Guest article: The importance of versatility and flexibility in the community care of complex patients
In this article, Nurse Specialist at NHS Berkshire West Clinical Commissioning Group Anita Rush talks to Hillrom about her experiences using the Hillrom Sabina Sit-to-Stand Mobile Lift in the management of complex individuals in the community.
Anita Rush is Clinical Lead Nurse Specialist for equipment at NHS Berkshire West Clinical Commissioning Group (CCG). Anita has over 20 years’ experience in her current role and specialises in the care of complex patients, which includes gatekeeping the CCG’s budget for bespoke equipment for patients.
This testimonial covers a case study of a 28-year-old man who was sadly diagnosed with an inoperable brain tumour in 2016. Anita discusses how the support of Hillrom’s Sabina Sit-to-Stand mobile lift aided in keeping the patient in the comfort of his own home, allowing his family to care for him without the added implementation of a care package.
Can you share some background on the patient and how the Hillrom Sabina Sit-to-Stand aid made the difference to his care?
I was first involved with this particular patient back in 2016. The patient was a 28-year-old man who had been diagnosed with an inoperable brain tumour. His family were obviously devastated as he had a young family with two children under the age of five.
Our desired outcome for the patient and his entire family, in this case, was to allow them to treat and care for the patient in a home environment for as long as feasibly possible. They wanted to remain as a family and to have some semblance of normality for the children, while at the same time ensuring the patient could retain his dignity and independence.
What were some of the challenges faced in this case?
The home environment itself was the first obstacle. The house was a small, rented accommodation, it was carpeted throughout and had an extremely small bathroom and shower space. The second obstacle was the body dynamics of the patient. He was a very tall man at 6”6 and he weighed around 28 stone, which made caring for this patient in a small space potentially very difficult and made this case quite complex.
After diagnosis, how did you further support the client and his family?
After his initial diagnosis, the patient was first placed in a care home. However, being at the young age of 28 years old, it was not where the patient or his family wanted him to be. The outcome we wanted to achieve was to get the patient back in his safe, familiar, home environment with the support and care of his family.
His immediate and extended family were very hands-on – with each set of grandparents taking it in turns to stay over and support the children, offering a sense of normality, while also helping with the personal care of the patient. The family did not want a care package, so it was important for us to try and accommodate this.
What did the Hillrom Sabina Sit-to-Stand offer the client that alternatives did not?
The key thing that the Hillrom Sabina offered, in this case, was its flexibility and versatility. While the patient still had some ability to weight bear. the Sabina was ideal as it is modular, which I am not sure is commonly understood.
As the patient was so tall, the height of the Sabina could be adjusted to meet his needs and because of its design, it was easy to manoeuvre over the carpets in his home. It also has flexibility on its safe working load up to 200kg, so it could easily support this particular patient’s weight. There was also the choice of different spreader bars, so the equipment could be easily altered to fit the needs of the patient.
Why was the Sabina Sit-to-Stand put onto contract with your authority?
It was primarily its flexibility. Once people know how to use it and once people have been trained, it was very easy to use. We did a thorough evaluation on the different lifting machines available that would be able to support this patient’s particular dynamics and home situation, and the Hillrom Sabina came out as the top option. It could support the patient’s height and weight, had a versatility of slings and straps as well as having good mobility over carpeted flooring. The Hillrom Sabina became part of our core equipment list and, in fact, still is to this day.
Had the Hillrom Sabina Sit-to-Stand not have been used, what would have been the alternative for the client?
We would have looked at the other potential mobile lifts available, but the safe working load would not have been as high. We may have had to resort to using full body hoists, which would have impacted his dignity, independence and would have been more intrusive for the family at that time.
In the short-term, his independence would have reduced and as this was key for the family it wasn’t really an option. It also would have impacted on the ability to successfully carry out rehab, as using the Sabina enabled us to stand him during the day, allowing him the muscular stretches he needed for key functionality, such as breathing. It could also be stored away in the corner even though the property was small, which reduced the impact on his family and, to an extent, the children could ignore it.
I believe that without it, he would have deteriorated much more rapidly.
How do the key functions of the Hillrom Sabina Sit-to-Stand meet the needs of individual clients?
Often the equipment we have available to us may not be the perfect fit for patients but as it is all we have access to, there is no way around it. The flexibility of the Sabina meant that it can be tailored to the needs of the patient. It has inter-changing parts, such as knee supports that can be adjusted to a patient’s height, knee pads that can be taken off, the foot platform can also be removed and because the Sabina is modular, it allows for so much more versatility than other pieces of equipment. It allowed us to adapt the equipment to fit the patient rather than trying to fit the patient to the equipment.
How important is it to get the correct solution for the client first time, both for a patient benefit but also for cost efficiencies?
It is paramount that you do. Unfortunately, the diversity of patient complexities means that sadly we do not always get it right the first time. However, it is so important to the dignity of the individual and their wellbeing that you do try to get it right the first time if at all possible. If you get the correct solution the first time, you gained the patient’s trust and confidence in their treatment. If you get it wrong, they could become unsure as they may have been injured by the wrong equipment in the past, meaning they could be reluctant to try future solutions. It is paramount that you get it right first time but it is also very difficult to do so.
From a financial perspective, the cost savings of getting the correct solution the first time is immeasurable. If you get the right solution, you may not need to organise care packages which, in turn, reduces the cost of care. It also has enormous benefits for CCGs and social services, as families can continue caring for their loved ones in a home environment, only needing an update when there is a change in the patient’s condition.
How do Hillrom support your local authority in terms of client assessments and wider training, both face-to-face and virtual?
Very well, they are excellent. The support I get from Hillrom is amazing. iIf I have a problem, I just contact them and their response is always very good. At the moment, due to the pandemic, the training is all virtual, but they continue to be very supportive. We manage to cover a lot of prescribers with the virtual training and the response time to go out is normally a matter of days rather than weeks. From my personal experience, Hillrom meets the needs of their clients both efficiently and effectively.
More about the Hillrom Sabina mobile lift…
Versatile by design, the Sabina’s specifically engineered accessories provide several unique application opportunities, all easily accessible in one product. The Sabina lift can meet the needs of a wide range of individual patients by offering the ability to adapt to their unique situations; adjustable height, a safe working load of up to 200kg and a variety of different straps allows the equipment to be altered to fit the needs of the patient.
The lift may also be used as a conventional patient lift for lifting in the sitting position and the easily exchangeable sling bars offer added convenience.
For more information on the Hillrom Sabina range, click here