“Without the Occupational Therapists, my life wouldn’t be what it is today”
A Nottingham man who suffered a life-changing head injury has thanked the team who helped him to regain his independence, as part of National Occupational Therapists Week.
Harvey Trout, 60, a retired flooring businessman, has heaped praise on the teams across Nottingham University Hospitals who have helped him to get back on his feet after he fell, suffering a head trauma and multiple neck fractures.
On the day of his accident in May 2023, Harvey had spent the day with his son and friends watching Nottingham Forest beat Arsenal at home and had gone to his local pub once he got home.
It was outside of the pub that he tripped on a grass verge, fell backwards and hit his head on the road. Thankfully, one of the friends he was with is a trauma nurse at QMC and so was able to care for him until the ambulance arrived to take him to hospital.
Harvey explained that he was in a serious condition when he arrived at the QMC emergency department, and there were times where it was touch and go as to whether he would survive.
He said: “I was out of it and my eyes were swollen out of my head. The doctors thought I would have sight loss or be blind, and that I would be in a wheelchair.
“You can’t believe a fall like that would cause so much damage.”
Harvey spent several weeks on the Major Trauma ward where he began to make a slow recovery.
Whilst Harvey doesn’t remember their presence, the Occupational Therapists (OTs) attended the ward to assess his cognitive, physical, visual and perceptual functioning. This normally includes assessing the patient’s ability to carry out everyday actions such as sitting to feed themselves, washing, navigating their environment, and engaging with family members.
A multi-disciplinary team of OTs, Physiotherapists, Speech and Language Therapists, Doctors and other clinicians then met to decide a rehabilitation plan for Harvey, and it was determined that a stay on a rehabilitation unit would be most beneficial for him.
Linden Lodge on our City Hospital site is the current rehabilitation unit at NUH, but from next summer this will be the National Rehabilitation Centre near Loughborough.
Harvey spent seven weeks at Linden Lodge where he had support from Occupational Therapists, Speech and Language Therapists, Physiotherapists and his Clinical Psychologist Hayley. Harvey’s vision, mobility and ability to function independently significantly improved during this time.
Occupational Therapists focused on helping Harvey to regain his independence with everyday activities through relearning necessary skills or adapting tasks. This included accompanying him to catch a bus, navigate to a shop, select ingredients for a meal in line with a £5 budget, and then cook the meal back at Linden Lodge.
Over time, the OTs also supported Harvey to visit his home in Wollaton to help him prepare for being discharged from Linden Lodge in to his own environment.
Harvey said: “They were fantastic. I still have days when I am fuzzy and exhausted, but without the OTs my life wouldn’t be what it is today.
“They have taught me how to cope with what I have and how to manage it.”
The work of the Occupational Therapists doesn’t stop when the patient is discharged home - some patients who have been discharged home with a traumatic brain injury need ongoing OT support.
There are two services at NUH where OTs work to provide community support – the Linden Lodge Reablement (LLRT), and the Traumatic Brain Injury (TBI) team.
The LLRT is a small team which helps to enable early hospital discharge, with support provided for up to four weeks. This allows the OT to see the patient in their home environment and address any of their immediate goals or concerns, such as fatigue management and implementing practical strategies to support memory, for example, setting alarms for medication or reminders for appointments.
Patients who have had a moderate to severe TBI will also have support from the TBI team. This is a long-term community team where an OT will evaluate how the brain injury is impacting them and ascertain what goals they want to achieve. For some individuals they need time to adjust to being back home with a TBI and manage their difficulties with new ways of functioning. Other people may have recovered more and need support from OT to return to work. The OT works with patients to set goals which will motivate them such as taking steps to re-establish hobbies and regain their social life.
Since being home, Harvey has continued his rehabilitation including using a home gym, monthly calls with an OT, and he recently attended a Fatigue Management course run by OTs at City Hospital which he describes as ‘magical’.
He said: “It was extraordinarily good for me. It gave me the chance to chat to other people who were experiencing fatigue and to hear what they think about it and how they are adapting their lives to manage it.
“It wasn’t just me sat at home on my own dealing with it. It was magical, and so uplifting.”
Importantly, as he continues to recover 17 months on from his accident, Harvey has also been able to return to watching Nottingham Forest matches with his friends and his sons.
Anna Marshall is one of our senior neuro rehab OTs at NUH, and she explained that the work OTs do with patients can be transformative.
She said: “I really enjoy working as a neuro OT across the pathway at NUH as the work is varied and interesting and I am a valued member of the team.
“We use our OT skills to enable patients to participate and improve their independence with meaningful occupations.
“When OTs talk about ‘occupations’, we don’t just mean employment or jobs, we mean everyday tasks and life roles which add meaning and purpose to our patients lives.
“This can be as simple as brushing their teeth, dressing themselves, making themselves a hot drink, or further along in their recovery it could be returning to work, re-establishing hobbies or leaving the house to meet a friend.
“I feel proud to work in a profession that improves people’s lives after a neurological event.”