CASE STUDIES

CASE STUDY 1

SUMMARY OF CLIENT INJURY

Mr and Mrs X were involved in a road traffic accident in December 2017 when travelling back to their home in London having visited their relatives in the South West of England.

They were treated at the scene by the emergency services and thereafter airlifted to separate hospitals via air ambulances.

Mr X and Mrs X were both approximately 80 years of age. They have been married for 60 years and rarely spent time away from each other.

Mr X sustained multiple physical injuries including spinal and limb fractures, lung puncture and kidney failure, as well as traumatic brain injury.

Mrs X also sustained multiple physical injuries including extensive trauma to the bowel with the main artery being severed, leading to abdominal sepsis, lung puncture and broken bones.

CASE MANAGEMENT INPUT

An Immediate Needs Assessment was completed under joint instruction in February 2018 for both Mr And Mrs X.

The main recommendation was for them to be repatriated to an NHS hospital in their local area where they could receive ongoing treatment and rehabilitation together or alternatively if this was not possible for them to be transferred to a private hospital in their local area.

In agreement with the solicitor and insurer, Mr and Mrs X were transferred to a private hospital in March 2018 where they were reunited and received ongoing medical and therapy input specific to their individual needs coordinated by the Case Manager.

They were thereafter discharged home, Mrs X in April and Mr X in May 2018 with the Case Manager arranging the necessary therapy, care and medical input in order for their rehabilitation and progress to continue.

For Mr X therapy input included Physiotherapy, NeuroPsychology, Occupational Therapy and Music Therapy. He also received care from a private care agency for 10 hours a day which was gradually reduced over time. As a result of this input and his commitment to engage in therapy, he has made substantial improvements. For Mrs X, her therapy included Physiotherapy, Psychology and support from the carers. Mrs X also made an immense recovery with the assistance of the support that was implemented.

It is without doubt that Mr and Mrs X’s progress was also assisted by the relentless support and attention of their family and friends, in particular their children, who wrote the following in relation to the Case Manager’s input to their parents’ case:

TESTIMONIALS FROM THE FAMILY IN RELATION TO CASE MANAGEMENT ON BEHALF OF MR AND MRS X

I COULDN’T RECOMMEND HER HIGHLY ENOUGH

Jenni has been working with my family for 2 years after my parents were involved in a near fatal car accident. They were both left with life changing injuries. Jenni has been a lifeline, ensuring they both had the treatment they needed while in hospital, speaking with Doctors, therapist and ensuring they had the treatment, equipment and support they needed. She facilitated adaptations to their house to make it possible for them to return home and start to rehabilitate. Throughout this experience, Jenni has been professional, very approachable and always on the end of an email or phone. She has been a continual support to all of our family, without her, I don’t know how we would have managed. I believe that Jenni has been a vital component in my parents recovery and has enabled them to rebuild their lives, albeit, a different life. She has worked tirelessly on their behalf and I couldn’t recommend her highly enough.

SO, client’s family - November 2019

WE CAN NEVER THANK YOU ENOUGH

Jenni was recommended to us just after my parents were involved in an RTA in 2017. From our first meeting at the hospital, Jenni proved to be compassionate, professional, organised and a ubiquitous whirlwind of saving grace.

Jenni was able to organise every aspect of my parents care whilst in hospital and was able to prepare for their needs for their return home. She was always first to react to anything that needed arranging tirelessly negotiating with the legal team and insurance companies to ensure every last detail was taken care of.

My family will be forever grateful for everything she has done for us, and their future lives and care will most certainly be longer and better due to all of her hard work.

We can never thank you enough.

JL & TL, client’s family — December 2019

CASE STUDY 2

SUMMARY OF CLIENT INJURY

Mr B was a 65-year-old pedestrian involved in a road traffic accident in April 2014.

He was taken by ambulance to the local Emergency Department and was diagnosed with a Traumatic Brain Injury, fractures to the thoracic region of his spine and fractures to his ribs.

He had a previous diagnosis of mild cognitive impairment secondary to Alzheimer’s disease though had been living on his own and had been managing all of his personal care and domestic tasks.

Having treated his physical injuries, the hospital transferred Mr B to an intermediate care facility with a focus on providing 24-hour nursing care for patients who do not require an acute medical bed and are expected to be discharged within 2 weeks of their admission.

