When the sun is shining, there really is no better time to get outside and enjoy all that the season has to offer. Maybe try a sport or hobby you have only dreamed about. With so many opportunities for adaptive athletics across North America that are focused on the outdoors, there has never been a more exciting time to join a team or find a community group to inspire the adventurer in you!

At the Neilsen Foundation, our Creating Opportunity & Independence (CO&I) portfolio works with nonprofit organizations that run exceptional programs geared towards providing people with spinal cord injury (SCI) access to outdoor activities. When summer calls, most people love the idea of getting outside—maybe establishing a fitness goal or meeting new friends. Sports and recreation projects have always been a big part of CO&I, and this year more than a quarter of all the applications received come from organizations that provide opportunities to connect with the great outdoors.

If you are looking for fun this summer, from the East Coast to the West Coast, there are programs to fit every personality and skill level.

In upstate New York, Sunnyview Rehabilitation Hospital’s Adapted for Action program offers hiking and golf, and South Carolina Spinal Cord Injury Association provides yoga and wellness sessions. There’s ziplining, swimming, and track and field for the whole family at Georgia’s BlazeSports, and workouts with the United States Rugby Association in Alabama.

Team sports like softball and football are up for grabs at Midwest Adaptive Sports in Missouri, and, in Colorado, Breckenridge Outdoor Education Center offers camping, rafting, and the experience of life among the trees with one of the only fully wheelchair-accessible high ropes courses in the world. Individuals with SCI can enjoy life on the water with the first adaptive sailing program in Canada—The Disabled Sailing Association of British Columbia, and, if you have a passion for the sea, there’s Shared Adventures’ upcoming annual A Day at the Beach event in Santa Cruz, California.

Engaging within your community in an active way is so much more than just trying something new; it can also help reduce anxiety and boost wellness. Breckenridge’s Development Director Hallie Jaeger insists access to outdoor recreation and “finding a sense of community in nature” can lead to improved wellbeing. “The sense of joy, connectedness, awe, and self-accomplishment…is very difficult to put into words,” she explains. The Neilsen Foundation is proud to celebrate our grantee partners’ commitment to motivating people and prioritizing their wellbeing.

We acknowledge it might be tough for individuals recovering from a traumatic injury to think of a return to activities that now feel out of reach. We applaud the courage it takes to push your comfort zone, and the efforts of program leaders, peer mentors, and volunteers, who provide the encouragement that makes participation so much fun! So, go outside and enjoy the day!

The indignities faced after spinal cord injury (SCI) range from loss of independence and privacy to the perpetual fear of “having an accident.” The inability to control one’s own bowel and bladder impacts every aspect of daily life. Consistently one of the top priorities identified by people with SCI, managing bowel and bladder needs continues to be an unmet challenge that has not been well represented in funding research grants.

Because of this mismatch, we wanted to attract more focus to the issue. In March 2017, the Neilsen Foundation convened a three-day workshop with the goal of identifying key issues surrounding bowel and bladder dysfunction and developing strategies for boosting research efforts. We stepped in to provide some leadership, asking researchers and physicians, as well as people with SCI to identify the most urgent issues and imagine what could be done within 10 years.

Since then, we approved approximately $4.5 million in grants for nine research studies. And, working with our partners at Paralyzed Veterans of America, an updated Clinical Practice Guidelines (CPGs) for Management of Bowel Dysfunction was published in 2020, and a CPG update for bladder management is expected to be completed in 2024. Funding for research focused on bowel and bladder care by federal agencies has also expanded in the last few years.

The hope is that researchers with new ideas and crosstalk between experts from different fields will lead to exciting advances as more resources and funding opportunities become available. “It’s rewarding to know that our efforts motivated the development of these important studies,” Neilsen Foundation Program Officer Tracey Wheeler explains. “Researchers had noted many challenges in progressing their ideas, due to lack of funding and other roadblocks, and the Foundation prioritized this research, ensuring treatments for SCI bowel and bladder dysfunction would advance.”

