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

Useful tools

There are lots of specific strategies in Toolkit B Promoting Independence, e.g.

11. Remembering information and messages
13. Managing time
15. Food and meals