Making Headway Autumn Winter 2015

Autumn/Winter 2015 Edition

MAKING

Bringing positive change in the lives of those affected by Acquired Brain Injury

Making Headway is published by

Headway is accredited by CARF International (www.carf.org) for Adult Home and Community and Vocational Services (Brain Injury Speciality)

Inside Introduction to Autumn/Winter 2015 Edition

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Jobs Club

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A Different Normal

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The Art of Healing

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Fatigue after Traumatic Brain Injury

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Message from the CEO Dear Reader, As we approach the end of another year I have been reflecting on the perennial problem of raising awareness of brain injury. This is a theme which regularly crops up when I talk to family members, people with brain injury and practically everyone I meet.

Front Cover: Dara Friars at launch of Headucate campaign - Kevin McLaughlin (Leinster Rugby) and friend; The Lord Mayor of Dublin and Sarah Benson; Dancers from Headway Cork; Ronan O’Neill with the Equinox cycle ride; Owen O’Driscoll Headway Cork Client.

larger debate of the challenges people face when their difficulties are not immediately obvious to the public at large.

Another partnership that we have engaged with is with the Irish Rugby Union Players Association (IRUPA). Our relationship will help shine a light Brain injury and its many manifestations is difficult for on concussion, brain injury and also will help the average person to understand and it can be very raise awareness of Headway and the services we hard to explain to those who haven’t experienced it provide. directly. It really is the “hidden disability” and it can Quite separately to that partnership, Munster silence those who are injured and those who care Rugby have chosen Headway as their favoured for them. charity for the coming year – this is very positive However I am optimistic about a number of and again will help raise awareness - Headway developments that might help us in the years to has a strong presence in Cork and Limerick the strongholds of Munster Rugby. come.

Headway has been successful with a grant So, although the challenge of raising awareness application to the Department of Justice and remains, I am hopeful that 2016 could see us making Equality specifically to raise awareness of hidden great Headway in that area (pun intended!). disability. This is being done in partnership with Best, Epilepsy Ireland in 2016 and hopefully will initiate a Kieran

Having a Ball

(Thanks to Dublin’s Lord Mayor)

Sports Injury, Concussion and the Law

Headway were delighted to be selected by the Lord Mayor of Dublin, Críona Ní Dhálaigh, to be one of three charities to benefit from the recent annual Lord Mayor’s ball. This year’s event was extra special, as it marked the 300th year of the ball being held in the Oak room of the Mansion House.

Headway Psychologist, Dr. Elaine Kelly spoke recently on the ‘Neuropsychology of Concussion’ at a conference entitled ‘Sports Injury, Concussion and the Law’.

The conference was an opportunity to bring together professionals with growing concern about the incidence and management of concussion in all sports.

Speakers included doctors, legal professsionals and a variety of professionals from the worlds of Rugby, equestrian sports and GAA. Headway has been running its own campaign to encourage sports professionals to ‘If in Doubt, Sit it Out’. The campaign is being supported by IRUPA, the Irish Rugby Union Players Association and you can follow it on social media using #headucate.

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Headway Staff at the Lord Mayors Ball

The event was a fabulous evening and Headway would like to extend special thanks to the Lord Mayor and all the supporters who kindly donated on the night. Some Headway staff were lucky enough to attend thanks to the generosity of the Iris O’Brien Foundation and David Brabazon.

MAKING HEADWAY | Autumn/Winter 2015 Edition

Thank You, Thank You, Thank You! We can’t let this edition go by without thanking the amazing Ronan O’Neill. He and his colleagues and sponsors from Brown Bag Films have raised nearly €100,000 for Headway and Temple Street Children’s Hospital over the last five years.

effects of art and the creative therapies on the individual recovering from a brain injury. Headway staff have observed first hand this beneficial effect many times.

