Autumn/Winter 2013 Edition
MAKING
Bringing positive change in the lives of those affected by Acquired Brain Injury
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Inside Inside
The Neuro-Rehabilitation Introduction to Autumn/Winter Strategy? Edition 2 2 Telling Quiz Tales: Stars Joan’s Story 3 3 Making New the IDMost Cardsout forof Headway Community Clients Living 4 4 To The Taking Top ofthe theGood World from the Bad 6 7 ABI Ireland’s Carer support Community in the Based Mid West Neuro9 Rehabilitation Research Roundup Services 810 Rehabilitation Compensation of Executive - The Winds Function of Change 11 after Brain Injury 11
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Welcome to the Autumn/ Winter 2013 Edition
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e have plenty to share with you for this edition of Making Headway. Nicole’s story of recovery from ABI (p7) shows us just how far determination can take us. One of our guest contributors, James Glynn, sums up the research into using the hormone progesterone as a treatment for traumatic injury (p10) and our other guest, Jessica Goldrick from MacMahon Goldrick Solicitors tells us about developments in the world of compensation claims (p11). Added to this we put a focus on the much needed
Message from the CEO Here in Headway, we have a job to do. When clients walk through our doors, we want to provide the very best for them and their families. We’ve got the expertise in Headway and our staff are second to none. Everyday, we witness the incredible achievements, outstanding dedication and inspirational bravery of our clients and their families. However, a lack of funding and the threat of more cuts puts our essential and vital support to these people in jeopardy. We need your support. Our clients’ needs are at the heart of this request. We need to raise €25,000 by the end of the year to continue to deliver a better quality of life for people with brain injuries and their families and continue to bring positive change by inspiring hope and promoting understanding of ABI. So we are turning to you dear reader, friends, families, extended families and hopefully friends and work colleagues who would welcome the opportunity to play their role in the rehabilitation of their loved ones. Will you ask them to help us to continue our vital work? The change you can help deliver for our Headway’s clients will make it all worthwhile. Already, our clients and their families are benefiting in such a practical way from your support. Only recently, a table quiz organised by Headway staff and clients secured the continuation of our annual art exhibition which was under threat. Art is a vital outlet for our clients that provides a way to explore thoughts and ideas that might otherwise prove difficult because of
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Front Cover picture: (Clockwise from Top Left): Members of the Wolfe Tone Lodge No.3 (Ballincollig) and Cork Rotary Club and Headway Staff; Ronan O’Neill, Equinox Cycle Ride organiser; Equinox Rider; The Beach Clean up Gang; Headway Limerick Better Together Video; Equinox Helper
carer support programme in the Mid West (p8) and we also bring you news and snippets from around the Headway centres and introduce you to Sarah, our new Head of Communications and Development. As ever, your comments and contributions are always welcome to me at stablesr@headway.ie. Happy reading! Richard Stables, Editor, Making Headway Make a meaningful contribution to Christmas and order your Christmas cards from Teresa in Headway or log on to www.headway.ie and order online.
their brain injury. The annual exhibition showcases the work and is eagerly anticipated every year. So this is the type of fundraising that has an immediate effect and transforms lives. If you think you can help us, call Sarah Benson, our recently appointed Head of Communications and Development. She is on hand to chat through your ideas and see how she can support you to achieve your fundraising goal. If you want to make a vital donation you can log on to www.headway.ie and click on donate. Or if you think you can make a regular donation of €5 a month to help us plan for the future, we would be delighted to hear from you. See Sarah’s piece on the back page of this magazine to hear more about how you can get involved or support us and thank you for helping us to continue our mission of bringing positive changes in the lives of those affected by Acquired Brain Injury. You continue to be part of part of something truly magical. Kieran
Making Headway
Runners and Riders: the Equinox Charity Cycle 2013
Once again, we are grateful to the riders in the gruelling Equinox Charity Cycle Ride. This year the team braved the Irish road system to cycle from Howth to Galway in one day (yes, by bike!). Organised by Ronan O’Neill, the ride is becoming an eagerly anticipated annual event. Proceeds were shared with Temple St. Hospital and ourselves. Thank you! Also, we’d like to say thank you to everyone who participated in the Cork Women’s Mini Marathon, The Great Fjord Swim, The Cork City Marathon, and all the other events that you’ve trained for, collected for and donated your time and effort for. Huge thanks!
