Life-changing injuries
Challenges and strategies after injury or acquired disability
Life after injury often involves a continuous process of facing new challenges. Depending on the type of injury, these challenges may include memory loss, concentration problems, difficulty processing information, physical problems, and problems with sight and hearing.
Finding strategies for managing challenges after injury or acquired disability
People we interviewed adopted a range of strategies to help them manage challenges, and, as Simon A said, doing so was 'the key to life after injury'.
While people hoped these strategies might be useful for others, it was recognised that everyone is different and each person needs to find what works best for them. Finding the best strategy involved a lot of trial and error, according to Adrian.
In spite of having strategies in place, people still had difficulties, and, as Jane said, 'Bad days dash my confidence'.
Hospital rehabilitation staff were a common source of advice for strategies to manage physical challenges and with problems with memory and concentration. Initially, coming to terms with the lasting effects of injuries could be difficult.
Christopher remembered feeling upset when the occupational therapist first suggested developing strategies. He said that 'This was just like the pits. Because anybody who needs a strategy explained to them to live, there’s something seriously wrong with them'.
Jack used humour as a way to help him and his family come to terms with his limb loss, while Sam found that creative activities helped.
Sam used activities in which he could express himself to come to terms with being in hospital. He kept a diary, which he feels good about when he looks back on it.
Sam used activities in which he could express himself to come to terms with being in hospital. He kept a diary, which he feels good about when he looks back on it.
Accepting that life had changed was an important factor for some people in recovery when facing challenges. A man with a brain injury who we spoke with (Interview 23) said he almost wished the rehabilitation professionals would tell him he was not going to recover any further because he was frustrated with trying to improve and living with his impairments.
Having a realistic understanding of their limitations could be valuable but difficult to establish, epecially when people had problems with understanding after injury.
Accepting they were not the same as before, letting go of their 'old self', and not dwelling on the past were seen as helpful strategies. People felt it was important to try to remain positive and not let the new challenges they faced define their lives and who they were.
One person we spoke with (Interview 23) felt it was important to find things to do and 'start getting life back into order' rather than sitting at home. At the same time, Nick Y cautioned against overdoing things.
As part of accepting her brain injury, Amy held a funeral for her old self because she wanted to move forward.
As part of accepting her brain injury, Amy held a funeral for her old self because she wanted to move forward.
And to persevere – I think when people have been severely injured whether it's you know neck, brain, spine, hips whatever you can get an idealised picture of what you think you were and that old person becomes a big hero and the new person becomes like, why am I even here on this earth and I advise people to do what I did, is I had a funeral for my old self on the inside and I said goodbye she's never coming back, just said goodbye and I'll build again. Because life is not necessarily what you expect, it's not what you planned but life is what you make it, you know you can produce your own show as a you go along and unexpected things happen and it's not so much what happens to you but it's how you're able to respond to the things that happen to you that will make the difference in how your life turns out. For instance, the things that happened to me I wouldn't have wished them on anyone but in the end I met absolutely phenomenal people. I ended up doing things I never thought I would be doing.
Returning to employment was not an option for everyone, but those who were able to go back to work discussed ways of making it manageable. Strategies for work included going to the office at times which suited them, working flexible or part-time hours, and working from home.
Planning and organisation became particularly important after injury, and people were often encouraged by rehabilitation professionals to set themselves goals and think about and plan the tasks they needed to undertake.
One man who had a brain injury (Interview 23) recommended that people 'Start doing goals and little tasks and it just helps you get your life back into order'.
Careful planning and organisation were often important to people after injury because many were unable to do things spontaneously anymore. Simon B said his body 'no longer worked on autopilot' after his spinal injury, so he needed to plan more in advance.
Simon B said it is important to be organised. He keeps a couple of rucksacks packed with the things he needs to stay overnight by the door and in his car so he won't be stuck.
Simon B said it is important to be organised. He keeps a couple of rucksacks packed with the things he needs to stay overnight by the door and in his car so he won't be stuck.
Challenges after injury or with acquired disability
Extreme tiredness or fatigue is a common problem experienced after injury. Fatigue is often a direct effect of injury but is also associated with the effort of dealing with the daily challenges that come with injury and disability. People dealt with tiredness by taking naps during the day and scheduling activities for when they would be well rested.
Adrian said he found that keeping his mind active was a good way to manage tiredness. Some also believed that other changes, such as change of diet and cutting out sugar and caffeine, improved their energy.
Although brain injury was frequently described as 'a hidden injury' (Barrie), people also sometimes experienced lasting physical problems, especially with fine motor skills.
Wesley has problems using his left arm. He has adapted by using his right arm, but this isn't always easy.
Wesley has problems using his left arm. He has adapted by using his right arm, but this isn't always easy.
Challenges after brain injury
It was common for people to experience problems with memory, planning, concentration, and sensory overload after brain injury. Sensory overload is when people’s senses get overwhelmed by what’s going on around them, such as loud sounds, movements, or lights. Ed was surprised to find a relatively simple solution to sensory overload that worked for him (see below).
Ed was surprised that something as simple as earplugs helped him overcome the frustration he felt when it got too noisy.
Ed was surprised that something as simple as earplugs helped him overcome the frustration he felt when it got too noisy.
Sometimes people found decision-making difficult and needed more time than they did before injury to think things through. Multitasking and problem solving were also more challenging after injury, so people said they approached problems 'as if they were mini-projects', and broke them down into smaller parts to deal with.
Raymond breaks problems down into small manageable parts.
Raymond breaks problems down into small manageable parts.
People described struggling to retrieve information from their memories. Amy said it was 'as if someone had muddled up a filing cabinet' or had divided her brain into compartments.