We hope to ensure Annemarie’s passion and high standards continue in the Art programme in The Rehabilitation Services, and that current and future clients can continue to enjoy the benefits of the art and creative therapies that we offer as a very important part of the programme.

Ronan organises the annual Equinox cycle ride, which takes place during one 12-hour day from the East Coast to the West Coast. It’s an incredible achievement, and we are so grateful - Thank you.

You can read about the exploits of this years riders on page 4.

Thanks to the wonderful staff from the Limerick office of IT company WIPRO. They held a coffee afternoon and raised a super €720 for us.

Annemarie Durcan (3rd from R.) with Headway Artists

Titanic Trip

Headway’s Elisa O’Donovan with WIPRO staff

Thank you finally to Eileen O’Brien and the staff of Cork County Library for their kind donation in memory of Tim Cadogan.

As part of a community skills module held recently in Headway Limerick, the clients went on an overnight stay. They chose Belfast as their destination. There was keen interest amongst the clients especially around the Titanic Museum which is Belfast's main tourist attraction. They were also keen to see the yard where Titanic was built and launched by the famous White Star line.

Moving On All the clients and Staff in the Headway Dublin Rehabilitation Service said a sad goodbye to AnneMarie Durcan at the end of September 2015.

Annemarie left to pursue her own Art practice after 14 years of facilitating the Art classes in Dublin Day rehabilitation Services.

Annemarie built a great rapport and understanding with each and every one of the individuals she worked with . She always referred to the individuals as “Artists” and was passionate about spreading the word about the transformative and healing

Headway Limerick clients enjoying their visit to the Titanic Exhibition in Belfast

Feedback about the trip was overwhelming. For some clients who were going on a trip without their families for the first time, there were feelings of nerves, excitement and joy.

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Headway Dublin Jobs Club

by Kieran McCullagh Community Re-Integration Officer, Dublin

Losing your career after a brain injury can seem like yet another loss of self. But often, with time comes change and acceptance.

Sometimes people discover new careers or another side to themselves. Finding and keeping a job after experiencing brain injury can be difficult for many reasons. Following injury, people can experience many physical, mental and emotional difficulties that complicate their ability to function in work-related arenas.

All the “back to work” research that has been carried out in recent years has consistently found that a lack of vocational rehabilitation is a major cause of people with brain injuries not being able to obtain or maintain employment. They may attempt to return to a job that is no longer suitable because they have not received advice on planning their return to work and the required supports are not in place.

Like all employees, individuals living with an Acquired Brain Injury can bring a huge pool of skills, talents and abilities to the workplace. The onset or progression of a disability can be a devastating event. However, it does not always mean that you will have to give up your job or your goal of returning to employment, whether that is a paid or voluntary position.

The Headway Dublin Jobs Club Programme was set up to provide tailored support to job seekers who require assistance in preparing their C.V’s, improving their interview skills, identifying potential employment opportunities and most important of all in boosting their self-confidence and self-assurance.

Staff encourage participants to open their minds to alternative suggestions for employment and to set realistic and achievable goals. Individuals are supported in exploring their vocational strengths as well as areas of difficulty, and receive guidance regarding the best possible vocational options and opportunities. There is also an emphasis placed on realistic job-matching, which can involve onthe-job training as well as follow up support.

Great importance is placed on employer/co-worker education and support as well as in developing an 4

Headway Jobs Club attendees: Rachel Murphy; Catherine Craven; Paul Davies and Paul Kavanagh

accessible, open and supportive work environment for the individual with a brain injury. Staff will work with the individual to find suitable vacancies and liaise with a potential employer to support people in their work. The Jobs Club Programme can offer help in preparing individuals for the workplace if required or simply support and advise on how to undertake an interview and best present one’s skills and abilities to an employer.

Equinox Cyclists

by Ronan O’Neill This years Equinox cycle was the longest one to date at 260km! On the 19th September, 50 cyclists left Clontarf at 6:45 am en route to Westport - along with a crew of 15 volunteers and bike marshalls who all helped to make the day a great success.

