Caryl is a 49 year old lady from Wales who worked as a nurse. She was diagnosed with Huntington’s Disease and was cared for in a specialist nursing home. Her needs could no longer be met within the nursing home, after she presented with increased agitation and aggression and she was detained under the Mental Health Act.
Caryl was referred to St Peter’s Hospital. She presented as agitated and aggressive. There were multiple assaults on staff and she was nursed on 2:1 levels of support to manage the risk she posed to others. Caryl also refused to eat a healthy diet.
Caryl was assessed by the Multidisciplinary team at St Peter’s Hospital. Her psychiatrist carefully titrated her medication to alleviate anxiety and manage her impulsive and aggressive behaviours. The psychology team completed neuropsychological testing and behavioural analysis that led to the formulation of positive behaviour support plan. The Dietitian and Speech and Language Therapist, worked with Caryl to improve her dietary intake and communication.
The multidisciplinary team worked effectively to improve Caryl’s mental and physical health and over a 16 week period she was able to be managed without the use of enhanced observations. Due to the complexity of her presentation, requiring careful management of her mental and physical health needs, Caryl remains at St Peter’s Hospital, where she is now engaged with meaningful activity focused on promoting independence and adapting daily living skills to suit Caryl’s deteriorating mobility and cognitive function.
Caryl has improved her compliance with all aspects of her care and treatment. She has in fact recently joined the interview panel at St Peter’s, and was supported in interviewing candidates for the post of Psychologist. This improved her self-esteem and confidence and she demonstrated the overall improvement in her presentation.
The team at St Peter’s is now working closely with her commissioners and the community Huntington’s Disease nurse practitioner to find an appropriate placement for Caryl to step down to.