Case study of an older person with traumatic brain injury: from Greece to Glasgow, complicated by infection control protocols

Case study of an older person with traumatic brain injury: from Greece to Glasgow, complicated by infection control protocols

Introduction:
The average age of major trauma (MT) patients in Scotland is now 70 years, reflecting a rising trend, with falls from standing the most common mechanism of injury (STAG Report, 2024). Older adults frequently present added complexity due to frailty and comorbidities. This case describes an older adult who sustained a traumatic brain injury abroad and, following repatriation under strict infection‑control precautions, received complex in‑reach MT rehabilitation from the hyper‑acute multidisciplinary team (MDT) at the Queen Elizabeth University Hospital (QEUH).

Method:
The hyper‑acute MDT— Dietetics, Occupational Therapy, Physiotherapy, Psychology, Speech and Language Therapy, Therapy Support Workers, and Rehabilitation Medicine—delivered daily, early, and specialised rehabilitation within an isolation environment. Close collaboration with Infection Control, Microbiology, ward teams, and medical staff ensured safe practice and allowed timely planning despite stringent protocols. Rehabilitation was maintained through structured goal‑setting, coordinated timetabling, joint therapy sessions, regular family meetings, and provision of single‑patient‑use equipment appropriate for long‑term isolation. Support from geriatric medicine enabled effective management of blood pressure and medical complexity to optimise rehabilitation intensity.

Results:
The patient’s length of stay was 105 days. He received 245 therapy sessions, totalling 362.75 hours of intervention. Validated outcome measures demonstrated clear functional improvement from admission to discharge. He returned home with a package of care and onward referral to community rehabilitation services. The family valued the regular update meetings, which helped them navigate his hospital journey. Although infection‑control measures added complexity to in‑reach working, this case illustrates that clear communication, consistent protocol adherence, and coordinated MDT practice enabled delivery of high‑quality rehabilitation without compromising the patient’s overarching goal of returning home.

Conclusions:
Effective multidisciplinary collaboration and frequent communication with wider services and family ensured infection‑control measures did not restrict access to appropriate, intensive rehabilitation—capturing the Scottish Trauma Network principle of “saving lives, giving life back.”