At one point or another we all felt the pain of cycling such a long distance but we all managed to get there together and on time. We arrived at 7pm that evening to an atmospheric setting of Westport, with Croagh Patrick as a backdrop to welcome us. For the 5th year in a row we had no rain either!

A big thank you goes out to all the sponsors, particularly our title sponsor for the last 5 years, Brown bag films. The fundraising to date is almost at 100k in 5 years! To help us get there please see www.equinoxcycle.com!

Paul’s Story When I was offered a placement on the Headway Jobs Club Programme in September 2015, I accepted with great trepidation.

I thought to myself then, that this is another step forward on my long continuing road to recovery.

Since a road traffic accident in 2004, where I sustained life threatening injuries, including two brain haemorrhages, my life just consisted of aiding my recovery, and learning to accept and live with a traumatic brain injury.

This was a colossal undertaking for me, I had to commit to four days a week, for four weeks from 10am – 1pm. When I first started the programme, I wondered had I done the right thing or was I capable of fulfilling my obligation, considering the amount of time and energy that the course would take. This to me was a major challenge! I soon realised that I had made the correct decision in participating in this Programme.

The course was run by (the most brilliant and patient) Kieran McCullagh and Caroline Earley, and it comprised many aspects, including telephone skills, stress management, cover letter writing, and the compilation of a Curriculum Vitae.

At the finale of the course there were mock interviews for all willing participants, as well as a an All Day Group Activity excursion, followed by a most enjoyable celebratory meal. This All Day

MAKING HEADWAY | Autumn/Winter 2015 Edition

Group Activity day was superb in the sense it was all based on teamwork, and it really bonded us as a group, and of course, it gave us many a laugh during the process.

Personally, I would like to take this opportunity to thank the Headway Jobs Club Programme team for their dedication and endurance over those four weeks. They went to great lenghts to make the experience informative and enjoyable.

A very special thanks to my fellow participants, Paul, Rachel and Catherine. It was a pleasure to get to know you all, I have utmost admiration for each and everyone of you, you have been an inspiration to me, with your own individual stories of your ongoing journey to recovery.

It is vitally important to point out that the role of the other participants on the programme was paramount - it gave us all a sense of security, comfort, support, confidence and encouragement.

We, the Jobs Club Programme participants, all agree that this course gave us a sense of purpose. It brought home to us that there is life after sustaining a brain injury. If any person that has sustained a brain injury and is offered a placement on this programme, please say yes, without hesitation. If I can do this, anybody can. My road to recovery has been long and difficult, but this course has shown me that you should never give up on yourself.

Advice, assistance and guidance is always there.

Thank you Headway from the bottom of my heart.

Communication Matters Headway recently started an education and communication group with help from Trinity College Speech and Language Therapy Students. The focus of the group was to support clients with their communication challenges by providing them with strategies in a fun and social environment. The group was supervised

by Jennifer Grundulis, a Senior Speech and Language Therapist.

The education and communication group in session

Every Friday morning there is lots of laughter and chat going on in Blackhall Green where the group runs, but lots of progress has been made too and the participants have given very positive feedback so far. We would like to thank Jennifer and the Trinity SLT Students who have taken part – Katie McGivern, Megan Ryan, Laoise Gillere and Hannah Duffy for their work, and we wish them all the best when they graduate as Speech and Language therapists in 2016.

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A Different Normal Anne and Gerry had been happily married for 25 years before Gerry had a stroke in 2005.

Ten years on, Anne reflects on the challenges of coping with the hidden effects of brain injury.

Most times things are ok, they’re fine. Gerry can be very good, he can be fine when he’s out. He can make great effort..

But the person people see when he’s out is not necessarily the same person that I see at all. He uses all his energy to come across as fine, there’s no problem. You know, he’s grand and he can deal with things. And to a fair extent he can cope very well. But it’s more subtle things that are issues...

