Case Studies
Case Study – Falls and Mobility
Client Profile:
Mrs T aged 64, lived alone and had collapsed unexpectedly several times, luckily only sustaining minor injury.
This was investigated and she was diagnosed with an irregular heartbeat requiring surgery to have a pace maker fitted. The uncertainty and risk of further fainting meant that Mrs T felt vulnerableand frightened when alone.
Role of Telecare:
Mrs T was referred by her GP and an assessment was undertaken. This indicated that she would benefit from a falls pendant. The pendant works by sensing when the wearer is in a fall position rather then being upright, which is ideal for someone whose fall is caused by fainting as it requires no action from them to send an alarm.
Outcome:
Mrs T. now feels safe, confident and reassured that if she is unwell help can be summoned by pressing the pendant herself or in the event of a collapse that the falls sensor would automatically alert the care centre. The family feel more relaxed and able to go about their daily routine. They are happy that she does not have to rely on her ability to reach a telephone if unwell.
Case Study Falls & Mobility – Mrs T
Case Study – Personal Wellbeing
Client Profile:
Mrs I. Aged 85 lived alone, in reasonably good health, but suffered short-term memory loss, which caused her difficulty in remembering to take her medication. She found it confusing to know which pills to take and had difficulty in recalling whether she had taken them. The result of this was that she was at risk from overdosing and her condition was worsening as her medication regime was not being complied with.
Role of Telecare:
An assessment was undertaken both with Mrs I. and her family. As a result it was suggested that trying a pill dispenser linked to a telecare alarm may overcome her medication management problems. The family were happy to take on the responsibility for filling the pill dispenser and securing it with the key provided as an additional precaution. The dispenser can deliver up to 4 doses a day and at this level requires filling on a weekly basis, but if only 1 dose is needed then it will last for 4 weeks. Should a dose be missed the dispenser triggers an alarm call to the care centre so that a reminder can be given.
Outcome:
Mrs I is now taking her medication regularly. There was some initial apprehension about her ability to recall what the audible tone emitted from the pill dispenser was for, this sound being the prompt to pick up the dispenser and tip out and take the medication at the set time. However she has managed well and this has now become part of her daily routine. She finds it helpful and has stopped worrying, and more importantly as she puts it “has stopped my family fussing!”
Her family are now able to spend quality time with her, rather than having to rush in and out, fitting in visits before and after work. They generally feel less stressed and have expressed relief at not continually having to worry about making special arrangements to take time out from work. They are reassured that now that she is complying with her medication regime her condition has stabilised.
The pill dispenser has raised alarm calls to the care centre occasionally when she has not heard the reminder tone. A verbal reminder has been sufficient to prompt her to take her medication.
Case Study Personal Wellbeing – Mrs I
Case Study – Personal Wellbeing, Falls and Mobility
Client Profile:
Mrs E. aged 86, lived alone and had had a pendant and alarm since 2001. She been diagnosed with Parkinson’s disease, was partially sighted, a Type II Diabetic and her mobility was very poor with resultant falls. She was unresponsive to conversation and was in hospital from Sept 2006 to Feb 2007. It was felt that she possibly would be unable to return to her own home.
Role of Telecare:
A joint assessment was undertaken involving the Occupational Therapist, the family and the telecare team. The decision was reached to put in place a bed occupancy sensor in addition to the existing pendant and alarm to provide additional monitoring overnight and a keysafe, to allow speedy access for the emergency services.
The bed sensor is active during the night monitoring Mrs E if she gets up. It monitors the time she spends out of bed and if this exceeds the preset safe period then an automatic alarm call is made via the telecare alarm to the care centre. They respond by checking via the alarm if she is alright and if she has had a fall arranging for an ambulance. The preset time can be adjusted to suit the needs of the individual.
Outcome:
It was initially thought that Mrs E. would be unable to return home and would have to go into a nursing home due to her high needs. But with the aid of telecare and a good care package she has been able to return home where she feels more comfortable. She is able to summon help in between her homecare and family visits if required by pressing her pendant. Mrs E. and her family now have the additional reassurance at night, that if she was to fall that the bed occupancy sensor would automatically raise an alarm to the care centre.
This has assisted Mrs E’s family greatly otherwise one of them would have been required to stay at the property over night.
Case Study Personal Wellbeing and Falls & Mobility – Mrs E
Case Study – Home Safety
Client Profile:
Mr B. aged 87 lived alone with early stage dementia and had suffered several mini strokes. He also had arthritis in his knees making him prone to falling, and consequently he needed a frame to mobilise. He had used a pendant and alarm since August 1999. Mr. B’s daughter was concerned that electrical appliances were being left on and that in the event of a fire her father would be unlikely to escape or raise the alarm if the smoke had overcome him.
