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The holidays are about spending time with those closest to you. However, when you’re recovering from a traumatic brain injury (TBI), the holidays can be a little more challenging.
In fact, when you have a TBI, holidays can easily feel overwhelming. You may not have the energy to spend the whole day celebrating. And the worst part is that all you want to do is spend time with friends and family.
Moreover, you want to show up and be present with those you love without causing them or yourself worry. But overextending yourself and your time can leave you feeling exhausted and mentally drained.
Here are some great tips to help you get through the celebrations while still prioritizing your health. After all, you don’t want your TBI to prevent you from participating in family traditions!
Note: It’s important to listen to your body and rest when rest is needed. If you’re a survivor’s friend or family member, please remember these considerations as the holidays approach.
[Related: Noticing the Positive]
It’s OK to go at your own pace.
With or without a TBI, holidays and the accompanying celebrations can quickly become hectic. It may be tempting to try and match everyone else’s pace. But doing too much can make you irritable and put a cloud over a day that’s supposed to be full of family, love and fun.
Pushing yourself too far will lead you to wipe out early and leave you feeling worse the following day. Additionally, try to avoid doing too much cooking, decorating or participating in other activities you might traditionally undertake.
Most importantly, focus on enjoying the day in your own way. Do what feels right for your current energy level and mood.
If that includes taking a nap after dinner, then that’s fine!
If you have poor muscle control in your arms, you shouldn’t be lighting menorah candles for Chanukah. Similarly, if you have balance issues, you shouldn’t climb onto the roof to put up Christmas lights.
However, with this in mind, you’ll always have some identifiable strengths.
For example, although a person in a wheelchair may be unable to put up all the decorations on the Christmas tree, they may be able to put some on the lower branches. Additionally, a survivor may be unable to be fully responsible for cooking a turkey, but maybe they could cut some vegetables for a salad or help set the table.
If you and your family members look closely enough, there’s almost always something you can do or help with. Even taking on a small task will boost your pride and self-esteem.
Injury or no injury, working together on holiday celebrations brings family members together. You have a joyful opportunity to bond.
Some families traditionally go from house to house for multiple holiday celebrations throughout the day. However, you might become fatigued easily, and holiday parties tend to be long and active.
For many survivors, attending several celebrations on the same day may be very difficult. You might benefit from spending less time at each celebration.
Try to keep things simple and easy but still fun. Doing this has the added benefit of cutting out excess details or over-the-top traditions. Instead, you can focus on sharing the day with your family.
While last-minute shopping is sometimes necessary, TBI survivors should consider light scheduling closer to the holidays.
Space out everything you want to do, like cleaning or shopping. That way, you don’t feel rushed and have plenty of time to do things at your own speed. It’s also wise to give yourself a day of rest before any celebration.
Furthermore, try to figure out how long the trip will take if you’re traveling. An app like Google Maps can be helpful.
What’s more, there are plenty of options to get from point A to point B without being behind the wheel yourself! Look into rideshare apps, public transportation or bus schedules for long-distance trips. You can even sleep through the commute if you need a bit more rest.
However, it’s also a good idea to ask a relative to drive if you feel uncomfortable taking public transportation. And if you need support at any point, don’t hesitate to reach out to your network.
Many survivors struggle with the tradition of giving gifts during holidays like Christmas and Chanukah. You might be dealing with strained finances in the aftermath of your TBI, and that can make gift-buying for the holidays stressful.
If you’re a friend or family member of someone recovering from a TBI, simply reassuring them that you’re not worried about receiving a gift or are perfectly fine with getting a small gift can ease their concerns.
Alternatively, you could always create a handmade gift or card (with a family member’s help if needed).
Or families might switch to a gift exchange. For a gift exchange, everyone buys just one gift, puts it in a bag (no names marked) and then randomly chooses one of the bagged gifts. It’s fun, special and much less stressful.
In addition, families and friends might limit the cost of the gifts everyone buys. That makes gift-giving easier and helps everyone — you included — feel less financial pressure.
Plus, it’s wise to put little (if any) emphasis on the role money plays in the holidays. When you’re not worried about impressing others with pricey presents, everyone can focus on the meaning behind the holidays.
Setting boundaries is important for your mental health during the holidays. Whether that means politely changing the conversation with a family member who wants to know more than you’re comfortable sharing or stepping away from the hubbub for a moment, you sometimes must set boundaries.
Regardless, setting boundaries is a healthy way of maintaining quality relationships with those close to you.
And frankly, it might be a little difficult at first to set boundaries with a family member or move past worrying that you’ll hurt someone’s feelings. Push past those emotions! Setting boundaries actually has the opposite effect.
When you set boundaries, family members understand that you’re doing what’s best for you. They should know that with a TBI, holidays can require parameters in your social life. And this allows you to be at your best when you’re with them.
Survivors and their loved ones need to address several issues in terms of where they hold celebrations. But this consideration applies to both survivors and their friends and family members. If you’re a survivor’s friend or family, ask yourself these questions:
Some TBI survivors’ families find it’s easier to host holiday celebrations at their own homes rather than travel to others’ homes. They’ve already adapted their own homes to survivors’ needs.
Survivors and their families should also consider the physical layout of rooms where celebrations will take place. For example, rearranging tables and chairs so survivors can navigate rooms more easily is a good idea.
You should also make sure toys and gifts aren’t left on the floor — they’re trip hazards. Cords from lights or decorations can be trip hazards as well, so place them so they’re not dangerous when survivors move around.
Additionally, consider practical matters regarding holiday meals. Here are just a few questions to ask yourself as a TBI survivor’s friend or family member:
Small changes in room and furniture layouts can make a huge difference! Striving for safety and accessibility helps survivors enjoy celebrations and feel included.