Some of the new research is aimed at increasing our knowledge of how bowel dysfunction develops following SCI. New treatments being studied include drug and dietary therapies to prevent, manage, and reverse the dysfunction. Electrical stimulation designed to improve both bowel and bladder care has also become a major topic of research to help people with chronic injuries. The goal these efforts share is to identify successful new treatment options that will reduce the indignities of bowel and bladder management experienced by people with SCI.

Everyone deserves peace of mind, and improving the quality of life for people living with SCI is our goal. The development of and access to readily available, less-intrusive options must be a priority. We have seen growth in the numbers of researchers focusing their talents here, and we are hopeful their advances will become tomorrow’s treatment. We are excited to see where the next, best idea is coming from.

Spinal cord injuries are often the result of a traumatic, sudden event that no one can prepare for. One person is injured and, overnight, a whole family is changed. In what feels like the blink of an eye, family members take on new and wholly unfamiliar roles as caregivers. For most, being there for a loved one is not even a discussion point—it’s a given. However, the shift from partner, sibling, child, parent, or friend to full-time caregiver changes relationship dynamics. There’s a whole new way of life for an individual with a spinal cord injury (SCI) to get used to—and they can’t do it alone.

That support is so important. In the months following a traumatic injury, care can be needed 24/7. People who take on this critical role for newly dependent loved ones face a steep learning curve, and finding time to give the needed personal and medical care can force a rethink about careers to provide around-the-clock assistance.

The focus is on the person learning to live with SCI, which means the needs of caregivers can be neglected. Too often, the stress, frustrations, and concerns are hidden for fear of impacting others. But, not asking for and receiving the help one may need means the caregiver’s mental and physical wellbeing come second. That leads to a situation that is not healthy for anyone.

For the last 10 years, the Neilsen Foundation’s Psychosocial Research portfolio has funded research that focuses on caregivers and selfcare. The researchers start by asking caregivers about their needs and use that information to design skills-training programs and online educational resources. Emotional support for caregivers and cognitive therapy strategies are also being developed. Some researchers focus on parental caregivers and others on transitions across acute, rehabilitation, and community settings, helping families learn to advocate for the assistance they require. The much-needed acknowledgment that help is well-deserved and available goes a long way in supporting a caregiver’s mental health.

Dr. Susan Charlifue from Craig Hospital in Denver, Colorado, has dedicated much of her career to researching care for family caregivers. She insists providers must look after themselves as well as their loved one with SCI. “These people have a lot of issues, and they neglect themselves far too much, and by neglecting themselves they’re not really helping their loved ones,” she says. “It’s important to acknowledge the work they have to do, and they have to acknowledge it’s fine to cry, it’s fine to say no, and it’s OK to ask for help.” She notes that for some caregivers, a simple “thank you” is reward enough.

Help can also be found online via resources listed at the Christopher & Dana Reeve Foundation and FacingDisability, and in peer groups, such as United Spinal’s Wives and Girlfriends of Spinal Cord Injuries. But some families find solutions by hiring paid caregivers.

COVID compounded the issue, making it incredibly scary to bring people and supplies into homes. This left many families and “friend bubbles” fending for themselves, yet still needing support. If you were able to hire assistance, qualified professional home healthcare workers became scarce.

To solve this problem, Neilsen Foundation grantee partner Rochester Spinal Association recently created a Service Coordinator position to help individuals with SCI find the care they need.

“There’s not enough people to help,” Executive Director Chris Hilderbrant states. “There are programs that pay for personal care, but they don’t pay very well. We need society to respect personal care as a career and pay the folks better, giving them better benefits… They’re not just homecare workers. We need to make these careers a lot more desirable.”

The Foundation understands that everyone across the caregiving spectrum needs support, and funds those seeking to identify the best ways to help. We would like to follow the lead of our partners and applaud the work of those who provide the care.

Everyone needs to be heard. Validation can be empowering. Encouragement can come from the smallest success to the biggest victory. Individuals with a disability often have to shout louder to be heard, but those with lived experience must break through the noise. We must support those voices because they make an important difference and should be a key part of the conversation.

