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The Laura Fergusson Brain Injury Trust has been awarded funding from the ACC Innovation Fund for the development of an Employer Peer Support Service. The latest round of funding focused on projects that support recovery at work after an injury, so that injured clients can stay connected and engaged in their workplace while they’re recovering.

From 39 eligible proposals submitted from across New Zealand, LFBIT was one of two organisations awarded funding for their projects.

Established and managed by Katie Hodge, an extension of our Traumatic Brain Injury (TBI) Peer & Whānau Support Service, the LFBIT Employer Peer Support is a project that aims to train and support three employers to act as peer support to other businesses returning clients with TBI to the workplace.

The project also includes TBI training opportunities for large organisations and vocational providers.

We know that recovery from TBI is complex and not quick. The peer support service will help employers understand the workplace adjustments and changes to routines needed to enable success and sustained return to work. Congratulations to the team on being awarded this funding!

Today we would love to celebrate Tommy, one of the wonderful team members at Can Do Catering.

Can Do Catering provides paid employment for a number of residents and clients of Laura Fergusson Brain Injury Trust, for whom mainstream employment is not an option due to their care needs. Tommy began his work with Can Do Catering eight years ago, and he has loved his time there!

Tommy works in the essential business of delivery. Alongside his co-worker Jane, Tommy is the face of delivery at Can Do Catering. If you have ever been lucky enough to have an event catered by Can Do, you likely will have met Tommy!

A regular week will often involve coming to work on a Monday and Wednesday, although this can change depending on what days a delivery is needed. Tommy has worked on different functions, from business catering to weddings. The deliveries take Jane and Tommy all over Christchurch and beyond.

Tommy thoroughly enjoys being involved in the community and says he is looking forward to the further expansion of Can Do Catering!

Thank you Tommy for all of your hard work! It is always such a joy to have a chat during the delivery of what is always an incredible bite to eat from Can Do Catering!

Life before 18 July 2020 was pretty hectic. I’m a Mum to three boys, a wife and a primary school principal of a little Catholic school. My life was a mix between running the household, caring for my family and dealing with the variety of problems and tasks you get when you’re a teaching principal of a little school.

We had just sold our house and had moved into temporary housing, waiting for our new house to be completed. I was pretty shattered and felt exhausted on many levels!

During the last weekend of the July holidays, my husband and I had decided to go through to Christchurch for a couple of nights. On the Saturday night, we were on our way to go out for tea, and as it was very cold, we thought that it would be a good idea to jump on a Lime scooter instead of walking.

My husband was in front of me and I followed. I don’t remember much after that, as I was hit by a car as I was crossing the road. I became aware of my surroundings a while later in one of the trauma units at Christchurch Public Hospital. After many hours, tests and treatments, I was taken to the Neurology ward.

My left wrist was broken and in a cast. I had a deep wound in my forehead that required plastic surgery, a fractured skull, a face full of bruises, the mother of all headaches that wouldn’t quit and I was vomiting. Although I was confused about why I was injured, I knew what day it was and who my family was. I slept a lot! I struggled with my balance and felt very dizzy, needing assistance to get out of bed and go to the bathroom. I spent 10 days in hospital and was extremely excited to get back to my family.

The next part of my recovery is all a bit of a blur – it seemed as though one day merged into the next. It was a longer period than I initially thought I’d be in, a period I called the “Four Fs” – Fogginess, Fatigue, Frustration and Fear. There was a lot of tiredness, a lot of sleeping and a lot of crying.

I found that I was tired after doing simple tasks such as doing the dishes! My initial goal was to do simple routine housework and build on it as I could. I had help to keep on top of the bathrooms and vacuuming, but I worked on achieving the rest throughout each day with lots of rests in between.

My balance was still an issue, but once I’d had some treatment, it had improved enough that I didn’t need to steady myself by holding onto the walls.

Therapists from Laura Fergusson Brain Injury Trust visited me every week at the start, talking me through what was happening and helping me set goals for my recovery.

I thought that I’d be back at work pretty quickly as I had no idea how severe my injury was. Every goal I set myself – workwise – had to be reset!

Very gradually, I made myself get outside and go for walks. My dog and I would walk to the recycling and rubbish bins daily – probably only about 100m in total. Then we would add going to the end of the houses in our block – another 100m in total. I wouldn’t do this daily, only when I felt I could.