If you’re a TBI survivor, your family may want to consider how loud they allow holiday celebrations to be.
Some survivors find that they’re more sensitive to noise than they were before their injury, and loud noises can lead to agitation, anxiety and/or anger. If this is the case with you, then you might want to attend smaller celebrations or spend time in quiet rooms during big, boisterous parties.
Noise can also be a relevant issue when considering attending religious services. It may be better for you to go at less busy times or find a smaller house of worship with fewer people present.
[Related: Which TBI Care Plan Is Right for You?]
When you’re a TBI survivor, fatigue can be a constant struggle — and this certainly extends to holiday celebrations. Holiday parties and celebrations often run for many hours, and you may become tired easily.
Sometimes, changing how long you’ll attend the celebration can increase your likelihood of going! Three hours of fun participation is better than five hours of exhaustion.
People drink alcohol on several holidays. For example, a champagne toast is often at the center of New Year’s Eve celebrations. Eggnog with liquor is standard at many Christmas parties.
However, alcohol can be highly problematic for TBI survivors. If you’re a TBI survivor, speak with your doctor before you drink. It’s much better than taking a risk.
When you have a TBI, holidays should be joyful as well as accessible. And they can be exactly that with a little effort from you, your family and your friends.
At Moody Neuro, we specialize in personalized rehabilitation programs for TBI survivors. We also offer help and resources to caregivers and family members. From residential care to outpatient therapy services, you can find the support you need.
According to the Centers for Disease Control (CDC), almost 800,000 people have strokes every year in the U.S. Someone suffers from a stroke in the U.S. every 40 seconds, and stroke fatalities occur every 3.5 minutes.
These are unsettling numbers, and the risks don’t end with the stroke itself. In addition to needing aftercare, stroke survivors face the possibility of a second stroke. Every year, about 185,000 strokes happen in people who have had prior strokes.
So, what’s the best way to prevent a second stroke?
To begin with, people who have suffered a stroke should receive treatment, change their lifestyles and follow preventive practices.
With age, human arteries become hard and narrow, which can lead to blockages. Unhealthy lifestyles and preexisting medical conditions can affect artery health, increasing the risk of stroke. In addition, sedentary lifestyles and poor eating habits are often leading factors in stroke victims.
These are a few other important risk factors for vascular diseases:
Avoid these risk factors to help protect yourself from becoming a stroke victim.
Ischemic strokes, the most common type of stroke, make up 85% of all strokes. A lack of oxygen or poor blood flow to the brain causes ischemic strokes. If not treated properly, ischemic stroke patients can be at risk for another stroke.
Hemorrhagic strokes make up the other 15% of strokes. Hemorrhagic strokes occur when there is bleeding around the brain. Main causes and risk factors for this type of stroke include high blood pressure and abnormal blood vessels in the brain.
Also known as a mini-stroke, a transient ischemic attack (TIA) is similar to an ischemic stroke. However, a TIA’s symptoms last a shorter period. These attacks are often warning signs for a more serious ischemic or hemorrhagic stroke.
The American Heart Association/American Stroke Association (AHA/ASA) guideline for stroke prevention addresses diagnoses, treatments and secondary stroke prevention.
Review some of the AHA/ASA guide’s key takeaways below:
Strokes affect people differently, so it is important to pick a rehabilitation facility that focuses on your physical, social and emotional goals. Due to the high risk of secondary stroke, a rehabilitation facility should also have individuals who will address your risk factors as you are returning to the community. Choosing the best brain injury rehabilitation is critical. Moody Neurorehabilitation Institute has 40 years of experience and specializes in brain injury rehabilitation, which is needed after suffering a stroke.
For more information, see what the CDC says about stroke prevention.
Since 1982, Moody Neurorehabilitation Institute has served Galveston, Texas, and neighboring Gulf Coast communities. With 40 years of experience, we provide quality treatment for a variety of brain injuries, such as strokes and support secondary stroke prevention guidelines. We offer effective home evaluations, in-house training and unique home exercise programs.
For effective treatment, one must understand the fundamentals of the brain. Explore our comprehensive resources to learn more about the body’s most intricate organ — the brain.
Let the Moody Neurorehabilitation Institute team answer your questions about brain injuries, rehabilitation and other treatments:
Moody Neurorehabilitation programs assist stroke patients in their recovery so they can maintain their independence. We consider cognitive, behavioral and physical limitations while tailoring personalized treatment plans for every patient’s unique needs.
We offer outpatient programs and residential services, as well as short- and long-term care. In 2019, our patient satisfaction survey revealed that 90% of our patients found our quality of therapy outstanding.
Furthermore, Moody Neurorehabilitation Institute provides long-term support to care for patients who are unable to return to an independent lifestyle.
Learn the latest information regarding Moody Neurorehabilitation’s Program Evaluation Data.
Moody Neurorehabilitation Institute incorporates technology and traditional therapy practices to help stroke patients recover quickly and effectively. Based on physician recommendations, we create a rehabilitation program for the patient’s individual recovery needs.
Our hours are flexible, and we work with patients’ physical capabilities using innovative robotics and technological simulations for optimal outcomes. At Moody Neurorehabilitation Institute, we’re dedicated to supporting families and assisting them throughout the recovery journey.
For people suffering from strokes, we’re here to help guide patients and their families through the difficult road to recovery. Our experience and personalized care make us the premier choice for neurorehabilitation.
Contact Moody Neurorehabilitation Institute to learn about our programs and quality services, or call us at (409) 762-6661 today for more information.
