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Graham is a dedicated family man and before he suffered an unexpected stroke was a hardworking construction worker. The stroke left him with a range of challenges including limited mobility, sleep apnoea, respiratory problems, diabetes and loss of vision in one eye; not to mention at high risk of a further stroke. Graham spent a long time in hospital until he was well enough to be discharged with 24hr care.

At first Graham struggled with being at home after his stroke. Experiencing difficulty with adjusting to being confined to a wheelchair, the changing role of no longer being the main provider for his family, to needing round the clock care for all of his activities around daily living and administration of medicine. He had a distorted perception of his own capabilities and was putting himself at high risk of injury by declining care. He was also using alcohol as a coping strategy for his frustrations, and was displaying signs of very challenging behaviour, including aggression towards his carers.

Following discussions with Graham and his family, the Routes Care Co-ordinator (with her many years of experience in Health and Social Care), realised his symptoms were indicative of mental health problems, resulting from the brain injury. She quickly arranged for a mental health specialist to visit Graham and his family and a full assessment was carried out.

Mental health training sessions were held for the carers, tailored specifically to Graham’s needs. Graham wanted to make his own choices and decisions as much as possible, and staff were trained on the best way to support this, taking into account Graham’s unpredictable behaviour. An ABC behaviour management plan (Antecedent, Behaviour, Consequence) was implemented by the Routes care team, enabling the care staff to identify early triggers and then use strategies to help Graham to modify his behaviour. A dietician was also enlisted to review Graham’s dietary habits and to provide education on how a healthier diet could help improve his condition, including an alcohol reduction plan.

Graham now has a dedicated team of 9 carers to care for his needs 24/7. This includes managing his sleep apnoea with the use of a non-invasive ventilation system, and administering his medication to maintain the stability of his condition. A daily activity plan, which Graham helps to develop, is in place to support his interests. This includes trips to the supermarket, involvement in helping him to cook his meals, and a daily exercise plan using exercise bars and stand aids.

Since his care package has been updated there have been significant positive improvements in both his health and behaviour. His diet has significantly improved, resulting in a healthy weight loss, reduced blood pressure and better control of his diabetes. Graham is also less reliant on alcohol and no longer drinks on a daily basis.

Graham now has a car and his carers delight in driving him around so he can enjoy his passion of visiting construction sites, not to mention many social trips out. This was made possible through the company’s in-house specialist moving and handling trainer being able to deliver one to one bespoke training to enable Graham to travel safely. Working in close partnership with other health professionals, Graham is reporting a much happier and improved quality of life.

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