On the day of his transfer, Mr B was reported to become physically and verbally aggressive, kicking a support worker, and saying that people were trying to poison him. Due to his behaviour, Mr B was transferred back to the Emergency Department.

Mr B was referred to a Consultant Old Age Psychiatrist, for assistance in arranging his discharge. Whilst in the Emergency Department, Mr B did not display any instances of challenging behaviour but managed to abscond in his pyjamas and make his way home on the bus. He was found by the local window cleaner who called an ambulance to take him back to the hospital.

The Consultant advised at this time that he could find no evidence of agitation or psychotic symptoms and given the behaviours that he had been displaying while on the intermediate care ward, suggested that these were caused by environmental or social factors.

The Consultant discussed Mr B with the community dementia workers who had input with Mr B prior to his accident. The community dementia workers supported the idea of a brief admission to a secure ward for dementia patients, the aim of this being to gain further perspective on his potentially challenging behaviours, and to give scope for the creation of a safe discharge plan.

CASE MANAGEMENT INPUT

An Immediate Needs Assessment was completed under joint instruction in September 2014 with Mr B’s older brother and sister-in-law.

Throughout September and October 2014, Mr B’s physical, mental and cognitive state deteriorated. He had a number of admissions to the local hospital due to dehydration and hypotension.

In order to avoid further deterioration, the Case Manager requested that 1-1 specialist Brain Injury Support Workers commenced with Mr B with immediate effect.

Funding was agreed and Mr B received 1-1 support 8am to 6pm, 7 days a week from the start of December 2014. Since the commencement of the Brain Injury Support Workers, Mr B had no further acute hospital admissions whilst on the ward and his physical health stabilised. His nutritional status also improved.

Regular feedback was provided to the solicitor and insurer as to Mr B’s progress.

Once the Brain Injury Support Workers commenced, the Case Manager focused on supporting the ward staff to arrange for neuro rehabilitation centres to assess Mr B in a timely manner to ensure that he received the input that he required.

Mr B was transferred to a neuro rehabilitation unit in January 2015. At this point, the Case Manager took over all dealings with the Clinical Commissioning Group (CCG) and successfully secured ongoing funding for Mr B’s care from May 2015 which remained in place for the remainder of his life.

Mr B was transferred to a care home in May 2015. Case Management continued in order to ensure that all his needs were met, and that additional support, services and equipment not routinely supplied by the care home, were sourced in a timely manner.

Mr B passed away in February 2016.

TESTIMONIALS FROM THE FAMILY IN RELATION TO THE CASE MANAGEMENT ON BEHALF OF MR B

JENNI IS WITHOUT DOUBT THE BEST IN HER FIELD

When my brother was knocked down on a controlled pedestrian crossing, he sustained physical injuries such as cuts, lacerations, broken bones, but most significantly a head injury. The obvious physical injuries were resolved, but his ability to function with normal activities was significantly impaired, and he was transferred to a dementia assessment ward for what we thought was preparation for rehabilitation. How wrong we were!

In desperation at the lack of progress or proper treatment for the head injury, we turned to solicitors who specialise in brain injuries, who in turn appointed Jenni as Case Manager. What a transformation!
Jenni immediately set about preparing an incredibly thorough Assessment Needs report, demonstrating the need for provision of services to adults with brain injury.
The transformation planned in the report was immediate.

Appropriately trained staff joined NHS staff on his ward, to ensure his welfare and dignity were maintained.
Plans were made and implemented to obtain the neurorehabilitation denied to him by the State, and so he relocated away from the Assessment Ward, where he got no rehabilitation, to a specialist Hospital where he got world class rehabilitation support.

Once the treatment period was over, Jenni led the application to the Clinical Commissioning Group (CCG), which eventually led to agreement for continuous NHS funding for his care.

From the initial Road Traffic Accident, through rehabilitation, and establishing full time care took over 18 months. Jenni was there all the way to provide meticulously reporting, implementation, reviewing, monitoring and adapting my brother’s needs: and to us who would have been worn down emotionally without her support. Beyond the call of duty Jenni routinely visited to ensure her former charge was being cared for appropriately.
Jenni’s knowledge, experience and above all humanity has been beyond all expectations and has been the major factor in securing my brother’s proper care.

Jenni is without doubt the best in her field, and we as a family are eternally grateful that she came into our lives and made such a difference for my brother.

Mr B, client’s brother - March 2017