I found this part of my recovery very challenging. I wasn’t used to putting myself and my health first. I wasn’t used to struggling to do things. I was a capable, intelligent woman who was independent and fierce. I identified with being a career woman who was in control.

I had to shift my thinking, which was huge. I had to accept help. I had to relinquish control at home and at work. I had to focus on myself in order to recover.

We finally moved in to our new house early September. I felt as though I had room to breathe and I had a purpose each day. I began scheduling my day in my diary, making sure I wasn’t overdoing it and going back to the boom-and-bust attitude I had before my accident.

Scheduling appointments for the week, daily chores/tasks, walks/exercise, social events and also scheduling in regular rests throughout the day was extremely helpful. Not only did I feel more in control, but it was also a creative outlet for me.

I started going to physio for both my neck/back/shoulders and hand/wrist/fingers (which we discovered had also been broken after my cast was removed). My aunt drove me to and from hand therapy appointments in Rolleston. The movement of vehicles and the surrounding scenery left me feeling very tired, and I had to give myself time in between and after journeys to recover. Eventually, I was able to manage longer trips and my recovery time would be shorter.

My concussion physio was still visiting me. However, I began seeing a psychologist to help me work through all the feelings and issues that were coming up, and this reinforced the goals that I was working on. My psychologist helped me find my joy. We spoke about what I found challenging, how I spoke to myself, what I found important and what gave me the ‘good’ feels. My therapists worked on helping me achieve the goals that I was working towards.

After the Christmas holidays, I returned to school. Once again, I thought I’d be able to do more than I actually could. Time and time again, I would have setbacks – I’d set myself goals of how long I could be at school, I’d push on and my recovery would take a dive. I spent all of 2021 trying to get back to school full-time. The best I could manage was Monday, Wednesday and Friday 10am–1pm, still only doing admin work. We discovered that, if I tried to increase my hours too quickly without a ‘consolidation period’, the headaches and fatigue would return. Progress was slow.

Now, nearly two years on, after resetting my goals, I am finally back in the classroom two days a week but still working on being in the office full-time on the other three days, with later starts and early finishes. Life at home has become very quiet as all the boys are now at university, so I find I have less pressure to be on call for them! I still get fatigued, still get headaches – especially when I do too much.

Changing the way I speak to myself has helped me come to realise that my recovery has been a very personal journey. Understanding and identifying my emotions and limitations has been the biggest challenge – and continues to be ongoing. I now tell myself that it’s OK to feel like this, it’s normal for recovery to take time and to have setbacks.

Doing things that I enjoyed was the most helpful thing in my recovery. Planning out my day/week in a creative way by journalling, doing a little gardening, walking (increasing my time and distance as I felt I could) and rekindling my love of reading – all these little things gave me happiness and purpose. They made me feel good about myself. Going for a walk is now my ‘go to’ when I feel overwhelmed or frustrated.

As I look back on the last 22 months, I have come a long way, and although I may never be 100% the same as I was, maybe that’s not a bad thing – my life was not sustainable.

I also think that it would be important for family members to have some support. I was fortunate that my husband had some experience dealing with concussion, however not to the same extent as my injury. He would have benefited from someone having a chat with him about everything – not relying on me to pass on information.

If I had advice to give someone that was in my situation, it would be to give yourself time and go easy on yourself.

Find what gives you joy.

Our incredibly skilled Community Nursing team at the Laura Fergusson Brain Injury Trust is led by Val Sandston, our Community Nursing Manager.

Val has over forty years’ experience as a Registered Nurse. After starting her career as an Enrolled Nurse, she entered further education to improve her skills, and has spent the majority of her Nursing

career working in Spinal Injury and District Nursing. Val also has a postgraduate certificate in wound management and is passionate about working in this area.

“I believe one of my key attributes is my communication which I feel is open and honest,” says Val. “I have a good sense of humour which can be beneficial in different situations.”

A usual day for Val and our nursing team involves seeing our group of regular clients in the morning, and then undertaking assessments for clients with specific needs in the afternoon.

We may see people for wound care, pressure injuries, bladder and bowel management, for continence products and other consumables.

The Community Nursing Team travel in the Christchurch and wider Canterbury region seeing ACC clients, mainly with traumatic brain injury or spinal cord injury, in their homes.

