Examples of Clients with Various Needs

Case Example 1:

Mrs. Kim is a 63-year old widow who lives alone in a small town. She is recovering from
surgery that removed her breast due to cancer and resulted in an infected wound. When
she first went home after surgery, she was very weak and could not take care of herself.
She received several days of home support services to help with bathing and dressing.
A home care nurse also visited her regularly to clean the wound and provide IV
antibiotic treatment.

After a few days, Mrs. Kim was stronger and able to get around. She switched from
home care to nursing care at her local health centre. The health centre continued IV
treatment and provided wound cleaning. She also began going to a support group for
women recovering from similar kinds of surgery. A community physiotherapist provides
exercise therapy to the group.

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Case Example 2:

Shirley is a widow in who lives in the city. When her husband died five years ago, she
moved to the city to be close to her daughter. Her son and his family live in a small town
two hours away.

Shirley’s children are happy to have her closer, but are limited in the support they can
provide. They both work full time and have school-age children. Shirley does not know
many people in her new community and has grown frailer over the past six months. She
does not sleep well, is short of breath and has lapses in her short-term memory. She
has fallen several times in her home. She recently fell in front of her apartment building
and fractured her hip.

Shirley was in hospital for ten days before going home to recuperate. While in hospital,
a physiotherapist showed her exercises to help her get stronger and arranged for
Shirley to borrow a walker. The hospital discharge nurse set up for a home care nurse
to visit Shirley. The home care nurse cared for her wound and monitored her overall
condition. Home support services were set up to help Shirley with dressing and
personal care. Her family installed safety equipment as suggested by an occupational
therapist.

After a few weeks at home, the home care nurse referred Shirley to the community case
manager. The case manager assessed her longer-term personal care needs. She
monitored Shirley’s shortness of breath and blood pressure. She also talked to her
about preventing falls, socialization and good nutrition.

***

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 Examples of Clients with Various Needs

Case Example 3:

Susan is 42 years old and a single mother with two school-aged children. She has
terminal lung cancer. She wants to die at home and have as much time with her
children as possible. Her mother, who lives nearby, is Susan’s only support. She helps
her daughter and grandchildren as much as she can, but her rheumatoid arthritis
restricts her ability to help with child care and many household tasks.

The home care nurse visits frequently. She helps Susan manage the pump that
provides her pain medication. She also takes care of Susan’s two catheters. One
catheter drains excess fluid from Susan’s lungs, while the other is in her bladder to
improve her comfort. The nurse regularly assesses Susan’s status and connects with
Susan’s family doctor to improve symptom relief. She consulted the specialist physician
when Susan’s pain medication was making her too drowsy to interact with her children.
She consulted with the Ministry of Children and Family Development to make sure
Susan had help with childcare. The nurse set up end-of-life care counselling and offered
to contact someone for spiritual care.

The community occupational therapist taught Susan how to move in and out of bed
safely, and how to adjust her position. She arranged for equipment, paid for by the BC
Palliative Care Benefits Program. A community physiotherapist also provides Susan
with chest therapy.

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Case Example 4:

Darcy is 34 years old and lives in a large city. He became a quadriplegic in a skiing
accident several years ago. He has limited movement in his upper limbs. After a long
period of rehabilitation, Darcy returned to his own home, with support from his family
and friends.

He is dependent on others for his personal care needs. He requires help with feeding,
positioning, physical exercise and 24/7 emergency response. Sometimes he needs a
ventilator so he can breathe normally.

Despite his many challenges, Darcy lives an independent life. He uses adapted
technology to do his work as a writer and advocate for the disabled. His case manager
helped him apply for self-directed home support services. This allows him to hire his
own caregivers and organize his care in the way that best suits him. She reassesses his
needs and changes his service contract as needed.

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 Examples of Clients with Various Needs

The community occupational therapist visits Darcy often. She has helped him get
equipment to help him be more comfortable, independent and mobile. A community
physiotherapist also visits regularly.

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Case Example 5:

Frank and his wife Anita have been living in their rural home for more than 40 years.
Their three children do not live in the area. Anita was diagnosed with dementia that has
progressed over the last few years. She is no longer able to manage her own bathing,
dressing, cooking or other personal care activities. Lately, she started wandering and
neighbours have returned her home on several occasions.

Frank provides all of Anita’s care. He takes care of the housekeeping and shopping
while Anita comes along in the family car. Frank has health concerns of his own. He has
high blood pressure, arthritis, and was recently hospitalized for complications from his
diabetes. He is finding it hard to manage his and Anita’s many medications. He wants to
stay living at home where he can look after Anita and himself for as long possible.

A case manager has completed a detailed assessment of both Frank’s and Anita’s
needs. The case manager set up home support services to assist with Anita’s daily care
and arranged for Anita to go to a local adult day program two days a week so Frank
could have a break. Frank has been given information to help him manage his diabetes.
He has also been given information to help plan for his and Anita’s future care needs.
The community pharmacist now organizes the medications into blister packages,
making it easier for them to take their medication on the right day and at the right time.

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