Frontal Lobe Dysfunction: Gina Part Thirteen
When evaluating frontal lobe dysfunction it is best to interview what is called a collateral source (friends/family members). Frontal lobe problems are not sensitive to neuropsychological testing, as such tests measure only narrow facets of brain function. Further, as these measures are given in a quiet test environment, they have little real world validity where distractions, stress and multi-tasking are required. Thus, we turn to Gina’s husband to get a fuller picture of her frontal lobe function.
We begin the discussion of frontal lobe dysfunction with the issue of absentmindedness. Is she absent minded?
Yes. A lot of times, yes. Even like tonight. We’re invited to a birthday party for a friend of mine and when I asked her about it today, you know, she said oh, yeah. I forgot all about that. She forgets where she needs to be. This morning coming here to meet you we were talking about our son’s continuing education. Finally I said Gina, we got to get going. And she’s like oh, for what? I was like remember where we have to be? Oh, yeah. It’s already 10 after 8:00.
Does she have difficulty with time?
Not as much as she used to. She’s overall a little bit better. She used to always be if she had a 9:00 appointment she though leaving the house at 9:00 was close enough and she has gotten better that okay that means I be back there at 9:00.
Does she seem to not understand that other people’s schedules are important or is this part of her frontal lobe dysfunction?
I think that’s something that she’s always had a problem with even before the accident. I think before she used to have an opinion of, you know, if you get to a doctor’s appointment well you always have to wait anyway so if I’m 20 minutes late then I won’t have to wait so long and she has finally realized that now if she gets there 15 minutes early and if the doctor is ahead she’ll be out of there before your appointment time actually is.
Does she have trouble making decisions with her frontal lobe dysfunction?
Yes, sometimes I think she does. I think some things I think she overanalyzes. Other thinks I think that she just doesn’t think through quite the way she wants to. We planning a trip down to Florida this March to Disney World and she has changed our reservations and different packages I’ll bet you six times already.
I think a lot of it is just with day-to-day tasks that she seems to make a lot of, you know, unthoughtful decisions.
Does she independently plan to do things and then actual complete such tasks?
It depends on, on the activity. If it’s something that she wants to do she’s very motivated however there are a lot of other situations where it seems like I do have to motivate her to do things.
She was motivated to be part of this interview?
Very much so. She came to the meeting here a few weeks ago. Apparently you were here. I was not feeling that good that night. I come to some of the meeting with her. That night I was not feeling good. I just stayed home. She came home and talked about your presentation that you had here and asked if I would be interested in helping her and you know I guess I felt that yeah I would do this more for her quite honestly than you.
Where do you see motivation problems as a frontal lobe dysfunction?
She seems to not have a lot of motivation. Housecleaning is a perfect example. She used to keep the house very clean. Now she does very little cleaning unless it’s almost like if she forced to so it’s basically my son and I that do a lot of the cleaning these days.
Does she have difficulty following through and completing tasks as one of her frontal lobe dysfunction?
Does she start and get distracted and then not finish with her frontal lobe dysfunction ?
She does. She, she gets distracted I think with a lot of issues that she’ll put something down and just leave it sit. Example is our auto insurance cards came in the mail a few weeks ago and there’s a card for each of the three vehicles. Our son has a vehicle on our policy and everybody needs to put these in their vehicle and the vehicle she normally drives I just noticed this morning her card is still sitting on the kitchen counter.
Does she ever plan something and follow it through and get it done?
Yeah, she does. (The trip to Florida for example.) Well, that’s a situation where we’re going with her sister and her sister’s family and we’re meeting them there so a lot of the situation is her planning and organizing with her sister as well.
Does she make the same mistakes over and over with her frontal lobe dysfunction?
Not that I can really tell. I think things are improving as far as the cognitive thinking.
How’s her judgment?
It’s not the same as it used to be but again I can’t you any examples.
If she would before the accident, was she a seven or eight on a ten point scale in terms of making good decisions, judgments, where would you put her now after the accident with her frontal lobe dysfunction?
Does she do inappropriate things in social settings?
She used to do a lot more. She used to actually get very frustrated and almost rude to people like at a grocery store or but in actuality like a party atmosphere’s or whatnot and amongst friends she does control her emotions. I think it’s a slow evolution the way things are happening. It’s not like a sudden change of anything.
What is important about her husband’s perspective of Gina’s frontal lobe dysfunction is not just that it is different than hers, it is that even in areas that are often thought to be intractable after frontal lobe injury, she is showing improvement. We have said before and find support for the statement in Gina’s story:
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