Background – Lifelong condition with new complications
Taylor was born with spina bifida, where the spine does not develop properly. This led to a further complication, hydrocephalus (excess fluid on the brain).
Taylor, 17, is paralysed from his mid-chest down and is therefore wheelchair bound and suffers from incontinence. More recently, in the last 12 months, he has also been diagnosed with epilepsy.
Strained Relationship: Both Taylor and his mother were struggling with his care needs.
From birth, Taylor’s carers have been his parents, with his mother taking the leading role. With Taylor now in his late teens and having a strong body and mind, his hunger for more independence started putting a strain on the relationship with his mother.
Additionally, with his more intimate care needs his mother was struggling to cope, with Taylor now being a young man. This meant Taylor, at times, was feeling unwell and uncomfortable as his rectal irrigation (bowel movement) was happening once or twice per week, as opposed to three. To compound matters further, from a holiday that the family had enjoyed, Taylor unfortunately contracted a chronic wound on his back.
At this stage The HSE then provided a nurse to dress the wound twice a week for an interim period to assist with Taylor’s recovery. With the high quality of care Taylor received, his mother then requested and was granted full time assistance by the HSE to help with his bowel movements.
Service – Nurse led support provided to the family keyworker
The HSE contacted Resilience Care (Resilience) to put a service and care plan in place, as we had a number of services already operating in this region. The proposed plan was to have a small team to assist with bowel care three times a week, in three hour shifts.
The initial challenge for this service to commence was to find the staff to work such short shifts on a minimal frequency, in addition to having staff with the skillsets to meet the care needs.
That aside, Resilience initiated its standard process which is to carry out its own independent and comprehensive assessment. This person centred process took a holistic look at Taylor’s and his family’s needs, including but not limited to;
- An initial meeting with both Taylor and his mother
- How care is currently provided and at what frequency
- Taylor’s likes and dislikes of the existing intervention
- Taylor’s personal goals and objectives
Recruitment Solution: We focused only on staff who would be a long-term option
With the fresh insights into Taylor’s need at hand, Resilience care agreed to the HSE’s recommendation and put a person centred care plan together, focused on Taylor’s medical needs and personal aspirations. A team was then recruited (a nurse and a relief nurse) by focusing on nurses already in full or part time employment who could accommodate the frequency of care needed.
Staff Competency: Training for all staff to meet Taylor’s specific needs
With the new staffing complement in place, to provide a consistent level of service, Resilience’s dedicated new team underwent additional bowel care training at a National Rehabilitation Hospital. With an effective plan in place, Taylor’s wound healed within six months and he started feeling fit and healthy again, gaining the weight he had lost from feeling unwell.
Outcomes – New found energy and independence
Taylor’s relationship with his mother has now gone from strength to strength, as his physical and mental wellbeing has improved. In fact, the care he receives is rarely a topic of discussion amongst his family, as Resilience has seamlessly integrated. With the burden of care lifted from Taylor’s mother she is now able to focus her support on encouraging Taylor to achieve his life goals.
Greater Independence: A small care package has had a huge impact
Taylor now feels more confident and regularly hangs out with friends, has nights out and is attending college to study computing. Taylor uses public transport with confidence and feels a real empowerment to work towards one day living on his own.
Resilience’s keyworker continues to work with Taylor in not just caring for him, but setting new tasks and goals to gain his independence. We look forward to helping him shape his own very bright future.
Challenges along the way
- Sourcing and retaining staff for short shifts. This is best overcome by hiring staff full time working on multiple care packages, and building the short shifts into a wider full time role within Resilience.
- Staff training. We have had one consistent lead nurse (key worker) who can train any additional staff on shift, in addition to the theory training received at the NRH.