By Jen Winarski, RN

Edward, 92, and Miriam, 91, live in their own two bedroom apartment in independent living at a Continuous Care Retirement Center (CCRC).  Edward is suffering from late stage Alzheimer’s and is very confused and uses a walker for ambulation.  Miriam has a history of falling with a previous hip fracture and uses a rolling walker for ambulation.  In October 2011 Miriam suffered another fall where she fractured her hip and was sent to the hospital.  Once Miriam was admitted to the hospital, Edward’s confusion became more and more increased.  Miriam was then discharged from the hospital to the CCRC health center next door to their apartment building and Edward went to visit her every day and have meals with her, but his agitation and confusion were increasing the more time he spent away from his wife.

During a care conference with the family, it was decided that Miriam and Edward were to remain together in their apartment for as long as possible and they would do whatever it took to make that happen.  In late November a multidisciplinary meeting was set that included the Wellness Supervisor and Social Worker, the Psych Nurse and Physical Therapist from the Medicare Home Health Agency and the BrightStar Nurse Care Coordinator.  After the meeting and a call to the clients’ family, the plan was to return Miriam to her apartment and to have a psych assessment done, physical therapy sessions, and the addition of caregiver hours so that the couple was never without the appropriate level of help.  Very shortly thereafter Miriam returned to her apartment and the plan was put into action.

For the next six weeks, a physical therapist came to the apartment to work with Miriam three times a week.  A Psych nurse performed a complete psychiatric visit, ordered an antidepressant, and scheduled a few therapy sessions with Miriam.  The BrightStar Nurse Care Coordinator visited the apartment once a week to reassess Miriam, helped to adjust her antidepressant dosages, and interacted with the caregivers so that their individual needs were met.  The BrightStar Nurse Care Coordinator also checked in weekly with the CCRC Social Worker and the CCRC Wellness Supervisor to update them on the status of the couple.  Also, the family was informed via phone calls or emails on a weekly basis.

Today, the couple is still together in their same apartment.  Miriam is very strong and still ambulating with a walker, but soon may not need to.  Her medications have all been well adjusted and she continues to remain in good spirits.  Edward still has episodes of confusion, but he is much happier with his wife by his side.  There are still caregivers in the apartment, but the hours have decreased as the couple’s conditions have improved.

Call BrightStar Oak Brook, IL today at 630.571.5555 to learn how we can Make More Possible for your loved one!