CASE MANAGEMENT
Taking the holistic approach TO REHABILITATION AND CASE MANAGEMENT Lauren Paikin, Clinical Lead and Specialist Rehabilitation Case Manager at HCML, outlines why every brain or spinal cord injury rehabilitation programme must address the physical, psychological and cognitive factors not only for the client, but their families and support networks too.
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ajor trauma impacts all aspects of life. The physical, psychological and cognitive state of the client is often dramatically changed by the event, leaving them unable to fulfil Lauren-Paikin the life roles they had pre-injury, whether at home, in society or at work. Effective rehabilitation needs to consider all the aspects of their lives and draw in many key people to achieve successful outcomes in the journey to recovery.
EDUCATION Managing expectations is an enormous part of a Case Manager’s role. Client and family are often experiencing a variety of emotions, from initial shock, to upset and anger. The ramifications of traumatic injury and what life might reasonably look like moving forward are hard to comprehend and, indeed, an ever-changing landscape to navigate. It is the Case Manager’s job to educate all involved parties on what is likely to be achieved from rehabilitation and to ensure that they are supported throughout the journey. A spouse wanting to look after their partner post-injury at home is often thrust into adopting a different role as a caregiver, tending to physical personal care, assisting with everyday activities and accessing services. While doing all we can to support the client and family’s wishes, we also need to make sure that decisions are safe and sustainable for all parties. To do so, we often need to draw on a number of different professionals in order to put the right packages of care and intervention in place. We facilitate regular meetings between the client, family and the treating team to proactively guide and manage the rehabilitation journey.
ADAPTING TO CHANGE
The complex nature of brain and spinal cord injury means that changes in symptoms – particularly psychological POSITIVE ENGAGEMENT and cognitive – are likely to Training and education for The emotional and physical occur over a lengthy period support of family and friends in the the families is a huge part of throughout the client’s recovery. rehabilitation process often has what we do, as their perceptions Training and education for the a positive impact on the client’s families is a huge part of what and understanding change rehabilitation. NICE guidelines for we do, as their perceptions and ‘Rehabilitation After Traumatic throughout the rehabilitation understanding change throughout Injury’ recommend the involvement the rehabilitation journey. journey of families and carers in planning and Changes in the client’s behaviour making decisions across all aspects and cognitive state may prove of the rehabilitation process. Their inclusion can help shape a challenging, so in addition to continuously reviewing client proactive and purposeful role for the family that inspires, motivates goals and adapting rehabilitation programmes, we also ensure and reassures their loved one. the right support is in place for the families as they realise the full extent of what life post-injury looks like. SETTING REALISTIC GOALS Family members can help the Case Manager and other health professionals understand what the person was like pre-injury, supporting them to develop suitable rehabilitation goals. It is often important to include the family when conducting Immediate Needs Assessments (INAs), to help effectively evaluate the current difficulties and plan for optimal intervention, particularly when the client’s impairments might limit their input into these discussions.
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tel: 020 8649 8006 email: info@hcml.co.uk web: www.hcml.co.uk
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