Depression and low mood are common symptoms after a brain injury. Some of this may be due to neurochemical changes in the brain after an injury. However, much of it is due to the feelings of loss, stress, and frustration following a brain injury. The brain injury experience can often disrupt routine. Instead, it takes brain injury survivors into the very different world of rehabilitation and recovery. Survivors may experience profound emotional struggles due to issues. They may experience loss of skills, frustrations doing everyday tasks or stressful thoughts about an uncertain future. The brain injury experience may feel very negative, even as the survivor takes tangible positive steps forward in their rehabilitation journey. Noticing the positive can feel difficult.
One of the complicating factors in the rehabilitation journey is that our brains naturally demonstrate a “negativity bias”. Negativity bias refers to the brain’s tendency to pay more attention and remember negative events better than positive events. Most people, even without an injury, display some level of a negativity bias. For instance, you likely remember the last time someone insulted you more quickly than the last time you received a compliment.
Most of our lives tend to have far more positive events than negative events, so the negativity bias does not take over our whole thought process. However, the brain injury experience often increases the number of negative events and decreases the number of positive events in a survivor’s experience.
Also, the positive events are different from what they would have been prior to the brain injury. The events are now often minimized or ignored. For many survivors, their brains’ natural tendency for a negativity bias, coupled with the difficulties of the brain injury experience, lead to depression and low mood.
With all of this in mind, it is clear that extra effort must be taken to notice the daily positive events during the rehabilitation and recovery process. This must be done consciously and deliberately, to override the brain’s natural negativity bias.
One activity that can help is to write a list of activities and experiences that were good or successful at the end of each day. The items on the list do not necessarily have to be things that were huge breakthroughs. They should simply include anything that was positive.
For instance, a list could be:
Although it may be tempting to simply think of some positive events at the end of each day, it is generally best to write the list down. A written list of the positive events allows the survivor to review not only the current positive events but also be reminded of past positive events.
If a survivor cannot generate at least 3 items on their own, they should ask for help from families, friends, and rehabilitation professionals. Daily focus and writing down of positive events help overcome the negativity bias, improving overall mood and life satisfaction. It also helps train the survivor and family. They can now recognize the new, different positive events of daily life after an injury.
Remember that every positive event, no matter how large or small, is important!
Learn about how Moody Neuro can help with neuropsychology and counseling, speech and language disorders, physical therapy, outpatient rehabilitation assistance, community integration programs, and occupational therapy.
Questions? Contact us today, we’re happy to help in any way we can.
Early June brings hurricane season to Texas, and with that comes a fresh reminder of the need to plan for emergencies. People often don’t realize the full extent of consideration that new challenges require following a brain injury. They particularly may not understand new challenges regarding emergency situations, such as sheltering and evacuation.
In this blog, we’ll tell you some useful and effective ways to approach those new challenges when planning for an emergency with a brain injury survivor. We’ll cover how to address transportation issues, medical and health concerns, and cognitive and emotional difficulties in the wake of a traumatic brain injury.
After a brain injury, many possible issues may arise concerning transportation preparedness during an emergency. We’ve listed some of those issues below.
Is the brain injury survivor able to drive independently to safety?
If the survivor hasn’t been cleared to drive, it’s vital to identify a responsible person capable of transporting them to safety.
Can a friend or relative drive the survivor, or does the survivor need to be evacuated through a municipal program?
If they must use a municipal program, are they registered for the program?
Many states provide emergency evacuation services for the disabled and elderly. We recommend that all persons with disabilities register with their local 211 system or another similar emergency evacuation system, even if they already have an emergency plan in place.
Registering with an emergency evacuation system doesn’t mean the survivor has to use the services it offers. However, it provides a safety net in case an emergency plan doesn’t work. Additionally, 211 services are free, so there should be no issues regarding registration costs.
Deciding which vehicle will be best to use during an evacuation is an important step when preparing for an emergency. Consider whether you have a vehicle that can accommodate everyone who would evacuate, as well as the necessary equipment (wheelchairs, walkers, etc.).
If the brain injury survivor has a physical difficulty that may affect their ability to enter or exit a vehicle, it’s important that other people in the vehicle know the appropriate transfer process and can assist them.
Preplan and locate rest stops that people with disabilities can access. If the brain injury survivor is incontinent, it’s important to find rest stops that have enough room for clothing changes and cleanup. Rest stops often simply put a grab bar in a regular-sized stall to comply with accessibility laws, but unfortunately such restrooms remain inaccessible from any practical perspective.
For those who take medication or frequently use assistive equipment, make sure you store that medication or equipment in an easily accessible location in the vehicle. You should definitely not store medication in an area of the vehicle prone to excessive heat because the medication may lose its potency.
The cardinal rule of evacuation is that the earlier you leave, the less potential you have for transportation problems.
In addition to transportation, it’s important to consider medical and health concerns for post-brain injury patients when preparing for an emergency. We’ve listed some of these concerns below.
When people must evacuate from areas affected by a natural disaster, evacuated cities immediately experience a population surge. This puts a remarkable strain on any local medical system, particularly pharmacies.
For example, let’s say a city has pharmacies normally prepared to have enough on-hand medication for a population of 50,000. Following an evacuation, the population may increase to 70,000 or more. Most pharmacies aren’t equipped to deal with this increase, and medication shortages inevitably occur.
Most government agencies recommend that people bring one to two weeks’ worth of medication with them when they evacuate. You may want to err on the side of caution and bring enough for two weeks to one month. You should use this same general rule when preparing a stock of disposable medical items, such as syringes, incontinence supplies and testing strips.
