Community neuro rehab
The Queen’s Nursing Institute has published a resource for community nurses caring for people living with Covid-19.
Commissioned by NHS England and NHS Improvement, the resource is called ‘Living with Covid-19 (Long Covid) and Beyond’. It provides information to support nurses working in community, care homes and primary care and also to the wider multi-disciplinary team including clinical knowledge, care responses and skills when caring for people during their recovery and rehabilitation. It is predicted that there will be a ‘new wave’ of physical, mental and emotional health challenges as individuals enter recovery from Covid-19 infection – and for some this is combined with issues resulting from the social and economic impact of lockdown, such as isolation and unemployment.
Eky Popat, of BIS Services, on supporting people with brain injury in the daunting world of online dating.
Isolation, loneliness, lack of social interaction and intimacy – the social norm following the Pandemic, right? Even more so for the vulnerable like individuals living with a Brain Injury living independently in the community. The dating scene has always been an extremely daunting and challenging step with individuals battling loss of self, low self-esteem, and then on the other side of the spectrum egocentric, inappropriate behaviours, and disinhibition. What this pandemic has quickly shown us is that social interaction and relationships - what seems a distant memory is the backbone of a sense of belonging.
Natalie Mackenzie, of BIS Services, has worked with 'James' since 2002. In fact, he was one of her earlier clients in her career. She is immensely proud of the challenges he has overcome; not all of the effects of the accident have been surmounted, but none the less he has exceeded many expectations of medical professionals, with a will of iron and an exceptional talent that is finally being acknowledged. Here she shares the experience.
James is not defined by his brain injury, but his experiences and the challenges of his TBI have moulded his work and the individual we now see. As we are all aware, living with a severe TBI is a lifelong journey, and I still support Jim in the community, and have continued to do so whilst he has travelled around the world, through the now ‘normal’ virtual rehabilitation.
I have watched his art bring meaning and focus to his daily life, encouraging a motivation and structure that is always needed for individuals like James managing their cognition. Although there remain issues with some areas of function, James has learnt, consolidated and implemented a toolbox of strategies that support him to pursue his passion and bring joy to others.
It has been a pleasure to work with someone as driven as James, and I have seen him take a turbulent journey through his recovery, which I am sure many professionals in the field can relate with.
After experiencing an acute stroke, patients come to the 20-bed Oxfordshire Stroke Rehabilitation Unit at Abingdon Community Hospital as part of their care pathway. They normally stay at the service, run by Oxford Health NHS Foundation Trust, for around four weeks before they’re discharged home or to other locations in the community.
Follow-up rehab is usually provided by the county’s community therapy service, but with the Covid-19 pandemic in March came a national focus on patients being discharged from hospital, and rehab services were put on the backburner.
In Portsmouth, the local Headway has had a difficult time in recent months. Two service users have died from Covid-19, and another has been sectioned and taken to a secure facility after their mental health took a downturn.There’s been a huge spike in mental health problems, and a few service users, who wouldn’t have done so under normal circumstances, have got in trouble with the police.
Most service users are gradually building their contact with the outside world again, with Headway’s help.
When lockdown began in March, service manager Deborah Robinson decided the best course of action was to identify the most vulnerable users and make sure she and her team maintained regular contact with them. The next challenge was gradually exposing them to more contact as restrictions began to ease.
It contacted the Department of Health & Social Care, NHS England and the Chief Medical Officer to request that ABI was included on the list of ‘vulnerable’ conditions. The change would result in the NHS responding to ABI people as high risk and any advice and support through 111 and 999 would be more likely to be treated as a priority. At the time of writing ABI is not directly referenced by Public Health England as vulnerable (please check online www.gov.uk for subsequent changes).
