Case Studies
Case Study 1
John came into Manor House in Dec 2009 from another home unable to meet his needs. He would show inappropriate sexual behaviour to staff and other residents and would not sleep at night making him very agitated throughout the day. He would steadfastly refuse any personal care and would become verbally aggressive to both staff and fellow residents who got close to him. For large parts of the day John was withdrawn, kept himself to himself and would not socialise.
Part of his induction involved looking at his life history, which brought to light his prominent time in the army and over the first few weeks we found he responded well to regression therapy. This helped him settle into the home and build a rapport with his carers. Diversion tactics were used whenever any inappropriate sexual behaviour was shown, staff would never act shocked but instead simply overlook this side of him slowly making him realise there were more interesting aspects about him. He started talking about some of his responsibilities in the army, his family, songs he liked to sing and funny jokes he remembered. Within the first 6 weeks we were able to completely curb all inappropriate behaviour he had been portraying.
We tried different approaches to attend to his personal care and found if a carer would sing a song he liked another could attend to his personal care. This worked so well that he would look forward to his bath time remembering more songs he could sing on the next occasion. We replaced his 7pm cup of tea with a warm milky drink and following this with a warm bath found he was able to sleep more through the night and thus develop a pattern.
Over a relatively short period of time John became relaxed, participative in activities, always smiling, more sociable and encouraged others to be sociable around him. His family were amazed at his turnaround.
Case Study 2
Thomas came to us in Oct 2011 from 2 failed placements, first a dementia home then a nursing home. He was doubly incontinent, very violent towards staff, would not allow personal care, unable to communicate and continually agitated.
We found he was an early riser and would be grumpy with it. Staff would encourage him to have a little lie in during the morning and tell him about the some of the fun things they would be doing that day. They would say ‘why don’t you get another 10 minutes in bed Thomas, because we’re walking down to the lake today and you’ll need your energy’. We found the more time we gave him to prepare in the morning the more relaxed he became, as a result he started waking up anywhere between 7-10 am. Since communication was difficult we would show him different towels in the morning to enable him to prepare for his personal care. He didn’t like surprises or fast movement, everything would be done very slowly whilst providing a running commentary. Due to his aggression he would need 3 staff to attend to his personal care initially, but after a 3 month period 2 carers could sometimes comfortably provide this care.
Thomas is very relaxed and hasn’t shown any violent behaviour for the last 10/11 months, he is friendly, sociable and a lovely character around the home. He is happy to share his opinions and express his personality more now than at any time we have known him. His children are delighted to have more of their old dad back
Case Study 3
When Sylvia came into Manor House in June 2010 from a failed placement she was also very aggressive, doubly incontinent, would go into other residents rooms to cause disruption and, like the majority of the residents we admit, heavily medicated with antipsychotic drugs to manage her behaviour. This caused her to feel huge lows over the course of a day.
Her medication would prevent any of her personality to come through and made it very difficult for us to build up a rapport with her. To manage this we firstly identified times of the day where we could talk to her, understand her background, her likes and dislikes and things she enjoyed doing for fun. Once that rapport was built we could continue to reduce her medication and allow her to express how she felt without fear of being reprimanded. If she was sad she would scream and shout and we would let her get it out of her system and comfort her through this trauma.
Afterwards we would always reinforce the positives in her life, show her photos of her grandchildren, encourage her to sing, listen to music, play a game or just talk.
Over time we noticed instances of sadness reduced despite a continuing reduction in the dosage of antipsychotic medication. She became more talkative, she smiled more, was relaxed and settled. Within 6 months she was completely off the antipsychotic medication and never went back on it again.