Cavendish Homecare was initially approached to provide care for Mr and Mrs Graham in their home in Virginia Water as a result of a recent stroke Mrs Graham went through. Initially, Mr Graham only required basic support such as laundry, food shopping and going to a few appointments. However, after some observation, the carers noticed that Mr Graham was very susceptible to falls. Monitoring falls in the elderly is of paramount importance as the elderly are particularly vulnerable to the adverse consequences of falls.
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Our Client’s Story…
Over a span of several months, Mr Graham experienced a series of falls, resulting in two instances that required visits to the Accident and Emergency department. In some instances, Mr Graham would hesitate to report any falls or near miss. Any time the team were alerted to a fall or near miss, Mr Graham always attributed these to a loss of balance and instability on his feet. This hesitance is common among the elderly due to the desire for independence and fear of needing more assistance. He worried about burdening carers, thus minimised the severity of his falls. To address this, it was crucial to create a supportive environment and encourage open communication between the carers and Mr Graham. The carers were also always nearby to provide assistance while respecting Mr Graham’s independence.
With this, it was evident to the team and the Clinical Manager, that despite Mr Graham not being the primary recipient of care in the beginning, the need for an improved care plan for him was implemented.
The Cavendish Approach…
A multi-disciplinary approach was essential in managing Mr Graham’s falls, with various team members involved in the care. This team included three live-in carers, our Clinical Manager, and Mr and Mrs Graham’s daughter, who became an integral part of the care planning process. Additionally, medical professionals such as his GP, physiotherapists, an occupational therapist, and a dietitian were consulted to address different aspects of wellbeing.
The identification of risk factors for Mr Graham’s falls played a crucial role in tailoring his care plan. Mobility issues, including weakness and instability, were a prominent concern. His preference for minimal adaptations in their home highlighted the importance of respecting any wishes while ensuring safety. His difficulty getting up from the couch and night-time wanderings further underscored the need for comprehensive intervention.
Mr Graham’s assessment by the Falls and Bone Health Service revealed several risk factors contributing to the history of falls, including frailty, incontinence, poor gait and mobility, and postural hypotension. His high risk of fragility fractures, in line with the FRAX Tool and NICE guidelines, called for specific actions. Equipment was supplied to enhance safety within the home, and bone health recommendations included exercise, balance retraining, lifestyle adjustments, and potential medication were addressed.
This collaborative effort from a diverse group of professionals and caregivers was essential in addressing Mr Graham’s falls, with a holistic approach that considered the unique needs and circumstances.
The Outcome…
It is crucial to emphasise that Cavendish Homecare’s private nursing goes beyond just supporting an individual client; the care extends to those around them who may also require extra attention during challenging times. This holistic approach is especially evident in this case where care was initially focused on Mrs Graham, who experienced a stroke. The broader benefit became apparent as both were supported, illustrating the comprehensive nature of Cavendish Homecare’s services.
Mr Graham’s journey highlights the efficacy of a multi-disciplinary approach to address recurrent falls in the elderly and by working with him, instances of falls can be reduced. Collaborative efforts involving carers and a team of professionals, respecting Mr Graham’s preferences, risk assessment, and targeted interventions, collectively demonstrate the power of patient-centered, comprehensive care in enhancing wellbeing and safety for the elderly.
Disclaimer: For privacy and confidentiality reasons, the names and locations in this case study have been changed. The events and outcomes described are based on real situations, but identifying details have been altered.
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