The following case studies show the types of care that can now be provided at home. They all involve patients in the Torrington area:
JD is an insulin-controlled diabetic who is visited daily by the community nurses to administer insulin.
He has some short-term memory loss, is housebound and only walks short distances with the aid of a walking frame. On one occasion the carers reported significant haematuria, so community nurses assessed the situation and liaised with the doctor.
Following review by the GP, it was felt that JD should be cared for and treated at home.
Due to a urine infection and his general vulnerability, over 48 hours he was visited up to four times a day to check his baseline observations and blood sugars. His food intake and general wellbeing was closely monitored.
The carers were educated on the importance of his increased fluid intake and to call for trained nurse assessment if required. The regular visits helped to ensure his safety by assessing potential deterioration and preventing possible hospital admission.
YE is a long-standing patient of the community nursing team.
She is bed-bound, has difficulty communicating and needs 24-hour care, which is provided by her daughter. She was troubled by a variety of issues and was thought to be reaching the end stage of her life.
The daughter called the nursing team some afternoons and they were able to make evening visits to review the symptoms and provide emotional support.
The nurses were able to enhance the quality of her life with advice on pain control, including from the out-of-hours GP if necessary.
This ensured MB didn’t experience unnecessary symptoms, while the whole family had a positive experience of care
Following a fractured femur and a transfer to hospital, Mrs F could only stand for short periods and take a few steps with the use of a pulpit frame.
Due to the extension of the team, Mr V could be seen on a daily basis – sometimes twice a day – and the extra rehabilitation had a positive impact both physically and emotionally. He became independently mobile with a standard wheeled frame and was able to walk short distances with elbow crutches.
Mr V started an exercise programme, developed by a nurse and assisted by a clinical support worker on the ward, and his progress enabled him to return home just 19 days after his transfer to hospital.
The expected length of stay prior to the additional therapy would have been estimated to be three to four weeks.
Mr E was referred by his GP for urgent intervention following a history of falls and decreasing mobility. This led to his becoming socially isolated and made it difficult for his daughter to support him at home.
Due to the extension of the team, it was possible for Mr E to be seen on the same day rather than be added to a waiting list. Equipment was provided to help him remain independent and prevent further deterioration.
Patients awaiting equipment and rehabilitation risk falling, being admitted to hospital and potentially requiring a large package of care or long-term placement, but these were avoided.