Better Care

'Own bed instead' care boost for Norma 

When Norma McKenzie fell and injured herself for the second time in less than a year, her family feared she might face a prolonged stay in hospital while she recovered.

But the 78-year-old was able to return to her Aston home after just a fortnight thanks to an initiative which enables patients to receive intensive rehabilitation at home.

The own bed instead (OBI) approach supports the principle that safe discharge planning is key to successful rehabilitation in the community. And Norma was pleased to be given the opportunity to return home sooner than she had expected.

“I had just started getting my confidence back and was walking with a frame but then I lost my balance and fell again walking out of our bedroom,” said Norma, who knows a thing or two about providing compassionate support in people’s homes, having spent many years providing care and support in surrounding neighbourhoods as a district nurse.

“It was the second time I had fallen and ended up in hospital. The first time, I fell while getting out of the car and fractured my hip.

 “The hospital staff are wonderful but I wanted to be at home; I think most people do better when they have their family around them.” 

Norma McKenzie and husband Jimmy
Norma McKenzie and husband Jimmy

Applying the OBI approach, BCHC nurse assessor Denise Fitzmaurice assessed Norma during admission to City Hospital and planning for a safe, supported discharge began straight away. 

Norma is among 187 patients in the last 12 months identified as suitable for an assessment during their hospital inpatient stay or in the community who were referred to OBI service to provide a level of nursing care and therapy which could be provided safely in their own home.

She received a visit from occupational therapists and physiotherapists three or four times a week to provide continuous assessment and rehabilitation support.  

Norma is fortunate to have a strong, supportive family network around her. She lives with husband Jimmy and daughter Carlene, who share the cooking between them, catering for Norma’s largely vegetarian diet. Her son Ian lives nearby and visits every evening to help her with the exercises she has been given as part of her rehabilitation plan.

Admissions avoidance co-ordinator Nadia Saeed explained how the ‘own bed instead’ approach is paying huge dividends for patients like Norma.

“It really is best for the rehabilitation prospects of the individual,” she said. It delivers patient-centred treatment.

“Norma was assessed by a nurse, physiotherapist and OT on the day she returned home – within a couple of hours.

“At that stage, she was bed-bound and needed two carers and a hoist to get in and out of bed. The Rapid response nurse assessor checked all Norma’s nursing needs at home, put a care plan in place  and requested care calls to start on the same day – two carers calling four times a day.

“She was unable to walk or fully weight bear on her right leg but her goal was to return to walking and sleeping upstairs. Norma’s determination and support from the rehab team and her family, enabled her to walk quite some distance with a frame under supervision.

“She no longer needs the hoist and is closing in on her goal of being able to sleep in her own bedroom upstairs of switching from sleeping in the hospital bed provided downstairs to her own first-floor bedroom.

“We’re very proud of what we’re able to achieve with this approach, working with patients like Norma. It’s cost-effective treatment, surrounded by family, progressing at Norma’s own pace.”

Norma McKenzie with physio Saju Sekher and OT Cynthia Vellum.

Physiotherapist Saju Sekher added: “It’s Norma’s determination that is making her rehabilitation a success.

“At the beginning of her rehab journey, it didn’t look promising. But her rate of progress in those first few weeks was amazing. “

The ‘own bed instead’ approach is based on acute and community providers working closely together to provide short term re-enablement in the patient’s own home for people who are medically stable with predictable health needs and who agree to a rehabilitation programme to regain function and confidence.

The 'own bed instead' approach aims to:

  • maximise independence
  • reduce need for bed provision
  • reduce length of stay in any bed
  • support timely discharge
  • reduce number of people needing long term care
  • provide an integrated service at home
  • reduce admissions to hospital.