Making Headway Spring Summer 2015

Spring/Summer 2015 Edition

MAKING

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

Making Headway is published by 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

The Neuro-Rehabilitation Strategy?

2 Introduction to Spring/Summer Edition Telling Tales: Joan’s Story 3 2 Making Measuring the Up Most - Headway out of Community Services Living 4 3 To The Top of the World 6 4 Helsinki Research Congress ABI Ireland’sPair Community A Different of Eyes Based Neuro7 Rehabilitation Services 8 A Big Thank You Our Amazing Friends 9 Rehabilitation of to Executive Function Research after BrainRound-Up Injury 11 11

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Message from the CEO Dear Reader, Listeners to the Joe Duffy radio show Liveline recently heard about the struggle of one parent, Reinhardt Schäler, to obtain rehabilitation services for his son, Pádraig following a horrific accident leaving him with a brain injury. What was highlighted in the programme was the inadequate, fractured and incomplete range of services that exist in Ireland for the welfare of people with brain injury.

Apart from the scant and fragmented nature of the existing services throughout the country, the cumulative effect of year-on-year HSE cuts to our own services are now at risk of affecting our clients and their families. The fact that funding cuts have been levied on already grossly underfunded services compounds the situation.

Our dedicated and creative staff at Headway are considering many approaches to this dilemma but we also know that if we don’t reach out to our supporters

that Headway may need to make some difficult choices.

With that we are reaching out to you, our readers, and appealing for help with fresh ideas, donations or support.

Front Cover Pics (Clockwise from top L): Eoin Foley, Dave Gilligan, Helen Gaynor and Karl O’Keane at the Clean Coasts beach cleanup; Patrick O’Shea on the Limerick Job Bridge scheme; Sally Conneely and Ciarán Nolan shooting the Vox Pop video; Paul Sheridan (pic by Art O’Connor); Derek Cummins; Noel Shinkwin and Tony Louth

As a loyal reader you probably know how important our services are and how they have already benefited families across Ireland in many ways. Headway may be a low profile charity but it has a big life-saving role in our society. We must find ways to continue to support those with acquired brain injury.

As ever, I want to thank you for your unswerving support for Headway over the years.

We look forward to hearing from you with advice, ideas and /or support.

Kieran

Delaney Family Raise Money In Memory Of Their Son Gerry and Mary Delaney from Co Meath presented a cheque worth €2,375 in support of Headway after a sell out table quiz in Caffrey’s pub in Batterstown in April.

Speaking at the presentation to Headway, Gerry and Mary Delaney said: “Headway was a great support to us when our son Ciarán acquired a brain injury. At that time we weren’t sure where to turn – it was a relief for us to be able to reach out to the Headway helpline to get the information and support we needed as a family.”

“For every 60 Euro raised we can already provide an hour’s counselling for a client and family member and every additional €10 pays for the cost of a helpline call to our information and support service.

I want to thank the Delaneys and the Batterstown community for supporting us to provide services for people with brain injury free of charge. We need to raise €100,000 this year for our services and to have this support and commitment means the world to our staff, clients and their families.” he said.

Speaking at the presentation to Headway, CEO Kieran Loughran said:

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“We are honoured and incredibly grateful that the Delaney’s organised this table quiz and donated the proceeds to Headway in memory of Ciarán. It can be difficult for people to grasp what brain injury is and what it means in peoples’ lives. The Delaney’s have shone a light on the devastating impact of brain injury in the community and gone a long way to help some of the 30,000 people in Ireland who need our support.”

Mary Delaney (L) and Gerry Delaney (R) presenting the cheque to Kieran Loughran, CEO (centre)

Making Headway

Spring/Summer 2015

Measuring Up - Headway Services Delivering Positive Change For the last few years, organisations in the charity sector such as Headway have had to do “more with less”. As some of our services are funded with public money, we are also very aware that we need to account very clearly for the financial support we receive.

Failure to be transparent can undermine the trust that is so vital between funders and service providers.

