Kevin Hagenson

11 Yarra St

North St Marys

NSW

05.02.2025

Re: Kevin Hagenson (DOB: 12.02.1964) NDIS review February, 2025

Dear Kevin and your NDIS team,

I write to provide a report for Kevin Hagenson’s 2025 NDIS review.

Kevin was first referred to see me for psychosocial support by Sarah Stafford at Effective Plan Management in October, 2022. He initially saw me monthly, however since his last review, he has attended fortnightly consultations over the past two years.

Kevin has a chronic and life-long mental illness and irreversible paraplegia, hence needs ongoing psychological support. This support will help him continue to navigate the challenges associated with his condition to achieve his goals of accessing the community independently and working towards a renewed sense of purpose in his life. He would like to incorporate fortnightly sessions into his NDIS care plan that is currently undergoing a review.

At the time of his review on the 5th of February, 2025, Kevin stated that the sessions continue to help him manage the combined challenge of bipolar disorder and paraplegia, and that continuing to access this support is vital for coping with his disability. He stated:

“It helps a lot coming here; it's an outlet; I can talk about things I can't with anyone else; I can download and get rid of emotional baggage; I can express whatever I choose to without expectations or judgement; it's a safe haven; a sanctuary." He also reported it has helped him feel more confident to pursue and achieve his goals around independence, which have progressed considerably over the last year.

In this report, I provide a summary of the impact of Kevin’s disability on his mental health, his current challenges, his supports, his goals and how my services aim to support him to achieve these. At the end of the report is a quote for fortnightly consultations for a one year period. Should his plan review be for a two-year period, this will need to be doubled.

Yours sincerely,

Michelle Hookham

Impact of disability on mental health

The medical injury that caused significant impact across all domains of Kevin’s life continues to impact his emotional wellbeing. He finds it difficult to talk about his mental health and considers that he still has not dealt with the ramifications. He frequently speaks about the impacts of having lost the ability to live an independent life, to work and achieve his life’s purpose, all of which cause ongoing distress. What he expressed in his previous report captures his experience well: “The frustration of dealing with a disability later in life and trying to adapt is very difficult - physically and intellectually. What is out there that I can strive to achieve that is within my realm?; it has taken away my independence and dignity”, which are a constant source of low mood. Kevin has been a high achiever and hard worker in the past. He stated “It’s hard remembering your abilities when faced with a disability; I have lost my capacity; I have no future in the workforce, but you need money to survive.” Being idle has been difficult for him, including the loss of his hobbies and passions, such as restoring old cars. He requires full-time care and has increased anxiety if his carers or other NDIS supports change their care provision schedule. Kevin also struggles with the way people “treat you like you have a cognitive impairment and being spoken down to, just because you’re in a wheelchair. One of the main things I miss is the time that I spent alone. I don’t have that anymore. I always have to have someone with me to go out, to shower, dress, cook, wash clothes and I can’t drive myself anywhere.”

For confidentiality purposes, more specific details pertaining to his mental health issues are not included in this report.

Current Challenges

Physical: Kevin sustained ‘incomplete paraplegia’ following back surgery in 2018. He reported paraplegia from the knees down and discomfort from the hips to knees. He has associated bowel and bladder issues, including incontinence. Kevin reported that this impacts his self-esteem and confidence to go out in public. In addition, Kevin reported past workplace injuries, including right shoulder and jaw damage in 2006 and injuries sustained from a motorbike accident in 1997 and MVA at the age of 17. He also has abdominal hernias and is awaiting surgery, however this has been delayed several times, much to his frustration.

Falls risk: Kevin reported that he occasionally gets up at night and forgets that his lower limbs are paralysed. This has resulted in falls and additional injuries, including a displacement of the right shoulder in November, 2022.

Mental health: Kevin has a diagnosis of Bipolar affective disorder and is stabilised on medication. When unwell, he reported that he becomes withdrawn and self-isolates. Kevin reported suicidal ideation and past attempts to end his life when very low, however denied current ideation and stated “I will never fall off the edge without reaching out for help”. He also has manic episodes and has had inpatient hospital admissions in the past. He reported a past history of childhood trauma and has been impacted by adverse events in his adult years, including relationship breakdowns in his two marriages, estrangement from two of his children and the loss of a close friend to suicide.

