David A. Johnson - Clinical Neuropsychologist
The person who suffers catastrophic brain injury has a wide range of mental and physical needs, often complex and interacting. This presents many and varied challenges to all concerned – injured person, family, therapists, carers, solicitor, social and welfare services. Moreover those challenges are both changing and chronic, for the remainder of the individual’s life.
In order to ensure optimal functioning, progress and quality of life the injured person needs a high level of trained care and support, consistently provided within a highly structured framework of interdisciplinary care and rehabilitation.
Achieving such a goal is fundamentally important to the injured person and the family but it is not easily accomplished. Indeed, most families are ill-equipped to meet such needs unaided and, in consequence, they suffer unnecessary additional stress to the detriment of their health and quality of life.
Case management can provide the answer but it is more often the source of frustration and disappointment to families and therapists alike. To some, it may also seem a thankless task.
An effective brain injury case manager is equivalent to the driver of the coach and eight horses, coordinating, encouraging, restraining, disciplining but above all leading by skill and knowledge to arrive at the destination on time, safely and ready for the next leg of the journey. The case manager knows and understands the team, helping them to work effectively together.
The continued achievement of progress 10 years after catastrophic brain injury is exemplary, especially when doubt was expressed initially about the potential benefits of rehabilitation in this case. There can be no doubt that such achievement reflects the commitment of the family, carers and therapists, and the efforts of the injured individual; but it is the coordination of that effort that is critical, the adoption of an interdisciplinary approach that ensures optimal cost-benefit at all levels, not least for the injured individual who remains dependent upon the knowledge and experience of the case manager to make improvement a reality. |