Sadly, in recent years, some high profile scandals in our sector have undermined that trust. At Headway, we wanted to ensure that we could stand over the quality of our services and justify a continued level of support for them.

So, last year, Headway decided to be more pro-active about measuring and demonstrating the impact of our services. By measuring the outcomes of the services we provide, we could gather information that would help us improve them further and at the same time show the value for money that our services represent.

We used different approaches to measure different aspects of the service. The resulting “outcomes system” we designed has three main parts: 1) A customer satisfaction tool called USPEQ which gathers anonymous feedback from our clients and stakeholders.

2) A research tool called the MAYO Portland Adaptability Inventory. This questionnaire is widely used in brain injury rehabilitation centres. It measures three key areas that we are trying to help our clients with: ability, adjustment and participation.

3) Finally, we used our own data systems to provide useful measures of services including the numbers of clients and how many hours of service each receive.

Our results for 2014 demonstrate significant positive change for our clients: The MAYO Portland results show that our programmes made significant impact in all three domains of ability, adjustment and participation.

The USPEQ survey showed that our service is overwhelmingly positively received by clients with over 99% saying they would “recommend to a friend”.

Other areas we scored well were: Respectful of gender, Respectful of sexuality, Information was kept private, Felt safe in Headway, Respectful of Culture, and Respected as a person.

According to Christine Flynn, Headway Quality and Standards Manager “these measures offer reassurance that Headways programmes meet their objectives and deliver on outcomes. Furthermore Headway has delivered in terms of client satisfaction, respect and confidentiality.”

In addition to the confirmation of quality, the results go further. According to Christine, “it validates for us all in Headway the value and meaning of the organisation’s work - that positive change can be made. It is a huge achievement for all involved and serves us well in continuing to provide client centred quality services.”

There’s no doubt that we have set a high standard for ourselves in 2014, so we look forward to next year and seeing how we continue to “measure up”.

You can download the full set of results in Headway’s Annual Report available from the website at www.headway.ie/publications

Nice to Meet You

Paul Tyrrell “Since my brain injury I am now following a healthier lifestyle, I no longer drink or smoke. I am more confident going out and about in the community and I enjoy working towards achievable goals that I set myself. I enjoy attending Headway Day rehabilitation Services as it is great to meet people who have similar experiences. I never knew there was somewhere I could go that didn’t just fix broken bones, and it feels great coming to Headway where we work on difficulties that are not necessarily physical.”

Margaret Browne “Since my brain injury I find it difficult to mix with others, however since I have started attending Headway once a week, I enjoy meeting the others in the group. I think this is because they understand the difficulties that you face after a brain injury.

I enjoy Brain injury education and the cognitive groups.”

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A Life Worth Living

by Martin Perry In September 2011 I suffered a traumatic brain injury (TBI). I cycled home from work one September Friday evening and collided with a Luas Tram in Dublin. When I regained consciousness 15 days later, I slowly became aware of having 6 broken ribs and having lost the ability to walk. At that time I had no awareness of experiencing a TBI to the frontal lobes. This very serious accident meant I spent 9 weeks in an acute hospital, and a further 9 weeks in The National Rehabilitation Hospital.

I found once I was discharged from hospital, the real challenges of my rehabilitation and recovery from TBI started. Since I felt fine, could speak, could recognize people, and could read and comprehend, I thought the journey back to life in the ‘real’ world would be simple. I believed my return to normal routine would be a matter of days/weeks. How wrong I was! I was caught in limbo of being out of immediate danger, yet not being back to “normal” either.

I was lost. I was scared. I felt I was thrown on the scrap heap. Those challenges were not just for myself, but are particularly challenging for my family members.

This is where Headway stepped in.

The physical challenges were relatively easy to navigate. I had double vision, which meant I couldn’t drive with that loss of independence; Balance was

impaired, I couldn’t run/jump/cycle and had to walk with a stick; I suffered (and continue to do so) weakness of my left side, which meant I couldn’t walk the dog and I have reduced sensory movement of my left hand; and finally a constant headache.