Relationship stressors: Over the past year, Kevin has reported tension at home between his primary carer and ex-partner, Noy and his step-son, Sutep.

Home modifications: Kevin has been awaiting home modifications for the past two years. There was discrepancy between two OT assessments, one recommending a new bathroom and the other the installation of handrails only. There were questions raised about the curb side access, which is also unresolved.

Driving independently: Kevin is keen to progress his goal towards being more independent. He has purchased a car that can be modified in steering and wheelchair mechanics to suit his needs. He has also been working towards renewing his driving licence. NDIS support in this goal would be beneficial for him.

Supports

Kevin’s key support is his ex-wife, Noy who resides with him in a granny flat.

3 children: Brad, Amanda and Jemma (unable to visit Brad as he lives in an apartment with no lift).

2 brothers and sisters very close in relationship and proximity.

Physio – Doris Qu

Podiatrist – Xin Yu

Therapeutic support - Michelle Hookham

TBC – hydrotherapy – trying to get into Penrith

Psychiatrist – Dr Naaz

GP – Dr Dang

Support Coordinator – Mandy Fraser, Empower Me: 0408 660 448

Support coordinator – Mandy Robinson – organising OT: 0402474 881

Georgina Mant – Plan Manager Effective Plan Management

Plan

Kevin is a person with the comorbidity of a physical disability and complex and lifelong mental illness. Therapeutic engagement aims to support his emotional wellbeing so that he can continue to cope with his physical disability, regain confidence and rebuild his capacity to find his purpose and live a meaningful life.

There is direct link with Kevin’s physical health challenges impacting on his emotional wellbeing. Because of the complexity and ‘co-morbidity’ of these experiences, a team approach to care is recommended. Kevin would like to continue to access therapeutic support with myself and I am happy to provide this as needed and as approved by the NDIS. At this time, fortnightly consultations are his preference.

Below is an outline of Kevin’s goals for our work together over the next year.

Kevin’s Goals and action plan:

Core area	Kevin’s goals/words	Challenge	Action/how I’m helping achieve this
Access to the community	I want to get back my independence and go places on my own	Kevin is unable to leave the house without supports in place because of his physical disability. Kevin has made significant progress with regaining his driving licence and has purchased a car. Challenges include: cost of car modifications and equipment for wheel chair handling.	I have assisted with exploring options and encouragement to pursue this goal; Kevin stated it has made a difference with his confidence to move forward
Independence	I want continuity of care so that I can feel free and unrestricted.	Kevin would like to be less reliant on Noy for his care. Noy has plans to travel, and Kevin will need to access respite care in the future. Consistency with NDIS support workers is optimal for Kevin’s sense of continuity of care.	Therapeutic support to help Kevin articulate and manage feelings arising from frustrations at home; problem solving to explore options for independent living.
Mood	I want to be stable in my mood.	Bipolar disorder leads to mood swings – mostly depressive, but with occasional elevated mood. His disability contributes to episodes of low mood.	Psychoeducation. Strategies for managing mood. Diversional therapy.
Healthy lifestyle	I want to be healthier.	Lifestyle goals are difficult as Kevin needs support for all activities of daily living	Work with Kevin to explore and learn about healthy eating and exercise and ways he can incorporate this into his life despite the physical challenges; work with his team as required, eg. OT review
Vocation	I want to regain a sense of purpose.	Kevin recognises that he has skills that could be useful in an employment situation, however is unsure what this might look like.	Help Kevin to explore ways he could engage in meaningful occupation. Connect with services where appropriate.

2025 NDIS plan for Michelle Hookham

One-hour fortnightly consultations are recommended and requested by Kevin.

A total of 25 over one year. Plus three hours for report writing for reviews.

Location: 6 Christie St, Windsor.

Yours sincerely,

Michelle Hookham