Most medications are sensitive to heat. Keeping medications in the trunk of a car or a similar location on a warm day can cause them to degrade. Furthermore, many medications (such as insulin) require refrigeration. When in a vehicle, consider storing such medications in an icebox with cold packs or a portable refrigeration device.
You should also keep medications in their original boxes or bottles and transport them in a container you can seal and reseal. Plastic bags with a zipper work great for this situation.
Don’t take medications and place them all into one container. This can be a nightmare to sort through later and can lead to crucial delays. It can even lead to dangerous errors in administering medication.
Additionally, you should protect medical devices and equipment from water and other environmental hazards.
If a medical device or piece of equipment operates on electricity, make sure to bring an emergency power source, such as extra batteries or a car adapter power cord.
Keep a list of all important medical information. This includes health history, medications (with dosages), doctors, allergies and immunizations. The Centers for Disease Control and Prevention has an excellent example of such a list available for download on its website. You can download another excellent example of this kind of checklist from the AARP website.
When you reach your new location, make sure you know where the nearest medical and health facilities are. Knowing where the closest pharmacies and hospitals are will help if a medical emergency occurs after evacuation.
Following a brain injury, many survivors require a special diet, such as a diabetic diet. When purchasing food for evacuation, make sure to keep this diet in mind. For example, you may need to check boxed foods (crackers, cookies, etc.) for their sugar and sodium levels.
If a survivor has an item that helps communicate the difficulties they suffer, such as a medical bracelet or aphasia card, remember to bring that item. Left at home, it’s of no use.
Read on to learn about issues that can arise regarding the cognitive and emotional difficulties left after a traumatic brain injury.
Post-injury, brain injury survivors generally become far more susceptible to stress and agitation in their lives. Therefore, it’s often handy to have items that you can use to help them remain calm. Music played on a portable radio, phone or pair of headphones that the survivor finds relaxing is an example of such an item.
For survivors who have cognitive difficulties such as memory problems, the evacuation process can be very confusing. They may forget why they’re evacuating or where they’re going. Calmly repeating the evacuation plan and/or having the evacuation plan in writing can help reduce confusion.
If a survivor has issues with impulse control, they may be more likely to make hostile comments or rashly suggest an unwise action during the evacuation. At these times, loved ones should calmly remind them of the evacuation plan and that the loved one has the situation under control. If the loved one reacts with anger, emotions are likely to escalate.
Most people, even without a brain injury, find extensive car travel stressful. Keeping to a regular schedule of planned breaks during an evacuation often helps reduce that stress.
Because many brain injury survivors have already experienced significant loss due to their injury, an evacuation and worries about potential losses resulting from a disaster may trigger difficult memories. Some survivors may need extra emotional support at this time as memories of old losses and new concerns for fresh ones result in significant emotional struggles.
All people, especially those with brain injuries that affect cognitive skills, do best when operating under a stable schedule. Survivors and loved ones should try to create a daily schedule to reinforce stability in the evacuation environment.
The more you plan and review an evacuation plan, the less stress you’ll have when it’s time for a real evacuation. Regularly going through evacuation plans will make the process less stressful for a person with a brain injury, too.
Hopefully, this guide can help bring attention to the important issues that brain injury survivors and their loved ones need to consider regarding emergency preparedness post-injury.
Learn how Moody Neuro can help with neuropsychology and counseling, speech and language disorders, physical therapy, outpatient rehabilitation assistance, community integration programs and occupational therapy.
Featured image via Unsplash
Visual scanning skills are essential for processing information in our daily lives. However, some individuals might have issues with recognizing ocular stimuli for a variety of reasons. Luckily, several activities exist that are not only helpful for improving visual scanning skills, but are also easy and fun.
In this blog we will go over the definition of visual scanning, some of the causes of visual scanning issues, and three of our favorite visual scanning activities for adults.
Visual scanning refers to the ability for individuals to use ocular strategies to efficiently, quickly, and actively explore various relevant visual information. This type of visual stimuli can include faces, objects, scenery, and certain written information. Visual scanning is a crucial skill for daily life, and helps individuals process information and complete a number of different tasks.
Visual scanning is important not only to be able to process visual information, but for mobility as well. Poor visual scanning skills can prevent an individual from avoiding obstacles when moving through their environment, causing collision.
It can also help individuals with daily tasks such as finding missing items, organizing a table or cleaning a room, or locating a friend in the middle of a crowd.
Many brain injured patients have difficulty with their visual scanning skills. This can be due to many problems such as partial loss of vision, left neglect or visual-spatial deficits. Often, but not exclusively, these problems are associated with an injury to the right side of the brain.
[Related: Disorientation and the New Year]
The following are three visual scanning activities that are interesting and easily organized.
One way to practice scanning skills is by using hidden pictures puzzles. Many people are familiar with hidden picture puzzles from children’s magazines. They involve a larger picture having many smaller items hidden within it. The goal is to locate the smaller hidden items. “Highlights” magazine has a number of free hidden pictures puzzles that can be printed from their online website: Hidden Pictures.
Although this is a fun way to practice scanning skills, it can be quite difficult, and some individuals may need help from loved ones to work on these puzzles.
An easy (and free) way to practice visual scanning skills is through an adaptation of the game “I Spy.”
The adapted version of “I Spy” is a very simple game to play. To begin, you need at least two participants. Then, pick a location or room with lots of items to see, but which isn’t so familiar that everyone knows the location of the items by heart.
One person is the “spy” and has to choose an item that is visible to everyone. The spy then says, “I spy with my little eye (the item).” It is now the job of the other players to point to the item and show that they have found it.
