One of the most devastating effects of TBI may
well be the memory difficulty associated with new learning. Your family member may have
considerable difficulty learning new job skills, new procedures to be used at the job
sites, and new routines in the home. Difficulties in memory, concentration, organization,
sequencing, and problem solving will all slow the new-learning process. However, the
memory difficulties are the biggest problems to this process. Your family member will not
be able to increase his skills from day to day if he does not remember from day to day. To
affect new learning of either a household task or job skill, your family member will need
to repeat that particular task over and over again until it becomes automatic. For
example, if you are teaching your family member to use a new system of balancing the
checkbook, you will have to go over this system with him step by step, over and over
again. At some point the system will be "automatic" for him, and the system will
The following are examples of new-learning problems you may observe:
1. When your family member returns home, you give him the
responsibility of taking the kids to their after-school appointments. He is not able to
keep up with the schedule. The kids do not get where they need to be on time.
2. While your family member was gone, a new system of billing was
developed at work. He complains, "the people at work have really screwed up this
time.. . they have a system so complicated that no one can figure it out!"
3. Your family member was always a game player. Your friends found a
new board game they want to teach him. He becomes very frustrated when he cannot follow
4. When he first returns to work he does very well. After 3 months, a
new supervisor is hired, and procedures change. Your family member is not able to catch on
to the new procedures and fears for his job.
1. Work with your family member in setting up his own system for
transporting the children from place to place. He is more likely to remember the pick-up
points if he develops his own system rather than attempting to adjust to yours.
2. Work with your family member in helping him understand that he
has to learn the new system. Ascertain whether there is a friend at the work site who
could help him learn the new system.
3. Teach your family member new games and activities on a one-on-one
basis. Once he has mastered the skills, then play these new games in social situations.
4. Be aware that TBI clients often lose their jobs when there is a change in a
supervisor or in management staff. Enlist the assistance of rehabilitation professionals
to help your family member in the transition between supervisors. This is a time when you
will need to be very supportive to assist him through a particularly difficult time.