severe acquired brain injury case study

“Thanks to the Askham rehab team, we’ve seen a dramatic improvement. We know she’s now back to us again because she started to become more of her cheeky self again.”

– Family of Miss J

Mr G was admitted to Askham for a period of rehabilitation from hospital after contracting Herpes Simplex Encephalitis. On arrival to Askham Village Community, Mr G was disorientated, confused and exhibited high levels of confabulation.

Mr G would wander around the unit, believing he was there for an overnight stay and would be returning home the following day as his “mother” would be picking him up. Mr G was fully mobile and able to tend to all aspects of his personal care but required significant prompting, and was disorientated to person, place, date and time.

Mr G received therapy input from the psychology and speech and language therapy (SALT) team. During formal psychology assessment, Mr G showed difficulties with immediate and delayed memory as well as sustained and divided attention. It also became apparent that Mr G was severely aphasic. With this, the psychology team referred Mr G to be assessed by the SALT team, who concluded that Mr G was suffering from Wernicke’s aphasia, meaning he was able to speak in fluent sentences, however almost all of the words would appear muddled and out of context. The psychology and SALT team then began work focusing on Mr G’s aphasia and cognition, first using picture cards and engaging in basic picture naming tasks.

Before the Christmas period, the assistant psychologist worked alongside the occupational therapist to arrange two home visits, the first supervised by staff, the second unsupervised for 2 hours. Mr G became orientated to time, place, date and person through visual aids and errorless learning, and was able to go home for a broken period of 10 days, returning to Askham for therapy during working days, over the festive period.

Mr G then began going home at weekends, and was able to engage in all the activities that he used to love such as gardening, walking the dog, working on his motorbike and spending time with his family. Mr G was able to form complete sentences, and although at time of discharge still struggled with people and place names, Mr G’s severity of aphasia had decreased significantly. Mr G began self-correcting, had insight into his difficulties, and was able to find ways to be understood if he could not find the correct word.

Mr G was discharged after 12 weeks of consistent rehabilitation and returned home to his wife and dog.

See below measurable outcomes from the Functional Assessment Measure (FIM + FAM) that was completed on admission and discharge.

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