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Toni - living with Aspergers and an eating disorder

 “Controlling what I ate felt like the only thing I had any control over”
 
Toni is a 21 year old Female living with Asperger syndrome and an eating disorder.  (* Names and images have been changed)
 
Previously Toni was living in a residential care home which had served notice due to her non compliance, challenging behaviour and low weight.
 
Difficulties identified before coming to Brookdale:
• High levels of anxiety – resulting in examples of challenging behaviour
• Poor levels of self-care
• Not recognising her eating disorder
• Over exercising – resulting in weight loss
• Difficulty mixing socially with people
• Poor self-esteem and feelings of self-worth
• Over spending on selective goods
• Not engaging with Clinicians
 

ADMITTED TO MILTON PARK THERAPEUTIC CAMPUS
 
Toni was admitted to Ashwood Women’s unit at Milton Park Therapeutic Campus in January 2014.
 
The therapists and staff at Milton Park got to know Toni, her likes, interests and dislikes and used these to devise a timetable of activities and therapeutic strategies that Toni would engage in.
 
Therapists worked with Toni to develop a greater understanding of her Asperger syndrome and to create coping strategies to help reduce her anxieties and deescalating techniques for her and the staff supporting her. This has meant a large reduction of incidents of challenging behaviour.
For Toni, her eating disorder was based around her need for control and feelings of self-worth. The Psychology team worked hard with Toni to help her overcome these feelings and to develop positive strategies for her to focus on.
 
Toni was supported to understand what constituted a balanced diet and engaged with the Occupational Therapists to learn how to prepare food so she understood how to make a nutritious meal.
 
Staff worked hard to get Toni to engage with meaningful activities and to reduce the level of exercise she was doing. This included Art & Crafts, joining social skills groups and cooking.
 
Social stories have been developed to help aid and prompt Toni to carry out her personal care activities such as teeth brushing, washing and laundry.
 
Staff are supporting Toni to learn about managing money and creating a budget. Currently she has a compulsion to purchase hoodies although the majority not worn.
 
TRANSITION TO PATHWAY HOUSE

In January 2015 Toni had progressed well and felt she was ready to transition onto Pathway House, a step down residential service for people leaving hospital.
Staff at Pathway House continue to use the support strategies that were developed at Milton Park Therapeutic Campus, Toni feels reassured by the consistency.
 
At Pathway House Toni receives support from the same clinicians and therapists that she has built a relationship and can access the Star Centre to continue group activities as well as going in to the community.
 
Toni’s BMI is now in a healthy range and she had a greater understanding of the negative effects of over exercising. When Toni is anxious it can still trigger issues surrounding food so she continues to have psychology input.
 
Toni now enjoys cooking meals with staff support. Staff support her to write a list and then travel to the shops to purchase the items required.
 
“I now feel ready to go to college and develop my skills”
 
Toni still struggles with some aspects of her Asperger syndrome, specifically being anxious when in new situations or with new people. But she has coping strategies that she can now use that enable her to be out in the community.
 
Toni enjoys her sessions with the Art Therapist at the Star Centre and has been supported to apply for an Art course at the local college.
 
Toni now hopes to move into Supported Living soon.
 
THE SPECTRUM STAR
 
Brookdale Care has developed the Spectrum Star, an Outcome Measurement Tool specifically designed for people living with Autistic Spectrum Conditions.
The star has 9 points that have been identified as key areas of difficulty for people living with Autism.
 
The tool is used with the resident and keyworker, they discus where they feel the individual is on each point of the star. A support plan is then written based on areas of identified need.
 
The Star also provides a visual tool for the resident to see how they are progressing and have successfully been used in CPAs with care professionals and families.

Here is Toni's personal star that she has completed with her keyworker since she has been at Brookdale Care. 
 


Brookdale's robust Care Pathway enables Toni to be supported throughout her transition from locked rehabilitation to living in the community.  This positive progression also results in a reduction of fees as Toni's skills increase, demonstrated in the table below. 

COST OF HEALTH & SOCIAL CARE - January 2014 – May 2015
 

If you would like to speak to someone about this case study or Brookdale's support services than please call 01707 646 646 or email info@brookdalecare.co.uk