It’s early in the morning, I get ready, put the kettle on and…start brainstorming the plan of action for the day ahead! This routine will sound familiar to many rehabilitation assistants, as they prepare for a fulfilling and rewarding therapy session with clients. Why is a structured routine so important in cognitive rehabilitation?
One of the main duties for a rehab assistant (RA) is to help people retrieve or maintain their independence skills by practising daily activities such as making a two-ingredient meal, doing the laundry or assist a client to wash up after having lunch.
Another part of the RA role is to ensure clients are safe in their home environment. This is done by partaking in OT assessments and visiting clients’ homes to see how the settings can be adapted to help them feel secure (e.g. walk-in shower, hand rails, fire alarms etc).
Monday morning finds me in Rayleigh, Essex introducing a new RA to one of my clients.
The process varies from time-scheduling to step-by-step initiating the new RA into the client’s daily routine. A shadowing session becomes an opportunity for the client to demonstrate progress they have made from the beginning of their rehabilitation journey.
It is great to see clients socialise and form new relationships after consistently working towards bettering their communication skills due to PTSD and anxiety.
Tuesday’s alarm tends to be the hardest wake up call of the week due to the long journey ahead. A two-hour journey to London’s outskirts is commonplace in the line of work RAs do. Top up on your favourite coffee and snack to keep your energy levels going.
Upon arrival to the client’s home, my main duty is to encourage them to start their day, as they struggle with their initiation and motivation skills. Once they’ve managed to start a task, it becomes a matter of engaging their attention and concentration ensuring they do not become cognitive or physically fatigued to successfully complete the task at hand.
Tasks vary from cleaning the house independently without relying on family or RAs to shopping more appropriate food choices and cooking healthier meals by watching easy recipes on YouTube.
I check my phone and ask myself the question ‘‘Is it Friday yet?’’ but the calendar notifications rushingly remind me it is admin Wednesday.
I may not be seeing clients face-to-face today, however administration is as vital as daily rehab assistance because it is the only time for RAs to write up daily reports, review rehab plans and risks assessments for clients, keep track of online timesheets and liaise with the office or colleagues regarding client updates.
On a Thursday morning I take another client food shopping to help them improve their spatial navigation and short-term memory. ‘’How many items did we write down on the list?’’, ‘’Can you remember what aisle is the milk in?’’ ‘’Is it appropriate to tap shoppers on their shoulder to ask for help?’’ are example prompt questions when assisting a client with a severe brain injury. Things don’t always go according to plan and the client may become agitated, confused and start shouting due to lack of awareness, insight and impulsive thinking. To overcome this situation, strategies include calming the client down and encouraging the client to self-reflect to the extend this is possible based on their brain-injury trauma.
Thank god it’s F..rrring! An important work call informs me of a new referral; a client who wants to try an independent living trial (ILT) near my home location and I’m the only RA in the area that can jump on this new quest. I call up the office having to shift my day round to fit in the ILT.
I am skimming through the client’s profile and my understanding is that they will be needing help with getting familiar around the new home setting; finding the kitchen utensils, remembering to turn the hob off after cooking, locking the door). Some clients also require sleep-ins to ensure they are safe and secure at all times until they are confident in their skills to live completely independent.
I might be spending a few days to a week with them whilst in-between sessions I jump on Zoom to teach relaxation techniques or educate clients and their families about the different types of traumatic brain injury.
Who can tell me that two days are the same in the life of a cognitive rehabilitation assistant? Adaption, flexibility, a strong mind, determination and empathy are only the tip of the iceberg in the RA skill set.
This article was written by Dimitrios Jamal Nakhid, a Cognitive Rehab Assistant at BIS Services.