Role of Telecare:
His daughter saw an advertisement about telecare smoke alarms and arranged an assessment for her father at his home. Smoke detectors were in place, but it was decided that he would benefit from a smoke alarm that would automatically contact the care centre through a telecare alarm, as his ability to understand the meaning of the audible warning tone or to evacuate the house unaided was now in question.
Outcome:
Mr. B’s daughter reports that she feels more confident that if there was a fire it would be detected much sooner and assistance called for without delay. She is also reassured that the Fire Crew in attendance would know that Mr B’s mobility and comprehension of the situation is limited.
Case Study – Personal Wellbeing and Falls & Mobility
Client Profile:
Mrs M aged 74 had suffered falls at home due mainly to her Parkinsons Disease. A particularly bad fall resulted in a two-month hospital stay and it appeared during this that she might not be able to return home. Her deteriorating mobility coupled with poor vision and confusion were making it increasingly difficult for her to cope with normal daily activities and also with medication management.
Role of Telecare:
Mrs M had a very supportive family who were involved in assessment whilst she was still in hospital. It was felt that if the medication management difficulties could be overcome then an overall improvement in her condition would result. The decision was taken to send her home with a care package and a pill dispenser to be filled by the family to ensure that she was prompted to take her medication at the correct times. To start with a family member was available to live with her whilst she re-acclimatised. The addition of a bed sensor once this period was over, to alert for potential night time falls was also planned.
Outcome:
Her family found that Mrs M got used to the pill dispenser very quickly and the result of her taking her medication in the prescribed amounts and at the correct times had a positive effect on her well being. She began to regain some of her lost independence and when the family member was no longer available to live with her she was at a stage where she could cope well with her essential daily activities. The bed sensor was added to give greater security at night in case of falls.
Case Study Personal Wellbeing and Falls & Mobility – Mrs M
Case Study – Home Safety
Client Profile:
Mrs B. aged 70 suffered from Alzheimers and lived alone. Her son was concerned as she had three times left the taps running in the sink in the bathroom with the plug in. This had resulted each time in the ceiling in the flat below collapsing. Her son was aware that unless something could be done to alert if this happened again her increasing forgetfulness would result in her having to move into a residential care home. He believed that to take her out of the environment she was used to would have a detrimental affect on her well being and could result in a rapid decline in her condition.
Role of Telecare:
Her son was put in contact with the local telecare team who went with him to visit his mother. The assessment recommended a flood detector on the floor by the bathroom sink to act as an early warning if the taps being left on caused an overflow. Whilst in the property the team noticed that Mrs B had burnt the toast and was unaware of this even when prompted as it remained under the lit grill. It was apparent that she might also struggle to exit the property if a fire took hold and would certainly have been very confused if this happened. It was therefore suggested that the addition of telecare smoke detectors as well as the flood detector would greatly enhance her safety and also reduce the risk to others in the building.
Outcome:
The telecare equipment was installed and Mrs B was able to continue living in her own home for a further 9 months before her worsening condition dictated that she needed a residential care placement. During these 9 months which her family saw as a bonus, which slowed the advance of her condition, there were no further incidences of flooding.
Case Study Home Safety – Mrs B
Case Study – Falls & Mobility
Client Profile:
Mr D aged 47 suffering from epilepsy, diabetes, arthritis and premature dementia. Due to his epilepsy and diabetes Mr D was suffering frequent seizures resulting in falls, which required hospital treatment and/or stays as an in-patient. His clinicians were conscious that many of these admissions or A & E visits could be avoided if assistance could be given as soon as possible after the event, as most of the times it was several hours before the next planned care visit.
Role of Telecare:
His social care worker was put in contact with the local telecare team who went with them to visit Mr D. The assessment recommended the installation of a telecare alarm system with a falls detector for daytime use and a bed sensor set for 20 minutes absence for the night time. A keysafe was installed as well to allow the ambulance crews easy access to the property at night, which was when many of the falls were happening. Telecare was seen by the social care team as the last attempt at keeping Mr D in his own home as otherwise the potential risks and cost of frequent hospital admissions would dictate that he be moved into some form of residential care.
Outcome:
The telecare equipment was installed and Mr D was able to continue living in his own home with in excess of 80% of his seizures now picked up by the telecare equipment which has resulted in a considerable reduction in A & E admissions and admissions. On all but a very few occasions the prompt response has meant that the paramedics have been able to treat him at home and allow him to stay there. Mr D remains at home to this day, which is almost 3 ½ years after the installation of telecare.
Case Study Falls & Mobility – Mr D
Photographic Acknowledgements: Chubb Community Care, Tynetec Ltd. and Tunstall Healthcare Group Ltd.