Headway (HW): And if you find that he is very different at home, how does that impact you?

I can sometimes feel a bit peeved. I feel he can be a bit selective. My son and I would be the only two that Gerry would get cross with. Maybe he can just relax with us or something . Doesn’t feel any need to put up a show with us. Even with the rest of the family it’s different. I don’t think the rest really understand that their dad had a brain injury.

HW: I imagine that that make you feel slightly disloyal if you have to explain that?

You can just feel that you’re a bit like a buffer, in that sometimes you’re trying to make excuses for Gerry to them and them to him. Gerry may say something inappropriate, nothing too bad, but the filter’s not there in the same way and he says things. You know - the way you might just think something, but Gerry might actually say it. He’s not saying things to be hurtful, he just doesn’t think.

HW: What do you find yourself having to do for him or to help him with?

I’d always be a fixer and a doer, to help the kids. I think it’s only now, and I’m nearly 10 years down the road at this stage, sometimes I just feel tired.

Exhausted. There’s so much I have to remember.

Dates, appointments, I work, I try to fit everything on my shoulders.

A lot of the things I help Gerry with. Since day one, I’ve been trying to make things right. Trying to make things better. Trying to compensate for what Gerry’s lost.

I feel so sad for him. I feel so sad for me, for both of us, that things are not as they were. And he hasn’t got the life he had before, and his confidence is 6

Untitled (flowers) by Colin Flynn

shattered. His self esteem is very low.

HW: Have you come to any accommodation with the idea that you haven’t been able to make things right for him?

No. I know I can’t make everything right. But I do try, insofar as its nothing to do with Gerry he’d never make me feel guilty about going out or anything. But I don’t go out with an easy mind because I’m always thinking there’s always a part of me at home. I’m never relaxed. I don’ t think I’ve been relaxed since he took the stroke.

HW: Has his memory been affected by the stroke?

In some ways yes, but in some ways he has a fantastic memory for days, times dates, places and people that were there. He’s very knowledgeable.

If I ask him to do something he’d be afraid he’d forget. It’s kind of a contradiction, he has a good memory but there’s this urgency that feeling that he must do it.

HW: Do you have to do all the remembering for the both of you?

Oh yes, I would remind him of everything. If he’s going for blood tests, for instance, I’d remind him he’s not to eat in the night.

We went on holidays recently with his family. I thought this would be great, and the family would be a great help. It was an absolute nightmare. An absolute nightmare. I don’t think they understood, or maybe they didn’t want to see that there were problems there.

MAKING HEADWAY | Autumn/Winter 2015 Edition

HW: Would it be true to say that a large part of what causes the stress is other people’s failure to understand the situation?

would never have done something like that.

Yes, definitely. Because Gerry looks fine and he appears to be fine to everybody. But there are things that he just can’t do. If he goes into town he can get very stressed. I sometimes meet him in town but he could be so anxious by the time I get there. Panicky.

No.

Things that seem straightforward and easy are not so straightforward and easy.

HW: What keeps you going?

I don’t really do anything. I don’t go anywhere. I work and I come home. I don’t really have any sort of a social life. Occasionally I’ll come home and say, come on let’s go to out for a stroll and that’s nice. But as soon as it’s over, it’s forgotten. I say no to everything. People come out to us but I don’t have an easy mind to go anywhere.

HW: Would you say you find it hard to relax? Even when he’s not there, do you find it hard to switch off?

I’m so jumpy. Watching him, watching him, in case something s going to happen. I know I can’t stop. I worry all the time if he’s going anywhere.

I don’t know, you ask me what keeps me going, I don’t know.

HW: I know that you’ve reached out for some help from Headway, I’m wondering how did that come about and what difference that has made to your situation?

Well I didn’t know anything about Headway initially, then Gerry was very depressed and in a very bad place. We went to the doctor and he suggested Headway. Then we came in and we had the assessment and from there on that’s how it came about.

