Head Injury & Paralysis
 

The key practical challenges here for any patient include mood swings, chronic fatigue and memory problems. On a slightly deeper level a core fear for many people is the fear of “losing” their mind because of the head injury. This is complicated enormously if additional damage is done to the sensory motor cortex resulting in mobility, or sensory difficulties. Ironically, the danger here is of doing too much for the patient. There are situations in which reliance on memory aids such as notes can be continued too long and the patient becomes dependent on them rather than working to improve their memory skills. This emphasises the importance of working with other professionals who can assist with a thorough evaluation of the patient’s potential for recovery. A range of concentration exercises combined with ‘mindfulness’ approaches can be used as well as learning associational strategies to help improve memory.

A parallel danger is when the patient is encouraged to lead as normal a life as possible but does not have it explained to them that normal life may have definite restrictions. One case at our clinic involved a person who was very depressed following an accident that left them with brain damage and paralysis requiring them to be in a wheelchair. Contrary to expectations the depression was more due to “burnout” from the patient trying too hard to return to their normal life. The depression lifted when the patient’s situation was carefully examined and they were encouraged to return to a normal life but to attempt only 60% of their old day instead of trying to achieve as much as possible and becoming caught in a cycle of failure and self blame. They could then work up to 80% of their old life by use of careful pacing and needed to work on developing a number of different work related skills that included better delegation and planning skills.

Our clinicians work using a comprehensive and preferably multidisciplinary approach to assist the patient deal with some of the more difficult symptoms associated with brain injury or severe damage to the central nervous system and spinal cord. This includes a program that may include any of the following:

• Helping with some of the more difficult problems of adapting to restricted function.
• This often involves some degree of depression and intense frustration and our clinicians utilise methods of mood management that have been modified to be appropriate to these conditions.
• The patient often experiences mood swings and can become irritable very quickly. We help the patient develop strategies to calm themselves and reduce these mood swings.

The patient may experience ongoing difficulties with headaches, problems with memory as well as struggling to concentrate. We can help to some extent with each of these areas by designing a series of interventions tailored to the patient’s current needs that help to extend their coping skills and regain some of their general abilities by a variety of graded mental exercises.