Karen experienced a traumatic brain injury when she was involved in a RTI whilst living abroad. 

Karen sustained left occipital and temporal skull fractures, extensive haemorrhagic contusion in the left front temporal region and a small sub-arachnoid haemorrhage. Karen also sustained a contusion to her right lung and fractured left transverse process of the first lumber vertebrae.

Karen was discharged from hospital approximately 6 months later and was cared for by relatives abroad until she returned to the UK. She was initially cared for by her father and a referral was made to an inpatient service due to prevalence of challenging behaviours and concerns for Karen’s safety within a community setting.Following a twelve week assessment period Karen was discharged to a nursing home, and later transferred to another residential rehabilitation service. Unfortunately, this placement broke down and Karen was placed under Section 3 of the Mental Health Act and received hospital treatment.

Following the successful implementation of a behavioural programme, Karen was admitted to Christchurch Group with a view to supporting a further transition into independent living and assessing her abilities within a more independent environment. Karen suffers from a range of cognitive difficulties following her injury. She is able to complete a number of activities of daily living at a functional level; for example, planning and undertaking a bus journey, however despite demonstrating a number of cognitive strengths Karen can also become perseverative (the tendency to continue or repeat an act or activity) when she is pre-occupied with certain issues and can experience difficulties in problem solving.

Karen also experiences difficulty in monitoring her behaviour. The ‘traffic light’ system is used to assist her in monitoring her behaviour. Karen suffers from both expressive and receptive aphasia (inability to articulate or comprehend ideas), which provides her with a significant challenge in terms of her day to day interactions. This can lead to her exhibiting some challenging behaviours which have at times placed her at risk, due to frustration or misunderstanding information provided.During her placement at Christchurch Group, Karen has received regular input from the interdisciplinary team in order to support her in both managing her behaviours and increasing her awareness of how she may be perceived within the centre and the wider community. There has been a considerable decrease in challenging behaviours.

Karen has been supported through goal setting in maximising her functional independence and implementing strategies to aid her communication and behavioural difficulties. She attends the gym regularly and has participated in a range of community based activities including attending a local aphasia support group.Following discharge, Karen is supported in the community and Christchurch Group will work with the future care providers to ensure they receive a full and comprehensive handover and on-going support following discharge.