Trinity Med Students
Belated thanks to the 500 Trinity medical students who collected for us and donated 3,000 Euro!. In the photo is Sarah Barry and Eoin Keating who helped organise the Trinity Med Day.
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Thanks to our Spot Prize Donors: Yves St Laurent and Chanel Counters, House of Fraser, Dundrum; Beeftro, Dundrum; Bord Gais Energy Theatre; Hilton Hotel, Charlemont Plc; The Westin Hotel; Bewleys Hotel group; Lloyds Pharmacy, Castleknock; Dunnes Stores, Tesco Stores; Searsons of Baggot St; Bourkes Pharmacy, Rathfarnham, and many many more!
Quiz Stars
Clients who attend the Donnybrook Wednesday Cognitive Skills group organised a quiz night on the 19th September in Winters Pub, Dundrum, to raise funds for the Dublin Day Rehabilitation Service Annual Art Exhibition which is kicking off the week of November 25th, in the Dublin City Council premises in Wood Quay. The night was a great success and there was a great turnout with the venue full to bursting. There was a superb performance from the North Dublin Community Choir, and lots of great spot prizes won on the night. The MC for the night, Dermot Nolan and his calm and capable daughter Peggy, both ran the show so smoothly, even when we ran out tables! A massive thank you to Sara Sabbioni and the staff and clients for organising this event, in particular Pat Kearney, Christine Gara, Geraldine Murtagh, Marian Gaule, Nick Boland, Atis Atteka and Alan Byrne, who not only organised the event but also sourced lots of the spot prizes.
Version 1
Thanks to Michael Donegan from top IT services company Version1 who compiled a video entry for a competition with the potential to win a grant of 4,000 Euro. We didn’t win, but are nontheless very grateful for the awareness raised. Thank you!
Michael Donegan from Version 1 -Youtube appeal
We managed to raise nearly 3K. Everyone is looking forward to the next event for 2014. Aslo, thanks to comedian PJ Gallagher who lent his support to another table quiz in aid of the Equinox cycle. A great evening was had by all in Dicey Riley’s.
Comedian PJ Gallagher (centre) with Headway Staff (L to R): Ruth Lunnon, Sarah Clarke, Samantha Whelan and Gillian Teague.
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Thanks also to members of the Wolfe Tone Lodge No.3 (Ballincollig) and Cork Rotary Club who raised a welcome €340 for Headway.
Great (paint) Job!
the ID card,a member of the public contacted her by using the card information. “It’s already brought me luck” she joked. We will be ordering more cards on a regular basis for any new/existing clients who wish to have one.
As part of their Disability Awareness Week and plans for corporate responsibility, the financial services company Deloitte sent 11 volunteers to the Headway centre in Clondalkin to paint the training rooms. The volunteers were great - they worked hard to finish the job within the day and left everything back in its place when they left! The Clondalkin staff and trainees are thrilled with the results and would like to thank all the volunteers for a very much appreciated job well done.
New Aphasia Project
Headway is delighted to be collaborating with the Speech and Language Department from the National Rehabilitation Hospital for a new initiative. The project is a pilot service for people with Aphasia, a disability which affects language and communication and is common following a brain injury. Volunteers from Deloitte at the Clondalkin training centre
New ID Cards for Headway Clients
Headway’s client advocacy group requested some time ago something to help in every day situations where people misinterpret or don’t understand the effects of a brain injury. The new Headway ID Card can be used by Headway clients to explain to people in shops, on buses, in the cinema or anywhere it is needed that the bearer has an acquired brain injury. The card also carries the person’s photo and the Headway logo and contact information. Jenn Cotter, one of the Headway Team working with the Client Advocacy Group says: “All the feedback we have received in relation to the cards has been very positive, clients and the Headway Board have all commented on how professional the cards look”. For one Cork client the card has already come in handy, she lost her wallet the day after she received
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The idea developed from feedback gathered from Headway clients with aphasia who had previously participated in groups. Under the initiative, the programme will comprise a weekly group and individual work helping people to access facilities in their local community. Sally Conneely, the Headway Speech and Language Therapist facilitating the project says “It’s a fantastic opportunity. I am delighted to be able to use my skills as a Speech and Language Therapist and provide a well needed service for people with a communication disability within Headway.”
