Dawson - Case Study

This case study is an example of specialist knowledge and intervention by Sarah Watson, Leeds.

Dawson is 66 and was diagnosed with Secondary Progressive MS in 2014. He lives alone but has family nearby. Two carers visit him four times a day. He struggles with upper limb function and has no active movement in his lower limbs, so uses a power chair. 

• Dawson has no active movement in his right arm and has ataxic movement (poor muscle control) in his left arm. This makes feeding himself difficult and his carers spend time feeding him.
• Has had two admissions to hospital in last 12 months due to infection.
• Has reduced respiratory function and is at risk of further chest infections. 
• Recurrent urinary tract infections (UTIs)
• He had been provided with specialist equipment (Neater Eater) and assisted drinking bottle. Due to Occupational Therapist waiting lists, he was not able to use the equipment, however, the AMSC was able to facilitate training for his carers so he can now eat and drink independently.
   

• Goal 1 - To be able to feed himself - AMSC carried out two sessions with  carers to teach them how to use a Neater Eater.
• AMSC referred to the Community Dentist to enable him to chew more easily. His swallow was assessed during admission, and he has commenced using one scoop of thickener in his fluids.
• Goal 2 - To reduce risk of further chest infections - AMSC referred to the Sleep and Ventilation Service for assessment with a cough assist machine. 
• Goal 3 - To reduce the risk of further urinary tract infections - AMSC provided urinary tract infection testing kits and referred to community continence team.

• Dawson can now eat one meal a day independently, pacing his meal and swallowing safely.
• He can now access drinks, which improves hydration and reduce risk of UTI.
• Increased independence with eating allows carers time to be allocated to his personal care tasks, which assists with his spasm management.
• Reduced risk of chest infections due to cough assist, and thickener in fluids.