“I enjoy the collaboration in working at LFBIT – collaboration with outside agencies. our own large interdisciplinary team and our small nursing team. I enjoy the autonomy of the role, being able to supervise my nurses and support them in their work.”

“We pride ourselves on being timely, efficient and professional.”

Take away message from Val & our Community Nursing Services:

· We travel in the Canterbury Region

· We see people at home

· We are timely and can respond quickly

· If covered by ACC there is no cost

· Referrals can come from your GP, specialist or self referral

There’s a new, incredibly cool vehicle in our fleet!

We are so thankful to our friends at Vehicle Adaptions, who pledged a significant amount of in-kind work towards our new assessment services vehicle.

Vehicle modifications can create a huge difference in a person’s independence and quality of life. Sometimes, all it can take is one small change to make independent transportation possible. In our new car, we have interchangeable styles of left- and right-hand controls with toggle switch indicators, an electronic left foot accelerator, various shaped standard and electronic steering wheel spinners, a transfer bench, and an indicator extender.

“It’s a pleasure for us at Vehicle Adaptions to help our friends at Laura Fergusson Assessment Services by modifying this assessment vehicle for the use of their clients,” says Margaret Hawkes, Director. “We love seeing the difference that vehicle modifications make to clients’ lives.”

“I really love the feel of the car that I can say that I love to drive,” says a client of LFBIT.

Thanks again to Vehicle Adaptations for their essential work! The impact you have cannot be understated, and we look forward to working together in the future!

Did you know that today is International Spinal Cord Injury Day? This year the theme of the day is “Access to SCI services; a life less complicated.”

In May 2020 Tony sustained C5 AIS D tetraplegia and underwent inpatient rehabilitation at the Burwood Spinal Unit. He was discharged home in November 2020 and has worked with the team from LFBIT since then.

Living with a spinal cord injury is obviously challenging, but Tony has remained fully committed to his rehabilitation journey to become as independent as he can. This year Tony worked intensively with physiotherapy support to successfully trial a C-brace to help improve his ability to stand and walk for longer periods, lower the risk of falls, and reduce the loading on his right arm.

At LFBIT, our specialist assessments and modifications for mobility and living are all designed to help our clients achieve independence and quality of life. Tony has been fully engaged in his partnership with the team from LFBIT and is appreciative of the support he has received. Awesome work Tony!

Today we would love to highlight one of our wonderful occupational therapists, Ulrike Luebcke!

At Laura Fergusson Brain Injury Trust, we help people with spinal and complex injuries, as well as brain injuries. As a member of our Assessment Team, Ulrike specialises in Wheelchair and Seating, where she assesses clients and helps figure out their needs in this space. Before working at LFBIT, Ulrike lived in Auckland working in wheelchair service, and she is very passionate about working with people to help them meet their physical needs.

Ulrike describes her role as being a kind of event manager- organising supplies, clients, technicians, research options – her day-to-day work involves a lot of coordination. Once the admin is complete, the fun part begins.

“The assessments are what I love, they’re the fun bits,” says Ulrike. “I get to know a person with their wonderful and essential goals and in the follow-up visits we might put an item in place or bring a new product, it becomes a great problem-solving exercise.”

Being hands-on is a massive part of the wheelchair and seating role. Ulrike has a great understanding of the human body, and how to work with a person’s body to help them meet their goals. Each client brings a unique challenge to the table, so her problem-solving skills are always put to the test. It is not always easy, but there is always a methodical way to approach and accept clients’ goals.

Some days, it is just the small adjustments that make the largest difference.

“The other day there was a guy who was leaning over his chair and couldn’t push himself back up. All I did was carried out an assessment, checked him out lying, understood what was going on, and we made a small adjustment to his seating and he’s sitting fine now. Small things like that have an impact not just on him but his family. And I think that’s what I found really rewarding when I went home that day.”

One thing Ulrike appreciates is the opportunity to work in a smaller, charitable organisation, where a balance is struck between being economically viable and doing truly good work.

“It is well balanced, and the priority is disability. It’s got good values to me, it’s charitable, and it is small enough that I can have lunch with the CEO and with the HR team who are approachable and accessible. That is pretty awesome and that also means that people are more responsive, I get a lot more buy-in from everybody in the team.