These challenges are minor into comparison with the psychological challenges. Relationships with my children and adult members of the family were completely changed. I was seen as a different person post-accident. Where I still had life memories they would be ‘vanilla’ with little or no emotional connection to the event. My judgement was off initially, it was not appropriate to look after my children. Headway provided the psychological support that showed me the way back, helped to my relearning to live my life again.

Many individuals with a TBI can achieve and maintain a high degree of functioning many years after the injury.

Emotional and relationship disconnects stubbornly remain and impact on social activities and participation. In this area Headway is strong in their support, and invaluable to their clients and families.

I see my recovery as taking 3 distinct stages: The acute hospital saved my life; The National Rehabilitation Hospital put me on my feet and taught me to survive and Headway showed me how to have a life worth living.

I am truly thankful for that. Simply living my life again is a gift, Headway were central in showing me the way.

Helsinki 13th Congress on Research in Rehabilitation Headway’s Cork Psychology team recently travelled to Helsinki to present an analysis of a Headway group therapy programme at the 13th congress of European Forum for Research in Rehabilitation.

them. It also provides a space for people to explore their emotional responses to brain injury.

The Europe-wide conference has the aim of “improving both the provision of social, vocational, health-care and rehabilitation services and the standards of practice in these services, for the benefit of people with disabilities.”

The team presented about the Headway “adjustment” group. This programme runs twice a year for 6-8 sessions and has a focus on providing clients with information on brain injury and what it means for

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Niamh Lowe (L) and Dr. Barbara Mensenkampff from the Headway Cork Psychology team

Making Headway

Spring/Summer 2015

The study was written by Psychology students on the Masters programme at UCC. Barabara Mensenkampff, Headway’s Senior Clinical Psychologist in Cork said: “Networking with our European colleagues in Helsinki was stimulating as it provided new ways of looking at similar training programmes in rehabilitation, vocational, supported employment.

We were also gratified that our group programme was well received and relieved that we are following best practice guidelines for working with our client group - we are doing the right thing!”

Mark O’Sullivan, Isabella Tuohy and Diarimuid MacGarry presenting Headway research at the Neurological Alliance Research Conference during Brain Awareness Week 2015

Snap, Crackle & “Vox Pop”

by Ciarán Nolan

Smithfield Square on the north side of Dublin’s inner city centre was the backdrop chosen by the most recent Headway “Harbour” peer support group to shoot a vox pop video to help raise awareness of acquired brain injury (ABI). On Thursday April 23rd nine members of the group strapped with camera, tri-pod, and bucket loads of courage and charisma, set out to capture what the general public knew and didn’t know about acquired brain injury.

The group also wondered if people understood the consequences of brain injury and the various supports available to people facing any number of challenges after such an injury. The task at hand was to interview random members of the public to ascertain their thoughts, general knowledge and opinions of brain injury.

The resulting piece of footage highlights an ongoing need to educate our society about acquired brain injury and its effects, while also continuing on the work of raising awareness of not only Headway To date the video has had over 600 views on YouTube

with this number rising daily. The group have been up-loading the vox pop video to their social media platforms, as well as encouraging family and friends to do the same. It’s currently available to view on our own web-site www.headway.ie On behalf of the Harbour Group I would like to thank you in advance for your support. Please go to the HeadwayIreland Youtube channel to watch this powerful & inspiring piece of film.

www.youtube.com/c/headwayireland

Headway Partners With Irish Rugby in Highlighting Acquired Brain Injuries Headway is delighted to announce its recently established partnership with the Irish Rugby Union Players Association, IRUPA, to raise awareness and promote education on the seriousness of acquired brain injuries in sport. As the collective voice of professional rugby players in Ireland , IRUPA is fully empowered to promote Headway amongst their members, across the wider sporting community and amongst the public in general.

IRUPA’s Omar Hassanein with Kieran Loughran, Headway CEO

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As a further element to the partnership, IRUPA CEO, Omar Hassanein now sits on the Board of Headway.