Women’s Group
A Women’s Group ran in the Dublin Manor Street centre earlier this summer over six weeks. The group was made up of women with brain injury who came from different service strands in the organisation and didn’t necessarily know each other previously. The rationale for the group was to increase awareness of women’s issues and resources through education and information sharing, as well as to give a chance for the women to share their own
Making Headway experiences of having an acquired brain injury, and to provide support and empower each other in a setting where they could express themselves freely and in confidence. The group was facilitated by Caroline Earley who reported that not only did the women enjoy meeting each other and sharing experiences; they also described an increase in mood and wellbeing, and decreased isolation as a result of this. There was also a lot of laughter and fun and the group culminated in a lovely ladies lunch in a restaurant chosen by the clients, which proved to be a very enjoyable closing experience for the group on its final week.
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took place at the Fashion Fusion event in the Louis Fitzgerald Hotel in aid of St James’ Stroke Unit. This fashion show was organized by the owner of Siopa Lara, a clothes shop also based in the Community & Enterprise centre Bawnogue. On the night €3,500 was raised in aid of St. James Stroke Unit. Catherine Craven, one of the Headway Clondalkin trainees was a model during the show which was opened by Frances Fitzgerald, the Minister for Children and Youth Affairs.
As it worked so well, we have decided to run another women’s group in the New Year. Plans for other groups include a men’s group and Young person’s group, to reflect the different perspectives and issues that can arise from your gender or age and living with a brain injury.
Out and About
Headway Trainee Catherine Craven (centre) with Headway Staff Samantha Whelan (L) and Gillian Teague (R)
Headway Dublin Trainees As part of the Summer 2013 programme, Headway Dublin trainees took part in weekly social outings. Venues included the Hugh Lane Gallery, lunchtime theatre at Bewley’s, the Science Gallery at TCD and a guided tour of Aras an Uachtarain. This module was a great success! Trainees really enjoyed the outings (and the fabulous summer weather!) and the Dublin training team are planning to incorporate social outings into the autumn/winter programme on a monthly basis.
Fashion Fusion
Earlier in the summer, a Headway Information stand
FETAC Success: LTI- Stepping Stones
We would like to send on our congratulations to everybody attending the Cork Local Training Initiative (LTI) programme “Stepping Stones”, run in Carrigrohane, on receiving FETAC certificates for the following modules: Health and Fitness, Health and Safety Awareness, Internet Skills, Career Preparation and Personal and Interpersonal skills. The official presentation of the certificates was held in Carrigrohane on October 2nd where the Senior Training Advisor from FAS presented the certificates. The clients now aim to complete six more modules this year in order to obtain a FETAC major award. We would like to wish all our clients another enjoyable and successful year on the LTI programme.
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Certificate Recipients: Ian Dorgan, Pat Doherty, Laurence Tobin, Noel Begley, Patricia Moynihan, Donal Dorgan, Mary O’ Mahoney, Michael Smithers, John Mc Grath, Shane O’ Mahony, Alan Quinn, Liam Bannon, John Mc Carthy, Alan O’ Connor and Jason Callaghan.
Clean Coasts
Clients from Headway Day Services in our Manor Street and Clontarf centres spent an enjoyable and productive morning taking part in their 2nd beach cleanup this year at Bull Island on 20th September. This was part of the Clean Coasts project and they were accompanied by Headway Staff members Sara Sabbioni and Michelle Hardy along with Michelle O’ Sullivan from Clean Coasts.
Finglas Graduates
Headway Finglas trainees recently achieved FETAC certification in Drama, Communications and Culinary Skills. At a graduation ceremony in Colaiste Ide the awards were presented by the Dublin VEC Chief Executive Jacinta Steward. The students who acheived the certification are: John Fogarty, Linda O’ Neill, Margaret Glynn, Mark Guest, Nicky Crabbe, Patrick Fitzpatrick, Mark Mc Donagh, Colin Neill, Sandra O Neill and Nicholas Cleere. Many congratulations to everyone on their success.
