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Original Question

Case study 1 Jane (82) and her sister Dorothy (84) live together in the Blackburn home they grew up in as children. They are both devout Catholics and catch the tram to their local church six mornings a week to pray with their church community. Both sisters never married so have lived together their entire lives, excluding six years when Dorothy lived in Brisbane. Dorothy’s career was as head nurse at a major hospital. Their bond strengthened further when their mother became ill, as they both nursed her through her final eight years of life. Their love for each other is evident due to their frequent physical affection. Dorothy had been diagnosed as living with dementia five years prior and her symptoms are increasing. She is cognitively present most of the time, though the number of scenarios is gradually increasing, which puts both Dorothy and Jane’s safety at risk. Jane is half the height and weight of Dorothy. Aside from occasional dangerous occurrences such as leaving the stove top on, at times Dorothy becomes short-tempered and verbally aggressive toward Jane. She becomes frustrated as she has lost the ability to verbally communicate; her thoughts are clear, though her words become scrambled, which is a result of her dementia. She has recently pushed Jane on numerous occasions, once as Jane tried to discourage her from crossing a busy road unsafely. Dorothy’s body rhythms are also changing as she wanders the house at night regularly, plus also leaves the home in the early hours of the morning to walk the local streets. She was recently twice found by the police in a confused state in the middle of the night. As a support worker you visit Dorothy at home 3 hours a week for outings and shopping, though think that with her declining mental health and increased aggression, she may require more assistance. Dorothy’s case manager has also recently suggested that it may soon be time for Dorothy to move to residential care, though Jane is very reluctant for this to occur. Dorothy and Jane both receive HACC government packages – Dorothy receives a level 4 and Jane a level 2 – which collectively entitles them to 21 hours and 50 minutes a week of support services, on average.

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