Chris

This case study is an example of specialist knowledge and intervention by Nicola Hare, Dorset.

Chris is 79 and was diagnosed in 1988. His wife, Sue, is his full time carer, assisting Chris will all aspects of daily living including cognitive impairment, incontinence, spasticity, feeding tube regime, and hoist transfers.

• Chris's wife has been providing twenty-four-hour care with no extra support.
• Chris's catheter was regularly becoming blocked, causing additional pain and discomfort.
• The position Chris was lying in in bed was putting him at risk of developing permanent tightening of muscles (contractures).
• Excessive oral secretions were becoming more difficult to clear.
   

• The AMSC understood that carer burden was a risk for Chris's wife Sue. They discussed options and completed a Continuing Health Care (CHC) checklist together. Chris was granted CHC funding and Sue has the extra support of once-a-day care and twice-a-day on two days a week.
• To resolve problems with his catheter, the AMSC worked closely with the district nursing team to change his type of catheter and his medication.
• The AMSC worked with the CHC occupational therapist to assess Chris's positioning in bed. The AMSC also provided specialist bed positioning aids, which improves his comfort.
• Chris's oral secretions have been improved after a medication review from his GP. The AMSC sourced a portable suction device, along with training for Sue, which also improved oral secretions.

• Chris has had no unplanned hospital admissions due to MS in the two years he's been under the care of an AMSC.
• The carer burden of Chris's wife Sue has significantly reduced.