Commenting on the partnership, he said: “Concussion is a complex and serious issue within our game, it is important that players are educated around the dangers and signs and symptoms. In a wider context, a brain injury can be a devastating event for the sufferer and their family. Headway provide invaluable services to help those who have suffered a brain injury as well as offering much needed support and education for those close to them. IRUPA and our members are looking forward to supporting Headway and helping to further generate awareness in this area”.

“Headway welcomes this new partnership with IRUPA and applauds their commitment to create awareness about brain injury in sport. The brain is the most delicate organ in the human body. And the brain can suffer injury – significant injury – without any immediate debilitating symptoms.”

Today, about 70,000 people play rugby at various levels in Ireland. Of that number, 45% are under 18.

That’s more than 30,000 Irish children and teenagers.

Together, with IRUPA’s leadership and the support of Ireland’s professional players, we can reach out to Ireland’s young people and debunk the myth that you are some sort of hero for playing on after a knock to the head,” continued Loughran.

“Brain injury is unseen and to most onlookers there is no real sign of damage, not like a dislocated shoulder or blood injury. Yet the brain is such a fragile piece of equipment that to play fast and loose with it and not take a knock seriously is tantamount to taking your life in your own hands.”

“We need to reach out to educate about the importance of minding your head to people involved in sport. With so many symptoms, and so many ways that a concussion can present itself, it’s easy to miss, so the message must be if in doubt sit it out.

Headway is looking forward to working together with IRUPA to bring that message home.”

Out and About in Cork | By Meghan Ryan Headway Day Rehabilitation Services in Cork have recently started a community outing module which aims to help people be more involved in their local community. During the module, clients visit places of interest in Cork City and County.

and it’s nice to travel out a bit”, others described the “good fun and craic” clients have with one another when on outings going on to explain “it’s good to socialise outside of Headway”.

The outings provide a friendly and relaxed atmosphere to interact and socialise with one another. During trips, clients are able to put into practice skills that they have been developing in the centre, for example decision making or money management. They also practice greater independence by, for example, buying their own tickets.

Places the group have visited so far include heritage towns, national parks, museums.

Activities the group have taken part in include bowling, guided tours, lifelong learning week.

To ensure that we can give everyone sufficient attention during an outing, a maximum of 5 clients are invited to join each trip. Group members are rotated on a fair basis to ensure equal access to all who are interested.

Clients decide the activities they want to part take in and the places that they want to visit and give feedback on outings each week. So far, feedback from clients has been very positive. One client said “I like going on outings because it is something different

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Bobby Chan, Headway Cork

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Spring/Summer 2015

A Different Pair of Eyes

by John Canning

Sometimes, rehabilitation calls for different levels of support at different times.

John describes his experiences progressing through several different services in Headway Cork...

My first time hearing about the name Headway was when I was a client in Bridhaven Nursing Home in Mallow Co. Cork, while I was waiting on a liver transplant in the year 2011. I attended a Headway Day Service for two days a week on Tuesdays and Thursdays.

We used to do many different activities which I found very interesting at that time. We used to do puzzles, play card games, read the daily paper and we had a book club. We also used to watch films. I found it very beneficial to me at the time and it has helped me to improve to the position I am in at the moment (very good indeed).

While I was attending the Headway centre in Mallow, I made some very good friends there. It was a great break for me to get out of the nursing home and it felt part of the real world both in the educational value and in the social interaction. Then in 2013, I had a liver operation and my condition improved drastically. I left the nursing home when I was deemed responsible enough to go home to live alone in Rathcormac.

I still attended Headway day services for a couple of months but I was advised that I would be better suited to move onto a rehabilitative training (RT) programme in the Headway centre in Ballincollig which offered a more suitable kind of course for me. At first I was very reluctant, as over the two years or so, I had built up a good relationship with the people in Headway and all the other clients in the group. But in the end, I made the right decision and I was helped greatly by the Headway staff.

