Working with people with TBI: Staff Self-Study Module 4

4.4d Strategies to compensate for cognitive changes: Case study B Q

Case study B: 40-year-old man

This 40-year-old man suffered a head injury in a motor vehicle accident. He is married with a family and had maintained full time employment for a number of years as a lecturer. He complained that since his injury he is forgetful, loses things, has difficulty finding the right word to say, and feels uncomfortable in social situations but manages better in one-to-one situations.

During the interview this man sometimes seemed a bit vague although was very talkative and his conversation often went off topic. At the time of assessment he was keen to return to some form of employment due to increasing financial concerns at home. In his eagerness he was applying for a variety of part time positions, which he could get but could not sustain.

Findings from a neuropsychological assessment indicated:

he had difficulties concentrating over time and difficulty keeping track of more than one
thing at a time
it was taking him much longer to complete things
he was only able to learn small amounts of new information
he was disorganised
he had difficulty thinking of new ideas
his reasoning skills were concrete
his self monitoring was poor (verbose, off-track conversation)
he was experiencing a high level of anxiety.

However he also showed:

that his memory for old knowledge is intact
he could remember the small amount of information he had learnt
he has a good attention span
he is able to problem solve at quite a complex level.

Questions

What could be recommended to help this man find and maintain employment? (Is he able to work?)

In reference to a work environment, what strategies might assist this gentleman to compensate for his cognitive weaknesses?

Check your answers here

Strategies for case study B: 40-year-old man

This man could possibly manage some form of work closely related to his previous occupation. He’d be unlikely to manage a whole classroom or administrative duties, but may be able to cope with one to one tutoring on a topic that he is highly familiar with.

Useful strategies

Use a diary to record all important information and organise activities/appointments
Keep a simple work environment where there are limited distractions
Have a well organised and tidy work space – everything has it’s place
Use a computer to work from and store information
Maintain well structured lessons
Sessions might need to be short
Could use CD Rom courses which are structured and sequential
Deal with one student at a time with a reasonable break between students
Prepare in advance for each lesson including a review of what was previously achieved
Weekly plan to assist with preparation and organisation.

Individual

Journal/diary to keep record of events
Make use of special places, avoid putting items down
Use of a bag to hold necessary items when going out (these need to become habits)
Might benefit from learning strategies of turn-taking in conversations or having another person to signal to him when he is talking too much.