Jack cares for his wife, Dianne who requires palliative care and has multiple health issues. Dianne also experiences severe pain and poor functional transfers and mobility. She is also at high risk of falls particularly when her cognition deteriorates.

Jack reports that Dianne is “really struggling to walk around the bungalow” and the couple use a glideabout commode as a transfer chair which Jack pushes. Her difficulties are exacerbated by recurrent Infections and muscular/skeletal difficulties.

Jack himself sustained multiple fractures resulting in ongoing pain and reduced range of movement in his shoulder and back problems following a motorbike road traffic accident. He uses a walking stick and crutches for mobility and has a recliner chair and profiling bed for his comfort.

Dianne requires a high level of care and supervision including: administering her medication; assisting with transfers and washing and dressing, including personal hygiene after toileting (which both Jack and Dianne find embarrassing) and continence care and night time care; preparing all meals and drinks; supporting with all household chores and maintenance; providing all transport needs together with accompanying her to the many appointments she needs to attend and being vigilant and responding to any slight changes in her condition in order to pre-empt a uncontrolled deterioration in her status.

Jack experiences feelings of exhaustion and overwhelming tiredness. He worries and is concerned for the future and is extremely worried about what would happen to Dianne in the event of an emergency. He says their situation is worsening – especially Dianne’s mobility – and with Jack not in particularly good health himself: – the demands and physicality of his caring is increasing and taking a greater toll on his own health. The couple also now reluctantly feel that 24 hour respite care would be required in the event of an emergency.



A Carers assessment was completed with the following recommendations and actions:

DCA support worker referred to the Social Services Occupational Therapist for the provision of permanent ramping and an adapted toilet (Biobidet) which will allow Dianne to attend to her own toileting needs. This will preserve the couple’s dignity and Dianne’s autonomy. Ramping will help manoeuvring Dianne’s wheelchair and thus reduce the strain placed on Jack’s back. DCA support worker assisted in the completion of a detailed contingency plan including advice and the formulation of a comprehensive care plan including “in the event of death care plan” and the names and contacts of medical practitioners for advice and guidance. This was used by Jack when visiting 24 hour facilities to ensure they would be able to provide an appropriate level of care. DCA worker then applied directly online for a Carer’s Emergency Card.

DCA worker submitted an assessment for the provision of a personal budget to allow Jack some time away from his caring role.



Jack reports that the provision of the Biobidet helped reduce the anxiety he felt having to assist Dianne attend to very personal hygiene tasks whilst allowing for a dignified way for her to clean herself independently or with minimal assistance.

It also reduced that strain on Jack’s back and pain experienced when bending over in confined spaces to assist. He reports that the adaptation has greatly improved the couple’s health and wellbeing both physically and mentally thus sustaining and easing Jack’s caring role.

Jack reports that both he and Dianne feel very much reassured following the formulation of a comprehensive care plan and contingency plan and the application for a carer’s emergency card.

Jack reports that without the support of DCA and without the award of a personal budget he wouldn’t be able to afford to socialise and that he found it relaxing and better prepared him as Dianne’s health continues to deteriorate.

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