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Acquired brain injury home care support

Acquired brain injury home care support from Voyage Specialist Healthcare

Voyage Specialist Healthcare provide complex continuing acquired brain injury home care support services.

What is an acquired brain injury

An acquired brain injury is a non-degenerative injury to the brain which has occurred after birth. They include traumatic brain injuries (TBIs) such as those caused by road traffic accidents and non TBIs such as those caused by strokes and other vascular accidents, tumours and also infectious diseases.

Acquired brain injuries in the UK

Between 1 and 1.4 million people attend hospital in the UK annually with a head injury and of these approximately 135,000 are admitted to hospital. A low estimate is that approximately 1 million people living in the UK have had a head injury but this does not include the much higher figure for all ABIs (health committee 200-1).

Consequences of Acquired Brain Injuries

An acquired brain injury can cause many kinds of physical, cognitive social and behavioural/emotional impairments. They may be either temporary or permanent. Impairments may range from subtle to severe, although the consequences may all be serious.

Some people may only be physically disabled, but the large majority have hidden disabilities which are less easy to observe and as a result lead to misunderstanding, loss of employment, relationship breakdown and social isolation.

Case study

History and Diagnosis:
Whilst on holiday with his family aged  nine, Andrew was involved in a road traffic accident which resulted in  multiple skull fractures, broken bones in his arms, legs and pelvis and substantial internal bleeding. Andrew was also diagnosed as having an acquired brain injury which required extensive neuro surgery and reconstructive therapies on his skull. After major surgery he was transferred to a rehab centre where he could receive neurological rehabilitation. During this time it was established that Andrew had developed epilepsy, expressed anxiety in social settings and demonstrated problems with memory, concentration, executive skills (planning and organisation) and emotion.

Plan:
Voyage Specialist Healthcare was contacted by the local PCT to determine if we could provide 24 hour home care support for Andrew’s acquired brain injury. Meetings with Andrew, his parents and his multi-disciplinary team were arranged to fully understand his needs, complete anassessment and to develop and person centred care plan. Both Andrew and his family were involved in the recruitment process which sourced suitable healthcareassistants to support his needs. Once the healthcare assistants had been recruited, they received mandatory and clinical training sessions from our in house specialist trainers as well as on-going competency support from our clinical managers and behavioural therapists. Honorary contracts were also signed by our healthcare assistants which allowed them to work with Andrew in the acquired brain injury rehabilitation centre and fully understand all aspects of his care requirements.

Andrew’s healthcareassistants were trained to provide him with the following support:

Clinical support

Medication administration, seizure recognition and management, emergency rescue medication for epilepsy, nutritional and physiotherapy procedures personalised to meet Andrew’s needs.

Cognitive and Executive support

Memory: Andrew`s support was provided with continuity and structure which helped to minimise maladaptive behaviours. As is often the case with severely brain injured clients, a structured timetable was essential to help him cope. Andrew was provided with a clear daily routine which explained who would provide his care and when it would be delivered. This plan was placed on his bedside table and ensured that it could be reached and referred to every day.  Pictures, large font and a simple language style also made his routine very easy to understand. Andrew used the board games Connect Four and Jenga, as well as the online card game Kings in the Corner to improve his attention to detail and concentration.

Planning and organising: To provide further structure and to support his memory, organisation and planning skills, Andrew was encouraged to pick a task which he could carry out during the week and plan when it would occur. All of his activities were age appropriate and perceivedas being fun to help sustain his motivation. Initially Andrew was offered a very limited choice of tasksas he found choosing very difficult. However,as time passed, he was offered a larger number of choices. Andrew used a diary to plan when a task needed to be carried out as well as a checklist to ensure that each activity was completed correctly. Our healthcare assistants also provided Andrew with prompts which focused his attention on specific tasks and delivered praise to support positive actions.

Social: To develop Andrew’s social skills, our healthcare assistants spent time with him in the school playground and encouraged interaction with his peers, something he had previously avoided. To build Andrew’s confidence, our healthcare assistants placed him in theoretical social scenarios which developed his body language, cues, sharing and friendship development. Our team also worked with Andrew`s school and family to ensure that these social skills could be supported in the absence of our healthcare assistants. Andrew was encouraged to attend a variety of leisure activities such as horse riding and cubs. Collectively, these activities created multiple benefits as they increased his confidence, physical activity (and weight control) as well as his independence in social settings. 

Outcomes:

Physical and emotional:
Andrew uses his weekly planneras a prompt to help him organise his time and support his memory. His attention and concentration has been greatly improved and he is learning to make choices on his own. He is also growing in confidence in the classroom and in social settings. Attending cubs has encouraged Andrew to become more able to dress himself, and swimming lessons have encouraged him to do it quickly. The on-going familiarity of the shifts delivered by our healthcareassistants have provided Andrew with a consistent routine which has had a positive impact on his emotional wellbeing.

Client and family feedback:
The feedback received from Andrew and his family has been very positive. They are both happy and confident in our healthcareassistants and have frequently praised their reliability and level of clinical and behavioural competency.

Commissioner feedback:
Very positive feedback has been received from the PCT regarding the speedy response to the commencement of the care package and the reliability and quality of care being provided by our healthcare assistants. The improvements seen by Andrew have also increased his independence and reduced the number of commissioned hours which are required to support his needs.

More case studies

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Voyage Care supports thousands of people with learning and physical disabilities, brain injuries, autism and other needs across England, Scotland and Wales.

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