Routine change with TBI

[Plenty]

It’s been mentioned before how a change in routine can have an effect on people with a brain injury.

Why is this? What’s going on in the brain when a unplanned change in routine happens?

Any thoughts appreciated.

[pinkvision]

Can you explain a little more please?

[Plenty in reply to pinkvision]

Possibly you could get into a routine that works well for you and a change in the routine, like new tasks or not being able to do something or even stopping part of your good routine - can cause a drop in mood or fatigue if you have a brain injury.

Everything being more exacerbated for some reason.

[pinkvision in reply to Plenty]

Ah. I think your cognitive patterns need time to readjust. I went through this and came out the otherside. What I learned was to just make one change at a time and do it repetitively for 8 weeks. It takes 8 weeks to hardwire the process into the neural network. If you try this you may find that you go a bit nuts in the 5-6 week period. Just keep working through it and when you come out the otherside the world seems a little bigger and more stable. It's a kind of integration process. Good luck. The phrase is what fires together wires together.

[Painting-girl]

Hi Plenty,

I only had a mild TBI, but have noticed that I feel quite thrown if I need to make a change to my plans for the day - which I find really weird, given what my job was like before. But I know my working memory isn't great, and I have trouble with decision making, so I assume it's because having to readjust and replan quickly is quite cognitively challenging somehow, and that feels like a stress to do it quickly?

[cirrus]

Same as Painting Girl. I have trouble with visual thoughts and memory, imagining, multitasking, etc as well as memory and being plain slow. Emotionally I wouldn’t be bothered but the cognitive challenge and stress can evoke anxiety that way, if I’m rushed etc. Though people can assume it’s the other way round.

[Pairofboots]

Hi, same as painting girl and cirrus say. I think it is dependent on how much your cognitive abilities have been effected. We have trouble with change as it disrupts routine that are part of our coping strategies, even if we haven't formally constructed them. It also our ability to adapt thinking, the brain is plastic in adapting gross actions, but any changes are difficult, causing stress and anxiety. Our brains can't change gear as easily as it previous would have done, because we have to actively think about actions.

[Plenty]

I agree.

It’s like the hidden disability, and not returning to a previous career.

Hard to put the reasons in writing.

But it’s definitely life changing.

[Annie-GBIA]

It very much depends, I think, on where on the recovery path someone is and whether or not they have lost self-awareness.

Routine is often instilled by an occupational therapist and by learned coping strategies so any professional input will also have a bearing on the need for and dependence on routine.

Routine helps people to remain more balanced and offers a whole host of other benefits. They know what to expect and while often unable to practically prepare, might often feel more prepared.

Many people lose the links to their 'higher thinking' functions which includes not being able to 'hear' the thinking voice in the head any more. Metacognitive skills help us to orientate ourselves in time and environment so without that part of the brain working people can feel a sense of chaos in their head. Routine helps to calm this effect.

Metacognition also enables us to monitor and be aware of what we are thinking while we are thinking it and also to be able to monitor what we are doing as well.

It is much more difficult for people with a brain injury to accept and adapt to change and this is mainly due to slowed and limited processing - in other words it is very difficult for them to turn information into understanding or realisation - it remains as intellectual knowledge (if they remember it) that they can't relate to.

There is a really good page about it - hopefully it will help in someway - globalbia.org/the-importanc...