Aged 27, John sustained a brain injury as a result of a road traffic accident whilst on holiday. He remained in hospital for a little over a year before being transferred back to the UK.
On admission to hospital, he was bed bound due to restricted movement in his right knee. He presented with variable alertness and when alert frequently presented with agitation and aggressive behaviour. At this time he was fully dependant for all personal care and activities of daily living and required the assistance of two to three members of staff for moving and rolling. John remained in hospital rehabilitation for eight months.
After leaving hospital, John entered another rehabilitation service, where he stayed for three years. Over this time he continued to make slow progress. He underwent a tendon release which allowed him to walk with assistance. On discharge from this rehabilitation service, the following disabilities were noted:
- Significant cognitive impairment, most notably complete lack of initiation for all activities
- Assistance required to initiate the communication of all basic needs
- Mobilised independently, although slowly indoors with a four wheeled walker
- Required an attendant propelled wheelchair for all external mobilisation
- Limited participation in leisure – activities had to be identified, planned and executed with staff
- 90% of morning hygiene programme was prompted by staff
- Doubly incontinent, managed with pads
Before being admitted to a Christchurch Group centre, the following goals were identified:
- The implementation of a toileting programme to improve continence
- Reintroduction of crutches (previously removed as had been used as weapons)
- Increase meal preparation – initially with breakfast
- Increased community exposure, including involvement in programme planning to choose activities
Within just four months at Christchurch Group, John achieved all four goals. After seven more months of rehabilitation, John was:
- Completely continent
- Independent in personal care following a graded errorless learning programme
- Independently able to prepare his own breakfast
- Able to prepares his own lunch with set up and supervision
- Fully mobile - both indoors and outdoors and can use the stairs independently
- Able to attend the gym twice weekly and choose leisure activities
John is now working towards preparing hot meals and setting up the kitchen independently, as well as increasing decision making and choices.