Windermere House Case Study 2

A 42 year old Male patient was admitted with severe anoxic brain injury, Pre morbid personality disorder, as a result of suicide attempt.

He has continued to be offered regular timetabled psychology sessions focusing on cognitive rehabilitation and appropriate stimulation. He has also been encouraged to attend psychology led group sessions focusing on well-being and cognitive skills and strategies.

He has engaged in OTA group sessions, completing ongoing formulation and assessment of need and the STARS recovery tool, but his engagement in 1:1 sessions has been more sporadic; he appears to benefit from the social aspects of a group. i.e. the weekly well man clinic, pop up pub and community engagement/home leave. He enjoys cognitive based games e.g., playing Connect 4 and Connect 4 using bouncing balls where additional motor and co-ordination skills are required. He also enjoys guessing the Catchphrase from picture cards.

In comparison to the withdrawal seen as a result of the necessary shielding, He has slowly but gradually appeared brighter in mood and more willing to engage since the end of the shielding and the ceasing of the quetiapine. He has attended psychology sessions in the afternoon but has declined sessions in the morning due to tiredness and problems with initiation.

 The patient appeared initially to be much disorientated to the layout of the service, and this seems to of affected his continence, therefore, orientation programmes were re-established, and he was supported with these on a daily basis. The deterioration evident that if he is not supported to follow the same routine and structure on a daily basis, then he quickly forgets and there is poor carry over. Despite having cognitive aids available to support his orientation e.g., orientation clock, He does not use these independently to support himself and needs prompting and support to use these.

The Multi-Disciplinary Team has been working with Speech and Language Therapy to use the Talking Mats to discuss topics, and this technique worked well. It is planned to use this to talk about his mood and well-being. To support his well-being, He has enjoyed listening to music and singing along at times and watching videos of tree surgery on YouTube to which he has offered spontaneous vocalisations.

Since his initial 8 week review, incidents of stressed and distressed behaviours have reduced and after 4 months he has transferred to our more independent recovery unit as part of his ongoing discharge pathway

He is looking forward in one day returning home to his family.