Strategies to Keep Holiday Home Visits Happy
Michael Langford, CBIS Clinical Examiner
Hector Gutierrez, CBIS Clinical Examiner

Happy Holidays! Do these words elicit a stir of anxiety in your heart? Do you find the holidays to be more stressful than joyful? Many caregivers experience these feelings and find the holidays to be more trying than they would like. Holidays are a time for togetherness, for family and fun, and are often the time when individuals in a residential rehabilitation facility go home for a visit, creating a great deal of anxiety for the individual and for the family. This need not be the case. In my 17 years of working with persons with acquired brain injury, I have helped in the planning and implementation of many successful and enjoyable holiday home visits. Being proactive is of utmost importance and advanced planning is key to a calm, smooth, joyous holiday.

It is important that as much preparation as possible be done in advance and there is communication and understanding among all parties involved - before, during, and after the visit. This includes family members, the rehabilitation treatment team, and the participant.

Structuring time and scheduling activities offers the family a plan of action and goes a long way toward minimizing confusion and anxiety. It is important to remain flexible in case plans need to change for some reason, but scheduling specific times for specific activities lets everyone know what is coming and lessens the potential for conflict and misunderstanding. It is also helpful to limit the amount of time spent at each activity to avoid over stimulation and lessen anxiety.

When a participant goes home for the holidays, it might have been a while since last visiting. Life has been going on in his absence, and he may feel like an outsider among his own family members. It is important to treat him not as a guest in for a visit, but as a family member who has household responsibilities and participates actively in household decisions and activities.

Maintaining some semblance of the familiar routine established at the rehabilitation facility during a home visit will help minimize confusion and promote a smoother transition back into the rehabilitation seting. If your loved one is involved in physical therapy or speech sessions, a home program should be created and implemented during the visit. Compensatory tools, such as a pocket notebook, programmable watch, or electronic calendar should also be continued during the visit if these are items used regularly at the rehabilitation facility.

Many family members find it difficult to set limits or establish rules while their loved one is visiting. Certain issues should be addressed and discussed before the visit when possible, so that as they arise, everyone involved knows what is expected. These issues may be how much time will be spent watching television, sleeping, talking on the phone, and how much money may be spent on outings. These are some areas where individuals with acquired brain injury may display limited judgement and the potential for a battle over these issues can be significant. If clear guidelines and rules are established and agreed on prior to the visit, there is much less chance for arguing.

Before the visit, agree upon a specific course of action if there is a behavioral outburst or lack of cooperation in some way. An “earn as you go” reward system is a good idea. For example, after a successful day, there might be a shopping trip to purchase a desired item. If unsuccessful in some way, no reward is earned. Focus on the positive and highlight the next scheduled reward.

Returning to a rehabilitation facility after a visit may be difficult. It is often helpful to have something desirable waiting - a reason to go back. This might be a large project started before a visit that will need to be completed upon return. It is important to remember that a home visit is, in part, a vacation. It should be fun, light hearted, enjoyable. At the same time, it should not be forgotten that any disruption in rehabilitation is a potential setback for overall progress.

Recognizing that having an acquired brain injury is a life long condition, and rehabilitation, in one respect or another, is ongoing, is key to making home visits successful and enjoyable for all.

Being proactive and following some simple guidelines can be the difference between having a good holiday visit and a great one!

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