Weekend Diagnosis: The best bed is your own bed
12 October 2016
This Weekend Diagnosis is from Jane Viner, our Chief Nurse
In 2013 when local people were asked what they most wanted from their NHS, one of the most popular requests was: ‘Support to stay at home, with a wide range of services and support.’
Interestingly, providing more care to people in their own homes or closer to home is the direction of travel for the NHS nationally. Growing evidence supports the view that hospital is not always the best place for someone who is unwell to be – especially if they are elderly.
Often, someone’s medical need may be quite small, and what they really need is care and support for a short time to help them through a difficult period, such as after a fall. They do not need to be in hospital to receive this care and support as it can be given to them in their own home. We call this ‘Intermediate Care.’
You can read about the experiences of two of our patients below – both these ladies had falls and have been helped to recover at home by our dedicated teams of Intermediate Care staff.
As Chief Nurse for our Trust, I am responsible for the quality and safety of care we provide, and for making improvements, whether it is in a hospital setting or elsewhere. I am therefore especially pleased to hear how our Intermediate Care teams are doing such wonderful work out in the community. There is no doubt, this kind of care is effective and is what people want. That is why from this year we are investing an extra £2.31 million a year in our Intermediate Care services: £1.5 million to pay for additional nursing and therapies staff; £160K to extend Intermediate Care to weekends; and £650K to fund additional out of hours nursing and our Rapid Response and Reablement teams. Owing to this investment, Intermediate Care services are now being made available to everyone in South Devon as well as Torbay, including at weekends.
So wherever you live locally, be it somewhere rural and remote or in a town, our Intermediate Care teams will be on hand when you need them to support you to recover at home – because the best bed is your own bed.
Intermediate Care – some patient stories:
Mrs Doreen Graham, aged 87 lives with her family in Paignton. After she had fallen several times, resulting in her being quite unwell, her GP referred her for Intermediate Care services: she needed physiotherapy to assess her mobility and help her rebuild her confidence; she also needed some equipment delivered to her home to minimise the risk of her having any more falls. Her family work during the day, so the Intermediate Care team did what they could to support both Mrs Graham and her family, so she could remain safely at home and the family would not need to worry. One of the adaptations and equipment include a trolley, as seen in the picture, which Mrs Graham uses to safely and easily transport her things around her home. The Occupational Therapist, Juliette Kite, pictured with Mrs Graham, also installed a bed lever so that Mrs Graham can get in and out of bed without needing anyone to help her. “It was a pleasure helping Mrs Graham,” says Juliette. “It is always great when we can make a difference and keep people independent at home by providing simple pieces of equipment, therapy and advice.”
Sarah Paviour, the Physiotherapist who visited Mrs Graham comments: “It’s so important that Intermediate Care teams and others like us across Torbay and South Devon are here to visit people at home at times of real crisis for them and their families – as in the case of Mrs Graham, who had fallen several times and was at risk of injury resulting from a fall or a long lie. We were able to stop things escalating and offer the equipment and support necessary for Mrs Graham to remain safely at home. Being able to attend Mrs Graham at home meant she was assessed promptly in the appropriate environment. At the time of assessment Mrs Graham would have been unable to attend physiotherapy outside of her home. Mrs Graham’s mobility returned to her baseline within a short space of time, and during the week of our Intermediate Care involvement she had no further falls. We are very pleased to hear she’s doing well!”
Here is what Mrs Graham has to say about the Intermediate Care service she received: “Everything was put in motion and I had everything I could have asked for. They even offered for me to have someone come the next day to get me my lunch, but I said they didn’t need to worry because I had my grandson coming round to do that! I couldn’t have asked for anything more.”
Mrs Elizabeth Crawford aged 78 lives in Torquay with her husband who is in his 80s and has Parkinson’s. Recently after a fall, Mrs Crawford’s GP arranged for her to have an x-ray at Torbay Hospital, where it was confirmed her foot was fractured. She was given a special boot to wear and was admitted overnight. To ensure her husband would be all right, Mrs Crawford agreed for the Rapid Response team – who provide temporary personal care and support such as help with washing, dressing, shopping and preparing meals – to visit her husband the next morning. When Mrs Crawford returned home, she managed over the weekend but on the Monday, she was struggling so she telephoned her GP who then referred her to the Intermediate Care team. Early the next morning Laura Boak, Occupational Therapist arrived at Mrs Crawford’s home to assess how she could help her, including deciding on what equipment could be provided to ensure Mrs Crawford’s safety and independence. Laura says:
“Mrs Crawford not only has a broken foot, but she is also managing other medical conditions, and on top of that, she is caring for her husband who is in his 80s and has Parkinson’s. My assessment showed Mrs Crawford was struggling with mobility and transfers – such as getting up and down from a chair, or in and out of bed – so I provided her with some equipment to make transfers easier and safer. I also noticed that Mr and Mrs Crawford are unable to leave their property due to the step access, so I’m helping them to try and get more equipment – a ramp – which they can trial and hopefully, they will then be able to safely get outside, out into their community.”
“The central ethos of Occupational Therapy is the holistic treatment of the whole person. Working in the community enables our team to treat people in their own home environment focusing on what is important to them, setting realistic goals and supporting them to work towards achieving those goals. I am so pleased that we are able to address the difficulties that Mrs Crawford and also her husband have been having with getting outside to access their community, as this is an important goal for her and her husband to achieve.”
Physiotherapist Carla Tucker who also visited Mrs Crawford says: “I find my job immensely satisfying – it is always a privilege to be allowed into someone’s home, and hopefully make a difference at times of crisis. Sometimes it’s the simplest of equipment or advice that makes the greatest difference. With Mrs Crawford I have prescribed exercises to help her stay mobile.”
“As we are able to see our patients as frequently as we feel is necessary, we build up a great rapport with them, so they trust in us to help them work towards the goals we set with them. “
“It’s been really marvellous,” says Mrs Crawford. “They came round in the morning and the equipment was with me a few hours later in the afternoon. You can’t ask for better than that, can you?”
Su Skelly is the Operational Manager for Intermediate Care:
“Thanks to the swift intervention from our Intermediate Care services, many people avoid being admitted to hospital, which is usually a big relief both for them and their families. People like Mrs Graham and Mrs Crawford who have had falls can receive exactly what they need to help regain their mobility and independence in the comfort and familiarity of their own home, without being exposed to the risks that we know exist once they are admitted to hospital as an inpatient. And as we all know – there’s no bed like your own bed!”
Weekend Diagnosis a fortnightly column published in the Herald Express discussing local health and care issues.