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Conducting the Orchestra in Lockdown

Lockdown has been tough for so many people for many reasons, none more so that people living with a catastrophic injury and the effects of major trauma. Support networks all over the UK have adapted to rehabilitation during lockdown and new challenges have been faced or existing anxieties exacerbated. However, out of the worry and struggles, good news stories are coming out of lockdown; stories of support, focus and drive.

Anne Armitage, Occupational Therapist and Bush & Co Case Manager tells the story of how one resilient client has emerged from lockdown with hope because of a strong team of solicitors, insurers, clinical professionals who have been creative, committed and worked as one team.

My client is an adult male with an Acquired Brain Injury following a Road Traffic Accident which has left him with significant impairment to cognitive function and his high executive functioning skills. Before his injury he was successful, secure and active within his employment, family and the community. Post-injury he became a person with a lack of focus, fatigued and the inability to regulate emotions. His working life stopped and the dynamics of his family changed as they grieved the man they ‘lost’.

Things were improving for him though. He had an active therapy schedule including physiotherapy, the gym, occupational therapy, speech and language therapy, neuropsychology and music therapy with a support worker.

His rehabilitation plan and goals were well established and as music was a big part of his life he was enjoying music therapy to improve his high executive function skills; using lyrics and songs to prompt everyday activities and bring memories alive. His support worker was encouraging daily routine and helping him to initiate tasks; using whiteboard systems, technology and a daily planner for example.

We were working towards clear goals; returning to work, focusing on vocational rehabilitation and looking at his health and fitness, and then lockdown happened. I knew we had a strong team on this case but at that point I didn’t fully appreciate just how strong until we had to rethink and keep the client moving forward through lockdown.

On this case I class myself as extremely lucky to work with such a high class team who cares about every aspect of the client’s life. The solicitor is hugely involved in the case and all correspondence and both the legal team and the insurer are invested in the client and their goals. In such a complex case it would be easy for challenges and barriers to present themselves but it is one of the most cohesive teams I’ve ever coordinated; from the claimant and defendant parties to the occupational therapist and neuropsychologist through to the support worker. We’re all focused on the client.

Keeping up-to-date and in touch has been key in lockdown. We have always had quarterly updates with the legal team and insurers to discuss rehab updates and funding and throughout lockdown this contact became more regular where we discuss the challenges of the virus and the restrictions on the client, their goals and the family. In these meetings we discussed creative solutions and the role everyone would play.

Not once did we lose sight of the rehabilitation goals.

In fact, actions to move the client towards getting back to work (albeit in a different role) actually began during lockdown and we’ve had calls with the employer, occupational health and the management team to keep things moving forward. Everyone has been phenomenal to the point where we now leave lockdown with clear plans in place for training and adapting his role.

We’ve also been able to adapt how the client can achieve physical health goals and reintegration into leisure pursuits. We’ve added a personal trainer to the team for outdoor twice weekly training on remotely via video conferencing so that health does not deteriorate, we’ve arranged weekly sessions remotely with Headway so the client can chat with other people following a brain injury and the OT has been instrumental in ensuring boredom does not hinder progress. They have identified equipment to use such as boxing kits, yoga mats and even a mini greenhouse for the back garden.

I have arranged weekly Skype calls with the client to review progress and to provide additional support and what’s amazed me the most is the progress made with the client’s lack drive and motivation. According to the Neuropsychologist their mood has not been impacted at all; a massive achievement in such an uncertain time with a brain injury. The family, who were unable to see the client during lockdown, have seen this too which has brought a glimmer of hope for the future. They also commented that his speech has improved and visits were positive. Setting up social bubbles in line with government guidelines has been an influence too.

As we emerge from lockdown I have every confidence in the team we’ve created and the strides we’ve made. We haven’t taken steps back we’ve had a job to do and it’s continued. At times I’ve felt like the conductor of an orchestra playing on its biggest night of the year and the ‘sound’ we’ve created has moved every single person in the room. It’s not time for the round of applause at the end of our performance just yet but I look forward to the day the client can ‘take a bow’.

To find out more about Anne's work and experience, visit here online profile: Anne Armitage