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Case Study 1 – Mr Paul Stevens 

Paul is a 48-year-old man who had an accident at work, resulting in a Traumatic Brain Injury (TBI). Paul has significant left sided weakness, severe dysphagia and dysphasia. He has been discharged from the acute setting to impatient rehabilitation for intensive therapy to help with his mobility, feeding and speech. Paul’s husband Gary is very supportive and has assumed primary caring responsibilities for their 8-year-old daughter, Rosemary. 

Paul and his family previously led a very active lifestyle that included regular outdoor activities such as hiking, horse riding and camping. Paul was in hospital for over 4 weeks prior to rehabilitation admission and is expected to spend a significant amount of time in rehabilitation to try and regain as much function as possible. Paul is currently unable to transfer himself and requires significant assistance with all ADL’s. Paul has tried using a 4-wheel walker in the hospital physiotherapy sessions but has not been successfully able to mobilise without significant support and assistance. 

Prior to the accident Paul was active with no significant medical history but does have a family history of bowel cancer, hypertension and cardiac issues. Paul is expected to be in rehabilitation for up to 8 weeks depending on his progress. Paul has not been able to express how he feels regarding his accident due to the dysphasia, but his partner Gary feels that he is not coping well with the possibility of significant longterm changes to his lifestyle if he is not able to fully recover. Rosemary has been visiting Paul daily but is reluctant to stay for long because the hospital “smells funny”. 

You have just admitted Paul to the rehabilitation centre. You are his assigned primary nurse. 


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