When “I Spy” is used to practice scanning skills after a brain injury, it is important to vary the location and the items that are being “spied.” For instance, you may first want to choose an item on the right side and then an item on the left side. Varying locations forces a person to scan the entire visual field.
If this game is being played with someone in a wheelchair or with other physical disabilities, make sure that each item can be seen from their visual perspective. For example, often items that are easy to see when standing are obstructed when sitting.
Also, make sure that the item is big enough to be clearly seen by all of the players. Sometimes a person with a brain injury loses some of their visual acuity due to the effects of the injury and may not be able to clearly see small items. If the person playing has left neglect, they will likely need extra help and direction to scan the left side of the visual field.
“I Spy” is one of the easiest, most portable visual scanning activities to practice active visual scanning and search techniques while still having fun.
One convenient and practical way to work on scanning is for the patient to practice with a telephone book or coupon circular.
The idea is pretty straightforward. The patient is tasked with locating various items found in the advertisements of the telephone book’s yellow pages or in a supermarket circular. You’ll want to pick items in a random order so as to prevent the individual from figuring out where each correct item is without really working on their visual scanning skills.
For example, if you are using restaurant ads in the yellow pages, you may first have the survivor find the hours of operation from an Arby’s ad in the top left corner, and then the address of a Taco Bell® advertised on the bottom left of the page. You can follow this up with the Domino’s® Pizza phone number down at the bottom right.
The supermarket circular can be used in the exact same manner.
As an example, you could ask the patient for:
It’s important not to tell the patient where on the page each item is located, but allow them to naturally search on their own. This activity should use all parts of the page, including the center.
If they cannot find the material, loved one should prompt the individual to conduct a slow, organized search for the item in question. In the case of left neglect, a search should always begin on the left side. A slow up-down search rather than side-to-side works best.
If the patient is missing the right visual field in both eyes, the search should always begin on the right side. If they are missing the left visual field in both eyes, the search should always begin on the left. Missing both the right or both the left visual fields is known as homonymous hemianopsia.
To help this task go smoothly, you’ll want to keep in mind a few things. You will want to ensure that the information can be easily seen by the patient. Sometimes the writing in phone books and circulars may be quite small. In this case, the person may need to use reading glasses. Or, they might need only to work with the bigger items on the page.
When working with yellow pages, it is better to pick pages with lots of display ads rather than listings. We do not advise using the white pages. The writing is too small, placed very close together, and is always in obvious alphabetical order. Supermarket circulars are generally much better for this task since they will tend to list more items.
If the patient has left neglect, it may be helpful to highlight the left side of the page. Or, put a bright object (such as a strip of paper) on the left side. Additionally, some individuals benefit from the use of a line reader (such as a ruler). This helps with their ability to focus on one section of information at a time.
[Related: Choosing a Brain Injury Treatment Clinic]
Since 1982, Moody Neurorehabilitation Institute has been a pioneer in the field of post-acute brain injury treatment and rehabilitation.
Learn more about Moody Neuro’s brain injury treatment programs and services, and how we can help with neuropsychology and counseling, speech and language disorders, physical therapy, outpatient rehabilitation assistance, community integration programs, and occupational therapy.
Featured image via Unsplash
Injury to the brain’s right hemisphere can cause left neglect. The condition is also known as left side neglect, unilateral neglect or hemispatial neglect. It is one of the oddest symptoms of brain injury and can be one of the most troublesome.
“Left neglect” is a term describing a deficit in awareness that occurs following an injury to the brain’s right side. Because of the injury, the brain has difficulty paying attention to items falling into the left hemisphere.
Left neglect or hemispatial neglect generally manifests most clearly in difficulties with visually noticing items on the left side. For example, survivors with left neglect may bump into door frames on their left side or miss eating food on the left side of plates. It often appears as if they’re blind to items on the left, but this isn’t a true vision issue — it’s an attention issue.
The brain isn’t attending to information generated from the person’s left side. The survivor can have perfect visual skills. However, the message their brain is providing is that the left side of their world essentially doesn’t exist, resulting in left visual neglect.
Left neglect doesn’t involve just visual components. It can also manifest as a lack of attention to sound or touch on the left side. For example, survivors may report they can’t hear as well from their left ear, despite audiological testing demonstrating perfect hearing.
Survivors may fail to notice left hands getting stuck in the wheels of their wheelchairs, and they may injure that hand. In severe cases, survivors may not recognize their own left limbs as being parts of their bodies. They may ask something like, “Whose arm is in my bed?”
Fine variations in damage suffered to slightly different parts of the right side of the brain lead to notably distinct manifestations of left neglect, which makes each survivor’s experiences differ.
[Related: Why Brain Injury Education Is Important]
Here are a few signs that rehabilitation professionals commonly see when diagnosing cases of left neglect or hemispatial neglect:
Left-sided neglect symptoms may result in considerable difficulties that can cause serious safety issues. For example, a survivor may not notice a boiling pot of water sitting on the stove on their left side and bump into the pot, causing serious burns from spilled boiling water.
Similarly, a survivor may not notice cars on their left and attempt to cross a busy street at a bad moment, which puts them at risk of being hit. It’s not uncommon for survivors with left neglect to have constant bruising on the left side of their bodies due to bumping into items.
To make the issue even more complex, many survivors with left neglect may have issues with impulse control or be very easily distracted. This substantially compounds the dangers and difficulties that survivors with left neglect have to deal with.
Some survivors may be missing vision on the left side — a condition known as a field cut (see below) that adds an actual visual problem on top of attentional issues. Even when survivors are completely aware of their left neglect, in the absence of treatment, difficulties and errors will persist.