Again, I was told it was time to move on -that there was another course on the horizon. So with the good advice of the Headway staff, I was on the move again. The new course was in Headway’s centre in Carrigrohane Road which is just near the county hall.

This Local Training Initiative (LTI) course was a more serious course - it was even more structured than Ballincollig. It is a FETAC level 3 and 4 course with several different modules including work experience, workplace safety, career planning, word processing, internet skills and nutrition and healthy options. It also had team working which is very important in today’s world.

On the course, I have learned a great deal about things which are needed in all aspects of modern life such as computers which are essential for online shopping, emails, facebook, skype and any information you can get off Google. Since doing this course with Headway, I have learned a great deal about computers - I now own my own laptop and my own android tablet. Before, all I knew about a tablet was the medication I was on!

I have learned how to do a good interview and all that goes with it to be successful in applying for a good position in whatever you are best suited to. Also, I have got certified in Manual Handling, Patient Handling, First Aid and Fire Safety.

In Ballincollig, it was more structured on the RT programme as we had a lot of different modules like cooking, gardening, art, cognitive skills and computers which I had a great interest in. While I was in there, I again met a lot of new lovely people, both staff and wonderful clients who were in similar position to myself. We all have an acquired brain injury which we were not born with.

Clients from the LTI Vocational Programme in Cork

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While I have been with Headway, my communication and interaction skills have improved 100% and I have improved enormously in my confidence and self worth too.

At the moment I am doing some volunteer work in Farranlea Nursing Home helping the elderly in the activities sector. I help them push their wheelchairs to the chapel to be able to receive Eucharist and say some prayers. I may also take them for walks when the weather is good. I also help them play bingo and Boccia. I also have chats with them. I have become a more confident and a more understanding person, which is vitally important when you are dealing with the elderly.

My time with Headway is now coming to an end it has been a wonderful experience and I have learned a great deal and I have achieved a lot and I am happy with myself in doing so. I also have met a lot of

wonderful people on my journey and I hope to have plenty of communication with them in the future.

Before I joined Headway, I was in a very bad place both physically and mentally but with help I am now in a much better place. I have many new friends and my state of health is excellent.

Headway helped me see the world with a different pair of eyes where I see life in a much different light to before. I am a much more confident man now and I look forward to a good and rewarding life helping and looking after people who aren’t in a position to help themselves. I know myself that I was once in that position.

Share your Story with us

We would love to hear from you. Whether you are a client, carer, volunteer, researcher, or a generous supporter, we want to hear from you. Your story is what makes it all worthwhile to us and to our donors.

Voices to be Heard – Headway’s Advocacy Groups Raise Issues In our Cork centre, representatives from the National Advocacy Group (NAG) have succeeded in their campaign to locate a bus stop on Carrigrohane Road so that Headway clients can access the centre more easily. A small thing can make a big difference!

Earlier this year, Limerick NAG representatives Catherine Keane and Ray Keane wrote an open letter as part of Headway’s bicycle helmet campaign. This letter was published on headway.ie as well as sent to various government representatives, in order to make people aware of the dangers of cycling without a helmet. In a disappointing response, the Minister for Transport, Tourism and Sport, Paschal Donohoe, indicated that he was not in favour of making the wearing of bicycle

helmets a legal requirement at this time. The NAG group still strongly believe that helmets should be worn by all bicycle users, particularly for those under the age of 16, and will continue their campaign in this regard. Please read the letter on our website ( w w w. h e a d w ay. i e ) and lobby your TD for change.

Headway Cork clients with Duncan Williams from Muster Rugby (R) at the new bus stop

Donnybrook Centre Open Day The Donnybrook Day Rehabilitation centre held an open day in March to mark Brain Awareness Week.

It was a chance to highlight the work done in the centre with brain injury survivors and gave anyone interested a chance to have a look around, and meet staff and clients.

We also launched the new Headway Information pocket leaflet “Getting What you Need After a Brain Injury”. There was a great attendance and thank you to all who were involved in organizing the event.

