|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.
"Different 'experts' involved in pediatric neuro-rehabilitation come from different organisational cultures which causes conflict and has a negative effect on the outcomes for the child."
"Often families don't have the financial capability to access services. We need to rethink how we deliver neuro-rehab services to children and young people"
"When different organisations assess different aspects of a child's neuro-rehabilitation needs, everyone looks at things from a different perspective and highlight needs and conflicting priorities"
"We would like to see earlier identification and support for children with brain injuries to help them succeed in school."
"Pediatric neuro-rehabilitation cannot be delivered in isolation. The needs of the child have to be looked at both holistically and within the context of the family unit. Parents need to be empowered to be parents in post-acute pediatric neuro-rehabilitation following brain injury"
"Restoration of anatomical functions and relationships must be done within 2 months of brain injury"
"Children and young people have poor social competence post brain injury due to reduced cognition, executive functions, and emotional control. As a result they are twice as likely to have mental health issues in the future"
"Families and professionals spend time focusing on the negative aspects of ABI. Families need to be properly supported as 'resilience' is key to delivering successful outcomes for children and young people."
"Thousands of children and young people living in the UK today without the help and support that can make a huge difference to their lives"
"New parenting support intervention showed how parenting style is related to executive dysfunction in children and young people post brain injury. With support parents cope better so the child has a better recovery"