Case Study

Facilitating quality of life and autonomy through specialist brain injury case management.

Summary of injury and rehab pathway
RTA in 1988 followed by specialist rehabilitation for 2-3 years, moving on to a longer stay accommodation at the rehab unit. At his request he then moved to his own house with minimal support until a gradual deterioration led to an emergency hospital admission in 2015, as which point case management was sought by his Deputy.

Injury

On referral to Head First in 2015 client had complex needs.

  • Severe cognitive issues including poor memory
  • Executive impairment and difficulty reasoning
  • Complex neurological and health needs
  • Poor mobility and deteriorating posture
  • Frequent falls causing injury
  • Gastric issues causing vomiting
  • Incontinent at night and unable to change bedding
  • Unable to use kettle or oven safely
  • Lack of insight into all needs
  • Fiercely independent, refusing support

Intervention

The overall aim was to provide P with sufficient support to ensure his well-being with regards his medication, his diet, his overall health and domestic management of his life/accommodation, providing  the possibility for increased community engagement and managed in a way as to reduce his predictable likely rejection of support.

  • Capacity assessments and Best Interest Meetings
  • Move to more suitable ground floor accommodation
  • Recruitment of specialist staff team through our in-house HR services
  • Referrals to OT, physiotherapy, and relevant medical consultants
  • Staff training in ABI and communication skills and provision of discreet support
  • Consistent communication strategies used by whole team
  • Bespoke support to enable him to take medication appropriately
  • Free time with no staff was monitored via movement sensors to ensure safety
  • Risk assessment and risk management to ensure least restrictive support

The Outcome

He was expected to require residential support for the rest of his life, but through a tailored approach facilitated by the case manager and provision of discreet and skilled support regime, P now lives in a purpose-built housing association assisted living flat.

Despite a deterioration in his physical and neurological condition, which has resulted in wheelchair dependence, he has learned to accept support for personal care and social participation and leads a full and enjoyable life, pursuing his passions, which include visiting the beach and all forms of motorsport.