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While under our care here at TLC, it’s very common for patients to talk with staff about post-injury deficits and areas of recovery that present those patients with particular difficulty. The self-awareness of deficits that such dialogue promotes is crucial to successful navigation of the therapy landscape. However, there is a specific aspect of this self-awareness that poses to our patients consistent and notable struggle. Namely, patients all too often encounter real difficulty in cultivating a healthy self-awareness of what they CAN do in spite of their deficits.
What brain injury survivors can do after an injury is equally important to that which they cannot do. For example, recognition of memory deficits is important but so is the recognition of functional hand use that allows a survivor to write memory notes. Recognition of motor deficits that prevent driving is important but so is the recognition of speech skills that allow a survivor to call a cab. Recognition of walking deficits is important but so is the recognition of upper extremity capabilities that allow for use of a wheelchair.
This topic often comes up in relation to patients’ desire to return to work. Survivors will often be upset that deficits necessarily preclude a return to pre-injury employment. It’s important to help these survivors realize that they still possess skills that can be utilized at a different job, and to then aid them in identifying these remaining marketable skills. For instance, a survivor with balance issues may not be able to return to his or her previous position as a roofer but if he or she has adequate speech and hand use then that survivor could serve as an online customer service representative. As one of our therapists is fond of telling patients, you work on your deficits but you get paid on your strengths. Self-awareness of strengths is vital to successful work re-integration.
This can also prove an important issue in successful family and home re-integration. Upon returning home from TLC, many patients struggle with significant necessary alterations to the roles they fill in aspects of family life. Conventional wisdom dictates the confronting of some remarkably distressing questions. How can one be a good spouse absent any capacity to serve as breadwinner? How can one still be a good parent to children and never once drive them to school? But there are so many wholly irreplaceable roles that the survivors can still fill in spite of any deficit. They can still be loving and attentive partners to spouses. They can still serve as the go-to parent for relationship advice. They can still be just as enthusiastic cheerleaders on the sidelines at sporting activities. All of these things that they can do just as well post-injury are tremendously valuable to their loves ones.
Ultimately, thoroughly identifying what a survivor can do allows that survivor to more easily overcome obstacles, locate future opportunities and maintain a healthy self-image. As a brain injury rehabilitation therapist, I do need to be told what it is that you can’t do. But you’d better be prepared to also tell me what you can!
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