Q1: What services would you consider referring to for Eve to remain at home?
1. Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.

Q2: Eve has Alzheimer’s disease, and her son and daughter are both inputting into her care. Who should be making the decisions about Eve’s care?
1. Eve – Eve’s children do not have power of attorney so, therefore, cannot make decisions about her care. As long as Eve has the capacity, following an assessment proving otherwise, she should be making the decisions about her own care. If her condition deteriorates and she lacks capacity her children need to look at gaining power of attorney.

Q3: It is ok to adapt the home to ensure that Eve does not do things that may put her at risk. Stopping her from going into the kitchen area by using black mats next to the door is an effective way to manage falls. YES AND NO, Eve’s home requires adaptations to reduce falls, see below.
1. Yes, this is a good strategy as it keeps Eve away from risks and 2. No, this is not good. It is not supportive and is going to cause further complications within Eve’s house and life – Eve’s house needs to be adapted to ensure her safety, such as taking up the multiple rugs and the loose wires on the floor that pose potential trip hazards. Eve’s house needs to be an open space that allows her to move around freely and safely. However, I do not agree with the ‘black mats’. The idea behind these is incredibly unethical – scaring patients to stop certain behaviours, and will cause more harm than good.

Q4: What did you understand from the answerphone messages left on Eve’s telephone? How did these messages sound to you? How do you feel about putting yourself in Eve’s shoes and hearing the answer phone messages as if you were her?
Eve
1. Eve thinks highly of her daughter and the care that she provides her but doesn’t want to ask too much of her
2. She does not recall the recent falls that she has had
3. Appears confused, and describes this as her mind being ‘muddled’
4. Speaks to John occasionally but does not want to bother/worry him
5. Becoming lonely, doesn’t describe a good quality of life – sits waiting for Josie to come and give her food/drink and doesn’t move around the house due to Josie’s advice on the dangers (this change occurred after being in the hospital)

Josie
1. Appears in denial/not sharing the whole truth about her mum’s current/declining condition

John
1. Appears to help his mum as much as he can, given the 100-mile distance
2. Offers a better picture of his mum’s health
3. Does not think that his sister is telling the whole truth
4. Concerned that his mum doesn’t move around the house enough, describes her as ‘stuck’. Concerned that she cannot get things like food/drink herself

I think that hearing these voicemails could upset Eve – she may be upset with what her son has said about her daughter given how highly she thinks of her, she may also be upset when hearing the true extent of her falls and declining health. She could also be angry at her daughter for not supporting her enough with regular visits, proving food and drink etc. and not being honest with the Nurse.