Client story: Using Vivid to support therapy goals

Fraser* is a middle-aged man who sustained an extremely severe brain injury. He lives in a group home with 24-hour attendant care, and works three days a week, 4.5 hours a day, in a supported workplace. Fraser also has the support of occupational therapy, speech pathology, clinical psychology and social work. Recently, we’ve been working with Fraser to plan and execute his first trip to see the Vivid lights. We’ve been able to incorporate a broad range of Fraser’s therapy goals into the planning and preparation of this outing.

First steps

Not every client will be suited to a community outing such as Vivid. When we started talking about supporting Fraser to go to Vivid, one of the first things we did as a team was to identify any potential risks and establish a few mitigations to ensure the excursion was possible and, more importantly, fun for everyone. For Fraser, this meant:

1. Ensuring his community access skills were up to the task
   Fraser, his occupational therapist and support workers have completed community access assessment and training. Fraser’s needs when accessing the community and public transport were identified and strategies were put in place to use during the outing. For instance, we’re aware that Fraser doesn’t always cross the road safely. However, we also know that when he is focused, he crosses the road safely. On the visit to Vivid, our team knows that for Fraser to stay safe around roads, he will need regular reminders to stay focused.
2. Assessing behavioural risks
   Fraser’s behavioural risks were identified by his clinical psychologist and extensive training was provided. Fraser used to abscond from his group home. However, now that he is working and organising outings of his choice regularly, the absconding behaviour has stopped. Because Fraser’s behaviours are manageable and considered low-risk thanks to prior assessment and training, we’re not too worried about taking Fraser into a crowded place like Vivid.
3. Finding ways to deal with fatigue
   Whilst Fraser does get tired, he is able to manage the occasional long day. To minimise the impact of fatigue, Fraser decided to Vivid when he has no formal commitments the following day, so he can sleep-in the day after.

Incorporating Fraser’s therapy goals into the preparation

We’ve focused the preparation phase of Fraser’s Vivid excursion around the following therapy goals:

Community access: (Occupational Therapist)

Fraser has extensive pre-injury history of using public transport to get all over Sydney. In preparation for the Vivid outing, Fraser has been working on travelling on public transport safely and navigating safe road crossings.

Budgeting: (Occupational Therapist and Support Worker)

Fraser has financial guardianship through the trustee. All of his essentials such as food, accommodation and transport costs are paid directly to ensure his basic needs are met. Fraser has control of his discretionary money, about $80 a week. He frequently spends this on scarves, hats and hamburgers. We’ve been talking with Fraser about whether he might want to take some money with him to Vivid and what he needs to do with his weekly budget before the excursion to make sure he has some cash available.

Meal preparation (Support Worker)

Fraser makes his lunch to take to work. He also makes dinner for all the residents of the group home one night each week. Fraser has been thinking about whether he wants to take a packed dinner to Vivid and what that might be.

Making quality internet searches (Speech Pathologist)

Fraser loves to look things up online, but due to language impairments, his search terms don’t always make sense and the results don’t always answer his initial query. Fraser doesn’t usually notice this, clicking his way down a digital rabbit hole. He needs assistance to ensure he stays focused and finds the information he was searching for. He also needs assistance to check the source of internet results to pick the best one. With his speech pathologist, Fraser has been working on internet searching to plan his Vivid outing and decide what he wants to see.

Decisions and plans

One of the most important aspects of Fraser’s Vivid excursion has been involving him in the decision-making around what to actually visit. Fraser, his support worker and his speech pathologist recently looked up VIVID online. We used the following scaffold to guide our internet searches:

1. Does my search term make sense?
2. Did my search results answer my question?
3. Which is the best search result?
   1. Do I trust the source?

Once on the official VIVID site, we looked for locations. We discussed the free locations around Sydney Harbour and used a white board to write them down and keep track. We looked at Google Maps to see where the locations were and then drew a mud-map of the locations to help visualise them. We then chose some locations which might be possible to visit in a single night. The speech pathologist suggested three locations but Fraser was pretty sure four locations was even better and could be achieved. By the end of the session, we had nutted out exactly where Fraser was going to go and how he would get there! The outing was really taking shape!

Final preparation

One of Fraser’s favourite support workers has signed up to attend Vivid with him next week. To ensure it goes as smoothly as possible, the pair has already worked out what’s going to happen on the night:

• They’re planning to take the train to get to Circular Quay by 6pm.
• They’ve decided to pack a sandwich and a water bottle for dinner.
• Fraser is taking $20 spending money, just in case anything catches his eye…maybe a light-up walking cane.

At Rehab Connection, we all have fingers crossed for a clear, dry night next week for Fraser’s excursion.

Tune into the next e-newsletter to hear how Fraser’s excursion went and what other therapy goals we’ve been able to work on with Fraser since the outing.

*Name has been changed