About ILS Case Management

On her way to a festival one evening in 2018, Emily was knocked down by a hit and run driver. Emily suffered a traumatic brain injury and was taken to hospital after being assessed by London Air Ambulance which is part of the Helicopter Emergency Medical Service (HEMS).

While in the rehabilitation unit of Amersham Hospital ILS Professional Mentor, Tim Gilbert, visited Emily to make an initial assessment of her needs. At this stage Emily used a wheelchair and one of her first goals was to be able to walk her dogs. Emily has a goat, donkeys, chickens and cats as well as her dogs at home and cites her love of animals as a big part of her rehabilitation journey. On returning home she recalls how her Dad would push her along in her wheelchair when they first took the dogs out. But through her rehabilitation Emily is now able to walk at least 5 miles which, as she says, is handy as it’s far enough to get to the local pub and back!

Emily has also reignited her love of art through art therapy sessions and has been channelling this passion into making and selling cards to raise money for the NHS and the HEMS who Emily credits with helping to save her life.

In early 2019, Catherine was assigned as Emily’s Case Manager and has been continuing to support Emily in defining her goals. This includes returning part-time to the job role she had before her accident. Emily recalls: “It was really nice to meet Catherine and meet someone who actually could understand me. [Because] she’s got a physiotherapy background it was very helpful in that respect.”

And it isn’t just Emily who appreciates the support that Catherine has been able to provide.

Emily’s Mum, Ann said “I was very relieved when Catherine came on board, and it was a great help because she was able to come with us to view all the different rehab centres.”

With her rehabilitation going so well, Emily has also been exploring new career opportunities for the future. Having worked for a Superfoods company prior to the accident, Emily was aware of the connection between the gut and the brain and wants to pursue her interest in nutrition further. She is considering undertaking a university degree to advance this interest with a view to becoming a qualified nutritionist. Her love of baking has been a constant throughout and she is still keen, despite having lost her sense of smell and taste as a result of the accident.

Another result of the brain injury is a condition known as pseudobulbar affect (PBA), which results in episodes of sudden uncontrollable and inappropriate laughing or crying. In Emily’s case she will laugh or giggle even when she hears something sad. Emily describes it as “emotional incontinence” but is learning to deal with it and tells people she meets that she has it so that they understand. Despite the potential for some awkward situations, her mum, Ann, explains that the upside is that something the family finds funny will be absolutely hilarious to Emily which in turn brings more laughter into the house.

Emily’s strength is improving all the time and she has now re-learnt how to drive. While her choice of vehicle to learn in was not a typical learner car, the large pickup truck is the one she is most familiar with as she used to drive it to and from the local railway station before the accident. She admits she had the occasional “incident” such as almost bumping the family barn recently!

Emily’s case manager has been amazed by her progress, stating “I remember coming to visit Emily just as I was about to take over [her] case from Tim, and physically [she] was in such a different position to what [she] is now… [She’s] achieved so much”.

Catherine continues to support Emily with her future goals which include moving out of the family home and living independently which is something Emily is hoping to do in the new year. With such a positive outlook on life and family, friends and her case manager beside her, we look forward to following Emily’s future achievements.

In August 1995, aged 7, Jamie was knocked over by a car outside his family home. Jamie suffered a severe brain injury; was unable to walk and had severe epilepsy.

Jamie was one of ILS’s first clients, and Karenmarie, now one of our directors, began his occupational therapy in 1999; initiating case management shortly after.

Since his accident, Jamie was in and out of hospital and undergoing rehabilitation for approximately ten years. Now an adult, he requires twenty-four-hour care and support, and uses a powered wheelchair both indoors and out.

In 2011 Eliot was assigned as Jamie’s case manager to support Jamie and his family. This includes supporting his transition through education, recruiting and supervising excellent support workers, and choosing suitable vehicles that can be adapted for Jamie’s wheelchair. Jamie now has one main carer each day which provides his mum, Lucy, with respite from his everyday care – a support that is highly valued by the whole family. Jamie also has a physiotherapist and occupational therapist to continue his multi-disciplinary therapy. Alongside this, he is encouraged to do recommended stretching exercises, and uses his standing frame at home.

He works closely with a neurologist which has meant that his epilepsy is almost completely under control. Eliot also arranges bi-annual team meetings for Jamie, his family and his support workers to get together, review Jamie’s progress from the past six months, and set goals for the next.

Eliot introduced Jamie to Disability Initiative, a charity offering activity-based opportunities to people with disabilities. To date, Jamie has taken-part in cooking, sewing and ceramics – a very good match for Jamie who is very creative. He has also developed a passion for boxing and attends the centre's regular training sessions which have helped to build his core strength and stamina in an exciting and stimulating environment.

In his spare time, Jamie has been companion-cycling with his support-worker, enjoys going out for meals, and loves to play board games with his family and support worker.

Case Manager, Suzanne Dickinson, has 25 years’ experience as an OT and has been providing case management for adults who have a variety of conditions and complex needs, including ABI and spinal injury, for over 8 years. Using her person-centred approach, she supports her clients in adapting to disability, maximising their independence and accessing leisure pursuits and employment, skills that were brought to the fore recently when one of her clients, Thomas expressed a desire to get a puppy.

However, instead of simply sourcing a puppy, Suzanne took the time to get to know why Thomas wanted a dog and talked to him about the benefits of becoming a pet owner and about the responsibilities and practicalities of looking after one. She recognised that a puppy would motivate Thomas to achieve some of his rehabilitation goals and would provide an excellent way of assessing his potential to achieve independence in other areas of his life in the future. Suzanne then arranged for Becky a dog trainer to visit and work with Thomas which prepared him for getting a dog and educated him about how to keep his pet happy, healthy and well-trained. Thomas was supported in defining what sort of dog would suit him best and in finally choosing a puppy.

“Reggie” the Cockapoo arrived and when Suzanne went to visit, she said Thomas opened the door with the dog in his arms and said, “This is Reggie and I love him!” Since then, Thomas has shown greater confidence and is thriving on having this additional responsibility. Suzanne has worked closely with Thomas’s work placement provider and made arrangements with them to accommodate Reggie so that he can safely accompany Thomas to work.

Suzanne continues to work with Becky, the dog trainer in supporting Thomas to learn new skills and develop existing ones. Becky has introduced Thomas to dog emoji’s to help him to identify when Reggie might be feeling anxious and when he is just excited! Becky has been creative and has adapted her approach to meet Thomas and Reggie’s needs. Thomas’s Mum says the way Suzanne has supported her son to achieve this goal in such a creative way has been ‘life changing’ for him and has bought her and her son closer together.

The preparation, continued training and the relationship with Reggie has taught Thomas so much. It has also taught Suzanne and others that support him, a great deal about Thomas.