Better Together
The clients in Headway Limerick have been busy putting together a great video for our entry in the Better Together competition run by The Wheel. The two minute video features interviews with clients in the Headway Limerick service.
Pat MacAulay, Florence Mokom (centre) and Headway’s Sara Sabbioni at the Beach Cleanup
Art Expo in Dublin Each year the clients in the Headway Day Rehabilitation Services eagerly anticipate the Dublin Art Expo. The exhibition showcases the work of the clients and illustrates the benefits of art as a means of expression for people with brain injury.
Voting in the competition closes on November 22nd, and we would love you to support the clients, which you can do by going to http://www.bettertogether.ie/video/headway-itsbetter-together-2013 and clicking VOTE!
We look forward to seeing you there. Check our website for details of the launch event.
The theme for this year’s Dublin Art Expo is “People and Places”. The exhibition will take place on the week of November 25th in the offices of Dublin City Council, Wood Quay. The exhibition will be in collaboration with two local community groups, the Halston/Church Street Parish Art Group and St. Andrews Adult Ed Art Group, Pearse Street.
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Painting by John Costelloe
Making Headway
Autumn/Winter 2013
Taking the Good from the Bad – My Road to Recovery from ABI
By Nicole Hi, my name is Nicole. I acquired my brain injury over 16 years ago when I was 11. I was asleep in the back of my Dad’s car. The next thing I was aware of was waking up three and a half weeks later with no recollection of who I or anyone else was. Before my accident, I suppose you could say that I had everything. I was highly academic, was involved in a lot of sports and athletics, I had lots of friends at the time and was extremely pretty. I lost everything as a result of the accident. I acquired a brain injury, my face was badly scarred and I lost a few teeth. I was in a coma for 3 and a half weeks. After I regained consciousness, I had to relearn how to walk and talk again and my memory was severely damaged. I forgot everything prior to the accident as a result of a left sided brain injury. I don’t remember much about my time in hospital. I was in Beaumont for approximately 7 weeks, then got transferred to the National Rehabilitation Hospital (NRH) and was there for over three months. Two weeks after I was discharged from the NRH I started secondary school. I struggled so much in school and could barely write, let alone remember what I was supposed to be learning! It was tough and my grades were quite weak in almost every subject. The only subject I enjoyed doing was art. So from that point on, I focused on art and got through everything else. I think I got mostly all Ds in my junior certificate except for art, for which I got a B. So instead of focusing on what I couldn’t do anymore because of the accident I focused on what I could do- that was art. When I finished school I went on to do a PLC (post leaving cert course) in graphic design and then I went on to art college. I was never top of my class in the beginning but I got better over the years and finished my degree in Fine Art with a very good result (top half of my class). In order to get the results I got I did have to put my heart and soul into everything I did. I do feel that my constant struggles were a result of the brain injury, but I got there in the end. Since my degree I have had a lot of challenges thrown my way. Yes, there have been plenty of occasions
where I wanted to give up. Some days I could wake up in bad form and not want to get out of bed. I still get angry because I feel different to other people and because life is tough. I do think that people with brain injuries have to make more of an effort to function than other people. But don’t ever forget that as people we have so much more life experience and compassion to offer than our peers. I’m sure you can agree that that in itself is much more valuable than being a “straight A” student. I’m sure you have heard the saying, what doesn’t kill us only makes us stronger. I think this is so true for all of us. After my degree, I went straight on to do a Post Graduate Diploma in Art and Design Education. This was the hardest year of my life as a result of problems I have with learning. I was very isolated in college because of my learning difficulties and barely managed to get through it. It took quite a long time for me to recover after that year. Unfortunately, I have not been able to get much work in teaching, so over the last four years I have done several different add on courses in order to broaden my skills and employability. As humans we never stop learning. We continue to learn all the time. I know that I may not learn at the same speed as other people but I still learn. For me, it’s through repetition. I tend to take things in better when learning in a real life situation - in context. Yes, it is hard and has been quite tough accepting that I have to apply myself more to get the same results as other people. So why do I do it? When you get there, when you accomplish something, not only is it satisfying but it also diminishes the barriers and differences between you and other people. This notion may be entirely in my head but it does help to make me feel more normal. The road to recovery from an ABI is tough. For a long time I have felt that whenever I made a step forward in my recovery I seemed to take two back. I get overwhelmed so easily because I put so much
