New ABI Training: Module 4

Hi, welcome back. Good to see you again.

This is acquired brain injuries Learning Module number for more Arcadia Home Care 

Okay, in this module we’re going to be learning about motivation deficits and task initiation and how to support someone with a lack of motivation. We’re also going to be talking about organization attention filtering. And what to do with a client that has difficulty filtering out attention. You’ll learn more about this later on, and it’ll all make perfect sense. 

Damage to the area of the brain that deals with motivation can result in a client who doesn’t want to do anything they aren’t interested in their hobbies, they appear apathetic. That means they have no interest in things, no enthusiasm, no joy. They may appear depressed or somewhat lazy. 

I’m not gonna lie. This is a tough one to work with. Having a client with a lack of motivation, someone who just doesn’t want to do anything might make you feel like you’re bad at your job or that you just can’t get the client to do anything rehab related. As the old saying goes, you can lead a horse to water but you can’t make a drink. 

Here are some strategies that you can try to help a client with low motivation or difficulty with task initiation. That is they have trouble getting started on a task. 

You want to give the client loads of praise for engaging in a task or completing the task. You can show the client that the task is beneficial that it’s good for them to do this task. Try using a first then first we’re going to do your exercises and stretches. Then we can go for doughnuts. The first part is the thing you want the client to do. And then part is the thing that the client wants to do. 

Sometimes you have to let the natural consequences take effect. If a client has stretches to do that will help them with their soreness and they don’t have the motivation to do it. Let them get stiff and sore. Then at a later session, you can remind them of what happened when they didn’t do their stretches. Don’t want to do your stretches. Okay. Remember what happened last week, when you didn’t do your stretches your back got really sore and you couldn’t get out of bed. Let’s do your stretches so that doesn’t happen again. 

Now obviously you don’t let a client go too far with natural consequences. For example, if you have a client who refuses to eat, you can’t allow them to starve. 

Use natural consequences within reason. And sometimes it’s just enough to remind the client of what the natural consequences might be. You don’t actually have to let them get to that point of the natural consequences. 

Okay, deficits and organization kind of tie into what we talked about earlier about the four P’s. Problem problems with planning, predicting problem solving, and especially prioritizing a lack of organization it’s pretty self explanatory. Clients will have difficulty organizing their schedule, organizing their living environment. Organizing tasks, you might notice in their home, laundry doesn’t get put away, or tasks only get partially done and then they’re left uncompleted or they might have documents and mail all over the place and they’re a little unsure as to what to do with them. 

There are some ways that you can help a client who has deficits to their organizational strategies. 

You might have to break large tasks down into smaller tasks. This is a way to help make jobs easier. It might take more time and may have to be done over several therapy sessions. But it will be easier for the client to manage all the steps involved. You may also have to create what’s called a behavior chain for the client. This is just basically a step by step list of how to accomplish a certain task. An example of a behavior chain is a recipe. It starts with step one and step two, and so on and so on. You might have to help the client understand all the steps involved with doing laundry for example, and the sequence that those steps take place. And you can also help organize the clients schedule by providing them with calendars, day timers whiteboards. During each session, you might have to help the client review their schedule to see what they have coming up. For the week or for the month. 

Here’s an example of attention filtering. You’re at a party. There’s lots of people there talking. There’s music. There’s a lot going on around you. It’s a very busy environment. You’re having a conversation with one person, and you can tune out everything else that’s going on around you and just focus on that one person and that one conversation that you’re having a person with an API that has difficulty with attention filtering is going to have a lot of difficulty filtering out all that extra stimuli that’s going on. 

They usually get very tired and very burnt out very quickly in a busy environment. They’ll have trouble focusing trouble paying attention, become very overwhelmed, possibly even get dizzy, tired, a headache, frustrated, nauseous, maybe even a bit angry, and they’re probably going to have to leave the situation 

if you have a client who has difficulty filtering their attention, try to avoid busy loud crowded environments. Pick a quiet place to have your session and try and minimize distractions. If you do have to go into a busy environment, say for example of a busy shopping mall, let the client know before you go in that things will be busy and a bit chaotic, but you’re here to help and make sure that they don’t get lost or overwhelmed. Let them know that if we need to leave, that’s perfectly okay. we can always come back when it’s less busy. 

Do you have a client that gets very easily distracted by things and they kind of present as though they have ADHD. You want to try and minimize distractions? have the client put their phone away, turn the TV off, and you’ll probably have to redirect them to pay attention to the task at hand. A lot of the time.