End of life - Ideas for practice: Case study

Person-centred care at the end of life

Lucy was 96 years old when she was referred to Elmgrove House Extra Care Service. She had previously lived alone for 40 years in her two bedroom house, but this was no longer thought to be safe for her, due to reoccurring falls. Although Lucy received home care, it was decided that this was no longer meeting her needs.

When she moved to Elmgrove House, Lucy quickly settled and adapted to her new home. Her daughter helped her to personalise her flat with  paintings and other sentimental belongings. Lucy made friends with some of the residents. Her daughter, close friends and relatives visited regularly for social and emotional support. Lucy also had a network of charitable organisations such as Blind Society who supported her with befrienders, who also visited her regularly.

Within a year of living at Elmgrove House, Lucy’s physical and mental health started to deteriorate quite rapidly. She suffered from dementia and lost her mobility which had an impact on her general wellbeing.

Equipment and support was provided by an occupational therapist. There was also intense involvement and support from a speech and language specialist and dietician.  Lucy was put on a liquid diet which meant that she needed a high level of support and supervision to ensure she was safe. Other professionals were also involved, but despite all of this, it was evident that Lucy still needed more support to meet all of her care needs.

A review of care needs was completed by Lucy’s social worker, who concluded that Lucy needed to be moved to a nursing home. Lucy did not want to be moved as she was happy living at Elmgrove House and wanted to stay there for as long as possible. Lucy’s daughter was also heartbroken at the thought of her mum being moved again, and felt that if her mum was happy living at Elmgrove House she didn’t have to be moved elsewhere. Elmgrove staff supported Lucy’s decision to stay at Elmgrove.

After further reviews and assessments and the involvement of Lucy’s GP, Elmgrove staff managed to get additional care hours approved by social services. This involved working in partnership with an external home care agency in order to ensure that Lucy was supported safely and to ensure her care needs were being adequately met.

This made a significant difference for Lucy and meant that her wishes of staying at Elmgrove were finally met. However, Lucy’s health deteriorated further and she was admitted into hospital, where she was discharged within a space of few days with a recommendation for palliative care.

The staff team caring for Lucy said:

We felt reassured with knowing that we did everything we could to make sure Lucy’s needs, physically, as well as emotionally, were met. We all pulled together to support Lucy and she was still happy and smiling even during the last day of her life.

Lucy remained at Elmgrove House until the end of her life. She was surrounded by familiar faces and people she knew, which made her very comfortable. Even though her daughter was finding it difficult to cope during her mum’s last days, she felt supported and reassured. She was grateful that Lucy wasn’t moved in the end and that she passed away peacefully in a place she now called home, which meant a lot to her.