A Case Study by Louise Sims.
Rebuilding Confidence After Catastrophic Injury
An Introduction to Louise.
Louise qualified as an Occupational Therapist in 2013 from the University of Southampton. She has predominantly worked in community roles which involve assessing people within their own homes. She has experience in assessing people with a range of physical and mental health conditions whilst also focusing on their environment.
Louise has experience in engaging with individuals with functional and organic mental health conditions and also people affected by long term neuro conditions as well as brain injury. Louise has a broad experience of working in statutory and private sectors and has recently been appointed as an Expert Witness producing reports for occupational therapy and care following personal injury and clinical negligence claims.
Louise has a high standard of report writing and communication skills and is able to self-manage and prioritise her work.
Louise has excellent communication skills and enjoys meeting people. As a therapist she has good listening skills, a calm approach and shows compassion and empathy.
She enjoys assisting people to achieve their goals and aspirations whilst supporting the individual and their family. She is a natural and a passionate advocator for individuals.
Louise has personal experience of living with a disability or illness and the impact this has on daily living and families. She has a positive holistic approach to life and always tries to empower her clients to live fulfilling lives with meaning and a positive sense of well-being.
An Introduction to the Case.
The client is retired and lives with her husband. They have a daughter who is supportive but does not live locally. The client was starting to enjoy her retirement; she was active before the incident and enjoyed cycling, walking in the countryside, swimming and holidays.
The Summary.
The client is a 70-year-old female and was a passenger in the front of her husband’s car.
They report that they were approaching a corner when they became involved in a head-on collision with another car in March 2024. The other car caught on fire, and they report that Mr Hillyard and members of the public physically removed the client from the car.
The incident resulted in a fracture of C2 located in the neck which is often referred to as “hangman’s fracture”. Fracture to the right radius and right ring finger. Extensive sternal and abdomen bruising. Development of Complex Regional Pain Syndrome (CRPS) in the right upper limb and hand.
The Case.
The client was in hospital for 12 days.
The client had the right arm cast and finger splint removed after 6 weeks and was diagnosed with Complex Regional Pain Syndrome (CRPS) following injuries sustainedduring the incident.
At 8 weeks the client had a CT scan of the C1/C2 area and talking therapies completed their assessment, which concluded with the client being placed on a year-long waiting list for Cognitive Behaviour Therapy (CBT). A physiotherapy assessment was completed and the style of neck collar was changed due to discomfort and irritation.
“Just to say thank you, without all your help and intervention, I don’t believe I would have got this far so soon.”
– The Client
A further CT scan of the C1/C2 area was completed at 10 weeks and the cervical collar was removed. At a similar time, following a review of CRPS, local anaesthetic and steroids were administered to alleviate elements of frozen shoulder and impingement.
The client had ongoing NHS physiotherapy reviews every 3 weeks. At this time also an assessment was completed by the orthopaedic surgeon who specialised in shoulder rehabilitation.
The client remained with a limited range of movement when flexing or extending her neck, she remained with an inability to rotate the neck following the injury, and it has been reported by the neuro consultant that this cervical rotation will not be regained.
The client reports a reduced range of movement with her right-hand function and the inability to grip and hold items. She also reports a reduced range of movement with elements of a frozen shoulder and impingement in the right shoulder. The client’s symptoms of Complex Regional Pain Syndrome include pain, discomfort and altered unpleasant sensations.
Thoughts from the case manager about their role in this rehabilitation journey
“Following case management approval the client was overwhelmed by the recommendations and required time and reassurance from the Case Manager to guide her through the rehabilitation pathway which was commenced at a slow pace to help her manage her emotions and limit the detrimental impact on her psychological wellbeing.”
“My thoughts are that this case settled earlier than anticipated in the rehabilitation process. This gave the client the confidence to return to previously enjoyed activities, gain some independence and attempt to put this experience behind her. The benefit of psychological therapy is that it has enabled her to process the incident and her injuries and although these will affect her long-term, her psychological wellbeing has improved.”
“I wanted to thank you for your dedication and support for the Client, it has been lovely to work with you and I know the Client has appreciated your input hugely.”
– The Claimant Solicitor
Conclusion
The client started with a private physiotherapist that specialised in shoulder injury and was seen to be benefiting from their approach and it was noted that there was an increasing range of movement in her right arm. This private physio also started massage and manipulation which was reported to be benefiting the client physically and mentally provided her with some relief. She said that she felt very safe with this physiotherapist’s approach, and had confidence in their knowledge of her condition.
The client reported being listened to and provided with answers. The therapist reassured her that her symptoms would improve and become more manageable as she progressed through the physiotherapy pathway and this gave her hope. The client also received psychological therapy, which really helped her come to terms with the actions of the other driver, his disregard of other road users and the impact of her injuries on her activities of daily living. This therapy helped her accept how impaired she was from these injuries as she is unable to drive anymore and lacks confidence accessing the community on her own. Psychological intervention has helped her manage her thoughts and feelings towards the other driver and provided her with strategies to process the pending court case which will be emotionally challenging.
The case is settled which helped her focus on her future and regain enjoyment from her retirement. She has returned to going abroad on holidays, and engaging in previously enjoyed activities within her limitations.