Client Profile:

Mr. Samuels is a disabled WWII veteran, 87, with moderate dementia, living at home. He suffered a leg injury during the war and is now unable to walk, recently had a stroke that has left his speech slurry and can interfere with socialization, and is incontinent. He needs assistance with meal preparation and eating, bathing, and cleaning his home. He takes 7 different types of medications. His daughter and son live in the same city, and care is provided through a care manager and private aides. He has been a client of SeniorBridge since February 2006.

Situation:

Mr. Samuels, a war hero and retired successful businessman, has had a very active and fruitful life, despite difficulty walking since his wartime injury. He was living comfortably at home with 24-hour care, but in a someway chaotic fashion with little structure to his days. Being unable to walk at all now, depressed, confused and more than a little forgetful from dementia, Mr. Samuels needed help with all activities of daily living. He still had many friends who wanted to see him, but when he was “having a bad day,” an increasingly frequent event, they were discouraged from visiting. He also had an addiction to alcohol and sleeping pills, which he said helped his pain. Mr. Samuels had trouble keeping aides because he could make offensive remarks. His adult children live nearby, but their busy family lives and careers allow them little time to supervise his care. They did not like the care manager they hired before SeniorBridge, and did not think she was doing the best job of monitoring their father’s condition.

The family financial advisor was also concerned about the privately hired caregivers. They had no insurance or supervision. And the sisters seemed overly dependent on them.

Solution:

Mr. Samuels' son and daughter had been referred to SeniorBridge by a physician. They asked us to assess this chronic care situation and recommend a comprehensive plan, including changes they wanted to see in his care. Our care manager completely overhauled his medication management and put two SeniorBridge aides especially trained to care for people with dementia in place to see that Mr. Anderson was well and safely cared for and to notice and report any mental or physical status changes. He obtained Medicare coverage for physical and occupational therapy. When the care manager instituted exercise therapy and nutrition management for him and changed some physicians to more appropriate ones, that accomplished a lot more. Communications were opened between his doctors and family, resulting in better awareness of Mr. Samuels' mental and physical health. A nurse came in to monitor his medications and health status. The social network that he had cultivated through the years could be continued as his condition noticeably improved and he was more alert more often. Through intensive care management over the long term, Mr. Samuels is able to live at home feeling more satisfied and encouraged than before SeniorBridge came in.

Prognosis:

His luster is restored and the family is delighted.