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Marion Gaule and Nick Boland at the open day

Making Headway

Spring/Summer 2015

A Big Thank You to Our Amazing Friends Around the Country

By Sarah Benson Padraic Brennan, head of business banking in Bank of Ireland, has been a great friend to Headway over the years. His fundraising has had enormous impact for our services. This year he has raised 4,000 Euro as well as facilitated numerous introductions for Headway to meet key influencers and sponsors.

We want to thank Padraic for his continuous efforts and support for Headway.

I would also like to take this opportunity to thank those who give monthly. Your ongoing commitment to help us demonstrates a deep understanding of the importance of delivering for people living with brain injury.

I hope our newsletter gives you an insight into the tremendous impact your generosity is having and that you will stay with us on this incredible journey in delivering for our clients today. For every €60 we can continue to deliver an hour’s counselling to one of our clients, for every €10 we can give people our information pack. If you have any questions regarding fulfilment of your pledge or about our work here, please don’t hesitate to call us or if you think you can become a regular donor call us today.

Thank you also to the Grand Orient Lodge no. 3 Cork and Cork Rotary for donating 275 Euro to the services. We appreciate your continued support.

We would also like to thank our anonymous donor who has gifted us €5,000. This is an incredible sum and if you read this we want you to know how grateful we are. It means the world that we have friends like you.

delighted to be able to contribute to the debate on this important topic.

Headway would like to thank the wonderful team at the Michael Smurfit Business School – Sean O Connor, Joanne Hurley, Jessica Kickham and Michael Lynch. Together they delivered a digital marketing strategy for Headway that has the potential to bring us forward in a more meaningful and targeted way. We will be in a position t to evaluate the effectiveness of our efforts and deliver real value to you . We want to thank the team for dedicating their time and energy to ensure that our strategy was developed with our unique goals in mind. Now it’s over to us.

If you use our current website and you wish to have your say please email bensons@headway.ie If you would like to raise awareness of brain injury in your company please do not hesitate to get in touch with Sarah.

And to all the great women who took to the streets for the VHI women’s mini marathon to support us.

A massive heartfelt thank you. Your kilometres will translate into much needed funds for our services this year. Please continue your amazing support.

Thank you to Microsoft who invited us in their head offices to raise awareness of brain injury in Microsoft HQ. Thank you also to Northern Trust Event who invited our CEO Kieran Loughran to speak on a panel discussing global diversity and inclusion. Northern Trust is a great supporter of Headway and we are

Smurfit Business School Students(L to R) Sean O Connor, Michael Lynch Jessica Kickham and Joanne Hurley. Holding the cheque are Kieran Loughran, Headway CEO (L) and Padraic Brennan, Bank of Ireland(R)

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My Friend, My Brain

by Derek Cummins

My name is Derek Cummins, I was born in 1970 and I will be 45 on my next birthday .

Over the last 44 years I think I have certainly been in a lot of things in my crazy world and sometimes I wonder have I anything else to give - Sometimes I just feel I have had enough.

Like a lot of people I never worried too much about things, I just got up and I did my best and I hoped that it would all work ok. But in June 2013 my world shattered and I fell in a million little pieces.

I was totally broken and I did not even know how to start again. My Stroke hit me hard, I had lost my words - I could not even say my name. Never mind this, I could not even say anything. My place in the world was gone.

And so I had to start at the beginning.

At first I did not realise how bad I was, in my mind I thought I was making sense but the pieces that I only had were mine - just the bits in my head - I was a mess.

Nearly two years on I am still not right, I am currently trying to push to talk, to speak, to say what I really want to say. If I work harder and try, I know I can make it better and maybe I can make a difference to me. But I also know I will never be the same again.

I think that this is ok and I can live with this but I have my worries and another stroke is always there waiting to strike me down again.

Jigsaws - by Derek Cummins I saw a piece once, It was a half job, Trying so hard to be heard, But the pieces were so wrong, And the jigsaws were lost.