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energy into everything I do. My confidence can get knocked so easily because I compare myself to other people instead of taking pride in what I have achieved. Living with a brain injury makes me feel different to most people which in a sense makes me more vulnerable. This is why I have found it important to surround myself with people I feel safe with. I lost all my friends after the accident and have struggled maintaining friendships ever since. Eight years ago I met Bernard. He was the first man I was honest with upfront. I told him that I had problems and that was that. I didn’t have to lie about who I was and so our relationship was built on honesty. He fell in love with me, warts and all, not the person I used to be or the person I tried to be but with me. Meeting Bernard changed my life. I felt safe with him and because of that I was able to start dealing with myself and the emotional trauma caused by the brain injury. About a year ago, I contacted Headway. I wanted to know if all of the ongoing issues and struggles I was faced with were a result of the brain injury. I had never been given an answer to this, but things have become a lot clearer for me since I reached out and asked for help. Most importantly, I realised that my symptoms and problems were not isolated to me but were directly related to the brain injury and common amongst people who had them. Knowing this helped relieve some of my inner tension and gave me a sense of peace inside. It has been a long road to recovery and every day I continue to improve as I get older. Which is why the most important thing I can do for myself now is focus on what I can do and not on what I have lost. In a nutshell - take the good from the bad!
I have been described as having a heightened emotional intelligence as I’m an extremely sensitive person. I do think that this is probably a result of the ABI. I’m pretty sure that this sensitivity adds to my character and gives me a lot to offer as a person. Would I be this person if it were not from the ABI? I don’t know. I just know that I have to take the good from the bad and be grateful for the person I’ve become. If you have had a brain injury, don’t ever feel less than other people because of what you have been through. Put it down to experience. Do not allow your life to be a consequence of a brain injury. Use the knowledge it has given you and allow it to add character to the great person you are. I have always been very independent and stubborn person but there comes a point when you have to say enough is enough. Why should I struggle? As a person I have a lot to offer but I cannot be that person when I am completely overwhelmed with stress. So I am going to accept help if and when I need it. This does not make me any less of a person. In fact, being pro-active and trying to change my life for the better is a very positive step for anyone to take regardless of an ABI. The way we live our lives, the quality of our lives, is in our control. I learned a long time ago that the world will go on with or without me, so it is up to me to live. The fact that I have brain injury does make me any less of a person than someone who does not have one. It certainly hasn’t ruined my life. I will not allow it to have that power over me. Nobody with a brain injury should allow their injury to have that control over them. We are still here, after everything each and every one of us has been through, we are alive. Life is for living, so live, to the best of your abilities.
Carer support in the Mid West
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‘It is a privilege to meet with these amazing and strong people. I admire the commitment, loyalty and courage of our families who are always there for their loved ones, regardless of the circumstances’ says Halina Downes, Rehabilitation Assistant with ABII(Acquired Brain Injury Ireland), on the carers attending the new family support group in the Mid-West.
these workshops, the focus was very much on self care, and carers looking after themselves. The carers all agree that coming together in a peer supported environment was extremely therapeutic and beneficial.
In October 2012, ABII and Headway decided to join forces to provide greater support to those caring for people with brain injuries in the Mid-West. The first family education workshops were delivered by both organisations to carers over three nights in October of last year. These evenings consisted of providing carers with information about acquired brain injury, with a particular emphasis on how to deal with the consequences of brain injury. On the last evening of
Since then, the carers support group has met on the second Tuesday of every month, in the ABII Resource centre on the Ballinacurra Rd. The group is facilitated by Halina Downes, Rehabiliation Assistant with ABII, and Elisa O’Donovan, Community Integration Officer with Headway. The role of the facilitators is just to see that everything runs smoothly, and to keep the carers up to date with any ABI related news or information.
