Enabling Good Lives
Enabling Good Lives (EGL) is an exciting new approach to supporting people with disabilities. Currently it is only available to school leavers who have received ongoing resources (ORS) funding while at school. It has been trialled for almost 10 years, starting in Christchurch, Waikato and now in the Manawatu.
EGL is a new approach to supporting disabled people that offers greater choices and control over the supports they receive, so that they can plan for the lives they want.
Enabling Good Lives Principles from Website
Achieving our future vision for disability supports is complex and will take time. There will be many details to work through. A principles-based approach will ensure we stay on track to progress the vision. We will use the principles in the Enabling Good Lives report to help guide decisions on the changes.
The principles are:
Disabled people are in control of their lives.
Invest early in families and whānau to support them; to be aspirational for their disabled child, build community and natural supports; and to support disabled children to be come independent rather than waiting for a crisis before support is available.
Disabled people are supported to live an everyday life in everyday places; and are regarding as citizens with opportunities for learning, employment, having a home and family, and social participation – like others at similar stages of life.
Disabled people are supported to access mainstream services before specialist disability services.
The abilities and contributions of disabled people and their families are recognised and respected.
Easy to use
Disabled people have supports that are simple to use and flexible.
Supports, builds and strengthens relationships between disabled people, their whānau and community.
For more information on Enabling Good Lives visit: https://www.enablinggoodlives.co.nz
True independent community living requires skills, adaptations and support. Therapy Professionals Ltd’s therapists can help people gain skills and adapt their environments so they can be as independent as possible.
Therapy Professionals Ltd’s therapists are available to help improve independence, health and wellbeing.
Just contact us: Phone: 03 377 5280. Email: email@example.com
Fatigue - An overview
What is Fatigue?
Fatigue is an overwhelming sense of physical or mental tiredness that may affect any or all areas of functioning: physical, cognitive, and social. For people who have had a brain injury, fatigue is a very common and persistent problem.
‘Mental’ versus ‘physical’ fatigue
Physical fatigue refers to the fatigue that results from any kind of physical labour such as exercising, mowing the lawn, and playing outside with the children. Just after a brain injury, physical fatigue may be a problem. For example, it requires a lot of energy to relearn how to walk. For most people, physical fatigue tends to subside after about six months following the injury.
Mental fatigue refers to the fatigue that results from ‘brain work’, such as working on the computer, writing a letter, reading the newspaper, conversing, studying, planning and problem solving, and driving. Although mental fatigue also decreases over time, it tends to be a very persistent problem that needs to be managed carefully. For most people it does not go away completely.
Why is mental fatigue a common symptom of brain injury?
It is not known exactly why fatigue is such a common problem for people who have had a brain injury. However, it is thought that fatigue results because the brain has to work a lot harder than it did prior to the injury. Some of the brain cells are damaged, and do not work as efficiently as they should – information does not flow as easily around the brain.
The brain has to work harder to cope with this, resulting in fatigue. Also, the brain takes longer to restore its energy, meaning that it takes longer to recover from fatigue than it did prior to the injury.
Fatigue may also be a side effect of some medication.
Mental fatigue can affect the success of all rehabilitation efforts. Fatigue decreases concentration, memory, and social interactions. It increases irritability, distractibility, depression, and anxiety. Fatigue can cause confusion and decrease the ability to make good decisions. It may also increase physical symptoms such as headaches and dizziness. It is therefore very important to manage fatigue.
What can be done about it?
It is a good idea to slowly build up active hours, gradually increasing stamina. The number of home and social activities undertaken may also need to be reduced.
There are a number of basic strategies that can be used to manage fatigue:
‘Rest’ can be simply lying down, or sitting quietly. It does not have to be a ‘sleep’.
Fatigue is a common and persistent problem following a brain injury, which may require some lifestyle changes. However, effective fatigue management can be achieved. Much of this revolves around weekly scheduling of activities, rest periods, and appointments.
