>>Ged: We already knew Nicola and her family before this latest admission. Nicola had been
a patient on one other ward before, as had her twin sister, and we’ve had lengthy chats
with Pat, her mum, who is a real advocate and real powerhouse when it comes to learning
disability and autism care in this city.
So we’d had long conversations before, and we knew of the family, and we received a referral
that Nicola was in, and in A&E, and so our service went down to see what the problem
was with Nicola., and how we could support her in the hospital on that occasion.
>>Serena: I went down to see Pat after our referral was received and spent time sitting
with Pat, understanding why Pat and Nicola came into hospital. It was very evident that
Nicola was rolling around in her bed, that she had pain, that she was upset. The family
were hugely distressed because it was a change in environment, it was a very different presentation
to what Nicola had be experiencing over the last few weeks. What I was able to do was
sit down and spend time with Pat understanding what had changed, what had gone on. My knowledge
and expertise within dementia was important, but also it was very much about how I could
gather information and support my colleagues with the E&D department.
What Pat had told me was that eight weeks prior to her coming into hospital, she had
a tummy bug that tummy bug seemed to be the beginning of the difficulties and challenges
within the day centre as well and also at home.
What we had learnt and discovered over those eight weeks was that Nicola was finding it
difficult to go to the toilet, she was find it more difficult to eat. Lots of habits,
lots of kind of normalities within the household had changed, along with behaviour difficulties,
and that might be screaming, shouting, which gave rise to a dementia journey kind of progressing.
From our discussions, Pat had also spoken to social services about changes in Nicola’s
presentation, and it was then agreed that a multidisciplinary team meeting would occur
within the hospital. That consisted of social services, the day centre staff, the family,
ourselves and also the community learning disabilities team, and it was discussing Nicola’s
presentation, how the family were in crisis, and how the day centre found the difficulties
presented and how can we move forward. What was agreed that she wouldn’t move to
a nursing home that dealt with challenging behaviour and progression of dementia because
the evidence told us that she had a physical health difficulty and that needed to be dealt
with initially before any changes or any move to a new area.
The family took on board that social services also, and there was a sense of relief from
the family to say actually, if we sort out her physical health, actually her mood, her
behaviour and things would change. And that was very evident as she was admitted to the
hospital, as we supported her on her journey within the hospital going admitted to a ward,
to working with the staff on the ward, looking at the reasonable adjustments that we needed
to do within the hospital to support Pat and Nicola in a very strange environment.
>>Ged: Nicola received around 10 days of support and treatment with the constipation, using
enemas and different stuff medically to help her. She became well, her constipation
alleviated, and she went back home to her family her with her sister and her mum, and
she didn’t go to the other place that was planned originally before the meeting. So,
from us as a learning disability service it was a really, really, really positive story.
Somebody comes in, we were able to look at what was happening physically, help her and
support her as a hospital with that physical health, be there to support, listen to and
liaise with the family throughout to offer them our help, and in the end that patient
goes home well to where they wanted to be with their family, knowing that they can come
and use, and speak to us at any time if they’ve got any further issues going on in the future.