Rehabilitation of Prolonged Disorders of Consciousness

February 18, 2015

Thank you to everyone who attended our free seminar on Monday 9th February 2015 – Rehabilitation of Prolonged Disorders of Consciousness – which we co-hosted with The Huntercombe Group. The seminar was a great success and we would like to thank our speakers, exhibitors and the staff at Grand Central Hotel for all their help and involvement during the day.

Dr Bill McKinlay, Neuropsychologist and Director of CMS, began the day with an opening address welcoming everybody to the event and introduced the theme of the day.

Our first speaker was Dr Andrew Harrison, Consultant Clinical Neuropsychologist at Case Management Services Ltd. Dr Harrison presented on the topic of Assessment of Prolonged Disorders of Consciousness. His talk highlighted the challenges of assessing these patients, the recommended assessments and patient pathways from Scottish Intercollegiate Guidelines Network (SIGN) and Royal College of Physicians – National Clinical Guidelines, the current behavioural assessment scales in use (CRS-R, SMART and WHIM) and neuroimaging and neurophysiological techniques.

Our next speakers were Dr Louise Reid, Consultant Clinical Neuropsychologist and Gillian Munday, Senior Occupational Therapist from Murdostoun Brain Injury Rehabilitation & Neurological Care Centre. Dr Reid and Gillian presented a case study of an inpatient at Murdostoun. They described the assessment process for this patient which included the use of behavioural assessment scales – WHIM & SMART. Through use of the SMART assessment this patient was shown to be emerging from a prolonged disorder of consciousness and allowed staff to identify goals for this patient to work towards. Their presentation also included video footage of a family member sharing their experience of brain injury and rehabilitation. Also included was footage of the patient taking part in rehabilitation activities and demonstrating their progress.

After our first morning break our meeting continued with Lynn Hodge, Senior Case Manager at Case Management Services Ltd, presenting a case study entitled Successful Community Placement – The Great Escape. Lynn discussed the case of a client who according to expert witnesses would be best placed within a nursing home as they were deemed not to have any rehabilitation potential. The client’s legal team challenged this view and Lynn was instructed to coordinate the clients discharge from hospital into their own home in the community with 24 hour care in place. Lynn then described the remarkable progress this client has made since being discharged and receiving rehabilitation and daily stimulation. Lynn presented video footage of the client at various stages during their first year out of hospital, this included the client interacting with staff, participating in self-care and eating and speaking for the first time in 6 years.

The morning speakers all gathered to answer questions from the audience before we broke for lunch.

Beginning our afternoon session was Dr Alistair Weir, Consultant in Rehabilitation Medicine, from Murdostoun Brain Injury Rehabilitation & Neurological Care Centre. Dr Weir discussed the Management of Pain and Spasticity. His presentation highlighted the impact they can have on all other aspects of a patient’s rehabilitation and the importance of implementing treatment and management for pain and spasticity. Dr Weir explained various treatment options available and the benefits of these.

Our next speaker was Gary Derwent, Joint Head of Assistive and Rehabilitation Technology at the Royal Hospital for Neuro-disability in Putney. Gary introduced various options for assistive technology for those with prolonged disorders of consciousness. Gary identified the advantages and disadvantages of the technology available. His presentation included discussion on the use of iPads, switches, touch screens and eye-gaze technology for assessing, communicating and interacting with this patient group.

Our final speaker of the day was Dr Alasdair FitzGerald, Consultant in Rehabilitation Medicine at Astley Ainslie Hospital.  Dr FitzGerald presented on Pathways and Accessing Services. Dr FitzGerald discussed the various challenges faced by those admitted to hospital following an acquired brain injury. The pathway for these patients can vary greatly depending on various factors such as other injuries they have sustained, their geographical location, access to specialists and services. Dr FitzGerald further discussed the various interventions available and improvements to the pathway which have been suggested following the evaluation of outcomes.

The day concluded with a final round of questions for the afternoon speakers and a closing address from Dr Bill McKinlay. We hope you all enjoyed the day, please remember to submit your evaluation forms to Jane Spriggs and you will receive your certificate of attendance. If you wish any further information or copies of the presentations then please contact jane.spriggs@fshc.co.uk