'See the Hidden Me': Katie | Fieldfisher
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'See the Hidden Me': Katie

Eighteen-year-old Katie and her support worker arrived at college 15 minutes early. Katie had a meeting with the Principal to discuss her application to enrol on their IT course, and assess any additional needs she may have. When Katie was called into the Principal's office, she was polite and charming. She had clearly researched the college, the course she wanted to enrol on, and even the Principal himself. Impressive. 

The Principal was aware that Katie had sustained a brain injury as a young child, and had severe communication and cognitive issues. During the meeting, Katie discussed openly her on-going personal injury litigation and medical diagnoses, as well as her extensive therapy team, using language and terminology that apparently demonstrated her understanding and insight into both of these aspects of her life. Katie is also ambitious, and she explained her desire to be an architect one day and the route she intended to take to achieve this goal. The Principal was satisfied that the college would be able to support Katie, and that the course she had selected was suitable.

Over the course of the first week of classes, things began to unravel. It became clear that Katie could not keep up with the work and she became disruptive and rude, to her fellow students and the tutor. Katie made friends initially, but her inability to read social cues, her lack of respect for personal space and her sometimes inappropriate language and behaviour saw her ostracised by her peers within weeks. 

Katie's story and Katie's brain injury are complex.  She was involved in a car accident, sustaining a brain injury, before she even started school. She regressed from being toilet trained to doubly incontinent, until the age of six. She suffered mood swings and behavioural problems and struggled when she went to school, academically and socially.

But from the age of five, Katie has had a case manager: a clinically trained professional, instructed by the lawyers involved in her personal injury claim arising out of her accident, to co-ordinate and manage her rehabilitation and welfare.  Katie has been surrounded by medical professionals and in contact with lawyers for almost three-quarters of her life.  She has listened to this medical and legal language for most of her life. She can now regurgitate it convincingly, to strangers such as the college Principal, but does not understand it. In fact, she struggles to tell the time. If anyone were to scratch her articulate surface, they would find Katie incapable of further scrutiny of the subject matter, or explanation of what she had just said – and this focus on her weakness would likely trigger her anger and rage.

Katie has a Financial Deputy, approved by the Court of Protection, since she does not have the capacity to manage her own money: she thinks £90 is a reasonable amount to pay for groceries for one day, yet £130 for a month's rent would be expensive.  She is vulnerable to manipulation by others, something which the Financial Deputy can help limit, at least in terms of money. 

Katie is currently living in the community, with assistance from support workers seven days a week.  She also has an extensive therapy team to support her, including a neuropsychologist to help her understand and moderate her feelings and reactions and to make sense of the world.  Her speech and language therapist works with her to try to prevent scenarios such as that in college, where her communication was inappropriate and at times offensive. The Occupational Therapist helps Katie with financial budgeting, as well as becoming more independent at home and in the community.

Katie struggles to regulate her emotions and can become vitriolic towards the people around her.  Sometimes the reason for this is clear, at other times it is not.

Katie will need support for the rest of her life due to her brain injury. It is unlikely that she will ever be able to live completely independently. 

You could meet Katie in the Post Office today, have a chat, and come away thinking what a pleasant young woman, or your trolley might bump into hers in the supermarket and you'd receive a torrent of verbal abuse.  In either scenario, it is unlikely to even cross your mind that this young woman lives with a brain injury.

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