If you are depending on others to help get you through the early phases after brain injury, illness or other health issues remember to keep these dependencies temporary.  Take back control and do all the things you can do for yourself providing you stay safe.  Put fear behind you. Don’t let fear control you.  Don’t depend, join in and attend life!

English: Self Determination Theory (Photo credit: Wikipedia)

If you fear falling because you have fallen many times, that is understandable.  Take every precaution to prevent falling.  Safety is always key.  The longer you have the problems, the more you learn about your situation, your body, your mind … and what works and what doesn’t.  Sometimes it’s so unpredictable you can’t figure out. Only you really know!

Injury Prevention (Photo credit: Army Medicine)

• Don’t let fear control you
• Put fear behind you
• Take back control
• Do ALL you are capable of doing

• Don’t depend … attend!
• Always be safe

Remember you need to remain independent as possible.  Don’t drain others when you can do it yourself!  Do everything possible for yourself.  It is too draining on others, and you should never depend on others when you are capable of doing things.  Some people have a need to be dependent, and others struggle to become independent.  Evaluate what you can do on your own versus the things you absolutely need someone to help you with.

• Don’t drain others
• Do it yourself
• Never depend on others when you can do it yourself
• What can you do on your own?
• What do you Need someone to do for you?

Are you safe doing your own activities of daily living?  Can you bathe or shower daily without help?  Do you wash your hair unsupervised?  Do you depend on others for all your care? What causes your problems and what helps make things better?  Try to understand what works best without draining the energy of others.  Separate what you can do, and what you cannot.

• What you can do?
• What you cannot do?
• What makes your problems worse?
• What makes your problems better?

It’s time to make a list to start doing the things you believe you might be able to do on your own.  Is it fear that keeps you from doing things?  What does your condition prevent you from safely doing on your own?  List all the things you can do, and you tackle on a regular basis.  List the things you believe you need help with, but think you might be able to do on your own.  List the things you absolutely cannot do, and you need to depend on others.

Which are your concerns about your personal hygiene? – SCA (Photo credit: SCA Svenska Cellulosa Aktiebolaget)

I identify three levels that begin with dependence to learn the skill.  As the learning progresses the skill becomes the next level as assistance.  While needing assistance you find creative ways to accomplish the skill until you are finally independent.  Independence is the highest level and helps in the process of reaching your optimal level of functioning.

The three levels-lists include: 

1. Dependence-Beginning
2. Assistance-Intermediate
3. Independence-Optimal Level

The following is an example:

Dependent

• Can’t drive, need someone for transportation
• Can’t cook, not safe around stove … need someone to prepare cooked meals
• Can’t write checks or do finances … need someone to pay bills and help with finances

Assistance

• Bathing
• Showering
• Shampoo
• Choosing Clothes
• Nutritious meals

Independent

• Toilet
• Brush Teeth
• Brush Hair
• Dressing
• Washing up

***The goal for self rehabilitation is to do as much for yourself as possible.  Do not depend on others for the things you know you can do for yourself.  There are many different types of injuries and illnesses that dependency is temporary.  Yet some injuries and conditions “dependency” in certain areas are permanent.  Every disease and injury is different, albeit many similarities.  

The key here is: TEMPORARY. Do you have an emotional need for dependency? or a physical need for dependency?  Only you can answer this question.  Unfortunately, those with paralysis have a higher level of physical dependency, but they accomplish many tasks that others perceive as impossible. By repetition, education, and determination even paralysis has been overcome. However, paralysis is not an injury that affects every aspect of life as TBI.  It affects specifically limbs (extremities).  These limbs can heal, some more than others.

Brains may or may not, but when the brain is broken every aspect of life is challenged!   This is not to say that every injury can recover like that, but you must give it your best effort … and never give up!  All injuries are different, but what remains the same is the level of determination it takes to overcome obstacles. DETERMINATION … that’s what it takes to be a TBI survivor! 

week 15 – Determination (Photo credit: Sweet Dreamz Design)

I personally do not know one TBI survivor that wasn’t determined.  Even those who died struggled for their life in one way or another.  The tools for rehabilitation are limited and I hope by offering this basic tool to help others get through some difficult times.  Many will find this tool totally useless. Others will cling to the things that they need and direction they were lacking.

Determination and success are rarely measured well in the invisible injuries because so many areas of one’s life are altered.  TBI survivors are constantly working on one area or another … it’s a lifestyle, ups and downs, adjustments and readjustments, adapting, then changing.

It’s simply a vicious cycle that once one has accomplished one thing, another issue needs work.  One system gets fixed and the other system breaks down.  It’s a ripple affect!  It’a hard for others to grasp this concept.  They don’t get it, unless they’ve been there with this type of injury.

This determination is often why so many traumatic brain injury survivors achieve a high level of functioning within their home environment.  Only because of the complex situations with brain injury is why many cannot obtain the goals they repeatedly try to achieve.  It’s not failure, it’s the complexity of brain injuries.  In the case of paralysis, you still go through the Dependency, Assistance, and Independence PHASES.  

Sorting through and accomplishing tasks in the dependency list and moving to only need assistance, and finally accomplishing each task becoming independent.  These tasks may need to be accomplished one at a time, but the goal is the same … Independence! There is no greater achievement, then reaching personal goals.

 What self-care task have you or do you find most difficult?  Why? What works most of the time?

Related articles

• VA Seeks to Expand List of Service-connected Traumatic Brain Injuries Effects (clarksvilleonline.com)
• Less intelligent after TBI? Not even close. (brokenbrilliant.wordpress.com)
• Devising Solutions for Traumatic Brain Injury: Interview with Dr. Michael Whalen, MD PhD (medgadget.com)
• VA Seeks to Expand TBI Benefits (EndtheLie.com)