Remember: The brain is unconsciously telling the survivor to ignore the left side, and the neglect is unintentional. Because the brain creates this false message, survivors feel like everything is normal and as if they’re attending to the left as well as they would have before their injury.
[Related: Tips for Improving Attention]
Multiple distinct symptoms of brain injury can present in remarkably similar ways.
For example, a brain-injured survivor’s failure to take medication could be due to a memory deficit that leads them to simply forget their medication, or the missed medication could be due to an attention deficit that causes them to be too distracted to take the medication.
The survivor missed taking the medication in each case, but they missed taking it for distinctly different reasons. A similar issue comes to light when looking at postinjury visual deficits. Did a survivor fail to notice information to their left due to left neglect or a field cut?
[Related: Visual and Verbal Memory]
Overall, a field cut is the simpler of the two conditions to understand. Similar to left neglect or hemispatial neglect, brain injury (often stroke) causes a field cut.
With a field cut, survivors have permanently lost the ability to perceive a portion of the field of vision. That area of the field formerly available has been “cut” away.
Because of their injury, the survivor is now in effect partially blind. In medical terms, this loss of vision is often called “hemianopsia.” A survivor with a field cut has had actual visual loss in their left visual field and thus misses seeing information on their left side.
In the case of a field cut, most survivors do reasonably well after becoming sufficiently aware of the condition. After enough practice, they’ll naturally turn and make extra effort to look for the information in their blind spots.
[Related: Different Parts, Different Speeds]
Although left neglect is certainly an issue of attention, it can’t be treated with stimulant medications like Ritalin, which rehabilitation professionals generally can rely on to improve more typical attention deficits.
Can left side neglect be reversed? Survivors can certainly get much better, although this takes dedication and time. Goals for left side neglect include retraining the brain to recognize the missing field of vision.
Survivors must engage in specific therapies and learn compensatory techniques to help make attentional deficits more manageable. Even with treatment, survivors must practice and carry over left neglect strategies into home life to avoid regressing in their performance.
Left neglect or hemispatial neglect can affect a survivor’s ability to engage in activities requiring both tabletop and environmental scanning. Rehabilitation professionals can observe left neglect effects on tabletop tasks when survivors miss words or numbers on the left side of a page.
Some examples of left neglect effects in terms of environmental scanning are survivors missing potholes on the left side of a street or a car parked on the left side of a parking lot. For such reasons, driving with left neglect is inadvisable.
For a survivor with left neglect, improvement requires awareness as well as daily scanning exercises and consistent visual aid use. Over time, survivors can improve. Below, we’ve listed a few common rehabilitation exercises for left side neglect.
A number of methods can help survivors compensate for left neglect. One method is known as prism adaptation.
Under the care of rehabilitation professionals, patients engage in an activity while wearing strong prism glasses that pull visual items from the left into a more central attentional domain. This visual change forces them to compensate for the effects of the prism to accurately complete the activity.
After the activity, some patients with left neglect notice an aftereffect. The brain continues to pull visual items from the left to their attention, even without wearing the glasses.
[Related: What Is the Goal of Rehabilitation?]
Professionals also use limb activation therapy to aid survivors with left neglect.
The focus is to get survivors to actively use their left limbs in the space surrounding the body’s left side. This engages the brain’s spatial and motor maps for those domains. The method is very helpful to patients, but they often encounter substantial difficulties.
Unfortunately, this method has limitations. It’s common for survivors to also have difficulty moving anything on the left side of their bodies (such as targeted paralysis or semi-paralysis, one of the most common symptoms of stroke or brain injury). However, research has shown that even passive movement of the left side can help improve issues stemming from left neglect.
Honing scanning techniques is one of the most frequently used methods to treat patients with left neglect. Therapists teach patients methods by which to ensure they’ve scanned the entire visual field.
In scanning therapy, therapists often instruct patients to pretend as if the head is a lighthouse. They direct patients to turn their heads fully from one side to the other while scanning an environment, like how a lighthouse turns its light. Therapists generally teach patients that if they’re scanning the environment and haven’t seen their left shoulder, they probably haven’t scanned as far to the left as needed.
[Related: Visual Scanning Skills With I Spy]
When involved in tabletop activities, therapists teach patients to scan to their left hand or elbow. Patients can practice this type of scanning in several ways. Therapists may ask them to scan for and identify letters or lights on a board or to scan and find features in a parking lot.
Therapists often teach patients to highlight the left side of a page or place a bright bookmark to a page’s left side to institute a cue. This cue helps them recognize when they’ve scanned all the way to the left. If patients haven’t seen the highlighted area or bookmark, they know they haven’t made it as far to the left as they should.
[Related: Visual Scanning Using Menus]
Patients learn to always start their scanning from the left and then move slowly to the right. Patients with left neglect are less likely to miss items if they begin the scanning process on the left and proceed to the right than if they do the reverse.
Therapists may also place items to the left side of patients to force them to move, scan and use their left sides. They may place a glass of water to the left of a dinner plate or pass a pen to the left hand. All these seemingly small acts help improve scanning to the left. In addition, they help patients use the body’s left side in the left hemisphere of their space.
The goal is for robust scanning and increased use of the left side to become part of patients’ daily habits. Therapists may use other cues to help a patient better attend to the left.
For example, therapists may place bells on a patient’s left hand. They’ll hear the bells ring when their left hand falls from their wheelchair. This reminds them to pick up the hand.
Therapists can easily teach scanning skills to a survivor’s family and friends, who can be of great help to them in extending these techniques beyond an environment dedicated to therapy.
Family and friends can also help by identifying situations in which the survivor may be unaware of left neglect-related difficulties. All involved can then apply this knowledge to identify how left neglect could affect future situations.
