Mary’s story told by Claire Flanagan, Team Leader, Mental Health Care Home Intervention Team

“Mary, aged 100 years old, was referred to us by the care home she had lived in since June 2014, because she was becoming aggressive at random points during the day, her sleep was increasingly poor and she was experiencing hallucinations and delusions. This was understandably making Mary quite distressed and reassurance from care home staff was not helping calm her down.

Mary had already been prescribed medication to help with her sleep and aggression.

When Mary was first referred to us we undertook an initial assessment, which included completing Challenging Behaviour Scale and Cornell Scale for Depression in Dementia scorings. These scorings help indicate levels of depression, cognitive impairment and functioning. Mary scored highly in them both; 149 out of 400 in the Challenging Behaviour Scale and 17 out of 38 in the Cornell Scale.

Mary has a very supportive son, called Steve, who visits most days for up to four hours and is very involved in her care. I spoke with Steve about his mother’s care and medication. After a good chat I suggested that an anti-depressant may help. Steve felt that Mary could be depressed and was content with the suggestion, so we stopped the other medication and started Mary on an anti-depressant.

We also considered moving Mary to a different bedroom in the care home, as she was currently on a busy concourse, but Steve thought this would be too disruptive for his mother.

For 12 weeks we regularly saw Mary and the care home agreed to record her sleep and behaviour during that time. It was reported that Mary had been sleeping better and her behaviour had settled.

A few weeks later we reviewed Mary’s progress again and found that she had no episodes of aggression and her sleep had become more regular. She still experienced hallucinations and occasional delusional beliefs, but they were more manageable.

We undertook one last assessment with Mary and there was a fantastic improvement. She scored 8 out of 400 in the Challenging Behaviour Scale and 4 out of 38 on the Cornell Scale.

I was so pleased we were able to help Mary, as these changes have improved the quality of her life significantly.”