The Importance of Routine

Daily Living and Routine

While some individuals crave excitement, opportunity for spontaneity and loathe the idea of routine, your brain loves habit!

Life post-brain injury often means we either can’t do the things we used to because of changed physical health or outcomes such as balance issues. Struggling to think, a lack of energy, changes in finances, and so many other factors bring vast changes that can be difficult to adapt to.

It isn’t only that need to adapt that is tough, the fact that we don’t have the cognitive and executive tools to enable this. 

Many people feel trapped in a hiatus that they can’t think their way out of. The pressure of being overburdened by a vast myriad of incomprehensible changes to energy, mood, pain, thinking, understanding, and an endless list of other horrendous symptoms and effects, is overwhelming in the extreme.

It can be impossible to make choices, to think your way through things or even to know what and how to prioritise your wishes and life, so making your mind up to be proactive about your rehabilitation journey often doesn’t even get on the list.

Among other contributing factors, such as personality and your psychological makeup, difficulties with thinking, and knowing what you are thinking,  often stem from a loss of metacognitive self-awareness.

Executive process operate on our metaknowledge and have been linked to the retrieval of memories. So, while we may feel everything we ever learned or experienced has been wiped out, it is often just the route to it that is missing.

Because everything we want to do is linked to our higher thinking or metacognition, applications of thought to any problem can be tricky. 

Despite the many challenges, having a daily routine provides benefits in many ways. You will feel more in control and will have more purpose. You will know what you want to achieve each day and the more you try to get organised again and address daily responsibilities, the more you are rewiring the brain. 

Although we might use paper or electronic tools to help us plan our day, these can be difficult to maintain and use because of a failure to realise their true benefits because of difficulties with self-reflectiveness.

However, the BEST Suite of apps tackles the attention and insight problems by providing a tool that encourages us to identify cognitive deficits and once you start to do this you can start to reduce them.

We recommend BEST Suite for these reasons.

Further Understanding

In a paper published by Cambridge University Press, Umberto Bivona et al repot that, “Decreased metacognitive self-awareness is significantly correlated with increased problems in some components of executive system.¹”

In other words, where there is lack of self-awareness, there is an impact on executive functioning. 

It is also known that when neuroinflammation is reduced it can boost cognitive recovery. The question stands, can we improve metacognition by tackling neuroinflammation and, if we can, will this help people to use knowledge of their cognitive processes and capacities to create and stick with routine and achieving goals?

Because routine and goal setting are linked, more needs to be done to find out why, when both are an imperative part of cognitive rehabilitation, goal management is difficult for people to maintain after initial training.²

Conclusion

Tackling neuroinflammation before attempting cognitive rehabilitation and the use of rehabilitative tools such as using routine may be beneficial. 

References:

¹BIVONA, U., CIURLI, P., BARBA, C., ONDER, G., AZICNUDA, E., SILVESTRO, D., . . . FORMISANO, R. (2008). Executive function and metacognitive self-awareness after Severe Traumatic Brain Injury. Journal of the International Neuropsychological Society, 14(5), 862-868. doi:10.1017/S1355617708081125 

²Tornås, S., Løvstad, M., Solbakk, A., Schanke, A., & Stubberud, J. (2019). Use It or Lose It? A 5-Year Follow-up Study of Goal Management Training in Patients with Acquired Brain Injury. Journal of the International Neuropsychological Society, 25(10), 1082-1087. doi:10.1017/S1355617719000626

Monty Lyman, Dafydd G. Lloyd, Xunming Ji, Marcela P. Vizcaychipi, Daqing Ma,
Neuroinflammation: The role and consequences, Neuroscience Research, Volume 79, 2014, Pages 1-12, ISSN 0168-0102,
https://doi.org/10.1016/j.neures.2013.10.004.
(http://www.sciencedirect.com/science/article/pii/S0168010213002253)
Abstract: Neuroinflammation is central to the common pathology of several acute and chronic brain diseases. This review examines the consequences of excessive and prolonged neuroinflammation, particularly its damaging effects on cellular and/or brain function, as well as its relevance to disease progression and possible interventions. The evidence gathered here indicates that neuroinflammation causes and accelerates long-term neurodegenerative disease, playing a central role in the very early development of chronic conditions including dementia. The wide scope and numerous complexities of neuroinflammation suggest that combinations of different preventative and therapeutic approaches may be efficacious.
Keywords: Neuroinflammation; Systemic inflammation; Microglia; Alzheimer’s disease; Postoperative cognitive dysfunction; Multiple sclerosis