Rachel’s story
INREACH support for a complex ventilated lady
Background
Rachel* was a sociable family lady who enjoyed life to the full, before an admission to hospital resulted in a significant change to her life. Widowed with two sons and many grandchildren, Rachel* was experiencing symptoms including weight loss and low moods.
She was admitted to hospital for tests and suffered a fall, which lead to her being transferred to another hospital for a CT scan. The scan confirmed Rachel* had sustained a bleed to her brain as well as a new diagnosis of motor neurone disease.
Initially, her family were reluctant to accept the motor neurone diagnosis, but a second opinion confirmed her condition. Her health soon deteriorated.
Rachel* developed respiratory difficulties and she required 24/7 ventilatory support via a tracheostomy. Rachel* was supported in ITU for many months as there was no suitable care provider able to care for her needs in the local area.
The NHS commissioning team approached VSH to support Rachel* using our innovative INREACH service, where one-to-one trained nurse-led HCA support could be provided within a residential home setting. This facilitated a discharge plan for Rachel*and her family after such an extended period of time in ITU.
By the time she was discharged, Rachel* was unable to walk and was in a wheelchair. She was on a soft diet with a PEG feed to give her additional nutrition. She had been in hospital for 16 months and was overjoyed to be going home.
Challenges faced
The biggest challenge we faced was due to bed availability in the hosptial setting. Rachel* moved between ITU units and this presented VSH with the challenge of training staff in multiple locations over 20 miles apart. Our clinical and operational managers liaised wiith the nursing home to ensure that protocols were drawn up and clear roles and responsibilties for the one-to-one staff members and nursing home staff were in place. VSH made sure that Rachel’s* support team were all fully trained in a number of areas including tracheostomy care (including emergency and full tube changes in the community setting), invasive ventilation and tracheal suction.
How did we help?
Consistency was key in Rachel’s* care. We arranged for the necessary contracts to be in place to allow her staff team to care for her while she was still in the hospital. We also ensured the same staff were able to be provide care at another hospital 20 miles away when she was transferred prior to discharge.
Results
Due to the support from our trained staff, Rachel* was able to finally leave the hospital to a safe community setting with the necessary support in place for her complex needs. She was able to become part of her community again.
She had many visitors to the nursing home, including her best friend Edith. Her Jehovah Witness faith was important to her and the elder from her church would regularly visit.
We supported Rachel* in the nursing home for almost eight months until she passed away due to her deteriorating neurological condition.
Rachel’s* family and the commissioning team complimented our team on our approach.
“Mum has finally departed from her illness and she will at last get some peace and tranquility. I do not know all the carers involved and the people at the home and people behind the scenes, but I would ask you to thank them all from me for all the time, care and thinking which went into looking after mum. It was a mammoth task, done very well.”
*Some of the details have been changed for confidentiality reasons.
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