Case Study 2  - Yvonne

Yvonne an 88yr old lady was admitted to the Care Home from hospital in November 2011 with a diagnosis of Vascular Dementia, skin cancer of the hand and face, osteoarthritis, diverticulitis, CVA, #pubic ramus and long standing back pains. Prior to being admitted to hospital Yvonne had spent two weeks’ respite in the Home.

Following transfer to the home the staff could see a deterioration in her mental and physical health and she needed twenty four hour nursing care; she was able to communicate her needs.

Advanced care planning was discussed with her son which included Yvonne’s life story in order to ensure a better understanding of her life. This included future wishes both towards and at the end of life. A care plan was tailored to meet Yvonne’s care needs and was signed by the son.

Yvonne was an entertainer previously and this was evident in her entertainment of those participating in the daily activities.

As she deteriorated over the years she required assistance with eating and drinking. She became verbally aggressive and was assessed by a psychiatrist who prescribed an antidepressant which had a very positive impact.  As Yvonne continued to deteriorate, she had swallowing difficulties, and following assessment by the speech therapist thickened fluids and pureed diet was given. However, deterioration continued with evidence of weight loss, and the nutritionalist suggested supplements which she tolerated well.

The family were informed of the Home’s Gold Standard Framework programme of care which they were happy to hear about. DNACPR was discussed and the Care Home said  they would do all they could to ensure Mum died in the place she called home.

The GP visited and communicated by telephone on a regular basis, and the family and all the staff were involved in sharing the information needed for Yvonne’s care needs through the Coding and review meetings.

As she continued to deteriorate her pain was controlled with pain patches and the dose monitored and reviewed as she needed.  All staff members were updated and training had been given to them with regard to GSF to enable them to be better equipped to give support and care.

Yvonne’s care was reviewed and her coding changed to C-D and the Out of Hours informed. The family were told and they visited more frequently, along with friends who were able to say their goodbyes.

Yvonne died peacefully with her favourite carer with her which gave the family some comfort as they were unable to be with her themselves. The Out of Hours doctor was called to certify death and she was taken to the chapel of rest following after death care.

The Staff were invited to the funeral and the family thanked the staff for the excellent care given to their mother over the years.

 

Updated 13/4/2016