Case Study – Putting the Client at the Centre of the Care They Receive

When working in a collaborative role with clients, it is important that dignity and control remain with them and that their choices about how they are looked after are at the centre of the care process. Clear written and verbal communication of their choices are vital to providing the client with the emergency care required, this is especially important for clients whom cognitive abilities are deteriorating.

This is demonstrated clearly in the case below,

Client: 91-year-old male, Alzheimer’s and prostate cancer diagnosis.  5ft 7”, weighing less than 50 kgs.  Very frail, with significant skin integrity concerns.  He lived in his own home with support.

Fall history: the client had been losing muscle bulk and associated strength for approximately past 12 months after lifelong good health.  His first fall happened in December 2022, at which point he was able to get himself up off the floor as his number of falls increased to once a month between January 2023 and May 2023, he was still managing to get up, however he was beginning to struggle more.

After a serious UTI, which ended in hospitalisation, the client fell a couple of times a week and needed support to get up again.

Carer: The primary carer was his 63-year-old daughter, who was supported by daily visits from professional carers and a call alarm system, which had a team who would visit in emergencies.

Lifting equipment: The family had discussed the use of falls equipment and following an assessment had purchased an Eagle lifting cushion, which they used regularly and easily to pick up their father when he fell.  The Eagle worked well and the client had been using it for over a year, he knew how it worked, he felt comfortable, well supported and confident how it was used to enable him to get up safely off the floor.

Significant fall event:

In August 2023 the professional carer arrived at the patients home to find he had fallen out of bed during the night.  The client was confused, tired but uninjured.  The carer called the alarm team for support before calling the daughter to notify her of the event.

When the daughter arrived, the alarm team member was already there and beginning a lift using the Raizer lifting chair, he was showing agitation as it was not his usual equipment and was confused about what was happening.

She became increasingly worried as her father started to cry out in pain, stating his bottom hurt because the Raizer seat was very hard and rubbing on his fragile skin.

He was trying to tell the emergency care worker that he felt he was falling through the chair, felt very insecure and was in considerable pain, however, was not listened to, causing  significant  distress to himself and his daughter.

Although the client was on the floor and needed to be assisted to get up as there was no apparent injuries, the care team had reacted without asking how the client got up in the past.

Outcomes

• The care team must always use the Eagle provided on site to pick the client up.
• The onsite care notes clearly indicate the Eagle must be used in the future.
• Both the care team and the emergency lifting team have notes on file about using the Eagle.

Conclusion

Client choice is critical, in this case, he had purchased an Eagle, as it provided the necessary support to provide the confidence in the equipment needed, comfort to reduce friction and shear on his delicate skin, back support to negate the need to be able to maintain trunk control and he knew the Eagle could fit into tight spaces if he fell awkwardly.

Notes

• Lifting cushions are inflated using a compressor and provide a comfortable, secure lift for patients with limited muscle/fat content and fragile skin.
• Inflatable cushion instantly reduces risk of developing pressure sores.
• The Eagle cradles as it lifts.
• Built-in backrest supports back, shoulders, neck and head.
• Feel supported from head to toe.
• Inflation speed can be controlled for cushion and backrest –so decreasing risk of postural hypotension.
• Patient can stay seated for as long as needed to recover before standing.