Rehabilitation story - Rescue, recovery and restoration after severe head injury

After a catastrophic car crash, my client, Chris* was left with severe brain injury from the trauma to his head which had staved inwards a large section of his skull. He was taken by the air ambulance service to the nearest hospital major trauma unit. From there he was moved to an NHS rehabilitation centre. When the NHS rehabilitation centre began preparing to discharge him to a care home, his family asked for my help through the brain injury charity, Headway. 

Prioritising my client’s move to a safe, specialist rehabilitation facility during lockdown

None of us will ever forget the fear and uncertainty at the start of the coronavirus pandemic, particularly for those whose loved ones were susceptible to infection owing to their age, disability or ill health. Hospitals responded to the increased demand for beds for COVID-19 patients by moving sick and infirm patients out to care homes, where it transpired that COVID-19 was rife and, as a result, thousands were exposed to the infection and lost their lives.

Chris was still in the early stages of recovery after his major trauma treatment. Part of his skull was missing and he was at high risk of life-threatening complications, particularly from infection. Preventing his discharge to a care home and moving him to a safe, specialist rehabilitation facility for multidisciplinary (MDT) treatment was an urgent priority.

Working with the insurer to provide MDT rehabilitation

The RTA car crash had been caused by another driver pulling out of a layby and colliding with Chris’s car. This meant that under the Rehabilitation Code the other driver’s insurers had an obligation to consider whether the injured claimant would benefit from additional medical or rehabilitation treatment. I sent an urgent letter of claim and the insurers responded, admitting primary liability, subject to a suggestion that Chris had contributed to the injury by failing to wear a seatbelt, which we disputed. Most importantly, however, they agreed to work with us to prioritise his recovery and provide rehabilitation funding, so that we could appoint a case manager to prepare an immediate needs assessment (INA). The rehabilitation funding could not have come at a better time.  In hindsight, the swift action by my team, the case manager and the insurer’s cooperation probably saved Chris’s life.

With the nation in lockdown, the case manager and I attended MDT meetings remotely with Chris’s family and his therapists, and successfully advocated for his move to a specialist rehabilitation unit near to his family’s home. Over the next two years, he received inpatient MDT rehabilitation which was funded partly by the ICB and topped up with funding from the insurers. His initial progress was slow, partly because healthcare services were delayed during the pandemic but also because repeated infections delayed the healing of his skull and he needed multiple surgical craniotomy procedures.  However, as soon as he was well enough, we helped him move into suitable, rented, bungalow accommodation with 24-hour live-in 1-to-1 care. He is supported by a Court of Protection deputy, a case manager and community-based MDT rehabilitation including physiotherapy, occupational therapy (OT), speech and language therapy (SALT), and neuropsychology.

Helping the family rebuild after a loved one’s life-changing injury

Working with families affected by head injury has taught me that my clients, as I know them, are often very different from the pre-injury personality that their family knew and loved. Brain injury, however subtle or severe, affects not only the person’s ability to mobilise and function physically as they used to, but also their memories of their former life, and the way they communicate and process information.  However successful their recovery, when compared with their post-traumatic condition, the client may never again be the completely restored partner, sibling or son that the family recall. 

In this case, the severity and complexity of Chris’s brain injury was life-changing, both for himself and his devoted family. When I look back at his horrific injuries, and the many challenges we faced in the immediate aftermath and ongoing months  following his injury, I know that we are all delighted with the success of his rehabilitation and recovery. He’s back up on his feet and living close to his family in a suitable home with fulltime care and support, but he has no memory of the car crash, and little insight into his own mental incapacity or the extent of his disability. 

Successful rehabilitation restores quality of life

Once Chris’s acute medical treatment and rehabilitation had successfully stabilised his condition, we shifted our focus towards finding activities which were in keeping with his former interests and lifestyle, to add interest to his life and increase his sense of wellbeing, enabling him to feel more himself. I learned from his family that before his injury he had lived a very full and active life. He had travelled and lived abroad and was an ‘adrenaline junkie’ who thrived on snowboarding, sailing, racing cars and other high energy sports.

During the pandemic, when so much slowed down and his recovery was delayed, the defendant’s insurers had argued that Chris would never be able to return to activities. I believed that Chris could improve with MDT rehabilitation and he didn’t let me down! Working with the case manager, we found a physiotherapist who had been in the army and knew how to engage with this sort of client. The resulting increase in his mobility massively accelerated his progress. Before long he was enjoying supported sailing experiences with Sailability, disabled skiing with Snozone, carer-supported UK-based trips and holidays with friends, and even rediscovered his love and talent for photography. The impact on his wellbeing is evident in his demeanour, his improved ability to converse and the re-emergence of his sense of humour.

I firmly believe that timely, coordinated, multidisciplinary (MDT) rehabilitation is a vital part of the specialist service we provide to our clients and their families. Our clients deserve their best chance of recovery as well as their full entitlement to compensation.  We often hear that compensation cannot undo the damage that has been caused by negligently caused injury, and to a large extent, sadly, that’s true, but timely, properly coordinated rehabilitation can definitely make a difference to the injured person’s outcome. In this case, my client’s life was not only saved but has also been optimised by his rehabilitation.

*names have been anonymised

Read more about the compensation claim.