Returning to the Community After Brain Injury Rehabilitation
Returning to leisure after a brain injury is very important. It offers a way to keep you active, get out of the house and meet new friends. Leisure offers social time and uses your skills in many of “life situations.” It may help you feel more independent and build your strength and endurance.
While you were in a rehab program, you may have worked with a Recreational Therapist. This person would have helped you learn about getting back into the community after your injury. This lesson will review some of the skills you learned in rehab such as returning to leisure and where to find activities that may interest you.
Challenges after Brain Injury that may affect leisure:
| Problems with memory and attention span | Strength |
| Social issues (related to behavior) | Pain |
| Accessibility issues (wheelchair access) | Medical problems |
| Transportation (since you may not be able to drive yet) | Finances |
| Behavior (problems with initiating activity, problems with anger, judgment, etc) | Family/friend support |
| Safety (safety judgment, getting lost, handling traffic, money, endurance) | Bowel and Bladder issues |
| Society attitudes/stereotypes |
Safe leisure activities to consider after brain injury:
There are endless activities and games you can do with your friends and family after a brain injury. It is always important to be aware of safety when choosing leisure activities. Some may not be safe to perform depending on your thinking or physical abilities. Many activities can be adapted so that they can still be feasible for you and your family to do. The following are suggested activities that with supervision you can participate in.
Horticulture Activities:
Gardening, flower arranging, planting indoor plants, helping with lawn care and landscaping.
Art Activities:
Painting, drawing, pottery, photography, woodworking, dancing, drama, singing or playing an instrument.
Aquatic Activities:
Swimming with friends and family, water aerobic classes and water exercises.
Sports and Fitness Activities:
Canoeing, kayaking, bowling, golf, aerobics classes, ping pong, billiards, weight lifting and home exercises.
Outdoor Activities:
Fishing, camping, boating, bird watching, Walking, swimming, going to the zoo or to the beach.
Indoor Activities:
Board games, computer/internet, video games, cards, reading, cooking, models or crossword puzzles, crocheting, reading, movies, scrap booking and trivia.
Community Activities:
Concerts, restaurants, movies, sporting events, museums, theater, shopping malls, grocery stores, church or synagogue and community service activities.
Attending Camp:
Through your local brain injury association or the Shepherd Center Therapeutic Recreation Department.
Unsafe leisure activities to avoid after brain injury:
After an injury there are certain activities that are unsafe. You will want to get your Doctors permission to be able to go back to certain high-risk activities. This list may not include all high risk activities, if you are unsure if the activity is safe for you to participate in please ask your therapist or doctor.
Competitive level sports activities:
Wrestling
Volleyball
Football
Basketball
ATVs
Jet skiing
Ironing
Roller coasters
Mowing the lawn
Using power tools
Hunting
Water Skiing
Riding Horses
Skateboarding
Rollerblading
Smoking tobacco and other drugs
Driving motor vehicles
Riding a bicycle
Drinking alcohol
How Do I Get Started?
Do you know where to go to play tennis, go swimming, take a pottery class or check out a good book? The ability to find programs, people and places is an important step toward becoming and staying active while enjoying recreational/leisure activities.
Listed below are some starting places to find whatever leisure interests you may have:
Brain Injury Associations (National)
Brain injury support groups (check national and local brain injury websites)
State support groups
Camp Hargrove
Shepherd Center Therapeutic Recreation Department (404) 350-7375 and Listing of news and events
Local city parks and recreation departments (you may want to ask about non-contact sports leagues)
Local community college/university
Chamber of Commerce
Yellow Pages
Local churches/synagogues
Local library
Newspapers, magazines
Friends and family members
Special Interest Clubs (Vacation Club, Foreign Language Club, Bridge Club, Bowling Club)
Service Organizations (Rotary Club, Elks Club, Kiwanis, Churches/Synagogues)
American Legion
YWCA/YMCA
Local rehabilitation center/day program/hospital
Georgia Brain Injury Association
Get Ready: Going Out on the Town!
Family members and caregivers can work with persons with brain injury to become as independent and safe as possible. When returning to the community be sure to have supervision of a responsible adult that can assist with issues that may arise. Here are some helpful tips when planning an outing for friends and family into the community.
