Column by Chris DeWald
‘Tis the season to be jolly, they say. I am talking about Thanksgiving, Christmas, New Year’s, birthdays and any other celebration day.
Things change with a stroke or a brain injury. or those who have not had anything change, you are very lucky. To those who are caregivers, friends and family of those with brain injuries, I commend you. I started doing some research as it pertains to me and I found such a similarity to an already printed article that I must share this with you.
Planning Strategies for A Happy Holiday Season
By Carolyn Rocchio
Thanksgiving through the first week of January is a special time of the year for family gatherings, parties, and holiday celebrations. As much as the family may look forward to this time of happy occasions, it can also be a difficult time for individuals with brain injury and their families.
For some it can be a period of depression when thoughts are more focused on losses and an inability, imposed by the injury, to participate in and enjoy the holidays as before the brain injury occurred. Families with unrelieved caregiving responsibilities may be unable to attend functions as in the past and in some cases refuse invitations which exclude the family member with brain injury. Even inclusive invitations may be declined for fear of embarrassing social skills lapses on the part of the individual with brain injury.
Alcoholic beverages are commonly offered at social events during the holidays and alcohol consumption can be very dangerous for persons after a brain injury. It is believed that the effect of alcohol is significantly increased after a brain injury, having possibly three times the effect to that of an uninjured person. Many individuals with brain injury use prescription drugs for seizures and other medical conditions and the use of alcohol may alter the effectiveness of these drugs and/or increase the risk of seizures.
When, as a result of a brain injury, individuals are dependent upon a structured environment to function at peak performance, the holiday season can be a difficult time.. In most households the holiday season is replete with added stress to get things done, additional entertaining, shopping, and extraordinary confusion. For individuals with low tolerance to noise and increased motion in their environment, they often become stimulus bound, and shut down cognitively. Therefore, it is wise to consider planning around problem areas for an enjoyable holiday season. Although many individuals with brain injury accommodate change well, it is often best to prepare in advance so schedule changes will be accepted more smoothly. Some suggested ways for making the holidays fun and less stressful for all, particularly when persistent cognitive /behavioral issues are problematic might include:
1. Holiday shopping should be a fun activity and indoor malls are weather controlled and safe places for strolling on foot and/or for those wheelchair or walker assisted. However, the holiday period can make shopping less than a fun activity without preplanning. Start early to avoid the holiday crowds and use the opportunity to incorporate cognitive exercises into the planning. The individual with brain injury should make a list of gifts to be purchased or hand made, when possible, suggested gift ideas and estimates of costs associated with the gifts.
2. Catalogs that come in the mail this time of year are wonderful for gift ideas and also for estimation of prices. Take some time to sit down and look through a few as part of the independent planning phase.
3. Make out a simple budget before going to the bank and allow your family member with brain injury as much control of the funds as possible even though money management skills may be impaired.
4. Place greater emphasis on use of journals or calendars to record routine events as well as holiday activities. Schedule a week in advance, with a daily review to make note of any changes as they come up. Those accustomed to a daily routine may be better prepared when special dates and activities are written in the journal and/or on the calendar in colored ink for emphasis.
5. Each day, during the holidays, orient the individual by discussing the day’s activities over breakfast to avoid misunderstandings about changes from the normal routine. It is helpful to repeat this information several times during the day for those with severe memory problems.
6. If bright or flashing lights bother your family member and/or possibly trigger seizures, carefully plan any additional lighting that will be used during the holidays and avoid laser holiday lighting displays.
7. Crowded places and loud music may also bother some individuals and should be taken into consideration and monitored, if necessary.
8. Food is a big part of holiday fun and many of the foods may be very temptingly displayed. Parties, holiday family dinners, and open house gatherings are often scheduled at times that do not coincide with routine mealtimes, thus, presenting a problem for those whose mealtimes are more rigidly scheduled. You may want to offer a light snack at the regular mealtime to “tide him/ her over” until the main meal, or make whatever adjustments are necessary. For those with more severe cognitive deficits, which interfere with appropriate food intake, it may be necessary to help with monitoring to avoid overeating. It is very common for damage in the hypothalamus area of the brain to interrupt signals to the brain which help the individual know when their appetite has been satisfied, thus, many with brain injury need help with quantity control monitoring. Additionally, memory problems and attention can derail a persons resolve to watch their food intake to avoid excessive food and beverage intake. After a brain injury burning of calories may also be changed and individuals who could eat anything and everything before the injury may need to more diligently watch calories to avoid weight gain.
9. By all means don’t forget that increased activity during the holidays may be more fatiguing than usual so plan rest periods accordingly. This is particularly important when cognition and behavior are problems. Fatigue often increases confusion that can result in an outburst or other kinds of unpleasant behaviors.
10. Structure can be your best strategy for ensuring the entire family has a higher quality of life. Initially it takes effort to get the structure in place but it pays dividends in the end. Flexibility is a key word during the holiday season but planning and preparation will hopefully result in a happy holiday for family and friends.
Next comes New Year’s resolutions! Start thinking about ways your entire family can enjoy life more fully, fulfill the demands of your caregiving role and provide the best possible quality of life for your family member with brain injury.
‘”Planning strategies for a happy holiday season,” by Carolyn Rocchio, Family News and Views, November 1997. Reproduced with the permission of the author.
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She covered everything I had written down from a survivors view. What a terrific lady with marvelous insight people. Take note of #6 and #7. I have issues with crowded places and sudden noise. This can be a restaurant or a home setting with many guests. This is not unusual as I talk to many with brain injuries. I startle easy, and that also is seen in may stroke survivors.
I am also compulsive, and I have to fight buying gifts for all my friends and family. This year’s personal-property taxes snuffed out me buying a Jaguar and Mercedes Benz.
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I have found some other websites of particular interest I suggest you go and read. You may find yourself or a survivor you know.
– www.rcep7.org/TBIMO/kathy/archive/misc/holidaycoping.html
– www.bianc.net/docs/Care%20Notes%20-Winter%2006final.pdf
– http://brainline.org/content/2008/12/ask-the-expert-social-skills-and-the-holidays.html
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