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Effective workplace communication with employees with acquired brain injury

Chapters

Talking about tools

Almost every task a supported employee does involves the use of tools or equipment. Communicating clearly which tools to use, how to use them safely, and how to store and maintain them involves you in a mix of explaining, demonstrating and observing.

Employees need to know about the tools and equipment they use to do their job. This means knowing not just the name of the tool or piece of equipment but also how to use it correctly, and ensure it is maintained properly. They need to know:

We learn the correct names and use of tools and equipment because we process the information in our short-term memory and then store it in our long-term memory. As many employees with ABI will have deficits in short-term memory functioning, the apparently simple task of learning that a pallet wrapper is called a pallet wrapper may cause great difficulty. You may think the employee has got it right and knows what you mean when you say, 'Take it down to the pallet wrapper', but you cannot assume that they will remember it is called that, and what it is used for.

In other words, do not assume that employees with ABI will consistently:

Ensure employees with ABI have structured training and practice in the use of tools and equipment. Check often to see if retraining is needed. This is especially important if the employee has a break from using the tools and equipment.

Employees with ABI may remember things they learnt before the injury occurred but have great difficulty learning new things. This may explain why an employee with ABI can't remember the names of the tools they use every day, but they can tell you the names of all of the planets in the solar system in the correct order or recite a poem or sing a song learned long before their injury occurred. This difficulty learning new things means you should never assume an employee with ABI can't remember because they are lazy or being uncooperative.

Trevor

Trevor's brain injury has caused him to lose the ability to use certain cues that seem obvious to anyone else. For example, he has problems recognising the differences in size in the tape dispensers he has to use. Similarly, he can't remember the names of the different hand tools he has to use – the Stanley knife, cutting frame, staple gun. This problem has obvious impacts on his productivity. Although his supervisors have tried over the years to organise his work area so that the things he needs are always within his reach, he still makes mistakes. He will pick up the wrong tool for the task in front of him, then look confused when it doesn't do what he wants. He is then unable to tell anyone what the problem is because he cannot name the equipment he needs.


From Em's notebook

I feel so sorry for Trevor some days. He's such a nice bloke and I hate seeing him look so dejected so often. The trouble is that he seems to know when he's made a mistake but can't actually name or describe what has gone wrong. You'll see him there holding the wrong tool in his hand and just looking at it in a bewildered way. It's as though he's thinking, 'What the heck is this I'm holding, and what am I supposed to do with it?'. Mary and I have been going over the names of each piece of equipment with him, two or three times a day for practice, but it seems to make no difference. He can't remember from one day to the next.

Strategies

  1. Concentrate on the key information. Think about the information that it is really important for the employee to remember and focus on ways to assist them retain it. For example, it is more important that an employee remembers that they need to use the wide brown reinforced packaging tape on big boxes than that they know the tape is 60mm wide. So focus on making a clear association between the type and colour of the tape and big boxes, not on the width of the tape.
  2. Give the employee frequent opportunities to repeat or rehearse key information in their own words. You will provide information in the order and will use the words that make most sense to you. So you might say, Use the wide brown tape on the big boxes. If the employee uses their own words to reinforce the information it is more likely they will remember it. Their version, Big boxes need wide brown tape, covers the key information in a way that makes sense to them.
  3. Ask supportive questions about the key information. Wording questions supportively may reduce the anxiety that some people with ABI experience when they are asked to do something.

Would you like to show me which tape you use for the big boxes?

  1. Relate key new information to pre-existing memories.

Seven pairs of socks in each pack. One for each day of the week.

  1. Create visual and verbal associations for new information. Using visual and verbal association techniques to learn new information assists recall of it later because it helps put the information into a more meaningful context.
  1. Avoid false reassurance. Don't tell the employee they have the right name for a tool when they do not. Don't tell them it doesn't matter if they don't know it. This can have the effect of minimising their feelings and making it even less likely that they will retain the information.
  2. Avoid intrusive questioning. People with ABI are likely to become very confused if you fire rapid or probing questions at them.

Do you remember what this is called? Don't you remember?… We spoke about it yesterday … Do you remember? Why don't you remember? You knew its name yesterday. Why have you forgotten?

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