Some felt that doing puzzles and brain training exercises helped to improve their memories, but Christopher disagreed and said these were not helpful for him.
Using tools such as transparent coloured overlays for reading helped some people process words, and earplugs helped them cope with noise.
Amy used software to convert written information into audio format. She felt that walking around whilst listening helped her remember it.
Amy used software to convert written information into audio format. She felt that walking around whilst listening helped her remember it.
For reading the disability assessor had me work with a programme and my reading was very, very slow in the beginning and now it's very fast. But the difference that was they had me work with a coloured overlays and now I colour the screen on my computer and it made a huge difference because it retrained my visual processing and so if I read with the colour the comprehension was better, the understanding was better. There's not a lot of good research on it but it made a huge difference for me and I'm sold for compensation. I can read more quickly. What I did a lot in the beginning is I not only read, it's important to use all your senses because each of, each of your sensory aspects has its own memory so if you can engage a certain smell with what you're doing. If you can hear it so I would put my papers and my text books on pdf, then I would send them over to an internet programme called Spoken Word and then a mechanical e-person reads your texts back to you and I would play that while I was walking because also when you're walking and engaging your motor cortex there's also links to areas of reading. So I would walk and I would listen and then I would read again and that would make the material more deeply processed and ingrained in my memory cells. That was one way of, a couple of ways I guess of compensating.
Meeting new people could also be stressful and people worried they would forget names. They used techniques like associating the person’s name with another word or a famous person and asked them for their card or to write their name down.
Amy said you shouldn’t be afraid to ask people for reminders.
Bridget explains the strategies she uses to remember the names of people she meets and routes she needs to take.
Bridget explains the strategies she uses to remember the names of people she meets and routes she needs to take.
I did see somebody at one stage who told me various things, which I’ve never forgotten, like if you want to remember a person’s name link it to something that means something to you. So you meet Alice and she goes with Alice in Wonderland, you know, it’s that sort of thing. And it’s hard work, you can’t do it all the time, but on occasions when I want to, I can do that. And I’ve never forgotten that, so yeah, I mean there are, there have been memory... And the spatial orientation thing, you know, forgetting the way, the way to go to places. I know the way to do it because I was taught it, is, you know, you’ve got to make sure if you going on a route, you know, is there a Lloyds, you know, do you turn right at the Lloyds bank? Do you, you know, pass the Sainsbury’s? All that sort of thing, the physical practical things. I was taught all that as well.
Aids and strategies after brain injury
People needed to be able to remember things they had already done as well as things they planned to do in the future. Having something they could use to help them recall things that had happened was reassuring for people with memory loss, so they often wrote things down on white boards or in notebooks or diaries.
In addition to appointments, they also logged formal and informal happenings, conversations, and meetings they had throughout the day. Having a factual written account allowed them to refresh their memories when needed and they could also rely on it if there were any queries about who said what. However, writing things down wasn’t always a good solution for everyone.
Adrian makes notes about everything that happened during the day so that he always has a way of verifying things he may have forgotten.
Adrian makes notes about everything that happened during the day so that he always has a way of verifying things he may have forgotten.
If you call me and I answered the call and we talked and discussed it, I’d have to make a note of that phone call afterwards in my memory aid because I can’t say I’d forget it. I can’t say I’d recall it. I don’t know. So make sure I could retain information I make notes straight away and when you say make notes straight away because I’ve got short term memory impairment, if you ask me to make notes in a minute’s time? That memory may or may not be gone. I don’t know for sure. I somehow know I can’t guarantee the information I’m writing down is right, which is why with an email I can see what was said and when, and what I replied. So that’s why it’s always good to have that, I can see what was said and when to be able to look back to be able to look back on it and say okay no I know what I said and why I said that. It’s recordable, yes.
Smart phones and tablets were often used as memory aids. This kind of technology made a significant difference to people’s lives, but Christopher pointed out that for people with memory problems, it is important to develop a system for remembering the passwords you may need for different digital devices.
People used phones in various ways, including to make digital notes which they could then email to themselves, set alarms to remind them to do things, take photos of people and places, and put appointments in their diaries. GPS electronic navigation on phones was also used to help people navigate through areas if they forgot where they were, and people also took photographs to remind them where they parked their cars.
Raymond has found his iPhone very useful because of the variety of ways in which he can use it to aid his memory.
Raymond has found his iPhone very useful because of the variety of ways in which he can use it to aid his memory.
Instead of using technological devices, some people noted landmarks such as shops or buildings and practiced routes to try to commit them to memory. Those who had problems with visual perception (e.g., failing to ‘see’ things) and spatial awareness (e.g., estimating distance) had to take extra care to negotiate traffic.
Smart phones, GPS, and landmarks were also important to blind people when learning routes. Additionally, people with visual impairments described a range of aids they used to help them live independently. Audible software made using the computer and reading documents easier, and bump-ons (raised, tactile stickers) can be stuck onto gadgets (e.g., microwaves) to indicate settings.
Rob describes the range of aids he uses to help him manage at home and when he goes out.
Rob describes the range of aids he uses to help him manage at home and when he goes out.
One challenging change to life after injury can be experiencing anxiety, mood swings, and sometimes anger and aggression. These changes in mood and behaviour may be because of damage to the brain but can also be from frustration due to 'not being able to do things so well'.
Techniques like mindfulness, meditation, and cognitive behavioural therapy (CBT) could help, as could exercise, which both helped with these problems and had the added bonus of promoting fitness, weight loss, and increasing feelings of self-confidence.
See also ‘Mobility aids for physical disability’.
Last reviewed: August 2025.
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