If you need help relaxing, with physical exercise or diet, our friendly therapists can help, just contact Therapy Professionals Ltd
Ph: 03 377 5280 Email: firstname.lastname@example.org
Laura Fergusson insight rehab
Your Parents need Residential Care
Therapy Professionals has work in Aged Care since 1985 and we have seen the industry grow and develop from almost a cottage industry to the corporate dominated industry it is today. We have personally experienced and watched others struggle to navigate their way through the whole process of entry into residential care.
We know how hard it can be for you and your parents to accept it’s time for residential care (rest home, hospital, dementia and special care hospitals). Once this decision has been made knowing how to access care is not always straight forward.
This information from the Ministry of Health can be very helpful when negotiating your way through the process.
This link will take you to the following questions and answers on the MOH website.
What is residential care?
Is there a list of residential care providers?
Who is responsible for funding residential care services for older people?
What are the criteria for entry into residential care?
How does a person apply for residential care?
How does a person apply for a residential-care subsidy?
What happens if the circumstances of the person in long-term residential care change?
While the person is in care, what individual services/items do they have to pay for that are not covered by Government funding (the residential care subsidy)?
What is a License to Occupy?
If a person is admitted to hospital whilst in a residential care facility, do they have to continue paying for their bed at the facility?
How does a resident make a complaint?
Once you have the residential subsidy or have freed up the funds to enter residential care, you then have to choose which facility will suit your parent/s and you. Working this out will be limited by the availability of beds. At the time residential care is needed your preferred option may not be available.
When looking at the options you need to have some way of comparing them. Consumer did a Rest Homes Checklist a number of years ago witch we have added a few items to. You may find this helpful.
If you have an elderly family member struggling at home or in care and you want additional rehabilitation, just contact us at
Phone: 03 377 5280 Email: email@example.com
Dyspraxia - what is it?
Dyspraxia is a brain-based motor disorder. It affects fine and gross motor skills, motor planning, and coordination. It’s not related to intelligence, but it can sometimes affect cognitive skills.
Dyspraxia is sometimes used interchangeably with developmental coordination disorder. While some doctors may consider these separate conditions, due to a lack of formal definition, others consider them the same.
Children born with dyspraxia may be late to reach developmental milestones. They also have trouble with balance and coordination.
Into adolescence and adulthood, symptoms of dyspraxia can lead to learning difficulties and low self-esteem.
Dyspraxia is a lifelong condition. There’s currently no cure, but there are therapies that can help you effectively manage the disorder.
Dyspraxia symptoms in children
If your baby has dyspraxia, you might notice delayed milestones such as lifting the head, rolling over, and sitting up, though children with this condition may eventually reach early milestones on time.
Other signs and symptoms can include:
As your child grows, you might also observe delays in:
Dyspraxia makes it hard to organise physical movements. For example, a child might want to walk across the living room carrying their schoolbooks, but they can’t manage to do it without tripping, bumping into something, or dropping the books.
Other signs and symptoms may include:
Although intelligence isn’t affected, dyspraxia can make it harder to learn and socialise due to:
Dyspraxia is different for everyone. There are a variety of potential symptoms and they can change over time. These may include:
· abnormal posture
· balance and movement issues, or gait abnormalities
· poor hand-eye coordination
· trouble learning new skills
· organisation and planning problems
· difficulty writing or using a keyboard
· having a hard time with grooming and household chores
· social awkwardness or lack of confidence
Dyspraxia has nothing to do with intelligence. If you have dyspraxia, you may be stronger in areas such as creativity, motivation, and determination. Each person’s symptoms are different.
If you have a child with dyspraxia and you want help, our friendly therapists can help, just contact us on:
Phone: 03 377 5280 Email: firstname.lastname@example.org
What is a Stroke?
What you need to know
(a great resource from the Stroke Foundation https://www.stroke.org.nz/what-stroke)
A stroke is a brain attack. It is very serious, but many people go on to recover and live healthy lives. A stroke happens when a blockage such as a clot blocks the blood flow to the brain, or when a burst blood vessel bleeds into the brain.
Over 11,000 strokes are experienced each year – that’s one every 45 minutes.
Stroke is New Zealand's second single biggest killer and the leading cause of serious adult disability. But many New Zealanders who have a stroke recover and lead successful, happy lives.
A stroke is a brain attack
A stroke is a sudden interruption of blood flow to part of the brain causing it to stop working and eventually damaging brain cells.