HW: You’ve been attending our carers group.

What’s that like?

Funny things can happen. Just different things that people talk about that you can kind of identify with. It’s a help to know that there’s other people, that you’re not unique in what you’re dealing with.

And there’s things that would be normal in our life now that weren’t normal before. For someone with a brain injury it kind of goes with the territory.

HW: Perhaps it’s supplying some of that understanding that’s lacking elsewhere in your circle?

True. And then Gerry was drinking for a while there he started to drink. Secretly drink. The Gerry before

HW: He doesn’t sound like the same man you married HW: Have you ever questioned that status?

Would you ever think of not wanting to be married to him?

I love him to bits. There’s times, there are glimpses of the man I married. I do love him and I know he loves me in his own way, not the way he would have. But there are little things he can do.

HW: There’s still a solid bond between you.

Ah yes, there is. I’m 35 years married this year!

Yes. I would never not want to be around.

HW: Looking forward to the future, how do you feel?

The future doesn’t look as grim as it did a few years back. It’s kind of settled into a different normal. In ways that it’s different, but If this had not happened things would have changed anyway. We’re getting older. We had no grandchildren when Gerry had the stroke. Now we have grandchildren. They keep you going.

I love them to bits. One of the little girls in particular has a great grá for grandda. I love to see that. It lifts his heart to see her. They all love him but that little one in particular has a special grá and it’s lovely.

Gerry and my children are my life. From the time I was a child I said, I want to get married and have five children, and that’s exactly what happened. I love them all to bits. They’re all very good - I love them all.

HW: What advice might you have to somebody encountering your situation, somebody just taken a stroke?

Things do get better, it can be very dark in the beginning, the unknown is so terrifying. But eventually you find your own way of working.

Every couple has their own way of dealing with things, it might seem off the wall to somebody else but there’s something that helps in some way that people can deal with their situation, it’s not wrong.

If that helps to get through each day.

It can be a different way of looking at things. Not always bad. There is light there and there is joy and there is happiness and nice things happen .

A lot was taken from Gerry. I can’t change that. But there’s good days too - happiness and joy there too.

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New Headway Research Published In new research, published in the prestigious “Brain Injury” journal, Headway Cork Psychologists have established the benefits of group work in helping people adjust to life following brain injury.

The paper is entitled “The value of normalization: Group therapy for individuals with brain injury” and is by the Cork Psychology team comprising Barbara von Mensenkampff , Marcia Ward , Grace Kelly , Sam Cadogan, Feargus Fawsit and Niamh Lowe.

The paper examines the experience of forty five

clients who attended therapy groups for adjusting to life following their brain injuries.

Barbara von Mensenkampff, Senior Clinical Psychologist and lead author said “We are delighted to publish this research in ‘Brain injury’. So much of our best work is done in group and many of our programs are group work so it is validating for us all.”

The results from the research illustrate a number of benefits to the participants, including normalizing effects, helping with acceptance, finding a new identity and positive mental health changes. The findings are encouraging and help to validate the effectiveness of group therapy as an intervention tool. Brain Injury, Vol. 29, No. 11. (18 June 2015), pp. 1292-1299.

I enjoy Headway very much and I have made new friends who share similar difficulties. I enjoy the crossword and the relaxation group. I am looking forward to doing some work around speed of processing. I feel happier in myself since attending Headway.

Nice to Meet You

Anne Cribben

After my brain injury I was left physically and mentally weakened.

People allowed for my physical problem and I got help with them. But only when I went to Headway could I get the intellectual help and therapy that I need.

Louise Myers

They have restored my hope and confidence. They have helped me to discover my abilities and talents that I never knew I had. I still have a long road ahead but I can feel the progress everyday. Headway staff are a joy to work with, they are so nice and friendly and helpful. It’s a sheer pleasure being in Headway.

