Module

Module 4

4.0 Aims

4.1 Neuropsych

4.2 Difficulties

4.3 Changes

4.4 Strategies
        Introduction
        Table         Case study A
        Case study B
        Case study C

4.5 Sources of      misunderstanding

4.6 Take home      messages

4.7 Resources

4.8 Take the Test

Feedback
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Case study C: 20-year-old-man

This 20-year-old man suffered a hypoxic brain injury** as a result of attempted hanging. At the time of his injury he had been working full-time as a truck driver and was living on his own.

When seen for assessment he was very polite, friendly and cooperative. He answered questions simply, followed instructions precisely, and sometimes needed additional prompting to continue with a task. (Essentially he did exactly what he was told to do without question). This man wanted to get better and believed that rehabilitation was helping him a lot.

A neuropsychological assessment indicated that he:

• had significant and generalised cognitive impairment
• had a very short attention span
• could not keep track of things
• was very slow
• registered only a small amount of information and repeating things did not help him to learn more
• was very poor problem solving
• was disorganised
• had a concrete thinking style
• had severe executive dysfunction (cognitive inflexibility, poor self-monitoring eg. rule breaking, limited generation of new ideas)
• was poor at initiation
• had limited insight about his cognitive difficulties.

However he;

• was able to follow simple, direct instructions
• could remember the very small amount of information that he initially registered
• could complete simple problem solving and simple calculations.

** Hypoxic Brain Injury occurs when the brain has been deprived of oxygen to some degree. The person would be likely to suffer memory impairment and severely slowed processing speed, with flexibility, self-monitoring and visual deficits. They might also have a generalised dulling of cognitive functions, and 'flat' or lack of emotions.

Questions

What strategies could be suggested to assist therapy staff with this man’s rehabilitation?

His goal is to eventually live independently. What could you suggest to help him achieve this goal?

Strategies you could use with case study C