Case Study
Mr A. - 34 Year old Male
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Background
Mr A is a 34 year old gentlemen who acquired a Traumatic Brain Injury in his childhood following a collision with a car, leaving him physically and cognitive impaired. After spending many years in a children’s hospital and two residential rehabilitation units, Mr A prepared for supported independent living in the community in his own flat. Mr A has worked with brain injury case management across his rehabilitation.
Since working with Sarah Davies, whose aim is to support Mr A to be as independent as possible, while receiving the support he needs. Sarah’s aims are also to address his work and vocational needs, his living environment to ensure safety and he is supported to be an engaged father and keep friendships which are important to him.
As a result of the brain injury Mr A has difficulty with memory, planning and organising, his executive functioning, emotional regulation, insight and awareness impairments as well as cognitive functioning difficulties. He is fun, loving, kind-hearted, sporty, an incredible footballer and is fiercely independent. He also has a smile and such a fun nature it’s contagious.
Mr A's Goals: Setting & Completion
Mr A’s Initial goals were to become as independent as possible through the rehabilitation process, but as a gentleman in his mid 30’s his goals now are:
To continue as a football Coach and FA qualifications
Mr A now has a Level 2 in FA sports coaching, volunteering opportunities and a paid job as a Football Coach to children under 12 years of age. This gives Mr A a sense of purpose and accomplishment, aiding his confidence and perseverance to set new goals. Case management and support team communicate with FA to ensure Mr A has the support to access and complete these qualifications, Support focus on helping with cognition such as concentration, word finding, general communication and information access.
Have a Family and long-term relationship
Mr A has a daughter and enjoys spending time with her and his step daughter, Neuropsychology input is used on occasion in conjunction with his support teams to aid their relationship, mentoring and role play to demonstrate parental responses when working with Mr and his daughter. Finding a romantic partner and building a relationship is an ongoing process with his support team, who encourage socialisation and role play to support Mr A in communicating his thoughts effectively.
House and lifestyle
Mr A’s finances are managed by a Court of Protection Financial Deputy to support Mr A in allocating his money. Due to the damage to the frontal lobe and executive functioning, Mr A has difficulty planning, prioritising and problem solving – when this involves money, Mr A’s deputy supports Mr A to make healthy decisions and plan his financial future. This enabled Mr A to purchase a property in an area of his choosing to begin a comfortable start to independent living. Finances are managed under the court of protection.
Driving license and car
Mr A now owns a full driving license and car, supported by his team Mr A to purchase his preferred vehicle, modern enough to remind him of its mechanical needs. Visual field assessments were completed by QEF to ensure Mr A would be safe whilst driving due to ….. in his right eye.
Overcoming Barriers to Achieve These Goals
Vulnerability
Mr A is vulnerable to the influence of the others and experiences difficulty assessing the intentions and motivations of others, the team encourage and practice an open and honest relationship with Mr A’s wellbeing as the priority, this way when Mr A is unable to identify when support is needed, the team are trained by Case Management and Neuropsychology to identify cues in behaviour and communications work together to support Mr A best they can to for fill his goals.
Selfcare and Routine
Mr A can quickly become overwhelmed by his brain injury and reflect on how his life could have been, this can affect his motivation in looking after himself and withdrawing from support. Mr A can find it difficult in recognising that his physical and mental health can be affected by lack of socialisation, sense of purpose, home hygiene, eating well and preparing healthy meals for himself. External memory aids (reminders) are used on platforms such as google calendar and using Siri on his iphone to reminder Mr A of monthly responsibilities encouraging independence.
Case management guide the support team to subtly check on Mr A in general living and health, ensuring ingredients are present to prepare enough meals, knowing when to flag presented emotions and conversations, to report any potential risks – all with Mr A’s wellbeing, privacy and confidentiality at the centre
Overall
Overall, Mr A and his case manager have a positive and progressive relationship, to which Mr A feels supported to complete the goals he sets and in daily living. Mr A’s current goals are to build a family, to find full-time employment and to become less reliant on Support, all positive and the next step in his independent living process.
Mr A continues to use case management positively and will ask for help and report any concerns or worries he has, he knows his team are there for him and they have a rapport and positive relationship with him which has build trust over time in their working partnership.