Making Headway While the facilitators are on hand to support, the group is very much led by the carers themselves. the group are extremely supportive of each other, and between them they have a wealth of experience. The group gives the carers an opportunity to talk through their own story and get advice from other carers. The group can instantly relate to and understand each other as they are all in a very similar situation, and it is a reminder that they are not alone. The ethos and focus of the group is very positive. For many it is an opportunity to meet new people and socialise. There is an enormous sense of fun and humor, and the group have been known to talk about everything from the Munster hurling championship to their favourite X-Factor contestant! The group does have a serous side too, and there is an emphasis on trying to deal with the challenges that caring for someone with a brain injury can bring. The group often requests guest speakers, which are facilitated by both Headway and ABII. Most recently, Linda Buck, social worker with ABII, came to talk to the group, and the carers had an opportunity to ask their own specific questions. To celebrate National Carers week, there was a very special evening held, where carers were treated to pampering hand massages by a qualified therapist, alongside some delicious homemade treats. There will also be a special Christmas outing where carers can celebrate all their achievements over the last year. The group is open to all carers of those accessing Headway services in Limerick. If you are interested in attending the group, and would like to find out a bit more about it, please contact Elisa O’Donovan in our Limerick office on 061-469306 or email odonovane@ headway.ie Sam Milburn attends our Carer Support Group in Limerick. We asked him about his experience. Elisa O’ Donovan reports... Elisa: How long have you attended the carer support group in Limerick? Sam: I went to the family education workshops last September. We all got so much out of that, and it was decided at the last session that we would form a family support group. The group has been running for about a year now, and has proved its worth in such a short space of time. What do you enjoy most about the group? I suppose the fact that it’s not formal. There’s no specific agenda. We start chatting about things in general,
Autumn/Winter 2013
someone makes a contribution and it centres around that, and it can be quite a humorous conversation, though we are talking about a very serious subject. The camaraderie and humour is the group is infectious. One gets more out of looking at a situation light heartedly. You can understand how people cope with the various difficulties. But at the same time it is reassuring to know people are in a similar situation and we laugh or cry about it. Both of those emotions are important to vent, while also respecting each others confidentiality and privacy of all the family members as well as the person with the brain injury. Self help groups are important because you meet people in similar situations who you can identify with, and you realise you are not in isolation. Do you think it is important to have a carer support group in the Mid-west (Limerick)? Oh gosh yes! When this (the Acquired Brain Injury) came up, we were at a loss. After the ABI, we had the medical attention, and the hospital dealt with the medical side, but there was no training or warning about the other aspects that would manifest themselves. Even if you ask the consultants, and in fairness no one has a crystal ball or can look into the future, and ask them how long it will take to get over the ABI, they don’t have the answer. I guess that is because no two brain injuries are the same, and it’s only in time you come to realise, not necessarily understand, what these changes are, and I think that’s where the difficulty is. It’s such an unknown for everyone. There is no training for managing someone with an ABI. Talking and offloading is so important. Do you like that ABII and Headway are working together to provide this service? Yes, I think it’s an excellent idea that the 2 groups are working together. Both organisations recognised the need for such a service, and the combination of resources is much more efficient. Any other thoughts? If other family members were having second thoughts about attending the group, maybe because they’re not familiar with discussing family issues or feel there is a stigma attached to talking about such things: Just go to one meeting and test the water, it can only be of benefit to the carer and the person with the brain injury. I highly recommend it. It’s something to look forward to every month. For some carers they have no other social outlets because f family circumstance, so it is a great social outlet. Give it a try as they say.
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Research Roundup: Progesterone treatment for Traumatic Brain Injury (TBI) By James Glynn
Jour research round-up this month focuses on the use of the natural hormone Progesterone in treating patients suffering from Traumatic Brain Injury (TBI). We examine the treatment’s potential based on some recent clinical trials conducted worldwide.
