Ronny Part 3: Five ways that helped change brain injury survivor Ronny's life

Ronny Parts 1 and 2 are available here

Here’s a real high five to OT!

In the final part of our series on bike crash casualty, Ronny, our Neuro OT comes up with five ways to help him transform his life…

Through her thorough investigation of Ronny’s past and present lived experiences, our Neuro OT was able to discover:

• Conflict between long-held values and new-found limitations.
• An inability to rely on hard-wired systems of coping;
• Regular confrontation of Ronny’s self-perception.

Armed with this new knowledge, she then set out to influence Ronny’s participation in activities and reduce the behaviours considered to be detrimental to his wellbeing. 

She applied a multi-faceted approach, but one based largely on the motivational and environmental aspects of Ronny’s life.

She had taken the time to affirm Ronny’s self-perception, including his strong held beliefs about himself and how he lived his life. 

Now she was ready to present a five-pronged plan to him in which activity – the Occupational Therapist’s key tool – was intrinsic.

Discovering Ronny’s ‘new self’...

   Our occupational behaviours are our response to our motivational thoughts - negative or positive - and the impact of the environment that, ultimately, leads to a functional output.   

Jo Throp, Krysalis Clinical Director.

Our Neuro OT unravelled Ronny’s rehabilitation needs and narrowed them down to five:

      1. Education: an avenue to explore Ronny’s strengths and reflect on areas of weakness, and to empower him with knowledge about his condition and a greater acceptance of some of his limitations.

      2.Coping strategies: these were introduced at a pace Ronny could accept and were graded so that he could have ownership in making some practical changes.

      3.Activities: these needed to

• Challenge Ronny’s physical and cognitive abilities.
• Provide opportunities for him to demonstrate his capabilities.
• Enable him to learn and develop self-awareness by reflecting on where barriers occurred.

       4. Acknowledge his value and belief systems, but also challenge misunderstanding or thinking that prevented him from moving forward.

       5. Present new and revisit old experiences relating to Ronny’s past and values in settings that could also involve his support team, creating a shift in the locus of control.

Rehab on repeat…

Our Neuro OT provided education and support for Ronny regarding expectations, limitations, pacing of activities and the importance of routine and consistency. 

But there was more she needed to do to put her plan into action. Ronny needed support to organise himself as time went on.

Traditional aids, such as calendars and diaries, created a ‘rub’ with Ronny’s belief that he was ‘unconventional’. Suitable strategies would need managing carefully.

Through a gradual process of occupational therapy intervention, Ronny agreed to:

• A planner and orientation board.
• Processes to help organise his daily affairs, including a paper shredder.
• Structure for engaging in domestic activities of daily living, including shopping and care of his home.
• A weekly routine to incorporate leisure and vocational based activities with support staff.

A unique approach…

Together with Ronny, our Neuro OT used occupation and activities to explore and influence his motivators, values, habits and abilities.  

She also explored how the physical and cultural environment was feeding into Ronny’s ever-evolving experience of his day-to-day life.  

Ronny’s involvement in the rehabilitation process and, thereby, day-today activities was, as a result, radically altered.

Krysalis Clinical Director, Jo Throp comments: “Occupational Therapists are unique in the way they view human function.

“They understand the dynamic relationship between human response to activity and the impact of the physical and social environment.

“And they recognise the influence of the ‘lived experience’ on our ongoing choices, actions, learning and, subsequently, our performance and participation.

“It is about recognising the challenges of life following an acquired brain injury. It is about recognising who our clients really are and what they could be and should be.” 

Final thoughts…

From Ronny’s Case Manager: “All rehabilitation and support for Ronny was challenging throughout the six-year period I worked with him.

“Having help was foreign to him, as he was used to feeling strong and helping others. 

“Occupational therapy assisted Ronny to gradually, through repetition and reinforcement, gain a fuller understanding of his strengths and limitations. 

“For example, through weekly supported visits to the same local supermarket for eighteen months, Ronny was able to start shopping independently.

“He started regular volunteering, completing handyman tasks at a local charity and swimming each week with his support team. 

“Having structure gave him purpose. This led to improved relationships with family and friends and having something positive to talk about again. 

Further reading

What the experts say - stress and anxiety advice for brain injury survivors during the Covid-19 pandemic. Turn off the news, engage with nature, practice mindfulness, stick to a routine and suss your stressors ...

More resources to help brain injury survivors and their families during Covid-19 here: Krysalis public resources

Over 200 stay at home activities for brain injury survivors and their families ...

Twenty apps to boost brain injury rehabilitation ...

Covid-19 Brain injury and me - Diary of an ABI survivor ...

And so much more on our exclusive talking heads blog ...

“The value of skilled occupational therapy should not be underestimated as it can make a unique difference to an individual’s quality of life following a brain injury. Thank you, Krysalis!”