- Lives with her husband, 65 who is retired and has manic depression
- Own their own cottage in a small Gloucestershire village.
- Sarah is a shepherdess with her own flock of sheep.
- She has three sons and a grandson and granddaughter.
- Sarah diagnosed with Stage 3 lymphoma initially for active treatment but after 3 cycles of chemotherapy there has been no improvement
- Sarah had been caring for her mum (sleeping at her house overnight) up until her mum died and then Sarah was diagnosed. Sarah has had symptoms for a year
- Sarah was an Independent and active country person who up until she fell ill was “bale bumping” and able to mange to care for her sheep and home
- She was also worked part time as a freelance decorator.
- Main carer for her husband whose mental health varied.
Important to Sarah
- To be able to stay in my own home with my husband.
- To live in the Gloucestershire area, close to family and be in the country.
- To know my husband will be cared for
- To be able to be independent and be able to look after my own home.
- My flock of sheep and my dog.
- Being part of my grandchildren’s lives and teaching them about rural life.
- Sarah has been struggling with her daily activities of living and is becoming increasing dependent on her family for support.
- She has bouts of urinary incontinence and now has to use pads.
- Since her last admission to Hospital her mobility has decreased so now he is only able to walk from the chair to the commode
- She was discharged with minimal support, the family organised a recliner chair
- Sarah is becoming increasingly physically frail but still able to climb the stairs to sleep in her own bed
Health Conditions, medication and provision
- Up until her diagnosis nil of note.
- Treatment consisted of chemotherapy.
- Had two emergency admissions to the local oncology unit following acute infections which affected her mobility and independent living
- District Nurse Support in place.
- Sarah has been prescribed analgesia for bone pain (fentanyl patch) but is poorly managed and problems highlighted with application (duplication of administration of patches)
- Sarah has been courses of steroids for her shortness of breath and is experiencing side effects (Cushing Syndrome) that is affecting her well-being and self-esteem
Resources and assets
- Sarah has a small cottage that she lives in with her husband and her dog
- Has supportive family who live fairly locally. The three sons (and daughter-in-law) visited daily to support
- Sarah is quiet and reserved (stoical) but is a friendly, polite person with an amazing sense of humour.
- Sarah was placed on the Gold Standards Framework register, following the oncologist discharge letter
- The community/district nurse visit once a week
Concerns and questions
Sarah is able to communicate with her son-in-laws, mother-in-low who was a Nurse, how frightened she is of dying
Sarah’s concerns and questions
- What is my prognosis?
- How will my husband manage?
- Who will look after my flock of sheep and the dog?
- How can I leave my legacy behind?
- Employment – Sarah was able to be finically independent working as a decorator but now is reliant on her husband’s benefits to bring in an income to pay for her additional support
- Social Network- Sarah had previously socialised within her work connections and spent time with her family only.
- Family contact Sarah’s role within the family was that she was the “head” and her sons and husband relied her to keep their lives in order. She was a carer for her husband. Sarah is now independent on her family to support her and she is unable to talk to them about how she feels.
- Daily living -Sarah is struggling to maintain her independence and trying to be strong for her family, she feels the roles have reversed
- Sarah’s sons and husband are struggling to accept outside support although the community nurse has started to build up a relationship with the family, even although they are becoming increasingly tired caring for her. Personal care is being provided by her daughter-in-law
- OOHs were being called to support incontinence needs as the husband was unable to manage at night