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A week in the life of a cognitive rehabilitation assistant

Aaron Riddle at BIS Services shares his experience of working in cognitive rehab



I have been working for BIS Services for a little under a year now as a cognitive rehabilitation assistant, and it has been one of the most challenging and rewarding years of my life.

I wish I could describe a ‘typical’ week for an RA, but there just isn’t one. Each client is unique, and each day comes with a new set of challenges. If I could sum up what an RA is (despite the official description!) it’d be an individual who needs to be adaptable, chameleon like almost, tough skinned and compassionate at heart. If you are this, then you are in the right job!

All the clients I support require a different approach, but there is one consistent approach that is adopted with all of them, and this is the promotion of independence and empowerment. I support six clients during my working week, ranging form 12 to 47 years of age, each ranging in severity and at a different point in the TBI rehab journey. 

I start my week by refreshing myself with the previous week’s Machforms I submitted, to pick up on any areas I feel need more attention with each client. Machforms can be easy or a challenge to complete, but providing you keep accurate notes of each session, you’ll find them easy – after all, you’ll be doing a lot of them.

A ‘typical’ session with a client can involve many different elements, ranging from organisation of a calendar, planning of a shopping list, through to physio and community access – oh, and don’t forget all the prompting! 

At times it can feel like Groundhog Day with all the prompting an RA does, but this really lays the foundation to a lot of the work we do during sessions.

No matter how many times you may prompt a client to check they have all their belongings before leaving the house, or whether they have updated a calendar, locked the back door, or remembered to turn the hob off, each and every prompt is just as important as the last.

The work of a cognitive rehabilitation assistant can mean at times you act as the damaged lobes of a client, whether it be frontal, temporal, both or neither. That empowering, planning, emotionally stable and encouraging voice that a client needs.

Day to day tasks we see as nothing can be exceptionally challenging for clients, and sessions will focus heavily on supporting a client with all manner of cognitively taxing tasks.

As an RA you will work as part of an MDT, providing vital feedback to professionals. You will often spend the most time with the client and can provide great insight into the day-to-day life they have that the wider MDT just does not see. A therapeutic session is usually an hour, whereas an RA session will be multiple hours across potentially several days.

That being said, the work the RA’s do with the clients is often influenced by the extremely valuable supervisions most professionals offer. You will get to have one to one or group supervisions with neuropsychologists, OT’s, physio’s, SALT’s etc, and these will often make up part of my working week, more than likely once I return home from a day with clients. Plus the input and training from my managers at BIS Services, we get a lot of extras, all which add to our growing toolboxes.

Sometimes, sessions with clients can result in you having to raise safeguarding concerns to a line manager or safeguarding lead, and in my experience, and in line with BIS procedures, no matter how small it may seem, report them. Don’t let it be that one time you don’t report it that something happens that may seriously impact your client’s life.

The job of an RA is very rewarding, at times tough, but nonetheless rewarding despite these tough times. A recent piece of advice I heard in a training session which stuck with me is, imagine the client is a member of your family, what sort of support would you like them to receive? That’s the level of support you offer every client you work with.

If, like me, you are still at university and hope to one day be a member of the MDT that is giving the supervisions to new RA’s, follow the mantra of:

“Push through the tough sessions, reward yourself for the great ones, get the forms in on time (check for spelling mistakes first) and absorb every piece of training you can get your hands on.

“Do this, and that dream of being in the profession you admire will be one step closer, and for me, it starts with being the best RA I can be”



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