The Craig H. Neilsen Visionary Prize was launched in 2020 to honor our Founder and celebrate influential voices in the world of spinal cord injury (SCI). Because it carries an unrestricted $1 million award, we knew it would be impactful for the recipients, and it appears the acknowledgement means almost as much as the financial support.

Kim Anderson-Erisman, PhD, (pictured) was one of three people awarded the Visionary Prize in 2021. Honored for her scientific works as well as her advocacy, she admits that receiving the prize gave her a fresh way of looking at herself, and a renewed drive to approach what was in front of her. For Kim, the world of SCI is education, diversity in the workplace, innovative rehabilitation technologies, bowel and bladder research, as well as relief from neuropathic pain.

“One of the biggest things that the Craig H. Neilsen Visionary Prize did for me was revitalize me to keep on pushing through all the hard things and then continuing to do these kinds of things that are important to people with spinal cord injuries,” Dr. Anderson-Erisman explains.

With a newfound confidence, she took the lesson from the award and translated it into action. After fighting for the needs of people in the SCI community throughout her career, she was receiving recognition that empowered her to step up to the next stage of her storied career.

“Everything I had been doing for the last 20 years meant something,” Kim adds. “It was validation. There were a lot of struggles and I put myself out on the line and this meant something to people—and it made a difference—and fueled me to keep on doing that. It validated me raising my voice when something needs to be said in support of people with SCI… I speak out even more now!”

Craig Neilsen was a man who spoke up for others. Our hope is that all of the recipients of the Visionary Prize feel the same validation and confidence to forge ahead with their own visions to make the world a better place.

Love is in the air and Valentine’s Day is an annual reminder for us to celebrate romance, friendship, connection, admiration, sexuality, and reproductive wellbeing— none of which end with a spinal cord injury (SCI).

For over a decade, the Craig H. Neilsen Foundation has partnered with researchers, who focus on intimacy, infertility, and breastfeeding after SCI, which speaks directly to the Foundation’s vision of a world where individuals with SCI and those who care for them live full lives.

Intimacy and sexual satisfaction are an important part of life that are challenges for many people post-SCI. With patience as well as the help of partners, sex therapists, and healthcare experts, these challenges melt away leading to deeper connections, pleasure, and sensuality.

Intimacy is highest when there’s an emphasis on what the whole body feels, and all the sensations, during intercourse. For many whose sexual sensation is altered by SCI, sensual exploration becomes vital, and some discover different areas of the body become erogenous. Even parts of the body directly affected by the injury can become pleasure zones again, given time, creativity, and practice.

The Neilsen Foundation has partnered with researchers throughout North America, who are committed to the wellbeing of individuals with SCI and fulfilling all their needs.

At the University of Michigan, intimacy research focused on female sexuality includes a trial of nerve stimulation to enhance the sexual experience for women with SCI, while research efforts at Kent State University are investigating how spinal cord injury changes the nerves controlling the reflexes that undermine important sexual functions in men.

Meanwhile, at the University of Miami, studies focus on semen and impaired sperm cell function, which often results in infertility. Researchers have spent decades studying cost-effective and less invasive ways to help infertile men with SCI become biological fathers.

Another innovative reproductive health project focuses on the psychological needs for women with SCI, who are thinking about or planning a first pregnancy. A tool being developed at the Shirley Ryan AbilityLab presents information about possible health issues and questions for women to consider, to better equip them with information and readiness to make this life-changing decision.

For new mothers with SCI, a team at the University of British Columbia is studying lactation and breastfeeding challenges, such as child positioning and issues related to engorged breasts, for new mothers with SCI, and seeking solutions. These findings are being shared with health professionals and new moms to help them understand and better manage postpartum.

Among all the science, here at the Neilsen Foundation we understand the importance of connection, intimacy, and the needs of the SCI community, and we remain committed in our goal to fund research, programs, and projects to enhance the wellbeing and quality of life for individuals with SCI. Long live love!