Kevin Bateman was 34 years old when, in February 2018, a lorry crashed into his car on the A38 causing him to sustain a life-threatening brain injury. It was only the previous week that he and his girlfriend, Vicki, learnt they were expecting their first baby. At the time of the accident they had yet to share the happy news with their families. This case study, written in February 2020, is Vicki’s account of Kev’s rehabilitation journey so far.

Car accident resulting in severe brain injury

Kev, an accountant for FedEx, was driving to work from Stoke on Trent when the accident occurred on 6th February 2018. He sustained a severe brain injury in the crash which left him in a coma. He spent 4 weeks in intensive care at Queen Elizabeth Hospital in Birmingham, before being transferred to a ward to be cared for. Kev was transferred to the Royal Stoke Hospital in April 2018 to be closer to his home, family and friends. He remained there in a very poor medical state for several months, having also suffered a series of infections alongside his accident injuries.

Missing out on the birth of his daughter

Kev and Vicki have been together for 5 years having met on a night out. Prior to the accident Kev was fit and healthy, he played football every Sunday for his local team and enjoyed socialising with friends …. he was Vicki’s “cheeky chappie”. Only a week prior to the accident the couple discovered that they were expecting their first baby. “It was a really exciting moment for us” recalls Vicki. “We were planning the right time to share the news with our families. Sadly, I ended up having to break the news to them on my own. It took me a few days after Kev’s accident before I could bring myself to tell them. Grace was born in Autumn 2018.”

Kev’s injury meant that he was unable to share in all the excitement of Vicki’s pregnancy and planning for the arrival of their first child. Vicki attended scans and midwife appointments without him and, tragically, gave birth to Grace without him at her side. “It was very, very difficult period” explains Vicki. “I experienced a huge range of emotions; happiness that I was pregnant with Grace but sadness that Kev was unable to share any of it with me. I gave birth at Stoke Hospital, the same hospital that was treating Kev at the time. Grace was delivered by caesarean with my mum at my side. The nurses and midwives were incredible as they kept him informed about what was happening (although he was unable to respond).

Choosing STEPS Rehabilitation

It wasn’t until December 2018 that Kev started to show any sign of improvement by beginning to respond to those talking to him with a slight flicker of his eyes. Up until that point he had either been in a coma or awake, but unable to speak or move unaided.

Since his accident Kevin has been supported by his Case Manager, Kate Lewis from Rehab Without Walls; and his solicitor, Clare Salmon from Stewarts. In early 2019 they began to explore rehabilitation options with his family. On choosing STEPS, Vicki says, “Whilst there were rehabilitation facilities closer to home, choosing STEPS was a very easy decision to make. Finding a place like STEPS felt like a huge weight was lifted off my shoulders…I no longer have to constantly worry about him. STEPS has a young vibe and family feel to it. I want Kev to have as much interaction with Grace as possible and STEPS is a place where we can be a family. Grace attends Kev’s music therapy classes, she goes to the gym and watches her daddy have his physio and he’s able to watch her interacting with me, staff and other clients. It’s absolutely fantastic.”

Residential Brain Injury Rehabilitation

Shortly after arriving at STEPS in May 2019, Kev suffered a severe relapse which required him to be placed on the critical care unit at Sheffield Hallamshire Hospital. He remained there for 2 weeks, before being transferred back to the Royal Stoke University Hospital for a period of 5 weeks. During this period the team at STEPS kept in touch with Vicki to check on his progress. In July 2019 he was deemed well enough to return to STEPS to embark on his rehabilitation.

When Kev returned to STEPS after this further stint in hospital, he was awake, and his eyes were open. He had also started to occasionally respond to the odd command. Physically, he was unable to lift his head or movement his body in any way, except for some minor movement in his right arm.