Traumatic Brain Injury, a brain injury resulting from a blow to the head often called TBI, is a highly complex condition that can have a devastating impact on a person. It is also a condition that is notoriously difficult to treat. So this quarter, our research has led us to a global study known as SyNAPSE (the Study of the Neuroprotective Activity of Progesterone in Severe Traumatic Brain Injuries). This programme aims to evaluate the effectiveness of using progesterone in the early treatment of patients suffering from severe traumatic brain injury. Progesterone is a sex hormone naturally present in the human brain that has been shown to have a protective effect on brain tissue with very few side effects. It is for this reason that the SyNAPSE programme, which is conducted by the BHR Pharma affiliate in Herndon, Virginia, and endorsed by both the European & American Brain Injury Consortiums, has such a keen interest in exploiting the therapy. The project is a large one with approximately 1,200 patients with severe brain injuries having enrolled at over 150 medical centres located across the United States, Argentina, Europe, Israel, and Asia so far. In the trial, patients are administered an intravenous dose of progesterone together with a placebo drug within 8 hours after incurring their injury. The patient is then put on a course of these drugs over a five day/120 hour period and then observed for a further six months afterwards. The patient’s progress is then evaluated using a number of standard measures including the widely used Glasgow Outcome Scale (GOS), as well as a measure of the patient’s overall quality of life over the period after administration. It is through these measures that the overall level of improvement, if any, can eventually be assessed. So exactly what potential effects can the early administration of Progesterone have on Traumatic
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Brain Injury? Well, initial trials have shown that unlike many other drugs, progesterone has a rapid effect time, entering the brain within one hour. It also has a safe history in both men and women suggesting very limited potential side effects for the patients. Recent studies on both animals and humans have also shown that progesterone can help to rebuild the blood brain barrier and potentially decrease inflammation and cell death. In addition to this, it has also been known to reduce post-injury oedema (excess fluids in brain tissue) and in some cases even lead to the recovery of lost brain cells. Finally, and perhaps most importantly, a recently published clinical trial demonstrated a decrease in mortality and an improvement in functional outcome in patients 6 months after administration of the hormone, which is in itself a truly significant breakthrough. Prior to this, none of the alternative therapies for TBI had produced concrete positive results. Trials of magnesium, albumin, and even hypothermia all showed past promise but are now seen as largely ineffective. Considering the potential benefits of progesterone therapy, together with the lack of negative side effects, it is easy to see why there is such optimism at this early stage. In fact, the U.S. Food and Drug Administration have indicated that should the SyNAPSe program prove successful, it may even approve the release of the drugs for patient use. The final assessments on the treatment are yet to be delivered with a number of factors still to be taken into account, but there is an understandable excitement in the medical community that this revolutionary new method of TBI treatment could be a reality before too long. For more information about the SyNAPSE programme, see http://www.synapse-trial.com/
MakingHeadway Headway Autumn/Winter Autumn/Winter2013 2013 Making
Compensation - The Winds of Change Jessica Goldrick of MacMahon Goldrick Solicitors explores how compensation payments might change in the future for individuals who suffer catastrophic injuries including brain injuries. In recent times, High Court judges have been vocal in urging the Government to change the system for compensation for those who suffer a catastrophic injury. The current system involves an award in the form of a lump sum. This has been the position for many years. This lump sum payment includes compensation for pain and suffering known as “general damages” and also compensation for out of pocket expenses, known as “special damages”. The limit of general damages is currently set at 450,000 Euro. Special damages are made up of earnings, physiotherapy costs, medical costs, nursing care costs, aids and appliances costs together with the cost of housing. They cover these costs up to the date of the award and also into the future. But there are many critics of this lump sum approach. The main criticism is that it requires clients, lawyers and judges alike to make assumptions about the future, particularly about the health and life expectancy of the Claimant. Some of the obvious difficulties are: • Predicting the life expectancy of the Claimant. The Claimant could live longer or shorter than the predicted date that was used when calculating the lump sum. • The prospect of a further deterioration of the Claimant’s health which makes it difficult to assess accurately what the Claimant’s future needs are. • Uncertainty about Social Welfare entitlements in the future. • Uncertainty about the rate of return that a Claimant might get on his/her investment in the future. • Uncertainty about the cost of future care, aids and appliances. In 2010, a working group was set up, chaired by Mr Justice John Quirke, to review the lump sum payment approach and to provide recommendations to the Irish Government of the day. In a lengthy report the group observed that: “The one virtual certainty about a lump sum award to pay for future care is that the wrong amount will be awarded. This is inescapable.” The Group made very strong recommendations to Government. Some of these are:
• The Courts should have the power to make Periodic
Payment Orders to compensate individuals who have suffered catastrophic injuries. These Periodic Payment Orders could be in relation to earnings, future treatment, future care and the future provision of aids and appliances. The group recommended that these be guaranteed and index-linked to provide future security for the Claimant. • The Group also recommended that Periodic Payments Orders might be varied at a future date or dates when it is known that a Claimant’s condition will seriously deteriorate or significantly improve (and where this future contingency has been factored in at the time of the Periodic Payment Order being made by the High Court Judge). • That the periodic payments should be exempt from tax • The Group also recommended that High Court Judges should have the power to make interim awards (payments to a Claimant before his or her case comes up for hearing) Although these recommendations have not yet been acted upon, they would revolutionise the system of compensation for those with catastrophic injuries. The resulting major advantages would be: • No tax to pay on the Periodic payment • Payments secured and guaranteed • Payments would be for life and would give a Claimant certainty. • Payments would be index-linked to inflation. The Periodic Payment Orders have already been implemented in the UK where they have proven very successful, particularly since the periodic payments relating to care were linked to a special index table to cater for the sharp rise in care costs (and which is a lot higher than normal inflationary increases) over the flux of time. It remains to be seen when the Government here will implement the recommendations of the Group, but in this writer’s view it is only a matter of time before they become law. The Government has indicated that it is committed to the change. This would create a much better platform for a Claimant to be adequately compensated and for that individual to be given the security that he or she deserves for the future.
