Case Study 1

by  S. Rees-Mathews,  WHRU, Cardiff Medicenter, Heath Park Cardiff

Patient  

Mrs J W a 58 year old woman with a 30 year history of rheumatoid arthritis.  

Social  

This lady is married with a very supportive husband.  She has two grown-up children who both live away.  Mrs J W has been in work for most of the time that she has been diagnosed with RA, but the last 5 years her condition has deteriorated and is now unable to work.  

Medical  

She has taken a variety of medication to try and control the RA but due to gastrointestinal complications there have been reduced to the minimal dose and are barely controlling the condition and pain levels.  
She has over the last few years lost a great deal of weight and bone density with a reduction of her height due to spinal changes.  Mrs J W has undergone multiple joint replacements with 2 new hip joints, 2 knee joints, 1 elbow and numerous finger joints.  

Problem  

Due to the pain she has a disturbed sleep pattern and moving around the house is limited  When she goes out in her wheelchair she has pain in her back and hips, any car journeys are limited except when she attends hospital clinic, with the result of this leaves her in bed for several days due to the pain and stiffness.  Because of her weight loss she is at risk of skin breakdown over hips, heels, shoulders and elbows.  Once in bed she is unable to turn.  
Intervention  
The Repose Mattress was used to improve comfort and reduce the risk of tissue damage. A Repose cushion was used on all chairs in the house, in the wheelchair and car, also the stair lift.  

Result  

Mrs J W settled into a better sleep pattern, waking less in the night and not feeling so stiff in the mornings.  The cushion reduced the vibration experienced in the wheelchair and the car journey was tolerated with no after effects, in fact she now is able to go out more and so improved her quality of life.  Pressure areas in bed were less pronounced.

Case Study 2

by  S. Rees-Mathews. WHRU, Cardiff Medicenter, Heath Park Cardiff

Patient  

Mrs V H a 50 year old woman with multiple sclerosis.  She is wheelchair dependent.  
Social  
Mrs V H lives with her husband in a purpose built bungalow.  Her children all live away.  She is dependent on her husband and District Nurses.  She spends several weeks each year in respite care. 

 
Problem

Due to her condition she is unable to move herself.  Once in bed she is put on her back, during the night a carer turns her to help prevent tissue damage developing, although this disturbs her sleep.  She is at constant risk of developing pressure sores on her heels and buttocks.  
When she is in her chair she is unable to move and needs to be lifted up to relieve the pressure to her sacral area.  
Intervention  
The Repose Mattress was used to provide comfort and pressure relief in the prevention of pressure sores.  Mrs V H found that the mattress gave her a higher degree of comfort and support.  She was able to stay on her back for longer, therefore better quality sleep.  With the cushion she found she was able to move slightly to adjust her weight. 

Case History 3

by S. Rees-Mathews. WHRU, Cardiff Medicenter, Heath Park Cardiff
 
Patient  

Mrs E R a 48 year old woman diagnosed with breast cancer 18 months ago.  
Social  
She lives with her husband who is at work all day.  A rota of friends and carers are always in the house with District Nurses calling daily.  

Medical  

Mrs E R has now extensive secondary deposits in her bones with bone erosion, reduced mobility, extensive pain and a pressure sore on her shoulder.  

Problem 

She has used an alternating pressure bed but said it was hard, noisy and difficult to move on when transferring with the District Nurses. Sitting in a wheelchair was painful and so reduced the length of time Mrs ER could spend out of bed.  She is on a high level of medication to control the pain.  
Intervention  
The Repose Mattress was used as well as a cushion.  

Result

Mrs E R is now able to rest and sleep for longer periods when in bed.  She is able to transfer from bed to chair with the District Nurses and feels safer.  The pain she experienced from the pressure sore on her shoulder has become more tolerable and does not keep her awake as much.  She finds sitting out in her chair easier and can now sit out for longer periods, with less pain in her hips and back.  Mrs E R has reduced her medication slightly due to the increased comfort of using this system.