Mr Neeraj Wadkar* is a 74-year-old senior with a history of Mental Retardation, who was shifted to our Assisted Living Facility post discharge from a hospital. He came to us malnourished, with rib fractures, severe muscle contractures and muscle stiffness in both legs, and was under treatment for pulmonary embolism.
During his first few days at our Assisted Living Facility, Mr Wadkar was given time to familiarise himself with the facility, staff and routine. Since he had been a member of our Elder Day Care Centre, his transition was smooth and he adjusted easily to the team. At meal times, he would eat the food served without any particular food preferences or dislikes. Nutritious, dietician advised meals were served to him through the day. Liquid intake was also monitored, and over a period of 2 months, his weight increased by 2 kgs. At the time of admission, Mr Wadkar was unable to walk even with support. He could not stretch his legs straight, and his back was slightly stooped. Physiotherapy interventions were introduced to improve his mobility, range of movements and to strengthen both his upper and lower limbs. Mr Wadkar was also preoccupied with concerns about his sleep and had an increased dependency on his caretakers which resulted in his need to have a companion present with him at all times. He constantly wanted to hold someone’s hand, even while sleeping. To reduce his over-dependency, he was gradually weaned off the hand holding habit by giving him other objects to hold during interactions, and distracting him from his need to hold hands. He was also given tasks during the day to physically and cognitively tire him, to improve his night time sleeping.
Towards the end of his second month with us, Mr Wadkar showed signs of loss of power in his left hand and leg. He was evacuated immediately to the nearest hospital, where he was diagnosed with Chronic Subdural Haematoma, which was a side effect of the blood-thinning medicine being given to him for the treatment of pulmonary embolism. Post-discharge, physiotherapeutic interventions were carried out for restoring muscle power and improve the muscle functioning. Our Doctor was in regular contact with the treating physicians and made the necessary changes in the treatment plan as advised. The nurses regularly dressed the operative wound and dispensed medicines on time, which led to an uneventful and quick recovery.
Currently, Mr Wadkar is able to carry out all his activities of daily living with assistance and he is walking unaided. His need for constant companionship and over dependence on caretakers has reduced, and although he is still preoccupied about his sleep, his night time sleep has improved.
The above case highlights the need for more facilities that can look after people who need a higher level of care than can be provided at home and at the same time do not require hospitalisation, such as an assisted living facility.
*Name changed to maintain confidentiality
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