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Making Headway
Autumn/Winter 2013
Meet...Sarah Benson
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email: helpline@headway.ie Monday – Friday, 9 am to 1 pm and 2 – 5 pm (local call rate) Dublin Office Unit 1-3 Manor Street Business Pk, Shea’s Lane, off Manor Street, Dublin 7 Tel: 01 810 2066 Fax: 01 810 2070 Web: www.headway.ie Email: info@headway.ie Rehabilitative Training & Day Rehabilitative Services, Employment Support, Community Reintegration, Neuropsychological Assessment, Psychotherapy, Counselling and Information and Support. Cork Office Unit B3, Link Road Business Park, Ballincollig, Cork Tel: 021 487 1303 Fax: 021 487 1305 Rehabilitative Training & Employment Support, Rehabilitative Day Services and Community Integration. Cork Psychology & Family Support Services Kenny Group House, Carrigrohane Road, Cork Tel: 021 434 7625 Fax: 021 434 7477 Brain Injury Rehabilitation, Neuropsychological Assessment, Psychotherapy, Counselling, Family Support,and Social Work Services. Limerick Office Jutland Hall, Steamboat Quay, Dock Rd., Limerick Tel: 061 469 305 or 061 469 306 Rehabilitative Training, Vocational Training Programme, Supported Employment, Neuropsychological Assessment, Psychotherapy,Counselling and Family Support and Community Reintegration Kerry Office (Psychological Services) Ashe Street Clinic, 36 Ashe Street, Tralee, Co. Kerry Tel: 087 6673857 Psychotherapy and Counselling South East Office 15 Old Dublin Road, Carlow Tel: 059 9134029 Information and Support, Family Support
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Hi - I’m Sarah. I’m delighted to join the Headway team. I’m already bowled over by the commitment of our staff to Headway’s clients and their carers – it really is second to none. I know there are people working hard already in the community to try and support us, to raise the funds that we need to continue to protect services. But as we look down the road and see further cuts, we need to ask everyone to get on board with us. So whether you think you might be able to get sponsorship for a run that you are doing, or host a table quiz or organise something in you work place – I will do my very best to try and support you in your fundraising. However if activities aren’t your ideal way to support us – would you consider supporting us with a monthly donation? A monthly donation would allow us in Headway plan ahead for our clients and ensure that we can deliver services into the future. No matter what amount you can afford it will make a transformative difference. Despite these tough times, I am confident that we can continue to deliver for people living with brain injury. With your generosity, together we can make all the difference. Please do not hesitate to call or email to find out how you can make a life changing contribution. Thank you. Sarah bensons@headway.ie - Tel: 01 810 2066
How to donate - Four easy ways Online - Go to www.headway.ie and click on Donate. There, you can set up a once off donation or a monthly gift. Post - You can send your donation to the Fundraising Department, Headway Ireland Ltd, 1-3 Manor St Business Park, Manor St, Dublin 7. Telephone - Teresa or Siobhan will help you make your donation. Call us on 01 810 2066. Bank - you can lodge it to AIB Bank; Georges St Dunlaoghaire; Sort Code:- 93 34 06 Account:- 40534408.