David developed necrotising fasciitis in March 2014 after falling on a tree stump. David’s health rapidly deteriorated and he went into multi-organ failure resulting in a cardiac arrest and a hypoxic brain injury. He was initially treated at East Surrey Hospital.
David was admitted in a low awareness state to the neuro rehabilitation unit (NRU) in Glenside’s acute hospital in July 2014 for a “SMART assessment, postural management and to develop a sleep-wake cycle”.
On admission, David required a hoist for all transfers. He had spontaneous movements of all four limbs but did not have any purposeful movement. David was provided with all his nutrition through his PEG. It was unclear at this stage how much David was able to understand, he was unable to communicate his needs to the team.
Following multidisciplinary input from the Glenside team (including Physio, Speech and Language, Psychology, OT, Podiatry, Dietetics, Nursing and Rehab Assistants) David slowly emerged from a low awareness state. This has allowed the specialist teams to work with David towards increasing his independence and quality of life. David has shown great strength of character and determination in his rehabilitation journey. Particularly when obstacles (that aren’t uncommon in rehab) have been put in his way e.g. infections, fatigue and dips of low motivation, David managed to persevere through to the other side.
David is now able to feed himself with adapted cutlery and set up, he is on a normal diet and fluids. His PEG was removed in May 2015 as he is able to take all his nutrition orally. David is able to use the call bell appropriately and verbally express his needs. His language is a strength of his and he socialises with the other service users in therapeutic groups and keeps the staff members entertained with his sense of humour on the ward.
Through Physiotherapy working on purposeful movement, selectivity of movement, strengthening and balance work David is now able to transfer with an electric standing aid and the assistance of two staff members. Close work with the Podiatry team has been essential to improve David’s foot position to allow him to weight bear through his feet. Modalities have included; splints, taping and frequent biomechanical alterations to David’s shoes.
The Psychology team have supported David throughout his rehabilitation journey, initially helping his orientation, completing formal neuropsychology assessments and supporting mood through facilitating contact with family members.
David has gained independence with eating and drinking through regular hand massage and specific task training with Occupational Therapy. This allows David to have functional and active hand opening to be able to do daily activities including holding built up cutlery and 2 handed mug with insert at meal times. David is also able to use his IPad and to participate in washing and dressing.
Person centred care is a key value to the MDT approach and to that end we have supported David with his wish to continue his rehabilitation in a facility closer to home.
David said “Everything is good at Glenside. I enjoy the food, the activities and the staff are helpful. When I leave, I look forward to being nearer my home and seeing my children.”