Alisha is the first service user from Graham Anderson House (GAH ) who has undergone a full service user journey of In-patient Clinical Input, then In-patient Assessment and Rehabilitation at GAH, followed by a period transitional living at Eastfields and, finally, Outreach support at home.

Pre-Admission

Alisha experienced a hypoxic brain injury in May 2015. BIRT received a referral as she was continuing to demonstrate difficulties with severe memory impairment, disrupted sleep pattern, poor self care, agoraphobia and difficulties engaging with, and parenting, her son. She also had emotional distress and fluctuating mood. It was felt at this point Alisha was not yet ready for a period of inpatient rehabilitation so GAH 's Psychologist and Occupational Therapist completed pre-admission interventions both at home and in the centre.

Alisha struggles to recall this period but her mum said: “This support was invaluable. They gave us re-assurance and helped us understand about brain injury. They helped us put strategies in place which made things easier.”

Admission to Graham Anderson House

As Alisha’s confidence grew and her anxiety became more manageable, she felt able to attend GAH . Initially Alisha became a day patient, gradually building up to overnight stays. During this period Alisha had input from the full clinical team for assessment and rehabilitation of her needs. Some of her interventions included:

Service user Aisha standing in the street

  • attending group sessions to develop her social communication abilities and build her confidence
  • graded exposure sessions with Occupational Therapists to increase her confidence in accessing the community
  • working on Alisha’s initiation difficulties by having a routine and structure to increase her independence with all activities of daily living.
  • implementing memory strategies

Alisha said that she found using her diary helped her memory improve and cooking helped her confidence by building a routine.

Eastfields transitional living flat

Alisha moved into her own flat at Eastfields. Here she had the responsibility to shop for, prepare and make her own meals. There was emphasis to access the community regularly and to build on her meaningful activities and ways in which she could occupy her time both within Eastfields but also at home during weekends when she planned activities she could do with her son.

Alisha says “when I moved into the flat this was much better because it was more like normality. I had my own kitchen and was able to make my own meals when I wanted. I increased my confidence out and about so that I could start going out by myself and using buses”.

Post discharge Outreach input

After Alisha was discharged, GAH ’s Occupational Therapist continued to offer on-going input at home. She helped Alisha explore more activities within the local area, including swimming.

I'm now able to use my phone to remind me when I have things coming up or when I need to do something.”

They looked at weekly structure and routines and the use of strategies like a white board for Alisha to come up with daily tasks to counteract initiation difficulties. Fatigue management education and strategies were put in place, especially in relation to her parenting.

Alisha was offered continued support with memory strategies, using assistive technology. Alisha’s memory continues to improve and she is going to the gym, socialising with friends and taking part in a number of community activities with her son.

She has now been discharged from BIRT’s Outreach service. A referral has been made to Alisha’s local community rehabilitation service for ongoing support. The team at GAH prepared extensive notes for the community team taking on Alisha’s rehabilitation to ensure a smooth transition.

Alisha's story was first published in our BIRTie publication in Autumn 2016.