During a stroke, the cells in the affected part of the brain start to die and that part of the brain cannot work properly. This can affect a person’s ability to walk, talk, eat, see, read, socialise or do things they were able to do before the stroke.
Many people with stroke may also have fatigue or problems with remembering, understanding or thinking properly.
This short video is an excellent explanation of what a stroke is (courtesy of HealthSketch).
Types of stroke
This is the most common type of stroke, particularly in older people. An ischaemic stroke occurs when a clot blocks an artery in the brain. The clot usually forms in a small blood vessel inside the brain that has become narrowed through high blood pressure, high cholesterol, diabetes or smoking.
This occurs when a blood clot or piece of plaque (cholesterol or calcium deposits) on the wall of an artery breaks loose and travels to the brain. When this happens, the flow of oxygen-rich blood to the brain is blocked and tissue is damaged or dies.
This occurs when an artery in the brain ruptures (bursts) and leaks blood into the brain (cerebral haemorrhage). This break in the blood pipeline means parts of the brain are deprived of blood and a stroke occurs. Blood irritates brain tissue, causing swelling and pressure, which cause further damage and loss of function. Subarachnoid haemorrhage (SAH) is when blood leaks into the surface of the brain. Intracranial haemorrhage (ICH) is when there is bleeding into the brain tissue itself.
The impact of Stroke
Different parts of the brain control a person’s movements, senses, emotions and intellectual functions. The effects of stroke depend on which part of the brain is damaged and how severe the damage is.
Disabilities from stroke range from slight to severe. Some people make a speedy recovery and return to their normal lives. Others have disabilities that may improve with time and can be managed. For many, disabilities may last a lifetime. A small number of people will need full time medical care.
Who does stroke affect?
Stroke can affect people at any age. Although strokes often happen to older people, 25–30% of strokes are experienced by people under the age of 65 years.
Stroke is largely preventable, yet each year about 11,000 strokes are experienced in this country. This number could be reduced by three quarters if all the recommended actions to reduce stroke risks were taken in the community.
There is a list of facts and FAQs about stroke and treatment
The Stroke Foundation’s Life After Stroke section also takes you through treatment, rehabilitation, and what to expect after a stroke - we strongly recommend this free resource.
If you have a relative who has had a stroke and you want additional rehabilitation or some support to improve life for you and them, our friendly therapists can help. Contact
Email: email@example.com Phone: 03 377 5280
1 NZIER research report 2020:
2 Ministry of Health (2018). Mortality and Demographic Data 2015, retrieved 14th August, 2018, from https://www.health.govt.nz/publication/mortality-2015-data-tables.
3 NZIER research report 2020:
How to Stay Fit and Active as You Grow Older
Fitness is not just for the young
- walking on uneven surfaces?
- climbing up stairs?
- getting out of a chair
Why Strength and Balance Matters
There are many reasons why we can lose strength and balance - the most common is lack of use.
As we get older we are less vigorous, less adventurous and less active, so we don’t challenge our sense of balance as we did when we were young.
We need to avoid the disuse cycle
Your sense of balance can be influenced by:
Be sure you stay on your feet. Remember if we don’t use it – we lose it
As you grow older you need:
Consider seriously increasing your level of fitness or activity even if your strength and balance and general fitness is still good.
Find an exercise class that suits you, something that:
If you join an exercise class and:
Other recreational or sporting activities you may enjoy:
Visit ‘Active Canterbury’ and ‘Sport Canterbury’ websites for a list of activities in your area.
Some general tips on exercise:
Physical activity is the best medicine for our bodies so keep it up as you age and enjoy it.
If you need some advice about what exercise is best for you our friendly physiotherapist can help, just contact us on:
Phone: 03 377 5280 Email: firstname.lastname@example.org
How fit am I?
As we grow older our strength, balance and general fitness is in danger of declining so much so that we put ourselves at risk of falls, something we all wish to avoid.
If you want to know how fit you are and to test your balance here a few tests you can do yourself.
Walking distance – are you able to comfortably walk:
Not being able to walk round the block from your home is one indicator for increased risk of falling.
