Huntington’s Disease:

Compassionate Care and Treatment at Brunel House, Specialist Neuropsychiatric Hospital

Huntingtons’ Disease can manifest in several different ways but the core symptoms fit broadly into
three categories: motor, cognitive and psychiatric. Motor symptoms are most often large involuntary
jerking-type movements of the limbs (chorea) although they can also affect the movements
associated with speech and swallowing. Cognitive symptoms commonly include difficulty organising
thoughts, controlling impulses or outbursts of anger and memory lapses. Psychiatric symptoms such
as depression, obsessions, psychosis and aggressive behaviour can occur and they can be some of
the earliest signs of the disorder. Brunel House is a setting where the complex care needed for these
individuals can be provided.

While it is not common for a person with Huntington’s Disease to need that level of care, if this is
necessary, it can be a scary time for their family. Their loved ones can behave so differently – they
can swear or hit out when they didn’t before the disease progressed; they can make accusations
against family members or take a sudden dislike to a son or daughter which can be very distressing
for everyone involved. Some of these patients will require detention under the Mental Health Act
and their relatives may not understand why it’s needed. The Mental Health Act provides a
framework to keep people safe either from self-neglect or a tendency to aggression towards others
and it is not at all like the archaic mental health hospitals seen in films! Loved ones are not locked
away in handcuffs or chemically restrained but approached with care and compassion.

Our specialist knowledge and skills can walk alongside a person’s journey through this tough part of
the disease progression for the individual and the family members involved. Brunel House is a
specialised environment that is welcoming and designed to maximise a person’s abilities. Patients
have their own bedrooms and meals cooked in-house which can be tailored to a person’s needs.
Input from our occupational therapists and ward staff will support daily living skills and structured
community activities. Speech and language therapists work towards improved abilities in
communication and our physiotherapist will look at gait and muscular discomfort, for example.
Medications for the symptoms as described above will be considered by the neuropsychiatrists and,
if prescribed, closely monitored in conjunction with regular physical health reviews. Psychologists
will assess cognition and aim to improve deficits with bespoke 1:1 therapy so that mental health and
cognition is approached holistically. Our nurses will support skills in washing, dressing and healthy
life choices, and care for the individual with empathy and kindness.

Rehabilitative approaches are key in a hospital setting and are needed for a period of time only,
working towards discharge. At Brunel House we understand that the families involved are likely to
be having their own struggles with the disease and this adds another dimension to the care that is
offered. Regular face-to-face meetings with family help to address these as well as interim
discussions as needed. Our focus is on excellent communication with best interests of the patient at
heart.

We at Brunel House are well-placed to provide compassionate care and treatment for individuals
with Huntington’s Disease and high levels of distress. Through a hospital stay, our objective is for
improved quality of life and to empower the individual to make decisions about their own treatment
in the future.

Dr Juzer Daudjee, Neuropsychiatrist Cygnet Brunel