This brain has the answers, But he will never say it now, He is the boss, that never tells, Him, looking me and laughing, That, how stupid I must be.

This thing that it is sad, Is that the answers are there, It is just that they are lost, And what we need is our time, Some good questions and a believe.

And so this is my friend, my Brain, and each day I can write something - a letter, an email, a poem - even just a text.

He (my brain) let’s me know that I am still here. Yes I am broken and my pieces are everywhere but I have a voice and I can be heard on this.

Sometimes it might take me a bit longer than other people but they are there. I just have to find them.

So yes, I am happy that I still have a chance to be heard.

So when sometimes I feel that I have had enough and I am at my smallest point, I look at myself and I see how far I have gone - and I just pick myself up, shake myself and go forward.

The back way is not the right way and anything that I can see are my jigsaws and I will always find another answer.

Brainey App

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Niamh Malone had worked as a clinical nurse specialist in stroke rehabilitation for over 10 years. In February 2013 she had a sub arachnoid haemorrhage which changed her life forever.

difficult challenges, adapt, be positive and come to terms with changes in my life. I decided to make this into an app to help people with an acquired brain injury like me; to help them understand that it is normal to feel like the way they do.”

Niamh says “When I went home I found it very difficult to adjust to life and stay positive. So I made up a motivational psychological programme in my head and stuck to it. I based it on my rehabilitation experience with small goals etc. It helped me get through

You can try out Niamh’s app from the Android store, Google Play or it will shortly be available in the App store for Iphone. See getbraineyapp.com for more details.

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Research Roundup – Post Traumatic Headaches (PTH) Headaches are one of the most common symptoms following a traumatic brain injury, but can the evidence indicate the best way to treat them? In this article, Headway Clinical Psychologist Claire McMoreland reviews the literature...

Headaches are one of the most commonly reported symptoms after a traumatic brain injury (TBI). Those that develop as a result of an injury are called Post-traumatic headaches (PTH). The types of headaches experienced after TBI share similar characteristics with other types of headaches, and can be further categorised into for example, migraine or tension-type headache.

Reports vary on how common headaches are after brain injury. Some studies report up to 90% of people developing headache following TBI. A study conducted

by Walker et al. (2005) of 109 war veterans in the US established a 38% prevalence rate of PTH in the first year following TBI, and of those, almost all reported daily headache. Other studies show that risk factors for developing PTH include being female, having a history of repeated brain injury, and having a pre-existing history of headache. Studies also indicate that PTH is more common in mild than severe TBI. PTH is considered chronic when symptoms persist for three months or longer. Chronic PTH is associated with poorer outcomes and cognitive issues such as memory difficulties and reduced processing speed. Migraine has also been associated with a longer recovery time after injury.

The adequate and accurate treatment of headaches following brain injury is important in order to prevent headaches becoming chronic. Currently however, there is insufficient evidence as to the best way to treat headaches after injury. Conducting research into posttraumatic headaches is difficult to do because there are many different types of headaches. There are also many causes of headaches following brain injury – for example, damage to the skull or brain tissue, muscular injury, or injuries to the cervical spine or peripheral nerves can all cause headaches. One recent article by Mayer et al. (2013) on migraine post-TBI has suggested that a neuroinflammatory response could be behind the development of migraine following brain injury. They propose that after the initial injury to the brain tissue, inflammation occurs in an attempt to defend the brain against further damage and to help repair damaged brain tissue. When this response persists however, changes in the brain may result in neurological symptoms such as headaches.

Very few rigorous studies have been conducted on the treatment of PTH. In a systematic review of 36 articles

conducted by Watanabe et al., (2012), this issue was further highlighted. From the studies identified, the authors were unable to come to definitive conclusions on the best interventions for PTH. The studies they did include in their review employed different approaches.

