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Brain injury case management: the potential and limitations of late-stage intervention--a pilot study

The focus of this study was to be upon case management intervention with the longer-term, often insidious cognitive and behavioural problems of brain injured patients, to effect a cohesive response towards improvement of function and social/community reintegration. Ten ‘in depth’ case management studies were developed. Age, sex, cause of injury, time post-injury, nature of brain injury, sequelae—and consequent intervention—differed widely. Three studies are pre´cised in this paper. There was no attempt to match or compare such a diverse group, each was accepted on the basis of need and potential benefit. Available information for each was studied. Field assessment was by the case manager who then engaged whatever appropriate resources could be mustered on behalf of the individual client. For some, this permitted access to funding for further assessments or specific inputs, for others there was nothing available other than existing statutory or voluntary agencies. For field assessment purposes, the case manager developed informal ratings of a range of disabilities within the cognitive and behavioural realms and the handicaps resulting. The assessments and nature of interventions are described, discussed and conclusions offered.