Kev has a packed programme of rehabilitation therapies and treatment as a residential brain injured client. They include:

  • Daily physiotherapy
  • Hydrotherapy
  • Neurologic Music therapy
  • Speech and language therapy
  • Occupational Therapy

Results of Kev’s rehabilitation

Kev receives physiotherapy twice daily. These consist of soft tissue work, stretching and positioning following / to compliment his Botox injections. He has these (Botox) every 3 months and has splints also to support his positioning. He also receives hydrotherapy, does sitting, standing and prone lying work, as well as short, intense gym sessions within a group.

Since coming to STEPS Kev has become more alert and engaged within his sessions, joining in with task / functional specific therapy. He is continuing to make positive progress and is starting to develop his use of voice again. He can use it when in pain or uncomfortable but not to generate speech. Staff at STEPS use a recorder to encourage him to blow and he has been pointing to his voice box to indicate he knows where his voice comes from. Recently he has been able to hum and has been attempting to mouth words on occasion. These are skills that he has been practising in music therapy and vocal skills group.

The Speech and Language team have been supporting Kev to make choices using his hand gestures, and through a communication app on an iPad. He has developed his use of touch access on the screen through joint sessions with Speech and Language therapy and Occupational Therapy, through repetition of motivating activities for example music selection.

He has been having activities to desensitize his mouth and improve his swallow control for example, licking frozen fruit. On admission to STEPS he could not open his mouth or move his tongue to command. He is now able to lick his lips to command which significant for swallowing skills.

In Neurologic Music Therapy (NMT) initially the main objective with Kev was to encourage him to use instruments and music-based iPad apps in order to sustain levels of alertness & attention and respond to simple cognitive demands. This has improved significantly - he is able to follow requests, explore active music making, which is becoming more purposeful and intentional, with his sensory orientation remaining stimulated, vigilant and attentive.

Now that Kev is much more alert and responsive, STEPS’ music therapist has been able to create more functional objectives that might lead to better means of communication for him. She is using music to train non-verbal communication behaviours such as listening, responding, dialoguing, initiating and terminating interaction; recognising others communication and creating communication structures within patterns of social interaction. She is also working closely with the Speech and language therapist in encouraging voiced sounds, spontaneously and to command, which hopefully (over time) mean that Kev might be able to use it as a means of communication.

Within Occupational Therapy, Kev continues to participate in functional tasks such as personal cares. He now demonstrates the ability to use items appropriately such as a hairbrush. With verbal prompting, he can brush both sides of his head. He is also able to wash and dry his face with prompts.

During functional tasks, Kev has been observed to have flickers of movement in his left upper limb. Occupational Therapy continue to facilitate bilateral upper limb tasks, encouraging Kev to attend towards his left side.

Kev has a visual impairment due to his injuries which affects his accuracy when reaching for an object. During his time at STEPS, he has shown improvement in discriminating between colours, shapes and items between a choice of 2.

Clare Salmon, a Partner at Stewart’s and Kevin’s solicitor said, “It has been brilliant to see STEPS’ patience and dedication to Kev’s client focussed rehab programme since his arrival. He is making significant improvements, which is clear for all to see and that has been reassuring for the family who made the difficult decision for Kev to transfer to STEPS given it was such a long way away from their family home.

I have been very impressed with all the clinical, therapy and rehab team available at STEPS. The team are all enthusiastic, of high quality and very client focussed. I would have no hesitation in recommending clients to STEPS Rehabilitation and certainly to visit their facility before making any final decision about their future rehab placement.”

Vicki’s verdict on Kev’s progress

“The changes in Kev over the past 6 months has been lovely to watch. Overall, he seems more alert and responsive. I can see that he has developed a rapport with his therapists – even down to having a secret handshake with some of the staff. He’s starting to smile and seems more relaxed in himself.

In October 2019 we had a first birthday party for Grace, and he watched her excitedly open presents for first time. At Christmas we were able to sit together as a family (including my parents and brother) and have dinner, although Kev remains unable to eat. Just being together as a family means the world to us. We’re able to visit whenever we like. I don’t care about the distance I have to travel to visit him, I know it’s the best possible place for him. I can’t recommend this place enough.”