Q1: What services would you consider referring to for Eve to remain at home?

1. Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
This combination would help address the variety of issues impacting Eve at this time: her memory issues and Alzheimers; her physical condition and investigating reducing her number of falls; the possibility of making improvements to her home to help her stay steady on her feet – along with other measures to improve her day to day life. Finally the possibility of professional carers who would be able to consistently and carefully provide support, as opposed to just at random times.

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?

2. Her son.
He seems to have more of a handle on the situation, whereas her daughter was extremely vague and couldn’t answer questions properly, even though she lives nearby, e.g. she couldn’t decisively state how often she visits or makes meals. However, the decision should ultimately come from Eve herself – ideally through setting up a Lasting Power of Attorney (LPA) document, stating her preferences for who decides about care.

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.

2. No, this is not good. It is not supportive and is going to cause further complications within Eve’s house and life.
However, it could be a good idea for an OT to visit and assess whether she would benefit from grab rails and other supports to help prevent falls. The black mats do not seem necessary in Eve’s case, as she was generally confident walking about her home and used to like being able to go into the kitchen. Just because she’s had falls doesn’t mean she should be completely restricted like this, as it’s a deprivation of liberty when she’s still in a position to make simple choices about what she wants to do. Options to help prevent falls instead should be offered to Eve.

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?
The messages show that Eve is not aware of the issues concerning her care, she’s oblivious to what’s going on and is trusting that her children have got things sorted out for her. Whilst she seems happy, it is alarming that she can’t remember how often she eats or how often her daughter visits. She trusts that her daughter is taking care of her, yet if she were to hear the phone call between the nurse and her daughter, she would be confused that Josie isn’t sure about lots of things concerning her care either. Eve would likely feel disappointed that Josie is unable to provide clear information, as Eve is relying on her to support her sufficiently. If I were Eve, I might also be wondering if my son is looking after my finances, even though I haven’t ever talked about this properly. And I may be surprised to discover that the cameras watch over me all the time. I thought, maybe they were just for when he wanted to talk to me directly during the day.