Susan

Brain Injury

Susan, 48, was found collapsed on the floor complaining of headache and in a confused state. Following a lumbar puncture at Addenbrookes Hospital she was diagnosed with herpes simplex encephalitis.

She was subsequently transferred to PiC Brain Injury Services, Grafton Manor, Northamptonshire. Her processing of information was markedly slow; she had word finding problems and there were lapses in her speech while she “searched” for the correct word.

Susan’s encephalitis resulted in cognitive and behavioural deficits including hyperactivity, dysphasia, confusion, poor decision making and agitation. She presented with marked neglect of self-care, was unable to initiate tasks, resistive to eating and displayed demand avoidance behaviour.

The multidisciplinary treatment at Grafton Manor introduced a structured morning hygiene routine, eating procedures were put in place and Susan followed a behavioural incentive programme.

She attended speech and language sessions which helped her maintain effective and consistent communication with her family. Domestic skills sessions to promote initiation of tasks, reduce demand avoidance behaviour, promote sequencing of tasks and decision making were also maintained.

Susan was soon granted home leave and her family were encouraged to adopt meal “set-up” to help her with decision making and re-development on independence.

Susan became independent with her daily shower routine and eating all meals and was eventually discharged with a care package.

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