These included drug or biologically-based interventions such as physical therapy, medication, and biofeedback; and behavioural interventions such as Cognitive Behaviour Therapy (CBT) and psychoeducation on headaches. In one study of the effectiveness of CBT for chronic PTH, overall improvements in the intensity, frequency of headaches, and overall emotional wellbeing was reported. As a guideline to future researchers, the authors emphasise the importance of diagnosing the specific type of headache since this will allow research to be directed towards different presentations of headache, their underlying cause, and identifying the most effective interventions.

Given the lack of information on the cause and treatment for PTH, headaches following a brain injury are currently treated in the same way as non-TBI related headaches.

The Migraine Association of Ireland website at www. migraine.ie provides information and support to people suffering from migraine. This advice may also be helpful to those suffering from post-traumatic migraine. The website stresses the importance of getting to know your migraine triggers, such as diet, hormonal changes, stress, or environmental factors. Keeping a diary of headaches will help to identify patterns of migraine and their severity and frequency. The website also offers advice on strategies for managing migraine through stress management, exercise, medication and adopting a structured lifestyle.

References: Mayer, C. L., Huber, B. R., & Peskind, E. (2013). Traumatic Brain Injury, Neuroinflammation, and Post-Traumatic Headaches. Headaches, 1523-1530.

Walker, W. C., Seel, R. T., Curtiss, G., & Warden, D. L. (2005).

Headache after Moderate and Severe Traumatic Brain Injury: A Longitudinal Analysis. Archives of Physical Medicine and Rehabilitation, 86, 1793-1800.

Watanabe, T. K., Bell, K. T., Walker, W. C., & Schomer, K. (2012). Systematic Review of Interventions for Posttraumatic Headache. American Academy of Physical Medicine and Rehabilitation

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Making Headway

Spring/Summer 2015

Blackhall Green, Off Blackhall Place, Dublin 7 Tel: (01) 604 0800 Fax: (01) 604 1700 Email: info@headway.ie Making Headway Editor: stablesr@headway.ie

Information and Support Line

1890 200 278

(L to R) Harriet Hill with Duncan Williams of Munster Rugby, Grace Murray and Kevin Conran at the new bus stop on Carrigrohane Road.

Monday – Friday, 9 am to 1 pm and 2 – 5 pm (local call rate)

Can you help us bring positive change?

email: helpline@headway.ie ww.headway.ie www.facebook.com/headway.ie youtube.com/c/headwayireland www.twitter.com/headwayIreland Headway Ireland Brain Injury Services & Support

Would you like to meet others in Ireland living with aphasia?

Would you like to hold a fundraising event in your community or work place? What about a golf day, a coffee morning or a lunch? Perhaps there is a 5k or 10k run in your community? Or are you brave enough to go for a half or full marathon? Set yourself a goal and we will help you - our support will get you started and make your fundraising a success.

You can also register with www.justgiving.com/headwayireland. With Just Giving it’s simple plus you can share it with all your friends.

Would you like to spread the word about aphasia?

Would you like training in advocating for others with aphasia?

We need you to join Ireland’s Aphasia Ambassador Network!

A donation can make all the difference. Here are four easy ways you can give.

Headway is seeking individuals with aphasia to be a part of our national advocacy network for people with aphasia. This network is being run in conjunction with the internationally renowned UK based organisation, Connect- The Communication Disability Network.

We are particularly looking for older people with aphasia in Ireland to get involved in this network For more information contact Elisa O’Donovan on 061-469306/ 086-1072597/odonovane@headway.ie

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1. B y Text Message: Text HWAY to 50300 to donate €2 100% of your donation goes to Headway across most network operators. Some operators apply VAT which means that a minimum of €1.63 will go to Headway. Service Provider: LIKECHARITY. Helpline: 0766805278.

2. O nline - Go to www.headway.ie and click on Donate. There, you can set up a once off donation or a monthly gift.

3. P ost - Send your donation to the Fundraising Department, Headway Ireland Ltd, Blackhall Green, Off Blackhall Place, D7 4. Telephone -Keira or Siobhan will help you make your donation. Call us on 01 604 0800.