Nancy* is in her 80s, and lives in Manly Vale with her son who has an intellectual disability. Nancy has cognitive delay, dementia, behavioural issues, chronic osteoarthritis and hearing problems. She becomes easily distressed, and has difficulty understanding ‘how things work’ in terms of community and service systems.
Nancy kept presenting at Mona Vale Hospital, and when the occupational therapist went out to do a home visit, they realised the cause was (at least in part) the extreme domestic squalor in which she lived: filthy beds with no sheets, showers that did not work and which could not be accessed, and other dangerous hygiene and health risk factors. Mona Vale Hospital then referred Nancy to CCNB.
CCNB has been able to organise a Level 2 Home Care Package (HCP) for Nancy and also brought her into The HOPE Project , a Commonwealth funded service to assist people over 50 years of age who are experiencing symptoms of Hoarding Disorder or who are living in severe domestic squalor.
Nancy’s HCP provides her with four hours of support per week, which is insufficient to meet all of her needs. Nancy does not qualify for a higher level package due to the way HCPs are assessed, which focuses on ADLs (activities of daily living) such as showering, but does not take into consideration the more complex interactions required to live in the community.
Nancy needs help with all facets of life in the community – getting her to the doctor, liaising with the pharmacy, organising for her hearing to be checked, organising her to visit the dentist, helping her to complete her Centrelink forms, taking her shopping, and understanding what funds she is receiving. Nancy cannot do the normal range of tasks and interactions needed to function in a society without constant and intensive assistance.
CCNB has been providing this assistance through case management, funded by The HOPE Project, so that Nancy can live safely at home, and in her community. And it is working. Since being on The HOPE project and CCNB case management, Nancy has not presented at hospital, or called 000, which she often did in the past when feeling distressed.
*not her real name