Mark Kane

Munster Charity Partnership Headway are delighted to be announced as one of two chosen charities by Munster Rugby. The club announced the partnership recently, saying: “Munster Rugby are pleased to announce CMRF Crumlin and Headway as their nominated charities for 2015/16. Over the season Munster Rugby will be working closely with each charity, providing them with active support on specific projects and will work to help them raise awareness and funds for projects in Ireland.”

Commenting on the announcement Claire Cooke, Munster Rugby Project Manager for Corporate Social Responsibility said, “As with every season, 8

It’s good to be around people with similar injuries – there is strength in numbers. Since I started at Headway my communication is so much better and I am finally independent again.

After my injury I needed someone to travel with me all the time. Now I hop on a bus on my own and travel all over Ireland. Thank you to Headway for this.

it’s never easy to choose between the many deserving charities that apply to us. Through the involvement of players, matchday interaction, a dedicated charity match and the association of the Munster Rugby brand, this season we hope that we can make a real difference for CMRF Crumlin and Headway. Both charities provide an invaluable service and we look forward to working with them.”

Needless to say, team Headway are really excited at the prospect. Liz Owens, Headway’s Southern Regional Manager commented: “Our clients in Cork and Limerick are really excited about the prospect of working with Munster Rugby. I can really see benefits for both organisations. It will be a chance for everyone to see the commitment that Munster Rugby put in to their charity work as well as being a much needed boost for brain injury awareness”.

Munster Rugby Photo Credit: Kieran Clancy Sportsfile

MAKING HEADWAY | Autumn/Winter 2015 Edition

The Art of Healing

by Paula Larkin Headway Cork

When we speak of Art, many of us tend to do so just like that, with a capital ‘A’, somehow imbuing the word with a grandeur that removes it from the reach of the everyday human experience and into the realm of galleries, theatres and concert halls.

Art is paintings on walls to be admired and critiqued, it is plays on a stage or an orchestral symphony. To make Art you must have talent, skill, and unusual creativity, characteristics of a certain lucky few amongst us.

This is, however, a relatively new approach to looking at art as a concept.

Visitors to the ‘Illuminations’ Project on Cork Culture Night

Art is first, and best, known and used as a means of expression and communication. From cave paintings to hieroglyphs and ogham stones, our own Irish tradition of Sean Nós, political murals painted on the walls of public spaces – we have been using the creative arts to tell stories for centuries. Stories remind us of the past and help us to make sense of the future. Stories can lend humour to tragedy, give voice to anger, and rationalise fear. Stories bond us together, they capture collective as well as individual spirits and experiences.

In Headway Cork, we have spent the last couple of years bringing the arts into our rehabilitation setting in order to help us tell stories, and in that way, to share and understand our experiences.

Dancers in “Connections”, the Headway Cork Dance project

We have worked with film, with murals, with paper, wood and string, with dance and movement, electronics and sound. We have created private pieces and public projects, choosing which parts of our shared process to keep private and which to share with the world. Using art, we have cried, we have laughed, we have been angry and we have faced fears. Each and every time however, we have grown. Grown in confidence, grown in strength - both physically and emotionally, grown in friendship. In short, we have healed, a little piece of ourselves at a time.

Art, expression and storytelling are three simple endeavours that belie a great transformative power. That power can be seen in the face of a woman who, following the creation of her own private piece of choreography for the first time, beams with pride and surprise as she realises she has learned, and remembered, something new for the first time since her car crash. It can be seen in the straightened back and confident, assertive walk of a woman who struggled so badly with her hemi-paresis that she refused to leave the house alone for four years, but who performed her own dance live on stage in front of 85 people. It can be seen in the smiling, tear-filled eyes of a woman with aphasia who watched herself sing on screen, and in the quiet calm of a man who battles sadness and frustration since his stroke left him without work, but who finds peace and meaning in the recording of a piece of sound art all his own making.

