Executive Dysfunction after a brain injury
What is it?
Executive functioning is a term used to describe a variety of routine abilities, which we use in our everyday lives. It includes the ability to multi-task, problem solve, concentrate, make decisions and think flexibly. It also describes other abilities such as controlling our emotions, being self-aware and regulating our behaviour appropriately.
Executive Dysfunction is the term used to describe when these functions aren’t working properly. It describes a range of cognitive, behavioural, and emotional difficulties which often occur as a result of traumatic brain injury.
Executive Dysfunction is sometimes referred to as ‘dysexecutive syndrome’ (because several of the symptoms usually occur together) or ‘frontal lobe problems’.
What causes it?
Executive functions are controlled by the frontal lobes of the brain. This part of the brain controls our ability to organise, plan, problem solve and pay attention. It also controls our behaviours, emotions, personality and social skills. The frontal lobes are connected to many other areas in the brain and are instrumental in co-ordinating these other areas.
Not all Executive Dysfunction is caused by brain injury, but brain injury is a very common cause. The frontal lobe is often damaged by traumatic brain injury, for example in road traffic accidents, falls or being hit on the head. Damage can also happen following brain tumours, strokes, encephalitis or meningitis.
Symptoms
People with executive functioning issues may have some or all of the symptoms below. The range and severity of each symptom is different in each case. Some brain injury survivors will experience all of the symptoms, while others will only be affected by some of them.
- Trouble organising themselves
- Trouble planning or completing tasks
- Difficulty concentrating or paying attention
- Difficulty multi-tasking or problem solving
- Difficulty processing new information
- Difficulty paying attention to, or taking part in, conversations
- Acting impulsively, without thinking ahead to the potential consequences
- Difficulty controlling or regulating emotions
- Inability to regulate behaviour appropriately in social situations
Impact on sufferers
The symptoms of Executive Dysfunction can be frustrating and confusing for brain injury survivors, as well as their friends and families.
Social interaction can become increasingly difficult as sufferers struggle to participate and engage in conversations. Furthermore, the inability to regulate behaviour in social situations may lead to the sufferer saying or doing inappropriate things, which can lead to a breakdown in relationships or low self-esteem.
Executive Dysfunction can sometimes be misunderstood by friends or family members, or misinterpreted as depression, aggression, selfishness or demotivation. Sadly, this often leads to social isolation as the sufferer becomes increasingly withdrawn.
Issues with multi-tasking, completing tasks, planning and organisation mean that Executive Dysfunction can impede a sufferer’s return to work after a brain injury. Even simple tasks at home, such as cooking a meal, can be exhausting as sufferers struggle with thinking ahead or planning the sequence of steps needed to complete a task or thinking flexibly when necessary. Sufferers often experience low motivation or loss of interest in things they used to enjoy, as everything seems more difficult to achieve.
Furthermore, some brain injury survivors with executive functioning issues may find they act impulsively and have difficulties anticipating consequences. This can lead to a range of worrying behaviours including spending more money than they can afford, which can lead to strain in relationships.
Managing the effects of Executive Dysfunction
Managing the effects of Executive Dysfunction is possible, and organisations such as Headway, the Brain Injury Association, can help.
Strategies can include writing ‘to do’ lists, using a diary to plan your week and breaking all activities into small and manageable chunks, to stop tasks becoming overwhelming.
Discussing plans with others can be useful to help sufferers break tasks into smaller chunks, stay motivated and keep plans on track.
Sufferers should remember to celebrate their daily accomplishments by ticking things off their lists and reflecting on plans they have put into action, but most importantly by being kind to themselves and not worrying too much about things they haven’t managed to do that day.
Cognitive Behavioural Therapy (CBT) or other therapies can help brain injury survivors who have difficulty managing their moods or emotions. CBT can also help survivors think about difficult situations that may have occurred previously due to their executive functioning issues, identify common triggers and create an ability to respond.
How can a legal claim help?
Bringing a claim for personal injury or clinical negligence can seem incredibly daunting, particularly if you are struggling with the symptoms of Executive Dysfunction. At Bolt Burdon Kemp we understand the impact a brain injury can have on your life, and we work had to provide support and care throughout every step of the claim’s process.
We are able to recommend care workers to provide day to day support and assistance with daily tasks. Interim payments can provide financial security and peace of mind if your employment has been affected by your injury. Our friendly team of solicitors are always available to talk, so for guidance or advice call 020 3603 3818.
Further help and advice
If you or a loved one are suffering after a brain injury and would like further advice or support, there is a wealth of advice available from Headway, the Brain Injury Association www.headway.org.uk
To discuss symptoms of brain injury, or for help and support, call 0808 800 2244 or email helpline@headway.org.uk.
