Navigating the Holidays With a Traumatic Brain Injury

Article by Moody Neuro

The holidays are about spending time with those closest to you. However, when you’re recovering from a traumatic brain injury (TBI), the holidays can be a little more challenging.

In fact, when you have a TBI, holidays can easily feel overwhelming. You may not have the energy to spend the whole day celebrating. And the worst part is that all you want to do is spend time with friends and family.

Moreover, you want to show up and be present with those you love without causing them or yourself worry. But overextending yourself and your time can leave you feeling exhausted and mentally drained.

Here are some great tips to help you get through the celebrations while still prioritizing your health. After all, you don’t want your TBI to prevent you from participating in family traditions!

Note: It’s important to listen to your body and rest when rest is needed. If you’re a survivor’s friend or family member, please remember these considerations as the holidays approach.

[Related: Noticing the Positive]

Go at Your Own Pace

It’s OK to go at your own pace.

With or without a TBI, holidays and the accompanying celebrations can quickly become hectic. It may be tempting to try and match everyone else’s pace. But doing too much can make you irritable and put a cloud over a day that’s supposed to be full of family, love and fun.

Pushing yourself too far will lead you to wipe out early and leave you feeling worse the following day. Additionally, try to avoid doing too much cooking, decorating or participating in other activities you might traditionally undertake.

Most importantly, focus on enjoying the day in your own way. Do what feels right for your current energy level and mood.

If that includes taking a nap after dinner, then that’s fine!

Undertake Reasonable Tasks

If you have poor muscle control in your arms, you shouldn’t be lighting menorah candles for Chanukah. Similarly, if you have balance issues, you shouldn’t climb onto the roof to put up Christmas lights.

However, with this in mind, you’ll always have some identifiable strengths.

For example, although a person in a wheelchair may be unable to put up all the decorations on the Christmas tree, they may be able to put some on the lower branches. Additionally, a survivor may be unable to be fully responsible for cooking a turkey, but maybe they could cut some vegetables for a salad or help set the table.

If you and your family members look closely enough, there’s almost always something you can do or help with. Even taking on a small task will boost your pride and self-esteem.

Injury or no injury, working together on holiday celebrations brings family members together. You have a joyful opportunity to bond.

Make It Easy

Some families traditionally go from house to house for multiple holiday celebrations throughout the day. However, you might become fatigued easily, and holiday parties tend to be long and active.

For many survivors, attending several celebrations on the same day may be very difficult. You might benefit from spending less time at each celebration.

Try to keep things simple and easy but still fun. Doing this has the added benefit of cutting out excess details or over-the-top traditions. Instead, you can focus on sharing the day with your family.

Prepare Ahead of Time

While last-minute shopping is sometimes necessary, TBI survivors should consider light scheduling closer to the holidays.

Space out everything you want to do, like cleaning or shopping. That way, you don’t feel rushed and have plenty of time to do things at your own speed. It’s also wise to give yourself a day of rest before any celebration.

Furthermore, try to figure out how long the trip will take if you’re traveling. An app like Google Maps can be helpful.

What’s more, there are plenty of options to get from point A to point B without being behind the wheel yourself! Look into rideshare apps, public transportation or bus schedules for long-distance trips. You can even sleep through the commute if you need a bit more rest.

However, it’s also a good idea to ask a relative to drive if you feel uncomfortable taking public transportation. And if you need support at any point, don’t hesitate to reach out to your network.

Don’t Stress About Gift-Buying

Many survivors struggle with the tradition of giving gifts during holidays like Christmas and Chanukah. You might be dealing with strained finances in the aftermath of your TBI, and that can make gift-buying for the holidays stressful.

If you’re a friend or family member of someone recovering from a TBI, simply reassuring them that you’re not worried about receiving a gift or are perfectly fine with getting a small gift can ease their concerns.

Alternatively, you could always create a handmade gift or card (with a family member’s help if needed).

Or families might switch to a gift exchange. For a gift exchange, everyone buys just one gift, puts it in a bag (no names marked) and then randomly chooses one of the bagged gifts. It’s fun, special and much less stressful.

In addition, families and friends might limit the cost of the gifts everyone buys. That makes gift-giving easier and helps everyone — you included — feel less financial pressure.

