Private Nursing
Cavendish Homecare was initially approached to provide care for Client A and Client B as a result of a recent stroke Client A went through. Initially, Client B only required basic support such as laundry, food shopping and going to a few appointments. However, after some observation, the carers noticed that Client B 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.
Over a span of several months, Client B experienced a series of falls, resulting in two instances that required visits to the Accident and Emergency department. In some instances, Client B would hesitate to report any falls or near miss. Any time the team were alerted to a fall or near miss, Client B always attributed these to a loss of balance and instability on their feet. This hesitance is common among the elderly due to the desire for independence and fear of needing more assistance. They may worry about burdening carers and minimise the severity of falls. To address this, it was crucial to create a supportive environment and encourage open communication between the carers and the client. The carers were also always nearby to provide assistance while respecting Client B’s independence.
With this, it was evident to the team and the Nurse Manager, Esnart Namakando, that despite the client not being the primary recipient of care in the beginning, the need for an improved care plan for Client B was implemented.
A multi-disciplinary approach was essential in managing Client B’s falls, with various team members involved in the care. This team included three live-in carers, our Nurse Manager Esnart Namakando, and Client B’s daughter, who became an integral part of the care planning process. Additionally, medical professionals such as Client B’s GP, physiotherapists, an occupational therapist, and a dietitian were consulted to address different aspects of well-being.
The identification of risk factors for Client B’s falls played a crucial role in tailoring the care plan. Mobility issues, including weakness and instability, were a prominent concern. Client B’s preference for minimal adaptations in the home highlighted the importance of respecting any wishes while ensuring safety. Client B’s difficulty getting up from the couch and nighttime wanderings further underscored the need for comprehensive intervention.
Client B’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. Client B’s 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 Client B’s falls, with a holistic approach that considered the unique needs and circumstances.
It’s crucial to emphasise that Cavendish Homecare’s private nursing goes beyond just supporting the 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 Client A, who experienced a stroke. The broader benefit became apparent as both parents were supported, illustrating the comprehensive nature of Cavendish Homecare’s services.
Client B’s journey highlights the efficacy of a multi-disciplinary approach to address recurrent falls in the elderly and by working with the client, instances of falls can be reduced. Collaborative efforts involving carers and a team of professionals, respecting Client B’s preferences, risk assessment, and targeted interventions, collectively demonstrate the power of patient-centered, comprehensive care in enhancing well-being and safety for the elderly.