Thank you Ulrike for all of the work you have done with us! We are thrilled to have people like yourself in our Wheelchair and Seating team.

LFBIT are currently involved in an exciting trial of a new Virtual Reality (VR) Brain Injury Rehabilitation Tool. We sat with Peta Murphy, Assistant Research Fellow of Otago University, to discuss the project, and what it means for the future of Brain Injury Rehabilitation. A huge thanks to Peta and the team for sharing your work with us!

Can you explain the basic idea of the project?

The Virtual Reality (VR) Brain Injury Rehabilitation Tool is an exciting project that is being trialed with people recently referred to LFBIT for a rehabilitation programme following a concussion, moderate or severe traumatic brain injury (TBI). The aim of the study is to obtain clinicians’ and clients’ perception of the VR Tool, its integration into their rehabilitation programme and whether it’s engaging, relatable and effective.

The project is a collaboration between LFBIT clinicians and clients, their whānau, researchers (Otago University, Christchurch), He Waka Tapu kaimahi and VR technical specialists (Auckland University – Empathic Computing Lab, Cerebral Fix, Callaghan Innovation). The Tool aims to increase a client’s awareness of changes following their TBI, and working with their clinician, identify and safely practice strategies to manage interactions and tasks in a noisy, busy community setting (café). The treatment is occurring in the client’s home or LFBIT Clinic. We also have a client trialing the Tool with her therapists in a correctional facility.

The Tool offers clinicians the opportunity to provide clients with a safe, immersive experience that can be graded with increasing complex conversations, distractions and tasks. These experiences can be repeated as often as is needed, which is beneficial for practicing skills and strategies as the client increases their competence and confidence. The therapist accesses a summary score sheet from the VR system to support feedback and measure their client’s progress across sessions.

Preliminary findings have overall been positive from both clients and clinicians using the Tool.

For people who don’t know, what is VR?

Virtual Reality (VR) is a computer-generated environment with scenes, ‘people’ and objects that appear to be real, making the person feel that they are immersed in their surroundings. This environment is viewed through a device known as a Virtual Reality headset (like a pair of large ski goggles).

VR headsets are rapidly evolving in terms of increasingly realistic computer-generated imagery and options to measure physiological responses (e.g. eye tracking, heart rate, skin moisture), which provides valuable information to the client and their clinician as to how they are responding to everyday hazards or stressors, across different situations. The headsets are also becoming increasingly more affordable, making it more accessible to a wider group of New Zealanders living in any location. (The VR Tool can run off-line). This technology is complemented by advances in artificial intelligence that would enable the ‘people’ in the virtual setting to provide unique responses based on the questions asked by the person with a TBI.

What kinds of situations does the software simulate?

VR can simulate almost any situation. For this study, the VR Tool involves interactions with realistic characters and the completion of tasks in a busy café. The Tool simulates real world interactions and stressors (e.g. environmental noises, group conversations and visual distractions), associated with this type of setting. The client is challenged to ‘filter’ out distractions, shift and sustain their attention, process spoken and written information and recall it. They are also required to respond to questions in this challenging but realistic environment, that utilises their retrospective (past) and prospective (future) memory. The client rates their fatigue and anticipated/actual difficulty at the start and end of the game to assist with increasing awareness of cognitive fatigue and its impact on functioning in this type of situation.

How will this be applied in the future?

Clients and clinicians involved in the trial of the VR Tool will help inform how VR can be integrated into rehab programmes and future improvements for the next iteration. The next version will include physiological measures to further assist with identification of challenges experienced by the client and potentially allow for more targeted intervention. Ultimately, we would like this Tool to be available to all New Zealanders no matter where they live or their personal circumstances. We also see its potential to benefit people living with other health conditions that impacts cognition, cognitive fatigue, communication and community integration.

Client feedback on the project has been positive, and it is exciting to hear about the confidence building potential of VR.

Client Participant: “It’s [VR] been helping me (to) order my own food (I’m feeling a) bit more confident in the community with conversation. I didn’t used to order my own food and stuff like that…” “Now I say ‘Hello’ and yeah, it’s been a bit better now at the gym and…that’s always busy and loud, so I used to avoid that as well.”

His whānau member: “…The week before he come in [takeaway shop]. He told them, well, they asked him and he answered, whereas normally he’d either sit in the car or wait for me to answer.”

