Initiation, Planning, Organization, and Brain Injury

The University of Washington TBI Model System and the University of Washington Medical Center

Page 1 of 2

Multimedia

• BrainLine got the chance to catch up with Michael Paul Mason about his role as a brain injury case manager and writer and talked with him about being a case manager and his experience finding resources for his clients. Transcript of this video. Michael Paul Mason Talks About Brain Injury Case Management
• This is the story of a girl named Logan who persevered through her brain injury to create a magazine for other kids with disabilities and inspire them to achieve their dreams and goals. As featured on Bizkids. Transcript of this video. How to Succeed in Biz-Ness by Really Trying (Logan's Story)
• Make sure you see the accompanying manual, Traumatic Brain Injury: Strategies for Surviving and Thriving Manual. From the Washington State Department of Social & Health Services, the Aging & Disability Services Administration, and the Department of Information Services. Used with permission. All rights reserved. http://www.adsa.dshs.wa.govTranscript of this video. Traumatic Brain Injury: Strategies for Surviving & Thriving

What is initiation?

“Initiation” is the ability to start doing something. It requires seeing what needs to be done, making a plan about how to start doing it, and putting the plan into action. For example, if a person wants to get dressed they must first recognize the need to get dressed, plan what they will wear, and begin gathering clothing.

What is planning?

“Planning” is the ability to choose how to do a task, and to list all the steps of the task. Planning also requires the person to decide what they will need to do the task and estimate how long it will take them to complete it. For example, if a person wants to cook a meal they must decide what they will cook, what ingredients they will need, where they can get the ingredients, what time to start cooking, and how much to cook.

What is organization?

“Organization” is the ability to put all the steps of a task (or many tasks) in the correct order. It also includes changing the order of the steps, as needed, so the task can be completed. Organization is also the ability to create logical places to store items and information so that you can find them later.

Why does a brain injury affect the ability to initiate, plan, and organize?

Initiation, planning, and organization are thought of as “higher level thinking processes” because they require a lot of brain power. To initiate, plan, and organize, a person needs to be able to think ahead, concentrate, remember things, gather and sort information, and set priorities. If you have damage to the front of your brain, you are more likely to have problems with initiation, planning, or organization. This is because the front of the brain is the part most involved in planning, organizing, and problem solving.

What happens with initiation, planning, and organization problems?

When you have problems with initiation, planning, or organization, other people may think you are unmotivated or lazy. You may also:

• Have a hard time starting or finishing things you try to do.
• Have a hard time with tasks that used to be easy, such as getting dressed or finishing a work assignment.
• Stop doing favorite activities.
• Have a hard time trying new ways of doing things.
• Only be able to do one thing at a time, where before your injury you may have been able to do many things at once.

What makes initiation, planning, and organization worse?

• Fatigue and lack of sleep.
• Stress or illness.
• Too much information to sort through.
• Trying to do too many things at one time.
• A distracting environment.
• Doing something unfamiliar that is not already well organized or clear.

When should I ask for help with initiation, planning, or organization?

Talk with your health care provider if:

• Your problems with initiation, planning, or organization are interfering with your ability to care for yourself or your family.
• You feel like you are having a harder time than usual initiating things, planning, or organizing.

What can I do to help myself initiate, plan, and organize?

Minimize distractions:

• Focus on one thing at a time. For example, if you are cooking, do not listen to music at the same time.
• Put things away when you are done with them.
• When you are doing a task, bring out only the things you are going to use. Put away everything else in your work space.
• Get rid of things you don’t need, want, or use.

Follow a routine:

• Set a specific time each day to focus on planning and organizing for the next day.
• Look at your schedule often during the day, so you don’t forget to do things.
• Set a specific day for each of your household chores. For example, do the laundry on Mondays, go grocery shopping on Tuesdays, and clean the bathroom on Wednesdays.
• Set a timer or alarm to remind you of important things to do in the day, such as starting to cook a meal.
• Do things that require the most initiation, planning, or organization early in the morning, when you are the least tired.
• Set a reasonable number of goals for yourself.
• Take breaks during the day.

Use organizers:

• Put all important information in ONE book or an electronic organizer. Include:

1. A monthly planner, where you write down appointments, events, and your daily schedule.
2. A short “to-do” list of 3 to 5 items. Check off items as you complete them.
3. Shopping lists.
4. A list of your medicines, including how much you take of each medicine, and when to take each one.
5. Phone numbers and addresses of medical providers, friends, and family.
6. Goals you are working on.

• Make a place for everything in your home, and label the location so you know where everything goes.
• Break down complex tasks into small steps.
• Have other people verbally remind you to start tasks.

Where can I learn more about initiation, planning, and organization?

Ask a professional:

• Your doctor or health care provider.
• Your psychologist.
• A speech and language pathologist or occupational therapist.

Check out these resources:

Brain Injury Association of America
www.biausa.org/
8201 Greensboro Drive, Suite 611, McLean, VA 22102
703-761-0750
Brain Injury Information Hotline: 800-444-6443

Brain Injury Association of Washington
www.biawa.org/
3516 S. 47th Street, Suite 100, Tacoma, WA 98409
253-238-6085
Helpline: 800-523-5438
E-mail: info@biawa.org

Multiple Sclerosis Association of America
www.msaa.com
706 Haddonfield Road, Cherry Hill, NJ 08002
856-488-4500