How KW Therapy Helped Tom Gain Greater Independence
When Tom sustained a life-changing brain injury at just 19, his world—and that of his family—shifted dramatically. KW Therapy began working with Tom in 2015, and over the past decade, we’ve remained a consistent presence in his rehabilitation journey. This case study highlights the importance of long-term, collaborative care in supporting complex brain injury rehabilitation, especially for case managers navigating multi-disciplinary input and evolving client needs.
Early Challenges and Initial Support
Tom was referred to KW Therapy while staying at Oakwood ABI Rehabilitation Service. Following a traumatic accident in 2013, he was living with hemiplegia, cognitive impairments, and significant behavioural and psychological challenges. He was wheelchair-dependent, had poor posture, limited upper limb function, and required full assistance with personal care.
Our initial focus was on improving Tom’s mobility, safety, and engagement. We recommended a more suitable powered wheelchair with safety modifications and a heavy-duty manual wheelchair tailored to his needs. We also supported the rehab team with strategies for upper limb rehabilitation and cognitive support, to address Tom’s low motivation and complex behaviours.
Transitions and Setbacks
In 2017, Tom moved to a specialist mental health unit. We continued to support him with equipment reviews and trials, although his cognitive limitations and behavioural responses made progress difficult.
A sensory assessment was recommended to better understand his triggers and support his emotional regulation.
Relocation and Renewed Focus
In 2019, Tom moved to a new unit, closer to his family. Despite initial behavioural challenges, we worked closely with the private team and the staff at the unit to build trust and structure.
We introduced meaningful activities like chess, which improved Tom’s mood, focus, and social interaction.
A volunteer was brought in to play chess weekly, helping to foster routine and engagement.
Community Access and Structure
Recognising the importance of routine and community engagement, we helped secure a second-hand wheelchair-accessible vehicle (WAV) and trained staff in its use. We also created a personalised activity binder to help Tom explore interests like cinema, music, and sport.
In 2021, Tom began working with his own fully-dedicated support workers, allowing for more consistent therapy and structured routines. He now enjoys regular ski sessions, cycling, and community outings.
His involvement in planning his week has grown, and he’s visibly more engaged and fulfilled.
Cooking and Functional Independence
In January 2023, Tom began working toward a new goal—cooking basic meals independently. Initially, he insisted on standing with his walker, so sessions were carefully co-led to ensure safety. Over time, he became open to cooking both seated and standing, exploring different recipes and using both upper limbs.
This activity has become a source of joy and purpose for Tom, supporting his upper limb function, cognitive skills, mood, and healthy eating habits.
To support this, we’ve continued upper limb therapy through exercises, games, and fine motor activities. A spasticity specialist has also been involved to help manage tone and promote better movement patterns.
Housing Transition and Long-Term Planning
In 2024, Tom transitioned into a rental property with 24-hour support—this time, directly employed staff rather than agency workers. Our OT ensured the home was fully equipped with a profiling bed, armchair, shower chair, and full wheelchair accessibility.
Meanwhile, a permanent home was located and purchased in mid-2024. It is now being rebuilt from the ground up to meet Tom’s current and future needs.
Our team continues to work closely with architects and contractors, with the goal of Tom moving into his forever home by the end of 2025.
A Decade of Dedication
Over the past 10 years, KW Therapy has remained a consistent presence in Tom’s life. This continuity has been vital—not just for Tom, but for the wider clinical and legal teams involved. We’ve worked through challenges including epilepsy management, behavioural complexities, and inconsistent staffing at care units.
Progress was sometimes delayed due to funding or staffing limitations, but Tom’s journey has been guided by a multidisciplinary team—including psychiatrists, epilepsy specialists, spasticity consultants, SALT, Physio, OT, and his Case Manager.
Today, Tom is more independent, more engaged, and—most importantly—happier.
His story reminds us that complex brain injury rehabilitation is not linear, and that true progress happens on the client’s timeline, not ours.
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