A personal experience by an experienced Telehealthcare Professional

 

My mother died from cancer 35 years ago when my father was 60 and had recently retired from the Civil Service. He then suffered from depression, a condition which wasn’t helped by a need for prostate surgery and 2 hernia repair operations over the next 5 years. His lifestyle became unhealthy, he didn’t exercise enough and he developed Type 2 diabetes. He was clearly not looking after himself.  His sister, who was a couple of years older than him, was then widowed. She had no children and was lonely. She jumped at the opportunity to move in with him; for 20 years they were able to share each other’s company, go shopping together and go on holiday together on a number of occasions. He took his first foreign holiday with her in 1995.

Over the years, they both had their health concerns but looked after each other. She did the cooking, and when her arthritis worsened, he did the shopping. Nobody really knew how well or how poorly they lived until his eyesight started to deteriorate and it was clear that he was no longer being careful about what he ate, and his compliance with diabetes medication had become pretty poor. She became housebound, and he wasn’t inclined to leave her home alone. Within 6 months they had become an old couple who needed daily help from both family and formal carers. Unfortunately, my aunt became confused as a result of a urinary tract infection and was taken to hospital where she suffered a fall one night as a result of which she broke her wrist. She died within a fortnight.

My father seemed to recover well after the initial shock of bereavement; he resumed his interest in horse racing and wanted to visit the bookmaker most days of the week. Yet, his balance was deteriorating to the point where he was having almost weekly stumbles. He admitted to getting up in the middle of the night for a smoke, a cup of tea and some toast so we were concerned at the prospect of him suffering a heavy fall and being left on the floor for hours without help. At this point we realised that his blood glucose levels were far from stable, and usually too high; he also frequently forgot his medication but was happy to eat cakes and marmalade that were high in sugar.

We took control of his medication and dispensed his tablets into a weekly dose organiser and tried to accept and use a social alarm telephone and pendant device. Unfortunately, he made it clear that he didn’t want the alarm and wouldn’t carry a pendant with him – a typically obstinate old man who confuses independence with a lack of common sense! But my sister and I knew that he was likely to suffer an accident or a bout of illness and would be without help for hours unless we came up with a more acceptable solution than an alarm. At this time, I came across 3rings. It was relatively low cost and entirely non-intrusive. I plugged my father’s kettle into it and told him that we were going to monitor his use of the kettle. He had no problem with this.

It was easy to program the 3rings device on the company’s website so that it would send both me and my brother an alert as a text message if my father’s kettle was not used during 3 time windows every day. Confirmation that he had boiled the kettle for breakfast in the morning gave use significant peace of mind as it confirmed that he wasn’t on the floor and incapacitated. The 3rings website allowed us also to check that he was having a cup of tea with his lunch, a coffee at tea-time and another cup of tea in this evening. In fact, we were able to track how many times a day the kettle was used. His average was 5 but he didn’t once boil it fewer than 3 times a day over a period of three months.

In July, we noticed that he had become more unstable on his feet. This coincided with us receiving more alerts from 3rings to tell us that he hadn’t used the kettle during one or more of the time windows that we were monitoring. We challenged him on why he was drinking less tea and coffee but he responded that he was having cold drinks because the weather was warmer. As he doesn’t like to drink tap water, we looked at how much orange juice and cordial were being used from the fridge. We found little evidence that he was having any cold drinks and because he had also been complaining recently about headaches, fatigue and muscle cramps, we suspected that he was dehydrated. We pinched the skin on the back of his hand and pulled it upwards. It maintains its pinched shape for a few seconds and dropped only slowly with time, again implying a dehydration issue. At this point he admitted that he had cut back on his fluid consumption because he wanted to reduce his number of visits to the toilet which was upstairs, and difficult for him to get to in a hurry.

As a result, we installed a downstairs toilet for him, and he has started to drink far more during the day. His balance has improved, and he hasn’t suffered a fall for several months. We have arranged a rota and now one of his children visit him every morning with a newspaper. This allows us to check how he is and whether he has taken his medication. We also administer his 7 different eye drops and ointments at night. He continues to live on his own and will soon be celebrating his 95th birthday, God willing.

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