The holiday season is a time for joy and togetherness, filled with cherished traditions, family activities and festive celebrations. However, for individuals with brain injuries, this period can present unique challenges, particularly in areas that require executive functioning skills like planning, organisation and time management.

As rehabilitation professionals, are we planning ahead to address the difficulties our clients face during this time? It’s tempting to focus primarily on their day-to-day rehabilitation progress without recognising the added demands the holiday season may impose.

Many clients with brain injuries struggle with executive functioning skills that are especially critical during the busy holiday period. Even seemingly simple tasks, like creating a shopping list or establishing a schedule, may demand more cognitive resources than usual, because of the overlay of the impact of a busier schedule generally.

Strategies for cognitive support

· Focus on strengths: Clients may enjoy creative projects that bring their children smiles such as managing the pesky visiting elf — but could struggle with broader planning tasks. Tailor support to their strengths and motivations to promote confidence.

· Break tasks into smaller steps: Help clients segment larger activities into manageable portions. Planning and “chunking” tasks can make them feel less daunting.

· Encourage delegation: Support clients in reaching out to family members and friends for help with more complex holiday responsibilities. Those less used to being around may not understand the subtle impact of brain injury, and so some education for them would be helpful.

· Use familiar tools: Now is not the time to introduce new methods. Stick to established calendars, charts or apps that clients already know and trust.

Managing sensory overload

The festive season often brings heightened sensory stimulation, with bright lights, loud music, crowded shopping centres and packed social calendars. This can intensify feelings of stress or anxiety, making common environments overwhelming.

Strategies for minimising sensory challenges:

· Plan for low-stimulation outings: Encourage scheduling shopping trips during off-peak times or opting for online shopping to reduce sensory input. Ideally Christmas shopping should start in October to ensure it is completed before the December rush.

· Create calming spaces: Help clients identify or establish a quiet, visually soothing area where they can retreat. This is a key part of fatigue management. A busy and cluttered home space is visually difficult and adds to cognitive load.

· Budget in advance: Using a planned approach to buying gifts gradually across weeks or months can minimise the chaos of last-minute spending sprees while also teaching practical financial skills. Many of our clients will struggle with budgeting skills and may require support to stay on track.

· Encourage external devices: Recommend noise-cancelling headphones or earplugs to reduce auditory distractions in busy locations. Not only do they reduce the load of auditory input, they reduce anxiety as well as extending times individuals can be present.

· Practice exit strategies: Develop “crib sheets” and role-play scenarios that allow clients to leave events gracefully if they feel overwhelmed or fatigued.

Supporting social engagement and communication

Holiday gatherings often come with expectations of prolonged social interactions, which can be tiring or frustrating for individuals facing communication difficulties. Clients may decline invitations out of fear of embarrassment or fatigue, potentially leading to increased feelings of isolation.

Strategies for encouraging social participation:

· Suggest alternatives: Recommend meaningful alternatives to in-person interactions, such as writing cards, sending emails or attending smaller, more intimate gatherings.

· Foster open communication: Encourage clients to have honest discussions with their loved ones about their challenges and limitations during social events. Education for both clients and those around them is key to promoting understanding.

· Provide support in social situations: Rehabilitation assistants or support workers can accompany clients to events, offering quiet prompts or facilitating conversations when needed. Not only can this aid with making an outing more successful, it aids confidence and allows a load to be taken off in many cognitive areas.

· Tailor plans around confidence: For clients who wish to attend larger social functions despite their challenges, advanced preparation and tailored strategies will be critical to their confidence.

Addressing emotional and psychological needs

The holiday season can evoke a spectrum of emotions, from joy and nostalgia to stress and grief. For individuals with brain injuries, these emotional pressures may be amplified by the added expectations of the season, or by isolation resulting from relationship changes post-injury. Some may prefer to avoid celebrations altogether.

Strategies for emotional wellbeing:

· Respect their choices: If a client wishes to avoid celebrating altogether, respect their decision. Do not impose personal expectations of how holidays “should” be celebrated.

· Encourage self-care: Help clients incorporate personalised self-care routines that are familiar and calming, such as listening to music, engaging in crafts, or practising relaxation techniques. These practices should already be well-habilitated and not reliant on learning new coping strategies during the season. This is the time to ensure that individuals are looking after their needs that they may not have an awareness of.

· Promote peer support: Connect clients with brain injury support groups and organisations that often host inclusive holiday activities that provide social connection within a safe environment.

· Plan for potential challenges: Encourage clients to anticipate and discuss emotionally tough moments with their support network in advance. Always ensure that in schedules there are buffers for unplanned matters or increased breaks.

Managing fatigue during a demanding season

The festive season is arguably the busiest time of year, involving travel, social engagement and physical activity. For individuals with brain injuries, fatigue management becomes even more critical, and can be the area that causes most difficulty, often ending in burnout and exhaustion.

Fatigue management strategies:

· Prioritise activities: Work with clients to identify events or responsibilities that matter most and reduce those that are less essential.

· Plan accordingly: There won’t be room for everything so plan across a longer period of time. Allocate at least three times as long to complete tasks as usual, that way if things are completed sooner there’s more down time.

· Schedule rest breaks: Make rest a priority by building breaks into busy schedules, balancing activity with adequate downtime. Rest should happen before tiredness hits.

· Limit commitments: Encourage clients to focus on nearby events with fewer participants, where possible, to conserve energy and reduce stress.

· Sleep takes priority: Ensure good sleep hygiene is practiced, especially keeping to routine.

While the challenges of the holiday period are significant, individuals with brain injuries can still experience joy and fulfilment during this season. Every individual’s experience will vary, which makes personalisation essential. Whether it’s simplifying shopping, creating sensory-friendly environments, or planning meaningful social interactions, the goal is to build confidence and provide the tools they need to enjoy the holidays on their own terms.