1. Build leisure activity into your weekly calendar
Keeping structure in your day is important when planning leisure or any other activity. When making your weekly schedule, plan leisure time on a regular basis. Be sure to give enough time to the activity, transportation, and meal and bathroom times. For example, every Monday and Wednesday is bowling night and every Tuesday and Thursday is cooking club.
2. Plan ahead: Accessibility
If you are in a wheelchair…When you are planning to go out, call ahead. Make sure you know the size of your chair so that you can get the accessible space that you need. For example, ask about:
Door Width
Parking
Table Height
Door Type
Curb Cuts
Elevators
Stairs (inside and outside)
Bathrooms
Spacing/Aisles
Ramps
Seating
Be as specific with your questions as you can. Do not expect the person you speak with to know all of this information right away. Ask them if they would write down the needed information and arrange to call them back.
Whether you are in a wheelchair or not, there are other important questions related to brain injury that you should consider asking.
Other important questions to ask:
- Is it noisy and busy?
- Are there any secluded areas...more quiet, less distracting?
- When are the more quiet times to visit?
- How long is the wait or how long is the event?
3. Call ahead for reservations
If going to a restaurant, try calling ahead for a reservation so there will not be long waits in loud areas. Ask for a table that is more private to reduce noise and distractions. If swallowing is still a problem you may want to talk to the restaurant about special diet or meal preparation issues.
4. Ticketed Events
If in a wheelchair...
Let the sales agent know that you want to buy wheelchair seating tickets and if you are going to have someone with you. Often, wheelchair seating sections do now provide seats for an able-bodied companions unless asked for ahead of time. They may also limit the number of people who can sit with you. When going to a movie theater, there may be special seating in the aisles or in the back. In some theaters, certain rows of seats are removed so wheelchairs can fit there comfortably. If you are going to transfer into a seat (and this would apply to anywhere), make sure you put your wheelchair in a safe place so it will not get stolen. Place it close by in case you have an emergency.
Just remember...even though events may be listed as "sold out", there still may be wheelchair seating available. Always ask.
5. Shopping
When shopping, plan on going during quieter times during the day. Have a list of what you need to buy already made before you leave the house so shopping will be more organized and speedy.
6. Transportation
Have travel plans made before leaving the house. If you take the bus, know the schedule and if the bus is accessible to any physical needs you may have. Call taxi drivers ahead of time to arrange pick up and drop off times. DO NOT DRIVE UNTIL YOU HAVE PASSED A DRIVING TEST FROM YOUR REHAB HOSPITAL.
7. Medical
If you wear a helmet, please wear it when you go out to protect your head. Consider an identification bracelet informing any caregiver of your brain injury. Carry important phone numbers and a phone (if possible) with you at all times. Bring extra supplies or medicines with you.
Facilitating Independence
As a caregiver, if you think the person with a brain injury is ready to return to higher risk activities such as returning to the community independently consider these safety tips:
1. Establish a routine for going places
A person with a brain injury can usually learn a route or task more easily when it is repeated several times. Once a routine is established it will be easier and safer for the person to duplicate that task or routine independently. However, if there is a change in the pattern such as not arriving on the usual bus or at the usual time, can create a problem.
2. Know people in community
Establish a regular bus driver or person at a store that will recognize the individuals’ special needs. They can help keep an eye out for potential problems, and help retrace steps when the person may become confused.
3. Carry information cards and a cell phone (or know how to use a payphone)
This card goes in the wallet or purse at all times. It contains addresses and phone numbers of who to call if the person becomes lost or frightened and cannot remember the information. Some statement about the brain injury may also be useful so that the persons’ actions or inability to express themselves’ are not misunderstood.
4. Identify appropriate people to ask for help
Prior to the individual heading out into the community independently, identify with them some appropriate people to ask for help while in the community. For example store clerks, and uniformed policemen are better then asking strangers on the street.
5. Pedestrian safety
Practice good pedestrian safety together and have the individual demonstrate it before allowing them to become independent in the community. Always cross the street at corners and cross walks, obey traffic lights and signals, and look both ways before crossing.
6. Step by step directions
Giving the individual simple directions with easy to recognize landmarks are sometimes easier to understand then specific directions.
7. Call upon arrival
Have the individual call upon the arrival of their destination so you know they arrived safely.
8. Written plan
A well-written plan with short, simple steps will help your family member be able to complete a task in a more organized timely fashion. Review this written plan with the individual before they leave home to complete the task.