For example, a family member may help a survivor in an airport recognize they’ve knocked over a fellow traveler’s bag. They can then help the survivor prepare to enter the plane without bumping into the left aisle seats.
Reinforced over time, this aided behavior will greatly improve the survivor’s solo interactions with the world.
Unfortunately, sometimes a survivor may suffer from both left neglect and a field cut. This combination can make successful functioning especially difficult, but with dedication and determination, left neglect and field cut patients can reach almost any rehabilitation goal.
We hope this article clarifies issues about left neglect/hemispatial neglect and field cut. Please leave a comment below with any questions, thoughts or ideas!
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If you or a family member suffers from a traumatic brain injury (TBI), you likely have a burden of expenses.
These additional costs compound the emotional and physical toll that is already affecting you and your loved one’s quality of life.
As Tax Day approaches, it’s important to know that many of your medical and caregiving expenses may be eligible for deductions and tax credits.
Need help figuring out your itemized deductions? Use Schedule A (either Form 1040 or 1040-SR).
Gross income is a term that throws people for a loop. It’s considered your overall income before expenses, which is typically completely taxable.
However, there are certain forms of income that you can deduct from your annual taxable income. Some of these items include:
Despite these additional forms of income, many people suffering from a TBI — or those caring for the loved ones with a TBI — remain financially underwater.
When preparing your taxes, make sure to look closely at what benefits you can remove from your gross income. Doing so will lower the amount of taxes you owe, thus saving you money to continue TBI treatment.
Insurance doesn’t always cover the total costs of medical expenses. Whether you need to pay out of pocket for yourself, your spouse, or your dependents, those expenses can often be deducted.
For those suffering from a TBI, or caring for a family member with a TBI, you need to know which expenses you can recoup.
Federal tax law permits write-offs for medical expenses due to long-term care. This eligibility is for people who are chronically ill and under long-term care by a physician.
Of course, a severe TBI can result in a patient being chronically ill and in need of long-term care.
It is important to note that according to the IRS website, “you may deduct only the amount of your total medical expenses that exceed 7.5% of your adjusted gross income.”
If your child, spouse, or other dependent with a TBI requires full-time care, you likely have additional caregiver expenses. Whether you are employed or using a caregiver’s services to find time to look for work, you may be entitled to a dependent care credit.
There is no age restriction when it comes to a taxpayer’s dependents who are not able to care for themselves. Meaning, even if you are caring for an adult child with a TBI, you may still be eligible.
As a caregiver for a family member or other dependent, you likely pay for several costs out of your own pocket. To help provide financial relief, some states have additional tax credits and deductions for caregivers.
If eligible, these specific tax programs will affect your federal tax credit. Taking these credits or deductions will reduce your taxable gross income.
It is important to note that these programs differ from state to state. The name of the program and the eligibility requirements will be different from one state to another.
The care needed for those suffering from a TBI often requires long-term care insurance, as it can be considered a long-term injury.
If you have purchased long-term care insurance, your state may offer a tax credit or deduction. However, this will vary between different states.
For instance, some states require that a long-term care policy is qualified. You should look into your state’s specific eligibility requirements to know what tax benefits are available to you.
A TBI can affect your entire family’s way of life. Financially, physically, emotionally, and logistically — the care required for someone suffering from a TBI can take a toll.
Moody Neuro is dedicated to helping patients and their families with the personalized care needed to treat the unique challenges of a brain injury.
Following a traumatic brain injury (TBI), sleep disorders are a common problem. Even in mild cases of TBI, the quality and quantity of an individual’s sleep can suffer.
Studies estimate that around 30% to 70% of TBI patients have sleeping disorders. Furthermore, regular sleep is a crucial part of our health. A lack of sleep may lead to various health problems — cardiovascular disease, strokes, depression, and anxiety are all possible.
So how can we help our loved ones find good rest again?
Identifying possible sleeping disorders is the first step.
Our brains play a crucial role in how our bodies sleep. The brain regulates essential sleep hormones, like melatonin. So, any trauma to the brain can cause a significant change in normal sleeping patterns. What’s more, any sleeping issues can quickly snowball into more severe health issues, affecting both mental and physical health.
Additionally, TBI patients can develop mental health problems like depression, anxiety, and more. Depression can make falling and staying asleep hard. Or, it can cause you to sleep for longer than you should. While your body needs rest to recover, too much sleep can indicate more serious issues.
Furthermore, because headaches often occur after TBI, pain can make falling asleep difficult. And, sometimes, even adding or changing medications will affect how we sleep. If you believe your medication is preventing or drastically increasing your sleep, talk to your doctor. It may just be a matter of adjusting the time of the day you take each dose.
If you’re looking for the best recovery programs for your loved one, reach out to Moody Neuro. We specialize in helping TBI patients and their families to recover and reclaim their lives. Our mission is to help each patient through their recovery.
When you experience a TBI, some of the following sleep disorders may develop.
It’s important to acknowledge changes to your sleep patterns as they occur. Keeping a sleep journal or making notes on your phone may help. There are also endless apps you can use that are designed to track sleep patterns.
Insomnia can make falling asleep and staying asleep tough. Additionally, you might wake up earlier than usual and feel restless.
Hypersomnia will leave you feeling tired throughout the day. This drowsiness makes focusing harder than usual. It can also make driving dangerous if you’re falling asleep behind the wheel.
Having a delayed sleep phase means that your internal sleep clock is off. You might not be able to fall asleep at your regular bedtime. Eventually, the delayed sleep phase makes having a consistent sleep schedule difficult.
