Case study: North Lanarkshire Council
Fiona Taylor of North Lanarkshire Council has provided the following case studies to demonstrate when assistive technology has been used successfully, when other options were explored and when imaginative, simple solutions were identified that led to technology no longer being considered. These examples emphasise how an individual holistic assessment is essential to good practice.
Individuals’ names have been altered to ensure confidentiality.
Case study 1
Mrs Brown was admitted to a residential home after being found in her gas-filled house. This had happened on several occasions and family and neighbours were very worried about both her and their own safety. Although Mrs Brown had been diagnosed with dementia some years earlier she was physically very fit. Mrs Brown regularly walked to the local shops or took a bus to a nearby town, but she usually returned without assistance although sometimes this was very late.
Over the next two weeks Mrs Brown’s anxiety increased, and she regularly left the building and headed into the surrounding countryside. Police returned her on several occasions. Previously good relationships with staff and people using the service quickly declined. Staff felt they needed to keep a close eye on Mrs Brown and tended to follow her. They had to keep leaving other people requiring a service in order to run to the door every time the door alarm was activated in case Mrs Brown was leaving the building.
Other people using the service became quite angry with her too. Their freedom was restricted as previously open doors into the garden area were now alarmed so staff would know if she left the building. The community nurse and GP suggested medication and a move to a nursing home. Her family became so anxious that they would often shout at her when they heard she had left the building again and their previously warm relationships were steadily eroding.
Assistive technology introduced
A case conference was called and the possibility of using a ‘Wanderguard bracelet’ was discussed. Mrs Brown herself recognised the danger she was in but also knew that when she became upset she just needed to get out.
Following agreement with Mrs Brown, her family and key professionals from the local area team, the bracelet was purchased and the system put in place. Procedures were drawn up locally and staff encouraged to see the aim of this intervention as to assist her going out safely, not to stop her going out.
Mrs Brown’s Bracelet was programmed into one staff pager. This meant that the other staff did not need to leave the people they were with. Additional resources were allocated to ensure that this staff member was not included in the core staffing levels required and was free to walk with Mrs Brown wherever she left the building.
For the first few days the staff member stayed a discrete distance behind Mrs Brown and only approached to offer assistance when she appeared tired, confused or in danger. This assistance was usually to call for a taxi to take them both back to the care home.
As the weeks progressed Mrs Brown would call the staff member from behind her and encourage them to walk and chat with her. Rather than rush back to the unit, the cook would often pop out with a flask of soup and two coats and arrangements were made enable them both to return later in the day. By the following month she was starting to check out who was walking with her that day and to call for them when she was ready to go.
Following a further case conference it was agreed that the crisis situation had passed and that Mrs Brown no longer required to use the bracelet. Staff now had a clear picture of when she was most likely to want to go out. How far she could walk without getting tired and where she liked to walk to. Her care plan was adjusted to coincide with these times when she liked to walk and this resulted in her going out with staff at key times every day to collect the papers, deliver the mail and feed the ducks in the local pond.
Her relationship with staff, other people using the service and her family improved significantly. Mrs Brown was now seen as someone who contributed to life in the unit and no longer a nuisance. She no longer saw staff as guards and began to build up friendships again. During the next few months Mrs Brown began to learn her way to and from the shops and latterly no longer required someone to go with her.
Case study 2
Mrs Watson lived alone and had been subject to several bogus callers who had taken cash and valuables from her home. Mrs Watson’s daughter decided to move in with her as she was worried about her mum’s safety. However once she had done this she found that she could no longer go out of the house as Mrs Watson may let someone in again when she was out.
Assistive technology introduced
A door entry system was fitted and this was diverted to her landline phone. This phone in turn had a divert facility and could be sent to Mrs Watson’s daughter’s mobile.
Mrs Watson’s door bell no longer rang when her daughter was not in the house therefore Mrs Watson did not open the door to strangers. Mrs Watson’s daughter could answer the phone (doorbell) wherever she was and ask the caller to call back later at a more suitable time. The caller was unaware that Mrs Watson was in the house alone, as he/she had just spoken to her daughter over the intercom. Both continue to live safely and with less distress in the community.