keep your instructions
the same each time
- Use concise
rather than wordy instructions
- Give the person
time to complete each step before instructing them how to perform
the next step. Allow them time to think for themselves (this may
be longer time than you need). When an individual with
a brain
injury is rushed, they can become overwhelmed, distracted and not
be able to focus on the activity.
3.
Routine
- A lot of people
learn by having a consistent weekly routine. For example every
Tuesday
they check their cupboards and make a shopping list ready for Wednesday's
shopping trip. It is important to try to keep to a set structure/
timetable.
- Routine can
also include getting up at a similar time each day and going to bed
at a similar time each day. This is especially important for those
people that experience high levels of fatigue following a traumatic
brain injury.
4.
Feedback
- To help someone
stay motivated when working on a goal you need to provide feedback
about their performance. The feedback needs to be honest and accurate.
- Feedback is
often more effective if it is on measurable qualities eg "This
week
it took you 30 minutes to make lunch whereas last week it took 40".
5.
Environment
- Try to teach
in a quiet environment with few distractions eg. turn off radio
- Think about
using the environment to cue behaviours eg using an alarm clock to
wake someone up or a whiteboard to list “jobs for today”
Remember learning a new skill
takes time, so don’t give up after only 1-2 weeks
Managing
fatigue
Plan
activity levels
- Try to evenly
spread “heavy” activities ie physically demanding
tasks such as vacuuming, over the week. This could mean that you
vacuum
the house on one day and do the washing on another.
Don’t
complete all activities on one day ie complete cleaning the bathroom
and vacuuming on different days.
- Alternate between
physical tasks and cognitive tasks. An example of this may be to mow
the lawn then sit and watch TV.
- Take regular
rest breaks
- Try to include
a rest at a set time each day eg directly after lunch.
Simplify
the task
- Can the task
be performed while sitting?
- Can parts of
the task be prepared completed at different times in the day eg make
a pasta sauce in the morning and then cook pasta in the evening?
- Is there a
different way of performing the task eg hanging clothes inside
on a drying rack
rather than on the line in the back yard?
- Can certain
steps within a task be changed eg buying pre-cut vegetables rather
than chopping up all the vegetables?
Memory
tips
Here are some suggestions
you could make to clients to help them with memory difficulties:
Diaries
- keep a written diary or electronic organiser of day to day activities
eg attend gym, meet friend for lunch, pay phone bill. Check your diary
at least every morning or evening
Calendar
-
keep a big calendar in a place where it can be seen clearly eg on a
kitchen wall or near a phone. Write information next to the date and
cross the days off as they pass. Make sure all the people in the household
use the same calendar
Whiteboard
-
write important notes on a white board. Use white board markers or textas
so it can be wiped clean. Make sure the board is in a position where
it can be seen and used easily. Keep information tidy and organised
Checklists
-
make checklists of things to remember. Tick the items off so that you
know you have done it
Rehearsal
-
repeat silently or out loud the information to be remembered. If
you don't remember or don't understand something, always ask questions.
Electronic
devices
- set an alarm clock or wrist watch to remind you to do a regular activity
eg to take medication or feed a pet. Use a kitchen timer to remind yourself
to do something within the next hour
Telephone
note pad -write
all phone messages in the same pad. Keep the pad next to the
phone so messages can be written down immediately. Get into the
habit of checking for messages when you come home. Cross off the messages when you have
called them.
Post-it
notes
- write yourself notes and put them in placed you can see them. Throw
them away when you have completed the task.
Special
places - designate a special place where you
keep things like your handbag, wallet, keys, mobile,
glasses and bills to pay. This may be a tray next to the phone, a cupboard or shelf in your room.
Telstra
wake-up and reminder call service - This can be used
if you are worried about forgetting important things
Dosette
box - a box with compartments for different times of
the day to help you to remember when and how much medication to take
Try
to stay calm - sometimes worrying or becoming upset
about being forgetful can make it more difficult to remember things
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