Parasomnia is a sleeping disorder that includes several types of disruptive sleeping behavior. For example, teeth grinding, sleepwalking, and night terrors are all kinds of parasomnia.
Having a TBI can make managing sleeping disorders difficult. But, certain lifestyle changes can help symptoms.
However, contact your healthcare provider if you have trouble sleeping for longer than a few weeks or feel like your symptoms are getting worse.
First, try going to bed at night and waking up in the morning at the same time every day. A regular sleep schedule is one of the best ways to help get your body used to a sleep routine. Although this can take some time to work, a little patience goes a long way!
Additionally, if you take long naps during the day, try to cut the length to only 20 minutes a day. Lengthy naps can disrupt a regular sleep schedule and make it harder for you to fall asleep.
Furthermore, regular exercise, a healthy diet, and avoiding caffeine and alcohol can help sleep disorder symptoms.
Each patient receives highly personalized care at our facilities. Our goal is to make the recovery process as supportive and successful as possible for both families and patients.
Get in touch with us today to learn more about the outpatient, inpatient, and other therapeutic services we offer to those with TBI. Together, we can tackle any challenges that lie ahead. Contact us today to learn more.
Certain symptoms may occur after you or a loved one experiences a traumatic brain injury (TBI). For example, changes to one’s physical health, emotional state, and behavior can all be signs of a TBI.
And before you can help your loved one on their path to recovery, it’s important to stay aware of the possible feelings and symptoms they might be experiencing. That way, you can find solutions to help treat them.
Symptoms may vary depending on the kind of injury you or a family member experiences. Additionally, age and overall health can also play a role in the types of symptoms.
There are different levels to an injury’s severity. When it comes to TBI, the severity is often initially based on how long someone loses consciousness. For example, a loss of consciousness for 20 minutes or less immediately after the injury occurs is usually considered a mild TBI.
In contrast, a moderate TBI can result in a loss of consciousness for up to 24 hours. Anything past 24 hours is considered severe TBI, and the symptoms may be more severe and long-lasting.
[Related: Which TBI Care Plan Is Right For You?]
Signs and symptoms can vary depending on the severity of the injury and the individual. Additionally, you may not experience each symptom on this list right after an injury takes place. Some symptoms may take days or weeks to appear, and they can change or worsen over time.
Headaches are a common symptom after a TBI. For moderate and severe injuries, headaches may grow worse over time. Occasionally, they may persist for a long time after a TBI.
Trouble remembering events and faces, even those of loved ones, may take place after a TBI. This can include issues with focusing and attention problems as well.
It’s common for people who experience a mild TBI to have blurry vision. For more serious injuries, a mild TBI can result in total loss of vision as well.
Ringing sounds that come and go may occur after TBI. Tinnitus can be louder and more noticeable right after a mild injury and the days that follow. However, tinnitus symptoms can remain for months or years afterward, too.
TBI can cause you to be much more tired than usual. If you are suffering from drowsiness every day, this will likely begin to affect your sleep as well. Developing sleeping disorders is not uncommon.
Instead of tiredness, you may feel the exact opposite. It’s common for TBI patients to feel restless, irritable, or anxious.
Balance problems or trouble with coordination are possible following a moderate or severe TBI.
You may feel like your emotions are harder to control than they once were. Additionally, you might notice signs of depression later on.
You may feel nausea and lose your appetite.
Seizures are also possible after a TBI.
Children experience TBIs a little differently than adults. While their symptoms are similar, they may not be as clear. However, if your child experiences a bump to the head, falls, or otherwise has an injury, you should watch for the following signs of a TBI:
[Related: Choosing a Brain Injury Treatment Clinic]
Some symptoms may persist for months or even years following a TBI. Conditions like sleep disorders, depression, or difficulties concentrating may arise later in a TBI patient’s life.
The following are all possible complications after experiencing a moderate or severe TBI. However, there are more than what is listed here.
At Moody Neuro, helping TBI patients through their recovery process is our mission. With the latest technology, personal support network, and dedicated staff, we take pride in providing the best TBI therapy programs.
As the new year is upon us, it is important for brain injury survivors and their families to be aware that the change in year can lead to disorientation. Survivors become used to the year 2021. Due to their injury, it can be hard to switch to the new year of 2022.
As a comparison, many individuals without an injury accidentally write the old year on their checks and other documents for the first few weeks of the new year, as they have become accustomed to writing the old year.
This difficulty in switching can become much more of a problem after a brain injury. For some survivors, it may take many months to naturally make the switch to the new year, if at all. This disorientation to year can affect not only activities such as the accurate completion of important documents and appointment tracking, but also survivors’ ability to track personal information such as their age.
To help with the transition to the new year, it is helpful to have new calendars in homes, particularly in the rooms that the survivors are most likely to use. These calendars should be in easy-to-see locations, such as on the refrigerator in the kitchen or over the bed in the bedroom. Usually, survivors show better orientation when the calendar dates have larger, more easily visible print.
For survivors who tend to have greater difficulties with disorientation, family members and other loved ones should remind the survivors of the new year. This can be done by regularly reviewing the current date and also in more subtle ways, such as by adding it into regular conversations. For example, a family member could say, “Today is looking pretty sunny. Seems like the new year of 2022 is starting off on the right foot.”
With all survivors who have orientation deficits following injury, the more orientation aids (such as calendars, clocks, and planners) that are accessible, the better they will perform.
Overall, survivors and their loved ones should expect that if orientation was already a difficulty, the switch to the new year will likely bring greater disorientation. They should prepare by using calendars, reminders, and other orientation aids to help the survivors make a smooth transition to the new year.