28 October 2010
Day 347 – Grayson’s Journey
Dear family and friends
Routine – it is one of those things that people like more or less of in their lives. Some feel confined by it, others find it comforting. Some amount of routine is essential and I for one am grateful that most people put daily showering in their routine! For those like Grayson who are recovering from brain injury, routine is one of the few things that can substitute for a lack of short term memory. Cueing Grayson through a routine helps him successfully complete a task. As the routine becomes more ingrained, fewer cues are needed.
If it was time for you to go to bed, you would just do it, including changing into bedclothes, washing your face, brushing your teeth and anything else that you might need. That is your routine. For Grayson, that is way too complicated. You need to break the task (going to bed) down into bite sized chunks then cue him through the chunks. Changing into bedclothes really consists of removing your clothing, putting them away or into the laundry basket, then selecting bedclothes, then putting them on. That is still too complicated for Grayson. Removing your clothing consists of: sit down, untie your shoes, remove your shoes, remove your socks, unsnap your pants, unzip your pants, remove your pants then remove your shirt. That is the level of routine that we work with – activities of daily living broken down into steps that he can be cued to remember. Around here, the following type of phrase is often heard: "Grayson what is the first thing that you need to do to take off your pants?" Grayson will likely respond with, "Unzip?"
Using routine to work around short term memory issues – another technique for dealing with brain injury!
Pax!
Brant
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Ah yes, the Neurological Highway. "Simple" things are revealed to be not all that simple; "easy" tasks aren't necessarily easy.
ReplyDeleteBecause that transition from "simple" to "complex" is unusual (up to this point), accommodation and adaptation seem like Quite The Tasks. But everyone accommodates and adapts all the time; short people use step-stools or other "tools" to reach high shelves, but no one thinks of that as being anything but usual.
As we who travel the Neurological Highway learn anew every day: "Normal" is a very, very wide target.
Hi Brant and Regina:
ReplyDeleteIt reminds me of doing a critical path schedule, or developing a computer routine....and over the past three years I have had to do that in my life "times without number". I still have to "think" before I can take a step! It is a "short think" now, but once was a longer one, so the improvement is always good. As Mr. Parker said, "wide is the target"....but the kitchen door is only 3' wide, and I keep bumping into the dad-gum thing...rrrrr!
In Him,
Doug