Jessica* is a person we support at our acquired brain injury residential care home, Carville Road, in Tyne and Wear. She loves doing word search puzzles and jigsaws, spending a long period of time completing them with great interest and patience.

Jessica was diagnosed with Korsakoff dementia, a chronic memory disorder, which causes confusion and memory loss. Jessica suffers from anxiety and addiction as a result of her brain injury. The team at Carville Road have helped Jessica to regain her independence and take control of her life through a person-centred support plan, techniques and establishing a daily routine.

Introducing techniques

One of the main techniques used is an orientation board, which is specially designed physical board, intended for those with dementia. An orientation board displays information that helps somebody to keep track of time. This was ideal for Jessica as she would often become frustrated when she would forget her daily routine. The team also posted key information around the building to help remind her of her daily routine, the day and time, her bedroom and people’s names. Jessica finds the orientation board very useful and refers back to it throughout the day.

It was noticed that Jessica’s challenging behaviour was often linked to cigarettes and cups of tea. Initially the team continued the routine that had been established at her previous home, which was to have a cigarette every hour and for the cigarettes to be kept in in a safe space.

However, soon after having a cigarette Jessica would become very repetitive and would ask when she would get another, which could often lead into verbal and physical aggression towards the team. To alleviate the anxiety this was causing Jessica, her routine was changed with the introduction of cue cards.  The number of cue cards she has left are how many cigarettes and cups of tea she has remaining for that day. At the start of the day, Jessica has three of each, which can be exchanged for an item.

The future is bright

This was a great turning point, as having a routine, reminders on cue cards and orientation boards massively lessened her anxiety and challenging behaviour. Although this was a challenge, this approach gave her some control back as she could choose her own schedule.

The new daily routine had a positive impact on other aspects of Jessica’s life too. For example, Jessica struggled with laundry as she would forget what clothes she had worn, and which sets had already been washed. The team worked on a new routine where she brought laundry out of the bedroom at the same time each day before being supported daily to complete washing. She also now has a laminated note to remind her that she has showered in the morning too. Once this routine was established, she was able to keep her independence and carry out her personal care and laundry tasks. This routine resulted in a step down in the level of support Jessica requires, which in turn increased her confidence and independence.

Overall, the combination of person-centred support and the introduction of a brand-new routine has reduced Jessica’s anxiety and behaviour that challenge. The future is looking bright and team and Jessica are looking forward to seeing more progress and trying new communication methods.

Find out more

Based in Tyne and Wear, Carville Road is an acquired brain injury residential care home where we support adults with learning disabilities and complex care needs. The property is purpose-built and fully accessible throughout. We currently have a vacancy at Carville Road. To find out more visit Carville Road’s service page.

*Names have been changed for confidentiality

• 
• Brain injury rehabilitation
• case study
• health
• long-term support
• quality