Jim’s Journey – Part 1: Insight to Improvement

Here is Jim at the end of an 11-week neurorehabilitation programme at The Marbrook Centre. He came to us after a hospital stay due to complications arising from his diagnosis of Hydrocephalus (a build of fluid deep within the cavities of the brain).

When Jim first arrived, he was facing significant challenges, including cognitive impairments, mood changes, and agitation. Jim was partially oriented to time and struggled to remember details of his injury and hospital admissions. His cognitive assessment revealed marked changes in visuospatial abilities and delayed memory, though Jim himself had not noticed these differences. Executive functioning tests showed difficulties with sustained and divided attention, reduced initiation of functional tasks, and a limited insight into his needs and risks. 

Cognition equates to thinking, to achieving understanding of the world around you via thought, experience and the senses. We explained these findings to Jim and began a course of cognitive therapy. On the one hand, we provide compensating strategies, such as prompting thorough visual scanning before beginning the activity. On the other hand, we promote cognitive stimulation using specialised software, to target specific deficits. 

Initially, Jim was often agitated when he got answers wrong and was highly self-critical of his performance. However, his motivation to try was unwavering—he remained focused and gave his all in each session. Despite occasional frustration at what he perceived as slow progress, our team reassured him that he was doing exceptionally well. 

As Jim completed more sessions, his memory began to improve. He started to remember tasks he had previously struggled with, requiring less explanation each time. His concentration also improved, allowing him to focus for longer periods without needing to rest. We encouraged Jim to revisit some of his favourite hobbies, like painting and drawing. As his abilities grew, Jim’s frustration lessened, and he began to face challenges with humour rather than self-criticism. 

Over the weeks, we witnessed significant changes in Jim’s cognition. He acknowledged the small victories in therapy and began to self-correct when he felt he had made an error. In the final weeks of cognitive therapy, Jim showed spontaneous memory recall without visual cues and demonstrated increased mental flexibility when facing new tasks. His reassessment revealed remarkable improvements in both immediate and delayed memory — so much so that his immediate memory is now considered above average for his age! 

Jim’s story is a powerful reminder of how appropriately directed therapy and neural plasticity facilitates improvement, which in turn boosts quality of life. Alongside cognitive stimulation therapy, our lead Clinical Neuropsychologist also worked with Jim to address his low mood and help him reconnect with who he was before his illness. 

Stay tuned for more on Jim’s journey next week!