A Dementia Case Study - Adapting support for Margaret and Peter*

This is one of a series of case studies written to help prospective  clients and those commissioning  care at home to have an insight into how that may be adapted over time to meet different needs.


Margaret and Peter are former senior executives of a major high street retailer who had moved to an apartment in Lee on Solent following their retirement.

In their early seventies they were both very active with many interests and a full social life.


Sadly in 2014 Margaret was diagnosed with Dementia with Lewy Bodies and Multiple Sclerosis. Some of the immediate impacts for Margaret were depression, an unwillingness to engage with new people and high levels of anxiety about leaving her apartment.


Peter was advised that both conditions were progressive and that he should secure the services of a home care provider who would be able to build a relationship with them both with a view to the future needs of Margaret as her conditions progressed.


Peter contacted a number of home care providers to discuss the situation but was disappointed that all insisted on conducting a meeting with Margaret which Peter felt would be counter productive.


Peter was referred to Home Instead by a health care professional and met with them to discuss the situation.


It was agreed that an assessment of Margaret's needs and her situation could be completed without her and a subsequent meeting with Peter and Margaret's community mental heath worker provided all the necessary information.


Initially companionship visits to Margaret were undertaken with her community mental health worker until it was judged that she had developed a relationship with her Home Instead Caregiver and the visits then continued with her alone.


Margaret and Peter have now been clients of Home Instead for over 3 years.

During that time the nature of the care and support delivered has changed dramatically.

Margaret's mobility has declined significantly alongside her ability to support herself with day to day living activities including washing, dressing and feeding herself.

Home Instead's support has adapted to meet these changing needs and included support to allow Peter to take respite breaks during the week from his caring responsibilities.

From support of 3 to 4 hours per week Home Instead now provide 25 hours per week with support every morning and two afternoons every week and occasional evenings.


Home Instead has worked with Peter and other health care professionals to ensure that Margaret can remain living at home which is his and her preference.


This has principally been achieved through working flexibly with Peter and committing a small team consistently to Margaret's care.


In commenting on the relationship with Home Instead Peter said:


"It was like someone had opened a door from a very dark place.


Home Instead understand the importance of having a small group of carers who can cover for each other.

Having cover from strangers or carers that only come on infrequent visits does not work with Dementia!

From my experience to date I highly recommend Home Instead, who have solutions that work".


*NAMES HAVE BEEN CHANGED FOR CONFIDENTIALITY REASONS

A group of Home Instead CAREGivers talking
Family welcoming a Home Instead care manager into their home