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Q1: What services would you consider referring to for Eve to remain at home?
1. Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
2. None the family have got this under control.
3. Mental Health Services, local council, and GP.
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.
2. Her son.
3. Her daughter, the person who lives closest.
Q3: It is ok to adapt the home to ensure that Eve does not do things that may put her at risk. Stopping her going into the kitchen area by using black mats next to the door is an effective way to manage falls.
1. Yes, this is a good strategy as it keeps Eve away from risks.
2. No, this is not good. It is not supportive and is going to cause further complications within Eve’s house and life.
3. It is up to Eve’s daughter how she looks after her mother.
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 answerphone messages as if you were her?
1. What services would you consider referring to for Eve to remain at home?
Option 1, dementia nursing team, physiotherapist, occupational therapist and consider carers
2. 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?
Option 1, Eve. If she has the ability to communicate her needs, then she should be allowed to continue to do this. When she starts losing mental capacity to make decisions for herself them her children can be involved, as well as healthcare professionals, to make decisions in her best interest
3. It is okay to adapt the home to ensure that Eve does not do things that may put her at risk. Stopping her going into the kitchen area by using black mats next to the door is an effective way to manage falls
Both options 1 and 2. This strategy might be in her best interest to keep her away from risks, but she should not be limited to only going into specific rooms. It is not supportive and could cause further complications within Eve’s house and lifeQ1: 1. Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
Q2: Eve, as she’s able to communicate her needs .
Q3: Yes, this is a good strategy as it keeps Eve away from risks and it shouldn’t be limiting Eve independence rather to promote her independence and ability to still try and do what she used to do by herself with supervision .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. Until a capacity assessment can be performed, it is assumed Eve still has capacity in her own decision making. Family can be involved but the daughter who lives physically close appears to have multiple stresses on her time. I feel it should be collaborative between Eve, her family and medical professionals
Q3: It is ok to adapt the home to ensure that Eve does not do things that may put her at risk. Stopping her 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.
Trapping Eve in a certain area, though probably meant with good faith could complicate Eve’s living conditions. The mats in question could be further trip hazardsQ4: 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 answerphone messages as if you were her?
I wasn’t able to load the page to listen to the answerphone messages it says there is a connection issue with the cele.coventry.ac.uk. link??Q1: 1. Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
Q2: Eve. Until Eve is found to lack capacity, she will take the lead with decision making. As Zara said collaboration between herself, family and professionals is useful, and it would be good for Eve to have others to support her in the decision process.
Q3: Adapting the home is an effective way to protect Eve and maintain as much independence as possible. I don’t Think adaptions should be used to prevent access to areas is counterproductive.
Question 1: Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
Question 2: Eve, as long as she has mental capacity, her rights should be upheld by healthcare professionals to protect her autonomy.
Question 3: Yes, this is a good strategy as it keeps Eve away from risks.I think she might associate certain areas with dangers, preventing harm.
Question 4: Unable to load pageQ1: What services would you consider referring to for Eve to remain at home?
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?
Eve, as she has mental capacity and neither child has 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.
No, this is not good. It is unsupportive and will cause further complications in Eve’s house and life. I do not believe Eve should be prevented from going into the kitchen. Other measures could be put in place to assist will falls; while still able to do things for herself, Eve should be encouraged and supported to do so.
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 answerphone messages as if you were her?
Unable to access link.
Q1: Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
Q2: Eve.
Q3: No, this is not good. It is not supportive and is going to cause further complications within Eve’s house and life. How will she eat and drink when needed on her own?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 as she still has capacity. As Zara and Hannah have mentioned collaboration would be helpful here so that Eve can have extra support.
Q3: It is ok to adapt the home to ensure that Eve does not do things that may put her at risk. Stopping her going into the kitchen area by using black mats next to the door is an effective way to manage falls.
I agree with Daniel so have chosen 1 and 2 as both have pros and cons.1. Yes, this is a good strategy as it keeps Eve away from risks. This will keep her safe but still give her some independence. This is a compromise between utility and dignity and is possibly a better alternative than medication.
2. No, this is not good. It is not supportive and is going to cause further complications within Eve’s house and life. This may be quite confusing to her and make her fearful. It will create a ‘visual cliff’ which could cause a fall.
Q4: What did you understand from the answerphone messages left on Eve’s telephone?
no linkQ1: Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
Q2: Just because Eve has Alzheimer’s disease does not mean that she does not have capacity. Until Eve is found to lack capacity, Eve should make decisions.
Q3: Although it ultimately keeps Eve away from risks I do not think this is an acceptable strategy, it uses fear. It is not supportive and is going to cause further complications within Eve’s house and life. I think other measures could be used to ensure that Eve is supported while also encouraging some independence.
Q4: No link for q4Q1: Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
Q2: Just because Eve has Alzheimer’s disease does not mean that she does not have capacity. Until Eve is found to lack capacity, Eve should make decisions.
Q3: Although it ultimately keeps Eve away from risks I do not think this is an acceptable strategy, it uses fear. It is not supportive and is going to cause further complications within Eve’s house and life. I think other measures could be used to ensure that Eve is supported while also encouraging some independence.
Q4: No link for q4Q1: What services would you consider referring to for Eve to remain at home?