Plus, it’s wise to put little (if any) emphasis on the role money plays in the holidays. When you’re not worried about impressing others with pricey presents, everyone can focus on the meaning behind the holidays.

Set Boundaries If Needed

Setting boundaries is important for your mental health during the holidays. Whether that means politely changing the conversation with a family member who wants to know more than you’re comfortable sharing or stepping away from the hubbub for a moment, you sometimes must set boundaries.

Regardless, setting boundaries is a healthy way of maintaining quality relationships with those close to you.

And frankly, it might be a little difficult at first to set boundaries with a family member or move past worrying that you’ll hurt someone’s feelings. Push past those emotions! Setting boundaries actually has the opposite effect.

When you set boundaries, family members understand that you’re doing what’s best for you. They should know that with a TBI, holidays can require parameters in your social life. And this allows you to be at your best when you’re with them.

Consider Celebrations’ Location and Accessibility

Survivors and their loved ones need to address several issues in terms of where they hold celebrations. But this consideration applies to both survivors and their friends and family members. If you’re a survivor’s friend or family, ask yourself these questions:

If the survivor is in a wheelchair or uses another assistive device to aid mobility and is going to someone else’s home, is that home accessible? Remember — it’s much easier to get a wheelchair across a hard floor than across carpeting.
Is there enough room in the bathroom for a wheelchair?
Should the survivor bring a urinal if accessing the toilet is too difficult?
If the survivor has problems with incontinence, is there a private place in the house where they could clean up or change clothes?

Some TBI survivors’ families find it’s easier to host holiday celebrations at their own homes rather than travel to others’ homes. They’ve already adapted their own homes to survivors’ needs.

Survivors and their families should also consider the physical layout of rooms where celebrations will take place. For example, rearranging tables and chairs so survivors can navigate rooms more easily is a good idea.

You should also make sure toys and gifts aren’t left on the floor — they’re trip hazards. Cords from lights or decorations can be trip hazards as well, so place them so they’re not dangerous when survivors move around.

Additionally, consider practical matters regarding holiday meals. Here are just a few questions to ask yourself as a TBI survivor’s friend or family member:

Can the survivor reach a dish, or will they need help?
Has anyone left silverware on a counter that’s too high for the survivor to reach?
Can the front of the survivor’s wheelchair fit under the table?

Small changes in room and furniture layouts can make a huge difference! Striving for safety and accessibility helps survivors enjoy celebrations and feel included.

Think About Noise Level

If you’re a TBI survivor, your family may want to consider how loud they allow holiday celebrations to be.

Some survivors find that they’re more sensitive to noise than they were before their injury, and loud noises can lead to agitation, anxiety and/or anger. If this is the case with you, then you might want to attend smaller celebrations or spend time in quiet rooms during big, boisterous parties.

Noise can also be a relevant issue when considering attending religious services. It may be better for you to go at less busy times or find a smaller house of worship with fewer people present.

Don’t Overexert Yourself

When you’re a TBI survivor, fatigue can be a constant struggle — and this certainly extends to holiday celebrations. Holiday parties and celebrations often run for many hours, and you may become tired easily.

Sometimes, changing how long you’ll attend the celebration can increase your likelihood of going! Three hours of fun participation is better than five hours of exhaustion.

Monitor Alcohol Consumption

People drink alcohol on several holidays. For example, a champagne toast is often at the center of New Year’s Eve celebrations. Eggnog with liquor is standard at many Christmas parties.

However, alcohol can be highly problematic for TBI survivors. If you’re a TBI survivor, speak with your doctor before you drink. It’s much better than taking a risk.

Moody Neuro: Innovative Therapy Programs Since 1982

When you have a TBI, holidays should be joyful as well as accessible. And they can be exactly that with a little effort from you, your family and your friends.

At Moody Neuro, we specialize in personalized rehabilitation programs for TBI survivors. We also offer help and resources to caregivers and family members. From residential care to outpatient therapy services, you can find the support you need.

Strokes are medical conditions that affect millions globally. In the United States, more than 795,000 people have a stroke each year, with about 610,000 cases being first or new strokes.

These can lead to a wide range of physical and cognitive impairments. Speech and language disorders are among the most common and most challenging consequences of strokes, occurring in about a third of stroke survivors.

