A Case Study Illustrating continuing assessment and rehabilitation for longer-term needs

In 2013 James* suffered a cardiac arrest and subsequent hypoxic brain injury. James was referred to Tŷ Aberdafen from the acute rehabilitation ward of a local community hospital where there had been difficulties managing James’ complex cognitive and physical needs.

In the hospital, James had demonstrated agitation, hypersensitivity to pain, noise and lights, an apparent lack of vision and severe epilepsy. On admission to Tŷ Aberdafen, James showed slow processing and verbal perseveration (the repetition of a particular word or phrase). His difficulty with initiation meant that he was unable to communicate his basic needs or join in social situations.

The team at Tŷ Aberdafen carried out a full assessment of James’ cognitive, visual and physical impairments which informed the bespoke specialist rehabilitation plan. It was clear that formalised assessments would be difficult due to James’ cognitive, visual and physical impairments so rehabilitation goals were set which would:

  • maximise his potential to engage in the assessment process
  • reduce risks to James and others, particularly around personal care and hygiene
  • enable behaviour changes and reduce anxiety; in turn these would increase motivation and widen James’ participation in rehabilitation

James’ stay at Tŷ Aberdafen has been a successful one so far in that a full assessment of his rehabilitation needs has been made and a programme established to improve engagement and rehabilitation outcomes. James is now settled at Tŷ Aberdafen where the team are continuing to work with him to work towards greater independence. He is regularly supported to attend theatre, concert and music events and in December 2015 he was supported to attend a rock festival. In between concerts, James enjoys listening to rock music playlists on his tablet.

Below is a summary of the outcomes and the rehabilitation delivered by the team.

  • Improved mood and levels of social interaction with others in the service led to James being able to re-establish a relationship with his brother, who visits Tŷ Aberdafen regularly.
  • A regular routine, supported by a neurobehavioural approach to rehabilitation, helped to reduce James’ anxiety levels which, in turn led to improved social interactions and, as a result, improved mood

*name changed to protect identity

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