Good Companions Care Home is a spacious Victorian house, set within a quiet residential area of Southport which accommodates 26 residents. The home forms part of the Benridge Group, whose forward-thinking management provide specialist care for people with all levels of dementia.
Lisa Connolly, Registered Manager for Benridge, was introduced to Immedicare in 2015 by a local doctor who is a member of the Frail and Elderly Steering Group. Lisa said, “I try to be proactive in terms of looking for new innovations, so when I found out about Telemedicine at one of the Frail & Elderly Steering Group meetings, I could see the benefits immediately. I was happy to trial it initially at Benridge and, subsequently, at Good Companions”.
Lisa expanded: “I knew the key to its success was to get the managers onboard with it straight away, so that it dispersed any initial fears or concerns. From the start it was described to managers as another set of eyes and, because we’re not nurses, would take away uncertainties that we faced and protected us from making wrong decisions in terms of the health and welfare of our residents. As far as I am aware, after their initial call, all the managers were very positive and felt that they had more support. We have also trained our night carers, who have found it to be such a comfort, knowing that there is immediate advice available from a professional”. Lisa went on to say that “Everyone uses the system as part of their everyday routine now, and all the carers are fully aware of the process that we now follow in using Telemedicine.”
Ceri, who is one of two care managers at Good Companions, added: “It’s a bit unnerving at first; with someone looking at you, but the nurses are so reassuring and friendly at the other end. We now know them by first name. It seems to work really well, and I wouldn’t be without it”.
Lisa explained “it can be difficult for someone living with dementia to communicate how they are feeling. However, we know them well and can usually determine when they’re feeling poorly. Telemedicine takes away that feeling of possibly wasting a GP’s time visiting the home and taking them away from someone with an emergency”.
The format of an Immedicare call is the nurses asking such questions as: How is the patient presenting? What are your concerns? Is this normal behaviour? What was she/he like last week? How did she/he eat last week? Have you seen this before? Tell me the past medical history. What medication are they on? They then check to see that if they get drugs delivered they are not going to interfere with any current medication. They also explain the reason for asking such questions.
“I just think it’s great”, Lisa went on to say. “Over time we’ve seen more uses for telemedicine, and the nurses have been very good. If ever we’ve asked for assistance, they’ve been very keen to try and help. I think at the last meeting we asked whether it was possible for them to do any training on things like diabetes or catheters over video, and it’s something they are looking at doing. We’re finding that, in this area, this type of training is becoming more difficult to find or that the costs are too high.”
“The other thing we’ve had issues with are DNARs (Do Not Attempt Resuscitation) forms. We’ve been in the situation where there’s been a DNAR in place, but they couldn’t be located, so we’ve been able to use telemedicine to show them the DNAR over the screen.”
Ceri explains: “For people with dementia, one of the first things you check is whether they have a urine infection. If we find our resident has a urine infection after twelve o’clock, we would have had to wait another 24 hours to get that sample to the surgery, to get antibiotics, by which time the resident’s condition could have escalated. Now we’re able to complete a dip test over telemedicine. The nurses are then able to arrange an antibiotics prescription. We’ve seen a huge drop in the volume of GP callouts too.”
Lisa explained “For someone living with dementia, busy environments such as hospitals can be a frightening experience for them, especially if they have to wait around. If the resident becomes upset or agitated in unfamiliar surroundings it can put them or others at risk. It’s also extra expense for us as well, as we always have a member of staff to assist them to hospital and wait with them until they have been seen, which quite often goes into the early hours. Having access to Immedicare means that we can reduce the need for hospital admissions”.
Lisa then describes the installation: “the Immedicare engineers came in and set it up very quickly, it was easy to do and took about 30 minutes”.
Ceri and Lisa then give details of how Immedicare has already helped them at Good Companions.
“One of our ladies gets quite agitated and doesn’t communicate very well, but is able to eat and drink independently. However on one occasion she seemed to be choking on normal fluid and fresh air, so we contacted Immedicare, and in no time there was a SALT (Speech and Language Therapy) assessor on the other end. We would normally wait weeks to obtain an appointment with this team. We had no idea this could be part of the service.”
“We’re learning about the different ways in which Immedicare is able to help us and provide clinical specialists.”
“Another lady suffers oedema of the leg, which involves swelling. On one particular day the area was hot to touch and there was a pocket of fluid that had collected. We were able to show the affected area to the Immedicare nurses on the camera, and by lunchtime there was a nurse that came out and dressed her legs, the nursing team had arranged that!”
“We find that the ambulance attendance is a lot quicker as well, when they know the call has come from Airedale.”
“We had a lady who banged her head after falling backwards for no apparent reason. The nurses talked us through how often to do her obs, what to check for, they told us to clean the area so that they could see the wound and they were quite happy that it would knit together. We monitored her obs, took her temperature, the nurse then watched her walk, watched her sit down, watched her eat, and then she rang us back every hour, to get a report.”
“On another occasion we had an unexpected death, and we called Immedicare who stayed on the call to the carer while the paramedics did their job”.
“The families really like Immedicare as well; we feel it is a unique selling point for our homes and have promoted it through our Facebook site. For anybody placing a family member within a care home – especially a residential home – knowing that we don’t have nurses on duty, it definitely gives them that bit of reassurance that a professional is available so quickly. Some of them have actually seen telemedicine being used; they think it’s wonderful, as it’s saved their relative/friend from going into hospital”
“We had a lady whose daughter-in-law is a GP, and when she found out we had Immedicare she thought it was brilliant.”
Lisa is the Telemedicine Champion for providers in her area and attends quarterly meetings where she shares good news stories. “We would most definitely recommend this to other care homes, as it goes a long way to reduce GP visits, hospital admissions, provides a quicker service and reduces our administration”.