Individuals who have suffered a traumatic brain injury or other serious injury are of course vulnerable especially in the current climate.

If a traumatic event has caused the injury, friends may slowly drift away and social isolation becomes problematic.

There are some fantastic support groups for those with brain injury, such as, for example, Headway. Headway has a national branch and many local groups and branches to support those with an acquired brain injury.

Irwin Mitchell has a unique offering of client liaison managers. They are nurses, occupational therapists and social workers by background. They support our clients throughout litigation before liability (fault) can be established.

In effect, they undertake the role of case manager until funds are secured to enable a private case manager to be appointed, together with a rehabilitation team.

In this article, we have identified how our client liaison managers have adapted their approach in light of the self-isolation which has been necessitated by the Covid-19 crisis. Here are some examples of the excellent work that they have been doing.

  1. A young female was rapidly discharged from a neuro-rehabilitation setting after suffering from a brain bleed. This was at a time when the NHS was, understandably, trying to create bed capacity. She has a blood disorder and was therefore in the high risk category. Our client liaison manager, working remotely, helped to secure funding for the continuation of her therapy and assisted with the discharge plan. This ensured that there was support available, despite her early discharge.
  2. Our client liaison managers have also been supporting individuals with benefit applications. The period of self-isolation has led to many feeling anxious about their financial situation and seeking benefits for the first time. Our team have signposted our clients to helpful resource pages and filled in the benefits forms for them if and when necessary.
  3. Our team has written guides for our Irwin Mitchell colleagues about looking after themselves when working from home, working on laptops for long periods of time, and collectively dealing with the sense of threat that we feel and face. Our team has used their skills in anxiety and trauma management, taught techniques for managing worrying thoughts and threat reactions, normalisation and simply just listening.

Here are some more examples of how one client liaison manager have changed their working practices.

Getting shopping/essential food deliveries:

Their role includes working closely with statutory services to ensure our clients have access to the services available. However given social distancing rules, not being able to meet clients face to face can pose difficulties.

History:

The client is a wheelchair user, with multiple other medical conditions that place them in a vulnerable category during Covid-19. They are a single parent to three school age children, with a limited support network. One week into social distancing and self-isolating rules, one child began to show symptoms of Covid-19; therefore all of the family self-isolated for 14 days.

The client reported that they were struggling to get basic essentials/shopping due to all the delivery slots at three local supermarkets being booked up. Our client liaison manager continued to call the client weekly for updates and provided support and advice at any time.

Despite clearly being classed as vulnerable due to multiple conditions, she had not yet received a letter from her GP surgery to advise she is now on the vulnerable list. Our client liaison manager forwarded the Government website to self-register as a vulnerable adult in an attempt to get her on the list for basic essentials and shopping. Our client completed this, but received an email to advise that the GP were backlogged and were not able to get her food deliveries started.

Our client liaison manager advised the client to contact a social worker for further advice and support. Unfortunately, the client advised they are unable to make contact with the social worker despite calls and messages sent.

Our client liaison manager subsequently spent time researching social media to find local produce shops that may be doing home delivery services. She suggested completing click and collect and then calling a taxi service to collect and deliver her shopping, using Uber as they take payment for trips on-line, therefore no face to face contact required.

However the prices for this service have increased substantially since social distancing rules began.  The client reported they had run out of most essential foods and was very anxious about feeding the family.

Our client liaison manager advised that the client should complete click and collect and on this one occasion whilst waiting for the vulnerable delivery service to be up and running, our client liaison manager collected the shopping and delivered it to the client’s door, complying with social distancing rules.

Alternative accommodation

In another example, our client’s parent was told that a hotel, where she had been staying temporarily to be close to the hospital where our client was, had closed the kitchen as there was not enough room to socially distance staff. The hotelier stated he plans to close the business soon as he was only able to stay open for two more weeks at most with only one resident.

The hospital rules on visits from all day visiting changed to one hour per day, one visit per patient only. Our client liaison manager provided reassurance to our client and their parent over the telephone during this difficult time.

Our client liaison manager urgently arranged a full day viewing of multiple properties with our client’s parent before more restrictions on travel were put in place. Our client liaison manager, a Registered Nurse, took the view at the time that this travel was essential to avoid the client’s mother being homeless. An appropriate flat was found and rented rapidly.

Following the successful renting of a flat, our client’s parent and our Client liaison manager visited some hardware stores and electrical PC stores to find the item to hold a phone on the table for our client to receive calls from her mother.

Our client’s mother is now residing in a property and she is now able to walk for daily exercise and do shopping to be able to do her own cooking. Our client liaison manager arranged a taxi to take items to furnish her new flat and is in daily contact with her by telephone.

Client A has an ABI and other underlying health conditions, including Diabetes. He lives alone and ordinarily his parents would provide support and hot meals for him on a regular basis. ‘A’ has no formal care or support in place; he had previously refused this when our client liaison manager went through the process of trying to get this set up for him last year.

Both parents are elderly and have been identified as ‘high risk’ and are both now in isolation, so can no longer provide support for our client.

Our client liaison manager had not had contact with A for some time, as previous interventions had come to an end.

Our client liaison manager identified A as a vulnerable client; she was aware he had not been good at asking for help in the past, so she called him to do a welfare check.

He explained that he had got in to a ‘mess’ with his medications, and two of his medications (antidepressant and PPI) were no longer on the electronic repeat prescription, which our client liaison manager had helped to get set up for him last year, and had been working very well until recently.

As a result he had gone without these medications and not taken them consistently in the last few weeks, and this was causing him a great deal of anxiety and stress.

‘A’ explained he has been to the GP practice four times in recent weeks in an attempt to get this issue sorted out and the last time he attended, he lost his temper with the receptionist and gave up, feeling very frustrated.

‘A’ confirmed he had a short supply of all his medications and he did not know how or when he would get his next prescription, and if the two medication’s mentioned would be included.

‘A’ agreed for our client liaison manager to contact the neuro matron, from the community team, to discuss the issues with his medication. ‘A’ had been known to this service in the past, but he had been discharged some time ago.

‘A’ also made our client liaison manager aware that his microwave had broken; she knew he was not safe to use any other cooking facilities. He told our client liaison manager he was resorting to eating cold beans out of the tin and cold instant mash potato. ‘A’ suggested he would be ok to manage without any hot food or microwave.

Our client liaison manager highlighted the risks to A of not eating properly, especially as he is diabetic, and he agreed for her to explore further support for him with his meals and shopping.

Following the call with ‘A’ our client liaison manager contacted the neuro matron and highlighted the issues, she agreed to add him back to her caseload and keep in contact with him over the coming weeks. The neuro matron contacted the GP to get all his medications put back on the electronic repeat prescription system. The neuro matron also agreed to arrange to get the clients medication delivered for him for the foreseeable future.

As ‘A’ had been known to social care previously, as he had a Care Act assessment completed last year, our client liaison manager contacted the social worker who was known to him.

The social worker agreed to contact ‘A’ and discuss with him the options of support that are available and arrange support with hot meals and/or try to get him a new microwave delivered, so he can maintain his independence.

Our client liaison manager agreed to keep in contact with ‘A’ over the coming weeks and she was reassured that he is now known again to two statutory services.