Finally, it can be seen in the quiet contemplation of strangers, as they visit an art installation born from the hearts and experiences of a group of adults with brain injury; as they connect with the stories before them, perhaps they begin to understand a little more about the human condition, and perhaps they too begin to heal.

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Research Roundup: Fatigue after Traumatic Brain Injury

by Michael McDonald, Assistant Psychologist, Headway

Mental fatigue is one of the most common complaints from people who have had a traumatic brain injury. It is experienced as a total lack of energy almost impossible to describe. It can go far deeper than what a non-brain injured person may describe as exhaustion. Despite this, the mechanisms behind fatigue are still the subject of research and debate...

What Causes Fatigue?

We still don’t fully understand the causes of fatigue, and more research is needed, but a number of contributing factors have been put forward over the years.

Coping with Attention and Processing Information In 1984, a study proposed a cause of fatigue called the “coping hypothesis” (Van Zomeren et. al., 1984).

This suggests that mental fatigue arises due to the constant effort needed to meet the demands of your day to day life. Because living with a traumatic brain injury also involves effort that you expend compensating for other problems with attention and processing information, this can be excessively tiring.

A more recent study by Zinno & Ponsford (2006) examined this relationship in a group of people with traumatic brain injuries of varying severity.

In comparison to a control group, participants in the study experienced higher self-reported and measured fatigue levels following attention-based tasks.

Other studies indicate a similar relationship and support the argument for the ‘coping hypothesis’.

Sleep Disturbances Disturbed sleep patterns following brain injury are common. Approximately half of participants 10

in a 2006 study of traumatic brain injury survivors reported sleep complaints (Ouellet et. al. 2006).

Nearly a third of the sample met the diagnostic criteria for an insomnia syndrome, almost 3 times greater than the general public. A significant number of participants in that study reported that their sleep disturbances impacted on their mood and mental capacities. It is recognised in the literature that fatigue levels leading from sleep disturbance have an impact on quality of rehabilitation and quality of life.

Emotional Disturbances Depression and anxiety are common problems that arise following a traumatic brain injury, affecting more than 60% of individuals within 5.5 years post injury (Whelan-Goodwison et. al., 2009).

A study in 2005 found moderate to strong correlations between depression and fatigue levels and also between anxiety and fatigue levels (Ziino et. al. (2005)). This suggests a complex relationship between traumatic brain injury, mental health difficulties and mental fatigue. Further research into this relationship is needed before we understand it fully.

Hormone Regulation Disorders Popovic (2005) noted that among individuals who have experienced a TBI, there are frequent hormone regulation disorders. Deficiencies in hormones are associated with a range of difficulties such as decreased physical strength, aerobic ability and well-being which in turn can lead to issues with attention, memory, depression and fatigue.

So overall, the literature points to the ‘coping hypothesis’ as being the most plausible explanation for the mental fatigue experienced by those who have suffered a traumatic brain injury.

But to arrive at a more complete understanding of fatigue, we also need to consider the other factors discussed; sleep disturbance, emotional disturbances and changes in hormone secretions.

MAKING HEADWAY | Autumn/Winter 2015 Edition

References Johansson, B, H Bjuhr & L. Ronnback.

Mindfulness based stress reductions improves long term mental fatigue after stroke or TBI. Brain Injury (2012) 26(1314) p. 1621-8.

Ouellet, MC., Beaulieu-Bonneau S., Morrin CM. Insomnia in patients with TBI: Frequency, characteristics and risk factors. Journal of Head Trauma Rehabilitation (2006). 21 (3), 199-212.

Painting (untitled) by Shu Zhang, Headway client

Fatigue - What you can do Unfortunately there is currently no effective treatment for mental fatigue. Recommendations for the management of fatigue include: • Adapting your daily activity or work activity so that it can be managed within your own limits • Working at a steady pace, completing one task at a time.

• Take regular breaks.

• Eat a balanced diet.