Get up and go test – start by sitting down on a dining type chair. Record how long it takes you to:
rise to standing
walk three metres (10 feet)
Try it again in a month’s time. A change of result by more than four seconds can indicate a change in the level of mobility.
six seconds slower - weaker/less confident mobility
six seconds faster - stronger/more confident mobility which is what you want
This test has four levels of increasing difficulty and should be done without assistance. We advise you have someone with you while you do the test.
Scoring - Note down how long you hold each position
Level 1 Feet together stand / 10 seconds
Level 2 Semi-tandem stand / 10 seconds
Level 3 Tandem stand / 10 seconds
Level 4 One leg stand / 10 seconds
Total / 40 seconds
Score of: under 20 seconds very poor balance
20 – 30 seconds poor balance
30 – 35 seconds moderately good balance
35 - 40 seconds good balance
Leg strength test
Level 1 stand up with arms crossed if possible
or use a hand to push up
or use two hands to push up
Level 2 stand up taking 5 seconds from when your bottom is off the seat
Level 3 sit down taking 10 seconds until your bottom touches the seat
Level 4 sit down, stopping half way down, hold 5 seconds, then continue to sit
Level 5 sit down stopping about 5 cm from the seat, hold 5 seconds, then continue to sit
Stand and sit arms crossed 5 points / 5
one hand to push up 3 points / 5
two hands to push up 1 point / 5
Stand taking 5 seconds (score number of seconds held) / 5
Sit taking 5 seconds (score number of seconds held) / 5
Sit and stop half way down – hold 5 seconds
(score number of seconds held) / 5
Sit and Stop when about 10 cms from the seat – hold 5 seconds / 5
Then continue to sit (score number of seconds held)
Total / 25
Score of: under 10 seconds very poor leg strength
15 seconds poor leg strength
20 seconds moderate leg strength
25 seconds good leg strengths
40 seconds good balance
If you scored poorly on any of these tests, it’s time to take action!!
See our How to Stay Fit and Active as You Grown Older information page.
Our friendly physiotherapist can help just contact Therapy Professionals Ltd on
Phone: 03 377 5280 Email: email@example.com
Financial support for those caring for
a disabled person
(from Ministry of Health Website)
If you have an elderly family member or disabled child you care for at home and you need some time off the Ministry of Health can help fund some support (Carer support) for you.
You may be able to use this support to fund some allied health services. Talk with your local DHB Needs Assessment and Service Coordination (NASC) services or Ministry of Health NASC Lifelinks in Christchurch.
Carer support provides reimbursement of some of the costs of using a support person to care and support a disabled person. This means their carer can take some time out for themselves.
What Carer Support is
Carer support is a subsidy that helps you take some time out for yourself. It provides reimbursement of some of the costs of care and support for a disabled person while you have a break.
Who can get Carer Support
Carer support is available for full time carers - a full time carer is the person who provides more than four hours per day unpaid care to a disabled person, for example, the parent of a disabled child.
The number of hours or days that Carer Support is funded for depends on your needs and those of the person you are care for.
Who funds Carer Support
Carer support for people with age-related support needs, mental health and long-term medical conditions is funded by district health boards.
Carer Support for people with disabilities is funded by the Ministry of Health.
Getting Carer Support
You can be assessed by a Needs Assessment Service Coordination (NASC) organisation, or, undertake a review with you, usually after a year.
You can find out more about claiming at Carer Support Claims or by talking to your local NASC.
Carer Support payments may be subject to income tax. This will depend on your individual circumstances. You may wish to seek advice regarding tax issues from the Inland Revenue Department or, if you receive a benefit, from Work and Income New Zealand.
Carer Support – funded by the Ministry of Health
The following information applies if you receive Carer Support from the Ministry of Health. Carer Support from DHB’s is not affected.
You must work within your current funding allocation.
You can continue to spend your Carer Support on any disability support/service/item that:
You cannot use your Carer Support for the following:
What people can buy with Disability Funding: Ministry of Health Purchasing Guidelines
Published online 17 April 2018
This document describes what government disability support funding (funding) can be used to buy. It is for people using:
Disabled people who can make choices about how they use their funding are more likely to buy goods and services that make their lives easier and/or better. This purchasing policy aims to give disabled people as much flexibility as possible over what they can buy with government funding.
