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Dementia

ETHEL

Ethel’s story

Ethel is a 93 year old lady who was diagnosed with Dementia approximately 6 years ago. Her cognitive and physical functions have deteriorated and she is now unable to mobilise and weight bear safely. Ethel is not orientated to time, place or people and struggles to follow instructions. She has very poor awareness both of personal risk and her own limited physical abilities. 

Although Ethel has minimal strength and is unable to push herself to stand, she has what the care staff describe as ‘fidgety movements’. This means that she can reposition herself and, consequently, is at risk of falling from both bed and chair. When unsupervised, she frequently attempts to get out of a standard low bed. Several bed falls have resulted in damage such as bruising, head and internal bruising and, consequently, hospital admission.

The care staff carried out a risk assessment and determined that the risk of injury from a chair fall was greater than from a bed fall. As a result, Ethel was cared for in bed nearly all the time and was moved to a central location enabling the staff to monitor her frequently. However, there was still the high risk of bed falls. A trial of the FloorBed™ was offered and the nursing home was keen to test the concept.

Results

The FloorBed™ was provided and although Ethel continued to fall out of bed, this was now a roll rather than a fall, substantially reducing the impact and risk of injury. It was decided to create an extension of the bed by placing a crash mat of bed-height next to the FloorBed™. This reduced the likelihood of injury even further.

The three main benefits of using a crash mat in conjunction with the FloorBed™ were:

• When Ethel fell out of bed she rolled onto an equally soft and padded surface.

• If Ethel fell asleep and was safe and comfortable after she had rolled out of bed, the staff could safely leave her sleeping on the crash mat.

• The transfer back into bed was very quick and easy as the carers could use slide sheets to transfer Ethel back to bed, eliminating the need for a hoist or other lifting system.

Click here to download the full case study.


 

TOM

Tom’s story

Tom is a 92 year old gentleman who was diagnosed with Vascular Dementia in 2011. He also has poor vision as a result of Macular Degeneration. Tom previously lived in his own home with his wife. In November 2013 he required more care than his wife could provide at home; he was moved into a care home where he was provided with a low rise bed of 350mm height (including the mattress).

Tom is not orientated to time, place, or people (other than his wife). He struggles to follow instructions and is not aware of the difference between night and day; he has very poor insight into his level of function and poor risk awareness. He is hoisted for transfers between the shower chair and bed as he is unable to weight

bear. Tom experiences frequent and vivid hallucinations and becomes fearful of falling, even to the extent of imagining he is falling from an aeroplane or boat. Tom grips the edges of the bed whilst experiencing these hallucinations and appears agitated and anxious.

On one occasion Tom displayed these distressed and agitated behaviours for an extended period of time, thus making his care difficult. He had refused to sit out of bed for several months, and so was confined to bed. In spite of this, he would still attempt to get out of bed at inappropriate times. When the carers asked him to stay in bed, he would become agitated and raise his voice, telling them to leave him and go away.

Tom was identified as an appropriate candidate for the trial, as he was frequently attempting to get of bed alone, resulting in bed falls. Even with the use of a crash mat, these falls caused bruising, head injuries and other damage. Medical intervention was often required and incident reports were being completed on a regular basis.

Results

The FloorBed™ was provided for Tom and set very low when he was left alone. The carers and Tom’s wife report that since having the bed, Tom has not attempted to get out of bed at all and so has not had any bed falls. They also report that Tom appears safe and comfortable in the bed and is happy to be left there alone.
In addition, it is reported that Tom has been a lot calmer throughout the day and night. Since using the FloorBed™, he appears more alert, more responsive and better able to follow instructions.

Another observation is that Tom has fewer and less intense hallucinations; Tom’s wife believes that Tom feels a lot safer and more secure when left alone which has led to him being more relaxed and calm.

The carers report that the FloorBed™ has not only improved Tom’s overall quality of life, but has also had a very positive impact on them. Relationships between the carers and Tom have greatly improved as they no longer have to cause him distress by repeated requests to stay in bed. The carers no longer have to fill out incident reports or provide such frequent supervision. The need for medical intervention has been significantly reduced, decreasing the carers’ workload.

Statement from Carer:
“Best thing I’ve seen anywhere for people at risk, no risk of tripping on the crash mats. This helps the carers a lot – makes the residents much happier, no calling doctors, no incident form, not having to monitor him as much.”

Statement from Tom’s wife:
“He is much calmer in this bed, maybe he feels safer and the hallucinations have become much better.”

Click here to download the full case study.


 

DOROTHY

Dorothy’s story

Dorothy is a 93-year-old lady who lives alone and is supported by her family, who visit frequently, and carers that assist four times a day with personal care tasks, domestic tasks and mobility.

Dorothy has dementia, which has resulted in poor safety awareness and poor orientation to time and place. In addition, a recent stroke caused significant weakness throughout the left side of her body. Dorothy requires the support of one carer and a Zimmer frame for all mobility. Unfortunately, there are times that

Dorothy will attempt to get out of bed when unattended, and since she is unable to mobilise alone, this often results in a fall.

Dorothy’s family reported that they had significant concerns regarding Dorothy at night and requested that bed rails were provided. However, the OT service were aware of the increased risk due to Dorothy’s confusion and did not feel this was appropriate. They provided a low bed with a mattress platform height of 200 mm and a crash mat. The family monitored Dorothy’s night-time behaviour over a four-week period and reported their findings, which they gathered each morning. On five occasions Dorothy was found on the crash mat, on five occasions half of Dorothy’s body was in the bed and half out, on six occasions she had been found in bed on their arrival and the rest of the time the family found Dorothy sat up sitting on the edge of the bed. The family were very concerned about the risk of injury and wished to explore further interventions.

Results

A FloorBed™ was put into place for a trial and was set at the lowest point of 70 mm from the ground when Dorothy was assisted into bed each night. Since the FloorBed™ has been in place, Dorothy has not fallen out of the bed. Each morning, the family find Dorothy lying safely on her bed.

The family have also reported that they are aware that Dorothy’s behaviours can be inconsistent, however they feel reassured that should Dorothy roll out of bed at any time, the risk of injury is minimal as the low height reduces the impact significantly.

Click here to download the full case study.


 

little boy Paul

Phillip’s story

Phillip has a diagnosis of dementia which results in poor risk awareness and confusion. Phillip is dependent on a hoist for all transfers due to difficulty weight bearing. He would frequently attempt to get out of bed, unaware of the associated risks. This was resulting in him falling1-2 times per week, and unfortunately the consequences of these falls was skin tears caused by the impact against the side of the bed, the bedside cabinet or the floor. On one occasion, Philip sustained a head injury, despite there being a crashmat in place.

Results

A FloorBed™, with a mattress platform height of 7cm from the ground, was put into place for a trial. The outcome far superseded expectations as not only has the FloorBed™ eliminated bed fall injuries, it has eliminated the falls completely. The carers have reported that they have observed Phillip reach out and place his hand on the floor, then turn over in the bed and go back to sleep rather than attempt to get up and out of bed.

Phillip has not had any bed falls since the provision of the FloorBed™.

In addition to reducing the risk of bed falls and injuries:

• The FloorBed™ provided reassurance to the care staff as the risk of bed falls and injuries was significantly reduced.
• The FloorBed™ provided a safe and appropriate working height for the carers when assisting with care tasks.

Testimonials

‘It is really comfortable and it’s funny how this bed works; it goes up and down like being at the funfair.’ – resident

‘If we could give a FloorBed™ to each resident, we could reduce the amount of night checks required and therefore reduce staff levels.’ – Home Manager, Barnfield

Click here to download the full case study.