• Regular aerobic exercise (once your GP has given the all clear of course! ) • Mindfulness - A Mindfulness Based Stress Reduction (MBSR) programme has been shown to be a clinically effective tool to alleviate stress and ruminative thoughts and allow people to live in the present which in turn saves mental energy (Johansson et. al., 2012).

Popovic, V. GH deficiency as the most common pituitary deficit after TBI: Clinical implications. Pituitary (2005) 8; 239-43.

Van Zomeren AH, Brouwer BG, Deelman BG. Attentional deficits: The riddles of selectiveity, speed and alertness. In: Brooks D, editor. Closed head injury: psychological, social and family consequences. Oxford: Oxford University Press; 1984, p. 74-107.

Whelan- Goodwinson, R, Ponsford J, Johnston, L & Grant F (2009) Journal of head trauma rehabilitation Vol. 24 (5) pp. 324-332.

Ziino C., Ponsford J. Measurement & prediction of subjective fatigue following TBI. Journal of International Neuropsychological Society (2005) 12: 100-10.

Ziino C., Ponsford J. Vigilance & fatigue following TBI. Journal of International Neuropsychological society (2006); 11: 416-25.

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Autumn/Winter 2015 Edition

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Set yourself ainingoal way.ie like to hold a fundraising event your Monday – Friday, 9 am to 1 pm and 2 – 5 pm (local call rate) community or work place? What about a golf day, 9 am to 1 pm and 2-5 pm we will help you our support will get you started or work about a golf a community coffee morning or aplace? lunch?What Perhaps there is aday, 5k a (local call rate) coffee morning or a lunch?

Perhaps there is a 5k or or 10k run in your community? and make your fundraising a success. book.com/headway.ie 10k run in ayour Set you yourself goal and Set yourself goalcommunity? and we will help - our asupport we will help you our support will get you started get register you started and make your fundraising a You canwill also with success. and make your fundraising a success. www.justgiving.com/headwayireland. With Just You can register with with www.justgiving.com/ You can also also register Giving it’s simple plus youJust canGiving share with plus all your headwayireland.

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Calendars Now on Sale!

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Brain Injury Services & Support

A donation can make all the difference. Here are P&P A donation make all themake difference. fourcan easy ways you can give.

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HWAY toto 50300 1. across

By Text Message: Text HWAYSome 50300 toto most network operators donate €2 100% of your donation goes to VATof which means that a minimum €1.63 donate €2apply 100% your donation goes toofHeadway Headway across most network operators. will go to Headway.

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Some operators Some operators apply VAT which means LIKECHARITY. Helpline: 0766805278. a minimum €1.63awill go to Headway. apply VAT that which meansof that minimum of €1.63 2. Service Online Provider: - Go to www.headway.ie and click on LIKECHARITY. Helpline: will go to Donate.

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There, you can set up a once off donation LIKECHARITY. Helpline: 0766805278. a monthly 2. or Online - Gogift. to www.headway.ie and click on Donate.

There, you can set up a once off Post Send your donation to theand Fundraising A perfect way to start the new year, the Headway 2. Online3.-donation Go -to www.headway.ie click on or a monthly gift.

Department, Headway Ireland Ltd, Blackhall Green, 2016 Calendar features artwork from clients in centres A perfect way to start the new year, the Headway Donate.3. There, you can set up ato once off donation Post Send your donation the Fundraising Off Blackhall Place, D7. around country.features artwork from clients in 2016the Calendar Department, Headway Ireland Ltd, Blackhall or a monthly gift. centres around the country.

4. Green, Telephone -Teresa Siobhan Order Now from Teresa on 01 6040800 or email Off Blackhall or Place, D7. will help you your donation.

Call us 01 Fundraising 604 0800.

Order Now from Teresa 01 6040800 mcgeet@headway.ie.

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start eatures artwork from clients in centres try.

Off Blackhall Place, D7.