A disability support (support) is a good or a service that helps a person overcome barriers that come with having an impairment within a disabling society.
There are four criteria that must be met to be able to use funding to help buy a disability support.
1. It helps people live their life or make their life better
The support should help people live a good life.
Each person has a different idea about what a good life is. The person’s goals and aspirations
for a good life should be written out in a personal plan. This can be done with help from their
Needs Assessment and Service Coordination (NASC) organisation or Independent Facilitator.
Personal plans should include goals such as:
2. It is a disability support
3. It is reasonable and cost-effective
Generally, the support should be ‘reasonable’. Here it means that the support should cost about
the same as (or less than) the market price for comparable things.
‘Cost-effective’ here means the best available outcome for the money spent.
It might cost more than another type of support but will help the person more, it will last longer
or mean that less is spent on some other support now or in the future.
4. It is not subject to a limit or exclusion
A person should explore other funding options to help get a support. Examples of other options
In some cases, people can buy a support when funding for that support has been turned down by
(or on behalf of) the responsible government agency or if waiting times are too long and the
proposed support is expected to:
The funding cannot be used for:
For more help in understanding this policy, people can talk to their NASC organisation or their provider to work out if a support they want to buy meetings the criteria.
See Ministry of Health Purchasing Guidelines Processes
Ministry of Health Purchasing Guidelines notes
A Guide for Carers - He Aratohu mā ngā Kaitiaki
Has a good summary of financial support available to carers
See Ministry of Health Carer Support
What is Dementia?
(By Dementia NZ 2017)
Dementia is a progressive disorder where there is a decline in a variety of mental functions. The declining functions are primarily cognitive, that is, the person has a change in thinking abilities. The word dementia is a term which covers a group of disorders of cognition. Different types of dementia have different underlying disease processes and usually present with a different pattern of cognitive symptoms. However, all forms of dementia are associated with a decline in the ability to function day to day, emotional distress or behaviour changes. This will discuss:
Types of Dementia
This is the most common form of dementia. It usually begins with a decline in memory and the ability to learn new things. Later, in the course of a steady, gradual deterioration, there are problems in other areas (for example speech, planning or reasoning, recognising objects, changes in emotions and behaviour). The cause of Alzheimers Disease is unknown though old age and certain genes appear to make people more prone to it. In the brain, there are microscopic changes, “plaques” of a substance known as amyloid and “tangles” within dying nerve cells.
This occurs when there is insufficient blood supply to the brain. The symptoms are variable depending on which part of the brain is affected, though changes in the ability to pay attention, slowing of thought and frontal-lobe changes (see below) are common. The progression may be steady if the blood supply is gradually reduced by the narrowing of small arteries. Alternatively sudden or, “stepwise” progression occurs if the blood supply suddenly closes off to an area of the brain, often because a blood clot has formed or been carried from another location. The diagnosis is made from the history and evidence of blood vessel damage e.g. previous stroke seen on a brain scan or heart attack.
It is quite common especially in the very elderly to have “mixed dementia”, that is, both Alzheimers and vascular changes.
Lewy Body Dementia (LBD):
This condition is the third commonest cause of dementia, perhaps 20% of dementia cases. LBD is on a spectrum that includes Parkinson’s disease and the dementia associated with that condition. People with LBD have symptoms similar to those of Parkinson’s disease, such as stiffness, shaking and changes in gait. Cognitive changes include poor attention, changing levels of alertness and visual hallucinations (that is, seeing things that are not there).
Sometimes those with LBD fall, faint or thrash about in their sleep as if acting out their dreams. Memory is typically not too impaired early on, but as the condition progresses all aspects of thinking are more widely affected. It is important to make the diagnosis to distinguish it from delirium, a potentially treatable medical condition, and to ensure the person is not given antipsychotic medication which can have severe side-effects in LBD. In this condition we see large spherical protein deposits in the brain – these are Lewy Bodies. The cause is unknown.