Understanding Stroke-Induced Speech & Language Disorders

Stroke-induced speech and language disorders significantly impact communication abilities. Among these, aphasia, dysarthria, and apraxia of speech are prevalent. Understanding how they are diagnosed and their specific symptoms can aid in prompt and effective management.

Aphasia

Aphasia is a common outcome of stroke, manifesting as difficulty in speaking, understanding, reading, and writing. There are many different types of aphasia, depending on the affected brain area, and are categorized based on the symptoms present:

Expressive Aphasia (Broca’s Aphasia): Characterized by broken speech, limited vocabulary, and difficulty forming complete sentences. Patients often understand what is being said to them but struggle to verbalize responses.
Receptive Aphasia (Wernicke’s Aphasia): Patients can produce fluent speech but may lack meaning or include nonsensical words. They often have significant difficulty understanding spoken language.
Global Aphasia: A severe form of aphasia where individuals have extensive difficulties with both speech production and comprehension.
Anomic Aphasia: Individuals have difficulty finding words, particularly nouns and verbs, making their speech sound vague.

Dysarthria

Dysarthria is a speech disorder that affects 20-30% of stroke survivors. It occurs when stroke impacts the muscles responsible for speech, leading to slurred or slow speech that can be hard to understand. It is typically diagnosed through a physical examination and a series of speech evaluations conducted by a speech-language pathologist (SLP).

It is characterized by the following symptoms:

Slurred or slow speech that can be difficult to understand
Monotone or robotic-sounding speech
Difficulty controlling the volume of speech, which may be too loud or too soft
Challenges with the rhythm and flow of speech, including rapid speech that’s hard to interrupt or slow, drawn-out speech
Respiratory issues affecting the ability to speak loudly or for extended periods

Apraxia of Speech (AOS)

Apraxia of speech is a neurological disorder characterized by difficulty sequencing the movements needed for speech. This is caused by the impact of the stroke on the brain’s pathways involved in producing speech.

Patients with AOS know what they want to say but struggle to coordinate the muscle movements to articulate words correctly. This results in distorted speech, difficulty initiating speech, or the inability to accurately produce speech sounds or sequences of sounds.

How Long Is the Stroke Speech & Language Recovery Time?

According to one study on post-stroke speech and language therapy, approximately one-third of stroke patients experience speech problems after a stroke. Many of these individuals begin to recover within a few months, with significant progress typically observed within three to six months.

In another study, 62% of subjects had speech challenges after suffering from a stroke. By six months post-stroke, 74% were able to completely recover their communication abilities.

However, the figures above provide a general timeline for post-stroke speech and language recovery. Stroke speech recovery time is highly individualized and can vary depending on several factors. These can include the following:

Severity of the Stroke: More severe strokes often lead to extensive brain damage, resulting in longer and more challenging recovery periods for speech.
Location of the Brain Injury: The brain’s specific regions control different speech and language functions; damage to these areas directly impacts recovery complexity and duration.
Age and Overall Health of the Patient: Generally, younger patients with better overall health before the stroke tend to experience faster and more complete recoveries.
Pre-existing Conditions and Comorbidities: Conditions such as diabetes or hypertension can slow down recovery by complicating the overall health scenario and rehabilitation process.
Individual Variability and Resilience: Personal resilience, the support system’s strength, and the individual’s motivation significantly influence the pace and success of speech recovery efforts.

The first three months after a stroke is a crucial period for recovery, as a majority of stroke patients see the most significant improvement during this period. However, it’s also important to note that, although at a slower pace, recovery can continue well past the 6-month mark with continued therapy and practice.

This underpins the importance of early intervention and ongoing rehabilitation efforts, including speech therapy, to maximize each patient’s recovery potential.

What Does the Stroke Speech & Language Recovery Process Look Like?

The journey to regain speech and language after a stroke is multifaceted and varies significantly from one individual to another. Understanding the structured phases of recovery can provide insight into what patients and their families can expect during this challenging time.

Here’s a closer examination of each phase in the stroke speech recovery process.

