The Enhanced Health in Care Homes Project – A resident’s perspective

James ‘Jas’ Reid and his daughter, Jill Gibson, told us about their experience of being involved in the project.

Retired teacher and president of the Northern Ireland Schoolboy Football Association, James ‘Jas’ Reid, lived in Northern Ireland for all of his life, until circumstances brought him to Bramley in Basingstoke. The eldest of eight, Jas was used to being in control of his life and even when his wife passed away, he coped well and continued on with his life with a great deal of independence.

Living in a remote part of Northern Ireland, with his daughter Jill and her family living in Basingstoke, was not without its challenges however. Lack of local transport links meant that Jas was often isolated and still needed to drive well into his old age. As time passed though, Jas began to suffer from balance problems which ultimately progressed into a cancer diagnosis. At 85 he made the difficult decision to decline treatment.

His daughter Jill found it very difficult to support her father in Northern Ireland at the same time as managing her family commitments back home in Hampshire. The frequent trips to her home country were a challenge and she worried about her father alone in such a remote place. Eventually she braced herself to suggest that perhaps he might be better off if he made the move to England and came to live in residential care.

Jas had always been a fairly quiet man and liked to keep himself to himself, so Jill anticipated some resistance to the suggestion, but was surprised at how readily he agreed. With a characteristic lack of sentimentality, Jas packed up his belongings and, with Jill’s help, made the arrangements to move to Hampshire.

They chose a care home in Bramley, due to its close proximity to Jill and the warm and cosy feel they got from it. The biggest selling point however was the room they were shown when they looked around. The view looked out on to trees and Jas could have his bird feeder outside the window and sit and watch them during the day. They were thrilled when it was confirmed that the room they had seen would be Jas’s.

Initially the change went extremely well, Jas gained weight and took it all in his stride. The move had seemed to resolve multiple problems. Not only was Jas getting the care that he needed, he was less isolated and could spend time with his daughter and grandchildren, as well as no longer needing to drive everywhere.

After a while though, Jas began to lose weight again. His appetite seemed to be declining, he was dehydrated and he was experiencing more problems with his memory. It was around this time that he and Jill were approached about the Enhanced Health in Care Homes Project and offered the opportunity to have a multi-disciplinary team (MDT) meeting with Jas’s GP, as well as a nurse from the care home, a dietician and a pharmacist. They jumped at the chance.

The meeting gave Jas and Jill the chance to sit down with all of the healthcare professionals at once and discuss Jas’s specific issues. It allowed them to air their concerns, ask questions, get feedback and better understand what was happening with Jas’s care.

Jill particularly appreciated the input of the Dietician, Helen Simpson, at the meeting, as she felt that she was able to give a different perspective that was really beneficial. Helen advised a number of practical solutions for the care staff, like fortifying Jas’s food with extra cream and butter to help with his weight gain. Having the MDT meeting meant that Jas and Jill had the space and time with the staff to really discuss Jas’s diet right down to the minutiae and uncover things which the staff had previously been unaware of.

Jas has a life-long dislike of cheese for example, but like many people he was uncomfortable at the thought of making a fuss or being seen as difficult. Because of this, he never said anything when it arrived on his plate and instead just picked at the meal or left it. The meeting gave him the opportunity, with Jill there supporting him, to air dislikes and preferences that he had, so that the nurse could take note of them. It also gave Jill a chance to stress to him, with the reassurance of the professionals, that’s it’s ok to speak up when something bothered him.

Having the pharmacist present meant that the group were also able to discuss Jas’s medication in more detail. Jas had been taking blood pressure tablets for many years and had recently been prescribed water tablets by the GP at the home, as he was suffering from swollen legs and feet and water retention. Having the various specialists looking at his medication together meant that they were able to identify that the swelling could potentially be caused by the blood pressure tablets, in combination with his new, more sedentary lifestyle. The decision was made to stop both medications and his condition rapidly improved.

“It’s brilliant to have everyone together all at once,” Jill told us. “It’s the little things, like being able to talk to the dietician and the care home staff together and make sure that dad’s getting the food he likes. It’s very reassuring to me to know what’s going on and it helps me to feel more in control of what’s happening.”

Jill would recommend that anyone given the opportunity to take part in the project does. “It hasn’t been perfect,” she said. “There are things that still need looking at, but overall having the MDT meeting has been the best thing that’s happened since dad came here.”