In this group of conditions the frontal and /or temporal lobes of the brain are affected. Memory loss and learning problems are less obvious early on and the main symptoms are changes in behaviour and / or personality and / or language. The sorts of behavioural changes seen are: disinhibition (e.g. unrestrained or antisocial speech or behaviour), apathy (not initiating or doing anything), loss of empathy (understanding of others thoughts or feelings) repeated behaviours or rituals, changes in eating and loss of ability to plan or make judgements. Language changes include slow or hesitant speech, word-finding, naming, grammar and word comprehension. Frontotemporal dementia is a common cause of early onset dementia (beginning before the age of 65) and about 40% of people with frontotemporal dementia have a family history, suggesting there is a genetic cause.
Who gets dementia?
The likelihood of getting dementia increases as a person ages. This doesn’t however, mean that younger people – people aged less than 65 – don’t also get dementia. Some people may be predisposed to dementia by pre-existing intellectual disability, head injury or family history.
Dementia is very common and as our population ages it is likely that everyone will have contact with someone with dementia. So the answer to “who gets dementia?” is really, “Anyone, though it is much more likely in older people”.
How do you recognise dementia and get assistance?
The important thing to note is that a person developing dementia has a change in how they function. For example, if someone has always had trouble reading maps or finding their way around and still can’t do this, there is no cause for alarm. On the other hand, if someone normally good at navigating, starts getting lost, you might worry. Sometimes the change is subtle: the usually reliable person is not paying the bills or the meticulous dresser goes out with stains on her clothing.
This might not mean dementia. Other conditions like depression or physical illness can cause these changes, hence it is important to get to the doctor and / or encourage someone with alterations in their thinking ability, behaviour or emotions to attend the GP. In New Zealand the GP has access to a “cognitive impairment pathway” which is a series of steps and tests to go through to rule out other problems and decide whether this is dementia. Sometimes it is hard to tell and the person might be referred to a specialist (usually based in a hospital) or a memory clinic.
While there are no cures, yet, for any of the common forms of dementia, there is a lot that can be done to help and possibly slow the progression of symptoms. There is evidence that if people get an early diagnosis and thus know what is happening, they and their family / whanau cope better in the long term. Knowing what to expect also allows people to plan for the future.
If you require some help managing a family member with dementia our friendly therpaists ca help. Just contact:
Therapy Professionals Ltd
Phone: 03 377 5280
Understanding Autism – Autism NZ
Autism is a neurodevelopmental condition that affects cognitive, sensory, and social processing, changing the way people see the world and interact with others.
Autism is currently estimated to be present in 1 in 54 people. It is not a mental illness, but a neurological difference - one of many variations of neurodiversity.
Every autistic person is unique, with a wide range of skills, qualities, interests, and personality styles. As the saying goes, "if you have met one person with autism, you have met one person with autism." The level of support required is also highly individual. This heterogeneity is due to the fact that autism is not a single condition but a cluster of underlying neurological differences that are present in varying combinations in each person. The behaviour and needs related to these differences share common themes but manifest in different ways for each individual.
Autism is considered an invisible disability since challenges and difficulties are often not immediately apparent. There are no visible physical markers. The cognitive differences associated with autism may also contribute to specific skills such as superior visual memory, attention to detail, and pattern recognition.
Traits and characteristics
An autistic person may experience challenges with social communication and interaction, have intense interests and a strong need for routines and predictability, and be hyper or hyporeactive to sensory input.
No two autistic people are alike, but can often experience difficulty with social skills and executive functions, and have sensory needs that are different from those of the neurotypical population.
Within these areas of challenge, autism will be expressed in different ways for each person, e.g. difficulty making small talk or having a balanced conversation, sensitivity to certain sounds or textures, and the need to stick to a daily routine. The traits experienced may change during the lifetime of a person as coping mechanisms or compensation strategies are learned and appropriate support is provided. However, this does not mean that the person has grown out of their autism. It would be more accurate to say that they have 'grown into' their autism, a process that is never finished and requires a phenomenal amount of energy to maintain.
Many of the challenges autistic people face are not self-perceived as 'symptoms' of their autism but as difficulties created by their environment: a society that largely refuses to make accommodations for people with cognitive/invisible disabilities
Reference Autism NZ