|Physical||Communication||Cognitive||Behavioural / Emotional|
Motivation is a person’s reason for doing something and an enthusiastic person is said to be well motivated. After a brain injury some people do not feel enthusiastic about anything. They may lack any drive and be unable to initiate anything of their own accord. They may not want to do anything and may not want to leave the house. They may ‘channel surf’ in front of the television, or wander about aimlessly. Other people may appear to want to undertake a particular activity but be unable to get beyond an inability to plan and initiate the activity. Difficulties with an ability to initiate or start activity, and the ability to keep going to finish an activity or task is called adynamia.
Poor motivation can be very frustrating for friends and family and can lead to social isolation for the person suffering the brain injury. People may think that the poor motivation is due to ‘laziness’ rather than due to the effects of the brain injury.
Introducing a structured routine is a good way try to get the person to participate in, and complete activities and tasks. A structured routine decreases demand on memory and thinking skills. Checklists and prompts, for example on a mobile telephone, may assist as well as breaking down tasks into smaller steps that are easier to achieve. In more serious cases one to one support can help to ensure the person maintains focus and motivation to complete tasks.
A person is more likely to have motivation to complete a task if it is something they enjoy doing. Try to find activities that will appeal to the person with the brain injury that may be in relation to previous hobbies or something new they may want to try. Conversely, it may not be a good idea to try to get someone to do something they did not enjoy or want to do before the brain injury.
Consider alternating some less enjoyable tasks with more enjoyable tasks to maintain motivation. They can be considered as a ‘reward’ for completing the less enjoyable tasks. Offer choices in activities and participation in decision making to ‘engage’ the person in their activities. Knowing the person and their likes and dislikes is key to rediscovering motivation. The more positive and motivated you are, the more likely that the person with the brain injury will also be positive and motivated.
"Case management for children and young people post acquired brain injury is 'pivotal' to successful outcomes and must be local"
"Positive and coordinated neuro-rehab interventions for children and young people is proven to bring health improvements; improve independence; reduces the need for sheltered living; decreases vulnerability; decreases drop-out rates in schools; decreases youth offending"
"With support parents cope better so the child has a better recovery"
"Intensive and individualized approaches work. A one-size-fits-all approach doesn't. You have to make it relevant to the child."
"Taking brain injured children home causes high stress for families. Disjointed services exacerbate family stress levels."
"NHS clinicians struggle with what intervention to prioritise in paediatric neuro-rehabilitation due to limited clinical time and the complexity of needs. Children, clinicians, parents and schools all have different neuro-rehabilitation priorities"
"More play increases brain plasticity and makes for better recovery post brain injury"
"There are problems with getting people into neuro-rehab. Those most in need are often those most excluded due to a lack of socio-economic resources."
"Participation in teen sports and normal activities leads to improved quality of life for children and young people post brain injury and helps to maximise outcomes"