When I am at home, I am normal. Joan’s Story: a case study

Joan's Story

“It is so important for me to be here in my own home, take that away and I might as well be dead. When I am at home I am normal.”

Joan is an independent and private woman who is an excellent example of health and social care services working with the person to support them to live in their own home.

Joan is now 89 but says, “I don’t feel like I am in my 80’s, I feel like I have always felt.” Laughing she said, “What are you supposed to feel when you are nearly ninety?”

Joan agreed to share her story because she wants others to know that there are different ways for people to get the support that they need and not just rely on hospitals and care homes.

Joan has several long term health conditions which contributed to her having frequent falls. After a number of falls and long stays in hospital, Joan was discharged to a care home, where she could be looked after safely. Joan was extremely unhappy in the care home because of a perceived loss of independence and cried constantly, insisting that she wished to return home, saying to the social worker “Don’t just look at my safety, look at my happiness. I want to go home.”

Joan insisted that she missed her independence and felt that her wellbeing and happiness were starting to decline. She insisted she wanted to spend her remaining years in her family home, the home she had lived in with her brothers, her family. “Living in your own home is part of being normal, being surrounded by your own things.”

Two social workers, a Community Occupational Therapist, a Mental Health Community Care Co-ordinator and the manager from the care home met with one of Joan’s family and an independent advocate representing Joan, to look at the options. During the meeting some of the professionals were very concerned about Joan’s safety and felt that she needed 24 hour care. Eventually they agreed to try and support Joan at home, because of just how important it is to her.

The social workers arranged a comprehensive package of care at home which would be closely monitored and regularly assessed by the GP and a Social Worker.

They also checked Joan’s home for potential causes of falls and made some changes to help Joan manage the risk of falling. An occupational therapist supplied a hospital bed, specialist engineers installed electrical health monitoring equipment at her home, care agencies  and district nurses all worked cooperatively together to  to maintain Joan’s safety, dignity and general wellbeing at home.

Joan found it difficult at first saying, “My privacy has all gone and I was annoyed”, she found it difficult having strangers coming to the house so often “Not being in control of my own life that’s what upset me. I want to be able to say I don’t want you but I can’t, I know that. I need to have carers so I had to accept it, I’m not daft.

Now, Joan has a particularly good relationship with one carer in particular. Joan says, “It’s not bad now that we are organised.” Social Worker Abrefa said “Joan said I told you that I just wanted to go home. I then spoke to the care workers. They said that it was working fine. Joan was chatting to the workers, following their instructions and falling less.

Eighteen months later and Joan is still at home being supported by her package of care and enjoying her independence and peace of mind. It’s been really important that the professionals have all worked closely together. The Social Worker and GP are based in the same office, so able to pop in and deal with any problems that do occur. It has also worked out more cost efficient than if Joan had stayed in the care home.

So the final word from Joan…

“It is so important to me to be here in my own home, take that away and I might as well be dead. When I am at home I am normal.”

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