Q1: I would choose option 1 for Eve to remain at home, considering referrals for the Dementia Nursing Team, Physiotherapist, Occupational Therapist and carers.

Q2: I would choose option 1 as although Eve has Alzheimer’s disease, with her son and daughter both inputting into her care. Eve can still input to make choices in the way she is cared for and communicate what she wants, so that care can be person-centred.

Q3: I would choose option 2 because stopping her going into the kitchen area by using black mats next to the door is not an effective way to manage falls as those with Alzheimers will see it as a hole in the ground which could increase their risk of falls. It is not supportive and is going to cause further complications within Eve’s house and life.

Q4: What I understood from the audio recordings:
(How did these messages sound to you? How do you feel about putting yourself in Eve’s shoes and hearing the messages as if you were her?)

Eve was not able to recall whether she had previous falls, what her nutrition and hydration were like, helping her go to bed, helping with her everyday needs. She sounded like she didn’t want to be a burden on her children.

I interpreted that Josie had “no concerns” but then after exploring the subjects in a conversation, such as meals, it was considered Josie “doesn’t know how she gets on” so Eve is clearly not having sufficient intake of nutrition and hydration, as Eve stated she “knows the rules and is not allowed in the kitchen”… there was banging in the background and Josie sounded very anxious, she is not providing full information to professionals on previous falls etc. so I would gain advice on this as a potential safeguarding issue.

Her son John lives over 100 miles away so is not local to physically input however the telephone conversation was valuable and qualitative, informing professionals of the video cameras installed in the house which would need to be checked to ensure dignity, whether there has been a problem with things going missing? John mentioned that he didn’t think “Josie would steal”. He strongly feels something is not right. He has a lot of video calls with Eve and has been able to assess why she may fall and may actually see her more than Josie, despite it being via video call, he is there for support. He stated that emergency help was previously not sought despite numerous ongoing, unreported falls, where Eve was not monitored. John was honest about Eve’s lack of mobilisation for food and drink and has concerns on why Eve is more confused when Josie is there. ? medication – is it being taken or not, could Eve be overdosing?

I would feel alone, waiting for a drink, suffering malnutrition, unable to go upstairs by self or in kitchen, or anywhere. Need to be encouraged to mobilise safely to reduce the risk of deep vein thrombosis, have basic needs met. Lack of personal cleansing and washing, maintaining a safe environment, sleeping, eating and drinking etc. Eve would need a full assessment and urgent referral.