Action for Brain Injury Week – Eilat

As we mark Action for Brain Injury Week, we spoke with Marie McDevitt, the Manager of Eilat, a specialist residential neurological care service in Bournemouth.

“Eilat opened in 2006 and originally supported six people. We extended the home to include a standalone studio apartment in the garden, giving people the opportunity to live with the overall support and safety of the wider home, but with more autonomy and independence.

“Every brain injury is unique to the person. We assess, and listen to the person to identify areas in which support is required and work with them to aid them regaining independence and develop a good proactive quality of life. People we support regain and retain many skills and abilities and we are there to aid areas where their capability has reduced or been lost such. People can regain abilities in areas of personal care needs, food preparation, washing, ironing, and cleaning, but still be very vulnerable in other ways; exposing themselves to risks in the community, for example.

“For some people it’s a balance of keeping safe and being as independent as possible, goal setting, and enjoying new things and experiences and enjoying those things which they have always enjoyed with confidence.

“Building confidence can often be part of our focus here, particularly for people as they’re becoming more independent after their injury. Adjusting to physical and cognitive changes that may have occurred can be very difficult. We see people lose confidence, sometimes the relationships they have had with people change or break down entirely.

“People can acquire their brain injury in many number of ways and their injury is always unique. At Eilat we support people for however long they need our support. Some people need longer-term care and support, while others achieve their rehabilitation goals and move quickly either to living independently, into a lesser supported living setting or back home. We say there’s no time limit on a person’s recovery or placement with us.

“The team are proud to say that many of the people we have supported have gained a lot of independence and moved on which has been amazing.

“Some people come to us for intensive rehabilitation programmes which sees clinicians come into Eilat regularly providing therapy sessions such as psychology, physio and occupational therapy. This sort of approach, agreed with the commissioners, has seen really great results – one person who used a wheelchair when he first came to us quickly progressed to using a walker, developing their leg strength and is now practicing stairs.

“The clinicians we work with are neurological specialists and on a day-to-day basis we mirror and emulate their work with the people we support ourselves.

“When we are working on an intensive rehabilitation basis, to maximise the clinical input when the clinicians are not here, we identify three staff members to work with the person. For each therapy session, one of them will be in attendance. They are then being trained in how to support the person therapeutically and they will then share and demonstrate to the rest of the team.

“That ensures we’re offering a rehabilitation focused 24-hour support. It is a fast-paced way of working, with routines often changing week on week as the person’s needs evolve.

“It can be a really effective way of helping people towards their recovery goals. We’ve seen people progress from needing significant physical interventions and having significant physical challenges to leaving to go home, back to their family, using just a walking stick.

“We look to see behind the injury. Brain injury often causes some character changes and sometimes some things about a person before their injuries get exaggerated or changed. That can include changes to the things they like. Or it can make someone struggle more with anger, for example.

“We have a really good high staffing ratio that provides a personal service and it helps us get to know the person and really develop a learned awareness of what’s important to them.

“We look to understand how a person perceives things. One of the difficult aspects is they may have limited insight following their brain injury. That must be the hardest thing because often no amount of discussion and demonstrating things can help a person see things differently.

“Their brain may be telling them they’re more recovered than they actually are, for example. This is a really specialist area where a lot of time and effort needs to be spent in building really strong trust, where a person begins to trust what we say is to help them and to help them achieve their goals. We don’t say a person can’t do something, but we amend and adapt what they hope to achieve to make it more achievable through a phased approach and don’t take that hope away. Where it’s safe, we’ll give it a try!

“We never say never. We’re constantly amazed by what people achieve.”