PE, a 68-year-old former Navy member, was diagnosed with motor neurone disease (MND) in July 2023. This progressive, life-limiting condition affects the brain and nerves, leading to muscle weakness, respiratory challenges, and impaired speech. Despite these challenges, PE remained mentally alert, deeply engaged in his care decisions, and committed to preserving his dignity and independence. His family, particularly his devoted wife, played a pivotal role in providing emotional support and advocating for his wishes. This case study from Mega Nursing & Care showcases how our team delivered compassionate, person-centred care to enhance PE’s quality of life during his journey with MND.
Following his MND diagnosis, PE’s condition progressed rapidly, necessitating 24-hour care. By the time he transitioned to Mega Nursing & Care, PE relied on a NIPPY machine (non-invasive ventilator) for respiratory support. His mobility was severely limited, and communication was challenging due to the mask required for ventilation, though his sharp mind allowed him to participate in care discussions actively. Using the Gold Standards Framework (GSF), our team ensured PE’s physical, emotional, and psychological needs were holistically addressed.
Upon joining our care agency, PE was assessed using tools like the Rockwood Frailty Scale, scoring a level 7, indicating significant frailty. The colour-coding tool classified him as amber due to symptoms such as muscle weakness, breathing difficulties, and a history of chest infections—common markers of MND progression. These assessments informed a tailored care plan designed to promote comfort and independence.
PE’s Advance Care Plan (ACP), dated 03/02/2024, was developed collaboratively with PE, his family, his GP, the palliative care team, and MND specialists. The ACP outlined his preferences, including his decision to decline a PEG tube and his wish to transfer to Cransley Hospice if his condition deteriorated. A Do Not Attempt Resuscitation (DNAR) order, dated 27/05/2024, was also in place. These documents ensured PE’s wishes were clearly documented and respected, forming the foundation of his care.
Mega Nursing & Care prioritised PE’s quality of life by fostering independence and meaningful connections. Assistive equipment, such as splints to reduce muscle contractions and a straw for drinking, supported his physical needs. Daily exercises and stretches maintained his range of motion, while emotional well-being was nurtured through regular consultations with counsellors and the palliative care team.
A cherished routine involved PE being hoisted from bed each morning into his wheelchair, allowing him to engage in family life. One particularly poignant moment was PE and his wife sitting in the garden, holding hands and chatting—a simple yet profound act that brought comfort and joy. These moments underscored Mega Nursing & Care’s commitment to integrating PE’s personal preferences into his daily routine.
As a proud Navy veteran, PE found solace in reminiscing about his service. Our carers incorporated his interests by scheduling time for him to watch Navy-related documentaries and films. This thoughtful approach not only honoured PE’s past but also enriched his present, demonstrating how Mega Nursing & Care goes beyond clinical support to celebrate each client’s unique story.
Consistency was critical for PE, who thrived on routine. Mega Nursing & Care assigned a dedicated team of five carers—two for night shifts and three for daytime care—to ensure familiarity and trust. Meals were provided at set times, and daily exercises were scheduled at midday. Detailed care plans offered step-by-step instructions, ensuring carers adhered to PE’s preferences and medical requirements.
Regular communication among the care team, including the GP, palliative care team, and home ventilation team, ensured alignment. Clear documentation tracked PE’s symptoms and care adjustments, enabling a responsive and adaptive approach to his evolving needs.
In Part 1 of PE’s story, Mega Nursing & Care established a robust framework for his care, balancing clinical expertise with heartfelt compassion. By prioritising PE’s dignity, independence, and personal interests, our team created a supportive environment that empowered him and his family. As PE’s condition progresses, how will Mega Nursing & Care adapt to his changing needs while continuing to honour his wishes? Stay tuned for Part 2, where we explore the next chapter of PE’s journey and the comprehensive support provided to him and his loved ones.
