Fatigue. And the good news is there are strategies to help minimize it.
Before I get to the strategies, here are a couple of real life descriptions to help explain what it is like:
In an article in The Guardian newspaper Tim Lusher described his experiences following an abscess on the cerebellum, (the part of the brain that controls movement, balance and coordination).He vividly describes cognitive fatigue:
Ah, the tiredness. That’s another thing everyone talks about. It’s not a tough-week-at-the-office tiredness that you can rally through with a couple of drinks and the prospect of a weekend lie-in. It’s a leaden blanket of exhaustion that sweeps over you – utterly undeniable, non-negotiable and unshakeable.
And this description in an article entitled “Learning to Pace Yourself” from Synapse
Those who haven’t had their brain banged around won’t understand the feeling – they’ll picture how they feel after a bad night’s sleep or a big work day. But this mental exhaustion is much more than that. It feels as though even the simple act of pushing a few sluggish thoughts through this damaged brain takes far too much energy, let alone attempting things requiring physical exertion. To make things worse, when I got tired my emotions were worse than ever – my family was already struggling with my temper, depression and poor social skills. What little control I had in these areas just flew out the window once fatigue set in.
Cognitive fatigue is common after a brain injury, whether mild, moderate or severe.
The brain is working harder to keep up all its functions, even ones that were once second nature. Eventually it is like an overload button, the brain needs a rest. Without rest it can lead to headaches, or becoming irritable, confused and sometimes increasing problems with behaviour.
What can you do about it? Well even understanding what it is, gives you clues about how you could assist a person manage it. Here are some ideas to get you started.
What Can You Do for Cognitive Fatigue?
Below is a list of strategies you might find useful to work with. Decide what might work with the person you are supporting and their network. Just choose the key strategies that might suit. Keep the change manageable for everyone involved.
- Balance the daily routine with quiet times, rests, or restful activity; building in whatever rest time the person needs whether a short nap or a longer sleep time.
- Help family and friends to understand cognitive fatigue and know that it is as a result of the brain damage, it’s not laziness or deliberate.
- Plan ahead to allow opportunity for sleep and rest, program this into the daily plan before fatigue occurs.
- Work out what time of day is best for activity. We often talk about whether we are a morning, afternoon or evening person, this is important in planning to minimize fatigue.
- Allow extra time to complete work that requires extra concentration and effort.
- Plan ahead for demanding activities, or when going to special events. Allow for extra rest time and / or quieter routines before and after.
- Use aids, equipment, and technology to reduce effort wherever possible. For instance if the person has mobility aids encourage their use to minimize fatigue.
- If helpful see about shorter days for school or work; and with frequent breaks according to need.
- Encourage saying no to activities or demands that are not important, or that would overly fatigue them.
- If there are a number of activities or things to do on a day, work out priorities and tackle the important, or interesting tasks first.
- As much as possible have familiar routines and surroundings, which reduces to effort and need to concentrate.
- Take notice of what factors contribute to fatigue and work out how to manage these as much as possible. This might include the effect of medication, weather, or illness, people, places.
- Be aware that sensory overload can impact on fatigue; situations such as a busy shopping centre with lights and noise. Limit or avoid these situations.
- Maintain optimal health and fitness. Take care with exercise that it is does not itself cause fatigue.
- Develop ways to manage fatigue if and when it occurs. Think about at home and when out.
- You as a supporter can minimize fatigue by assisting where necessary, and where appropriate. Carrying out tasks, understanding what needs to be done, assisting to maintain agreed rest routines.
When looking at ways to manage fatigue remember it is better for a person to try and manage cognitive fatigue before rather than after it happens. Plan to prevent rather than manage after fatigue occurs.
Finally remember to always work with the person and their support team when developing any strategies. Each person will have different needs and different responses. This may change over time. Consistency is a key.
Please share any successful (or unsuccessful ways) you might have seen cognitive fatigue managed.