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"Quest to live at home and avoid going to an old age care home"

About: Prince of Wales Hospital / Transitional Aged Care Program

(as the patient),

At 85 years of age and having spent 8 months in hospital with a fractured neck from a fall and sepsis from an infection around my spine that damaged my spine to the point I could no longer walk unaided (having completed physical rehab programme in hospital) I was facing the prospect of having to go to an aged care home which is one of the worst outcomes I can think of having lived independently in my own home all this time.

When I returned home to see if, with the aid of my son (49), I could manage at home I was assigned a number of care workers from the South Eastern Sydney Local Health District’s Transitional Aged Care Program who were tasked with the goal of getting me into a state whereby living at home with in-home care would be feasible.

I was assigned a Personal Care Worker (Ally) to assist me in bathing, a Physiotherapist (Jenny) to rehabilitate my stability and ability to walk, an Occupational Therapist (Genevieve) to help me improve my hand coordination and finger strength and dexterity and to assess the house for what modifications, aids etc that I would need to support me in my quest to remain living in my home and not go into an aged care facility. Additionally, I was assigned a Social Worker (Julie) to help me with accessing the services available through government and community resources in my area that would be essential to achieving my goal of being able to stay at home. As I have suffered from anxiety and depression disorders all my life this was additionally important to my having any chance of staying at home where I feel safest and most comfortable.

Due to the nerve damage I had sustained from the spinal infection my legs, which had been somewhat swollen for a number of years due to partial heart failure, had become extremely swollen as I could no longer walk or move my ankles effectively enough to keep the fluid levels down despite medication and compression wrapping of the lower legs 24/7 became necessary. Additionally the skin on my lower legs had become extremely dry and this coupled with the swelling had left the skin stretched and rice-paper thin resulting in frequent breaking of the skin and infections thereof so I was also assigned a Nurse Practitioner (Kim) to oversee the reduction in swelling as much as possible and work towards rehabilitating the skin quality by rehydrating and effectively and efficiently treating the breaks in the skin.

When I first came home I could barely walk at all with the aid of a rather large two wheeled walking frame, I couldn’t bath or cloth myself and my legs and feet were twice their normal size and the skin in my lower legs was riddled with broken patches. I was unsurprisingly in a very low state of mind with little hope of achieving my goal.

Over the course of the following 18 weeks however, the amazing ladies of my care team worked tirelessly and collaborated so amazingly to take care of me in the ways I no longer could and rehabilitate all the things wrong with my body to the point where I can now walk quite well with my walker, I can cloth myself most of the way, I am knitting and quilting again and my legs have been rehabilitated so well they are being used as a case study for a good outcome!

I will live with aspects of impacts from the spinal damage for the remainder of my life but I will do it from the comfort and security of my home thanks to the tireless and heroic efforts of my care team. I literally would not be where I am, happily, today without them.

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Responses

Response from Justin O'Hare, Co-Director CCVH Program, CCVH, Prince of Wales Hospital last week
Justin O'Hare
Co-Director CCVH Program, CCVH,
Prince of Wales Hospital

Nurse Manager

Submitted on 29/10/2024 at 11:46 AM
Published on Care Opinion at 12:41 PM


Hello GrannyAtHome

Thank you for taking the time to provide such a beautiful story. Your journey to the POWH TACP was such a challenging path and it is really heartwarming to see the person centered care you received from the team which has supported you to reach a level of independence at home you were not sure you would gain back.

Your kind words will be passed onto the TACP team members you have so graciously named. I hope you continue to do well at home and I thank you again for sharing this lovely story.

Kind regards,

Justin O'Hare

Nursing Co-Director

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