Initial Assessment and Diagnosis

Before recovery can begin, a thorough evaluation is conducted by a team of healthcare professionals led by an SLP. This assessment aims to identify the type and severity of the speech and language disorder, be it aphasia, dysarthria, or AOS. The evaluation may include cognitive-linguistic assessments, comprehension tests, speech production analysis, and functional communication measures.

Based on this assessment, a personalized therapy plan is crafted to address the patient’s specific needs.

Acute Phase

The acute phase typically occurs within the first days to weeks following a stroke. During this period, medical stabilization is the primary focus, with healthcare teams working to manage the immediate effects of the stroke.

Speech therapy may begin with simple exercises or assessments to gauge the patient’s abilities. However, intensive therapy usually does not start until the patient is medically stable. During the acute phase, the goal is to support overall recovery and prevent complications immediately after the stroke.

Subacute Phase

The subacute phase generally spans from two weeks to three months post-stroke and is characterized by more intensive speech therapy interventions. As the patient’s medical condition stabilizes, the focus shifts to active rehabilitation. Therapy during this phase is tailored to the individual’s specific speech and language deficits and may include:

Exercises to improve articulation, fluency, and voice control for those with dysarthria.
Language therapy to enhance understanding, speaking, reading, and writing skills in patients with aphasia.
Motor speech exercises and strategies to improve speech planning and production in apraxia of speech.

The subacute phase is crucial for taking advantage of the brain’s natural recovery processes and neuroplasticity, where the brain begins reorganizing and adapting to the loss of function.

Chronic Phase

The chronic phase of recovery extends from several months to years after the stroke. It focuses on long-term rehabilitation and adjustment to any residual speech deficits. During this time, patients may continue to see gradual improvements in their speech and language abilities, although the rate of recovery may slow. Therapy in the chronic phase often includes:

Advanced communication strategies to cope with ongoing challenges in daily life.
Maintenance exercises to preserve and enhance speech gains achieved in earlier phases.
Supportive technologies and aids, such as communication devices, to assist in effective communication.
Community reintegration activities to help patients return to as normal a life as possible, engaging in social, vocational, or recreational activities.

What Is the Role of Neuroplasticity in Speech & Language Recovery?

Neuroplasticity refers to the brain’s fundamental property to change and adapt its responses to new experiences, learning, and environmental changes. This adaptive capacity enables the brain to reorganize itself by forming new neural connections.

When the brain, or a part of the brain, is damaged after a stroke, neuroplasticity is what allows the other parts of the brain to take over the functions of the damaged area. Through targeted rehabilitation and therapy, such as speech therapy for stroke survivors, patients can retrain other brain areas to perform the lost functions and facilitate recovery.

Enhancing Stroke Speech & Language Recovery Time

Adopting a comprehensive approach involving several key strategies is vital to enhance the stroke speech and language recovery time. This multifaceted approach can maximize the chances of regaining speech and communication abilities.

This comprehensive approach must incorporate the following strategies:

Early intervention to leverage the brain’s highest potential for neuroplasticity in the initial period following a stroke, significantly improving the chances for recovery.
Alternative communication strategies, such as gestures, writing, and visual aids, to help maintain communication during the recovery process.
Adopting technology, including speech-generating devices and software applications designed for speech rehabilitation, for personalized exercises and continuous practice, which is vital for progress.
Providing continuous support from psychologists, support groups, and therapy to help manage feelings of frustration, depression, and anxiety, fostering a positive mindset essential for rehabilitation.
A healthy diet and lifestyle to supply essential nutrients that support brain function, along with regular physical activity, adequate sleep, and management of medical conditions.

Begin Your Post-Stroke Recovery Journey With Moody Neurorehabilitation

Moody Neurorehabilitation understands the complexities and challenges that come with post-stroke rehabilitation. We are dedicated to supporting patients and their families through this critical time with specialized care and personalized treatment plans.

Since our inception in 1982, Moody Neurorehabilitation has been a leader in brain injury rehabilitation. Our approach centers on providing comprehensive care tailored to each patient’s needs and goals. We believe in treating the whole person, not just the symptoms, to improve overall quality of life.

We invite you to start your recovery journey with us. Contact Moody Neurorehabilitation today to schedule a consultation with our experts. Let us help you navigate the path to recovery with care, compassion, and expertise.