The Vines Neuro-Rehabilitation Centre Case study
Stephen had an abscess to his left frontal lobe, resulting in significant dysphasia, left visual field deficit, global cognitive impairment, and partial paralysis affecting the right side of his body (right hemiparesis). Stephen previously had open heart surgery aged 9 and had suffered heart problems and anxiety for most of his life.
Stephen came to us in March 2004 after a period of intensive rehabilitation at the Blackheath Brain Injury Rehabilitation Centre.
When Stephen first came to us he was very anxious about walking both inside and outside and depended on using a walking stick. Negotiating stairs was a real problem. We provided Stephen with intensive physiotherapy and supervised an exercise routine in between sessions as well as giving him a great deal of encouragement and reassurance to build his confidence and reduce his anxiety. Within a short period of time Stephen was able to manage the stairs with ease and able to go out for long walks, play football and swingball in the garden with other residents and gave up using a stick.
He was afraid to shower alone in case he fell over, initially needing staff to accompany him to the shower room to offer both reassurance and practical support. As Stephen's confidence improved there was a staged withdrawal so that in the next phase we could just wait outside the shower room with the door left slightly ajar. Soon Stephen was able to shower independently using a checklist to remind him to take the necessary items including his room keys. As his confidence increased he became more and more independent, he was able to wash his own clothes instead of relying on staff and could put his clothes in the washing machine, add powder and select the right programme. He prepared his own meals from recipes, typed for him in large font, broken down into a number of easy steps and giving him plenty of time to avoid him getting anxious or overwhelmed.
He loved the garden at the Vines and grew vegetables in the greenhouse which he tended with loving care and zeal.
We gave Stephen a structured and consistent routine to cope with the cognitive effects of his brain injury and encouraged him to listen to relaxation tapes to manage his anxiety, which he enjoyed. He also loved his weekly trips to the cinema and to a transport course with other residents.
Formal assessments between 2003 and 2006 demonstrated a significant improvement in his communication and cognitive abilities. Stephen worked on goals for more independent living with support from the occupational therapist, the psychology team and support staff. Eventually he could manage his own medication and budgets and was able to write down his weekly expenses whereas before he had considerable difficulties with writing.
Stephen delighted us with his progress, his achievements a testimony to his courage and determination to work with our team to gain optimum control over the quality of his life. Sadly Stephen's health deteriorated and aged 57 following a seizure he was admitted to Maidstone Hospital where he died; we like to think that despite the debilitating heath problems that persisted throughout his life what we achieved together gave him the optimum quality of life to the very end.