Following a brain injury it is common to see a decrease function, especially in the areas of planning, sequencing and initiating. These changes influence how one accomplishes everyday activities, interpersonal relationships and success at home, work or school.
Survivors are generally able to resume some activities and life tasks but how much they can do and how long they can do it may have limits. Following an injury, the brain is often working 2-3 times as hard to achieve previous results and thus is easily subject to fatigue.
After an injury the brain is less efficient at filtering out non-useful stimuli.
Frequently the brain is more sensitive to surroundings such as bright lights, noise and movement, which may add to fatigue and overload. Brain injury survivors often talk about overstimulation, particularly when grocery or mall shopping.
After an injury the brain is less efficient at filtering out non-useful stimuli such as voices, blinking lights, moving people, and the sheer volume of choices one makes everyday.
The brain easily becomes “overloaded.” Home disorganization and clutter can further deplete the brain’s reserves, as do worry, anxiety and frustration.
Recognizing and describing these changes may be very difficult for those experiencing it.
After an injury, it may take more energy to complete basic tasks of daily living
To simplify the concept, we use a Brain Budget analogy. For example: if one has $20 to spend each day (or 20 units of brain energy), he or she must use it efficiently to avoid negative consequences.
After an injury, it may take more energy to complete basic tasks of daily living, leaving less brain budget for work, family or community activities.
With rest, the brain is able to renew.
If a person spends most of her budget in the first few hours of the day, their function becomes diminished. Survivors described this as “going blank,” temporarily “forgetting how to get home,” difficultly making decisions, a sense of “not being able to process what’s happening around me,” and “an urgent need to be in a quiet place.” With rest, the brain is able to renew.
Budgeting and planning help balance activities and create quality days.
While everyone experiences brain fatigue at times, the impact on those with brain injury is much greater. Continuing the Brain Budget metaphor: if one uses up their brain budget and goes into “debt”, the recovery period may be several days. Brain fatigue often causes to be irritation, abrupt mood swings, and much less ability to follow through with tasks or goals.
Budgeting and planning help balance activities and create quality days.
The Brain Budget concept helps survivors look at activities and schedules a week or even a month at a time. They can strategize how to best use their energy and are able to plan breaks between demanding activities. As survivors establish more organization and healthy routines, less of brain budget is spent “spinning their wheels,” leaving energy for work, family, friends or spontaneity.
The Brain Budget is one tool that may help explain to family and friends the many changes and challenges of brain injury. While recovery and acceptance of the injury are ongoing processes that require practice and patience, many report the Brain Budget empowers them to redesign their approach and better manage life with a brain injury.
Credit to Sharon Feeney, LICSW & Janice Worman OTR/L
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