His Clinician: “…really cool platform to actually trial strategies in a really safe, supported and repetitive environment…. practice skills…carry over into more real-life tasks…developing awareness into limitations and the functional application…we struggled with that within one-to-one therapy sessions. Even getting out in the community, his ability to identify what challenges he experienced was quite limited. It’s been a really useful tool to help build that insight, and for him to practice things in the same situation like on multiple occasions”

Feedback from another client participant:

“It’s [VR Tool] been awesome actually…. feels like if I get asked a question that’s not on point for me… I need a little bit of time after it to recap to get things stuck in there [my brain] properly… if things carry on too quickly I am going to lose what I just had, but if it stops for a bit… even repeat it in my own head… [I learnt this] recently.. I never used to notice anything, I thought I was perfect… but I’m noticing as I go along, in bits and pieces, and not remembering… slowly pulls it out of you… it must be something do with [VR]… I’m noticing different things that aren’t the same…”

Awards:

The VR Brain Injury Rehabilitation Tool was a runner up in the 2022 New Zealand Rehabilitation Association Innovation awards and second runner up at the MedTech awards (June, 2023).

At the time of Erin’s stroke, she was a full-time Mum who enjoyed driving, seeing her favourite cover band Mammoth, and travelling to Golden Bay and the West Coast. She enjoyed both the sunniest and the wettest parts of the South Island and enjoyed being creative with craft in her spare time. Erin was a talker, Sue “couldn’t get a word in”, and Erin’s Grandad was able to have long conversations with her from the weather to “really weird topics”.

On the 6th of June, 2020, Erin had a stroke. Now, she experiences a number of challenges including weakness on the right side of her body making it more difficult to walk and do things for herself. She also has aphasia, a communication disorder that makes everyday interactions so much harder.

Erin can understand what people say but finds it difficult to put her thoughts into words and get her message across. As a result, this has changed the dynamics of many of Erin’s relationships with her friends and family. Erin works hard to connect with people particularly her son by using other forms of communication and connection such as quality time, affection and asking questions about his day.

Since her stroke, Erin has improved every day. She’s gone from barely being able to say yes and no, to saying five or six words in a sentence. She has been consistently surprising her friends and family with the way she’d just come out with a comment or joke mid-conversation.

Erin recently attended an engagement party and people couldn’t believe how far Erin had come. Erin wants her friends and family to know that she’s still her “fabulous” self and still wants to engage and laugh with people. Erin’s progress is a testament to the determination and enthusiasm she has shown throughout her journey.

When asked what she would like people to know about aphasia Erin gave the following tips:

1. I am still me

2. I can understand what you say

3. I need time to get my words out

4. Keep it simple

5. Use gestures to help me communicate

During the 1973-74 year, the Rotary. Club of Christchurch set up a meeting to discuss the formation of a Canterbury branch of the Laura Fergusson Brain Injury Trust. Rotarian Colin Averill had heard arguments for the urgent need for a residential home for disabled young adults. After further discussions with the Laura Fergusson Trust in Auckland, the Rotary Club of Christchurch hosted a meeting with other like-minded organisations. A key attendee was Dr Julian Kirk, Director of Physical Medicine at Christchurch Hospital who strongly supported the initiative.

With the project underway, the next job was to find a site and the North Canterbury Hospital Board whose Chairman, Leslie Averill, had endorsed the project and with the approval of the Department of Health, made the land opposite Jellie Park available for the new facility. This got the project off to a great start as fundraising was not required for land purchase.

The next step was the building itself. Christchurch Rotarian Maurice Moffat, an architect with Griffiths, Moffat & Partners, prepared sketch plans and working drawings for the proposed building. Leslie Averill was elected president of the fundraising committee and following the Auckland model, a Ladies Auxiliary was formed with Mayoress Alexia Pickering elected chairperson.

Once the fundraising project was launched, Rotary’s direct involvement ceased. The new building was opened free of debt in March 1979, the successful result of a team effort involving the Rotary Club of Christchurch, the LFT and the Ladies Auxiliary.

The Rotary Club of Christchurch has continued to support the Laura Fergusson Brain Injury Trust over the years, most recently with an Impact Grant in 2022. We are so grateful for their contributions, and we are thrilled to have them join us for the trail!

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