Becoming a New Parent with ABI: Strategies for Overcoming Challenges

Article By: Melissa Malacaria, M.Ed. (Counselling), CCC, Rehab First Inc. & Christine Kennedy, M.Sc.OT, OT Reg. (Ont.), Rehab First Inc.

(Originally published in The Monarch – June 2011)

Following a traumatic brain injury, individuals have many new challenges to deal with; he or she must come to terms with losses in memory, difficulty concentrating, impaired judgment and insight, disturbed sleep, depression, fatigue and difficulty switching between tasks, among other things.

Now imagine becoming a new parent while dealing with these challenges. Add to the mix: a crying baby at all hours of the day, the responsibility of raising a child, changes in hormone levels, a new and disrupted routine and a tiny person who commands your attention all times. On top of that, often new parents battle with feelings of insecurity and worry about the new baby and their skills as a parent. For someone with a brain injury all of these feelings and emotions are amplified and these new challenges as a parent may sometimes feel impossible.

However, there are strategies that can be put into place for someone with an acquired brain injury to help understand and deal with the limits and challenges of becoming a new parent. 

 DEALING WITH THE ANXIETY

Even before becoming a parent, the anxiety and stress levels at the thought of a new baby may be difficult to handle.  A person with an ABI might ruminate about how their limitations are going to impact their ability to parent, “If I can’t even make it though a normal day without fatigue and a headache, then how am I going to do this with a baby?”

The first step in dealing with this anxiety is to identify the thoughts and feelings associated with the anxious experience and recognize how those thoughts and feelings hinder daily functioning.  Recognizing how these negative thoughts affect our overall functioning and learning ways of coping with them can help us to better deal with those feelings when they arise. An effective way of coping with anxious symptoms is to use diaphragmatic breathing and relaxation exercises to help calm the anxiety.  Before the baby is born, taking time to concentrate on your breathing patterns can help to alleviate stress. After the baby is born, dedicating extended periods of time to this task can sometimes be unrealistic, but finding even short moments to implement specific relaxation and diaphragmatic breathing techniques can still be very beneficial.

Another way to help deal with the anxiety is to work with a counsellor to combat unrealistic and negative thoughts. Using Cognitive Behavioural Therapy, a counsellor can help to question assumptions, evaluations and beliefs that might be unhelpful and to test new ways of thinking. A counsellor can also help to explore and monitor various strategies for coping with anxiety that can be implemented.

Lastly, anxiety can often be mitigated by being self-aware and identifying your limitations and preparing for those limitations. Accessing your support system at this stage becomes vitally important.

CALLING IN SUPPORTS

One of the characteristics of an acquired brain injury is a lack of insight, particularly with respect to your own limitations.  This makes asking for help at the appropriate time even more challenging. Working together with support systems (family, friends, spouse, caregiver, occupational therapists, counsellors, etc.) to identify what the challenges will be once the baby is born will help to put plans into place to recognize when support will be needed and who will be the most appropriate person to assist.  Educating those providing primary support is critical. A counsellor can assist with promoting effective communication between the brain injured person and their support system.Often it is necessary to call on extra attendant care supports once the baby arrives to assist with overcoming challenges with multitasking, memory, judgment and fatigue.  Personal support workers or rehabilitation therapists can assist with cueing and establishing a routine for the ABI parent and their new baby. Implementing relaxation and self care techniques should also be incorporated into the schedule and routine.

 PACING

 Following a brain injury, individuals find that every task requires more concentration and effort and consequently fatigue sets in more easily.   Pacing is a way of gradually increasing the amount you do in small planned steps, with the aim of building strength over time.  Without pacing, a busy and stimulating day can lead to extreme fatigue and the ability to parent for the next several days may be significantly decreased.

Learning to take small steps and frequent breaks can help to conserve energy over longer periods of time.  An occupational therapist can help assist with setting up a pacing plan.

Finding time to engage in leisure pursuits both with and without baby can be very helpful in reducing burnout. Look for opportunities to engage in hobbies, light exercise, and activities in the community, and find ways to work these things into your routine.

DEVICES

An occupational therapist can also help identify devices that will help to make life with a baby more manageable.  Devices to assist with planning and organization like calendars, smart phones, and white boards can help to keep pediatrician and other appointments organized, can help establish routines for the new mom and baby and can assist with memory deficits.

Safety devices for the baby are crucial for a parent with an ABI who may have attention or memory deficits.  Call on supports to ensure that the home is fully baby-proofed, with baby gates, electrical outlet covers, bumpers, carpet runners etc. and set-up a system for the kitchen. Using timers or a slow-cooker can help assist in preparing meals in a safe way when the parent is busy and distracted with the new baby.

 EMERGENCY PREPARDNESS

 Along the same vein, an occupational therapist can help to ensure that a plan has been put into place for emergency situations.  The plan will include ways to help recognize the signs of an emergency and what to do or who to call if a situation does arise.  Again, educating the family, friends and other support people about these plans will help to ensure that the necessary steps are followed in the event of an emergency.

 About the authors:

Melissa Malacaria provides case management, vocational and educational rehabilitation services, and personal counselling to both adults and pediatric clients. While at Rehab First Inc. Melissa has worked with many complex injury cases, including children and adults with traumatic brain injury and has also provided expert testimony.Melissa obtained her education at the University of Western Ontario, where she earned an Honours degree in Psychology and a Master of Education in Counselling Psychology. Melissa is a member in good standing with the Canadian Counselling and Psychotherapy Association. Her practice focus is individual and group therapeutic counselling with particular emphasis on vocational exploration and choice. While completing her studies, Melissa participated in a number of volunteer roles, as well as a placement with the Thames Valley District School Board where she gained experience working in a counselling role with children and adolescents.

Christine Kennedy is an Occupational Therapist and Manager of Rehabilitation Services with Rehab First. Her scope of practice encompasses assessments and treatments related to physical, affective and cognitive function, adaptive behavior, the recommendation of assistive devices, and rehabilitation and maintenance in the areas of self-care, productivity, and leisure. She is actively involved in discharge planning and works with hospital staff and families to be sure that patients make safe transitions from hosptial to home. Christine earned her Honors B.A. in Physical Education at Queen’s University and her Master of Science in Occupational Therapy from Buffalo’s D’Youville College.  Her practical experience was in the areas of mental health, acute care, pediatrics and rehabilitation in a variety of clinical settings. She is certified in the administration of the Progressive Goal Attainment Program (PGAP) and is a certified ADP authorizor.