June is Brain Injury Awareness Month: How Is Your Executive Functioning?

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

Last month, I spoke at a conference with my colleague Tamara Forbes ( on the topic of executive dysfunction.  Executive dysfunction is a common problem following brain injury.  Simply defined, executive functions are the capacities we require to achieve a goal.  They are commonly referred to as the “CEO” of the brain because they provide the higher order processes that allow us to plan, organize, initiate and complete tasks successfully.

Practically, think about the last time you moved.  Moving, as an example, is a simple goal of just wanting to relocate from one place to another. The goal is not the problem: it is the processes and thinking required to manage the transition effectively.  Several months before moving you are searching for a suitable place, weighing the pros and cons of each location, checking your budget.  Then you make the decision of where to move and you need to deal with your existing location.  When do you need to notify your landlord, or when should you list your house?  Then, months and weeks before you move there are calls to make to utility companies, mail to redirect, insurance to organize, movers to book and packing to do.  What belongings are you moving?  What should be sold, donated, discarded?  The day of the move is chaotic, stressful, and exhausting.  Then for months after you continue to unpack, move things around, find ways to arrange and store your stuff.

Your level of executive functioning, or your ability to delegate and enlist support for your areas of weakness, will determine the outcome of your move.  Now imagine, with brain injury, that you feel the same sense of stress, fatigue and frustration with more simple daily tasks, such as planning a meal, sorting your mail, or scheduling your time.  This is often how people with brain injury will feel on a regular basis.   The goal then of occupational therapy will be to simplify daily tasks and help a client break activities down into smaller and more manageable chunks.  More on this to come…