Case Studies
Making Work Sustainable


This client had a serious injury at work and the hospital did not diagnose his mild brain injury. Due to the effects of his brain injury his ability to perform effectively in his role at work was compromised. His coping abilities at home were also problematic as his relationship with his wife was under immense strain.

When we first met him, nearly two years after the injury, his relationship with his employer was breaking down; he had cognitive (thinking) problems that were worsened when he faced pressure and rapid changes at work. He had been sent home from work and was on leave. His situation was compounded with other mild neurological problems, pain, insomnia, low mood, anger, irritability, fatigue and severe anxiety. It was likely that without any help, his employment and marriage were on course to fail.

Our Interventions:

  • A referral was made to a consultant neurologist to assist with confirming a missed diagnosis of mild brain injury and to provide some guidance with rehabilitation and useful medications;
  • The client was referred to a clinical psychologist to assist with the cognitive issues, anxiety and low mood;
  • The client had some residual painful soft tissue injuries and the case manager referred him to a musculo-skeletal physiotherapist;
  • The client experienced dizziness and vertigo and was referred to a vestibular physiotherapist;
  • The case manager coordinated all of these clinicians, and also regularly communicated with the GP, the client’s solicitor and other relevant parties;
  • In this situation, the case manager was an occupational therapist experienced with vocational rehabilitation and had unique skills to support the client with maintaining his employment;
  • A workplace assessment was completed;
  • Education and training about brain injury was provided to the client, his family, the employer and key management/supervisors in the work place;
  • The case manager worked closely with the clinical psychologist and client to ensure that a comprehensive return to work plan was established;
  • The case manager completed several visits to the work place and supported the client with successful implementation of the various recommendations from the multidisciplinary team.

The Outcome:

This gentleman was able to successfully implement many strategies that allowed him to have more energy, make better decisions and cope much better in the workplace. He was able to return to work and gradually build up his hours back to full time. His mood improved significantly, as did his relationship with his wife.

This gentleman reported a dramatic improvement in the quality of his life and after he demonstrated that he was able to maintain his employment over a period of about nine months our involvement was gradually brought to a close.

Living Independently in the Community


Mr A sustained an injury aged 51 that resulted in both of his legs being amputated. He also sustained a right brachial plexus injury meaning that he has minimal use of his right arm. When we first met Mr A, he was living in a residential care facility, leading a less than fulfilled lifestyle.

The equipment he needed included:

  • An electric hi lo bed;
  • A ultra light manual wheelchair;
  • A power indoor wheelchair;
  • A power all terrain chair;
  • A hoist;
  • Specialised bedroom and bathroom furniture and fixings;
  • Stair lift;
  • Kitchen equipment;
  • Closomat- electric power toilet;
  • An electric bath;
  • A power shower commode;
  • Portable ramps;
  • Environmental control equipment – power windows, doors etc.

Our Interventions:

An initial needs assessment was undertaken to establish the client’s abilities, strengths, limitations, problems, priorities and goals. This information was incorporated in a report containing a plan of how to address identified problems and goals;

A priority was to assist the client with deciding upon where to live following discharge from the residential care facility, as his former home was no longer appropriate or adaptable to meet his needs.;

Guidance was given with property searches and suitability to Mr A’s interests and lifestyle, making some predictions about his physical abilities in the future and the many types of specialised equipment he might need;

Upon convening a suitable property, assistance and advice was provided with adapting the property specific to the clients needs. This involved extensive liaison with the architect, quantity surveyor, environmental control provider and main contractor;

Arrangements were made for the client to have a neuropsychological screening assessment for any cognitive impairment (thinking problems) or psychological problems after his injury;

The Outcome:

Mr A now lives in a fully accessible and adapted home that has environmental control technology to maximise his level of independence. He has a team of support workers to assist him with everyday domestic tasks.

He is independent with his personal care tasks using the equipment in his modified bathroom.

Mr A is able to drive his power chair right into his car, and drive and operate the car using only his left hand and a joystick and small control panel. He enjoys the freedom of being able to go out independently without relying on taxis or support workers to assist him.

Mr A is now able to mobilise short distances indoors on his prosthetic limbs, and continues to receive regular physiotherapy; with the aim of using a wheelchair for outdoor mobility only.