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?
Until it is established that Eve does not have capacity she should remain in charge of her own 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 going into the kitchen area by using black mats next to the door is an effective way to manage falls.
I understand why the family have done this but it is not appropriate. Eve should be encouraged and supported to remain as independent as possible.Q1: Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
Q2: Eve.
Q3: Yes, this is a good strategy as it keeps Eve away from risks.Q1: option 1 the family needs help to support Eve.
Q2: option 1 Eve still makes her own decisions.
Q3: option 2 I think it will cause further complications to her mental well-being. She might get frightened and react in an unpredictable way for example jump over the mat.Q1 Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
Q2 Eve as she can communicate her care needs.
Q3 Yes, this is a good strategy as it keeps Eve away from risks.
What are your initial thoughts on Eve’s social circumstances (outlined to the right and below), the other information provided here and the information you know so far?
I think Eve needs to have some form of care implemented, that’s not just focused on her son’s video observations and her daughters help. It’s clear that the daughter has family commitments of her own and, because of this optimum care cannot be given. I think that Eve is socially isolated as she is technologically capable, however the distance between her and her son is an issue. The history of repeated falls and the medication she is on, in my opinion justify the requirement of care. If only for daily visits to help wash and mobilise.
After listening to all conversations, I have complied a list of priorities of Eve’s current condition that need to be addressed. This is in order of most integral to less of a concern.
1, Repeated falls that haven’t been documented, or communicated by the family to the nursing staff.
2, Eve’s confusion regarding daily habits, mobilisation, dietary, fluid intake, medication adherence and socialisation.
3, inconsistent dietary and fluid intake, leading to UTI’s and hospital admission, interactions with medication, and potential weight loss.
4, The social isolation of Eve
5, The dependency on the daughter for dietary needs and lack of regular daily care.
6, Limited mobility and daily activities
7, Communication between the family members and Eve’s attitude towards confiding in them about health issues.
“A new technique to control the wandering of dementia patients involves placing black floor mats in front of unsafe areas, such as outside exits. Due to a fear of falling, persons with dementia will not walk on dark spaces on the floor (they tend to see them as holes). This is an alternative to antipsychotic drugs and lockdown units. Since this technique uses fear and a disability to guide behaviour, but with the intent of safety, is it ethical?”
In my opinion the use of fear and the effectiveness of black doormats stopping incidents provides an ethical quandary. On one hand the matts are successful in stopping such incidents as falling and access to unsafe environments, however the psychological impact of induced fear must be detrimental, especially if it’s sustained over a long period. However, it could be argued morally, that fear is a primal instinct, which inhibits us from performing or permitting ourselves to be in dangerous situations. The use of antipsychotic drugs and lockdown units could be argued as further diminishing mental capacity and agility (due to side effects). If the matts are being utilised for individuals to protect them from harm and limits the dependency/provides a healthy alternative for medication. In my opinion it’s not an ethically questionable thing to implement, if it’s done with no malice intentions.
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, since she has mental capacity.
Q3: It is ok to adapt the home to ensure that Eve does not do things that may put her at risk. Stopping her going into the kitchen area by using black mats next to the door is an effective way to manage falls.
2. Although it prevent Eve from fall, I will say – No, this is not good since it uses fear which could cause her anxiety. As such it is not supportive and is going to cause further complications within Eve’s house and life. There are better way to support Eve prevent future falls so, I will refer to occupational therapy and physiotherapy teams.
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 answerphone messages as if you were her?
No link
Q1: What services would you consider referring to for Eve to remain at home?
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?
Her son.Q3: It is ok to adapt the home to ensure that Eve does not do things that may put her at risk. Stopping her going into the kitchen area by using black mats next to the door is an effective way to manage falls.
No, this is not good. It is not supportive and is going to cause further complications within Eve’s house and life.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.Q3: It is ok to adapt the home to ensure that Eve does not do things that may put her at risk. Stopping her 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.
Q1: What services would you consider referring to for Eve to remain at home?
1. Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.4
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.
Q3: It is ok to adapt the home to ensure that Eve does not do things that may put her at risk. Stopping her 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.
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 and 2. Her son.
Q3: It is ok to adapt the home to ensure that Eve does not do things that may put her at risk. Stopping her 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.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 answerphone messages as if you were her? There is a lot of mixed messages from son and daughter almost like there are family dynamic issues which are impacting on the care that is needed for Eve.
Question one – Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
Question two – Eve should be making the decisions until a mental capacity assessment has been given. Eve may lack capacity in some areas but okay to make decsions in other areas, but it will not be clear until an assessment is done.
Question three – yes and no. I think in some cases it is a good strategy however, in other adapting her own may not be beneficial. Eve needs to be safe, but sometimes too much change can cause further confusion.Question one – Dementia Nursing Team, Physiotherapist, Occupational Therapist and consider carers.
Question two – Eve should be making the decisions until a mental capacity assessment has been given. Eve may lack capacity in some areas but okay to make decsions in other areas, but it will not be clear until an assessment is done.
Question three – yes and no. I think in some cases it is a good strategy however, in other adapting her own may not be beneficial. Eve needs to be safe, but sometimes too much change can cause further confusion.
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