Case study summary
Dimensions is one of the country’s largest not-for-profit organisations supporting people with a learning disability, autism, challenging behaviour and complex needs. Staff have been committed to the STOMP initiative since it began and are working with GPs to review all psychotropic prescriptions for people they support, with a view to reducing that medication where appropriate.
One person whose life has changed because of STOMP is Katy from Portsmouth.
Katy lived with her family until she was 19 and then moved around various residential care homes where she was taking medication to help manage her seizures. Over time Katy become malnourished and after a fall spent some time in hospital before being discharged into Lewis Road, a high dependency service run by Dimensions.
On admission to Lewis Road, Katy came only with a pair of pyjamas and little history on where she had been before or what had led her to need such high levels of care. She weighed just over five stones and was bed bound, too weak to mobilise herself.
Katy made no effort to interact with staff or the other people living at Lewis Road and her speech was slurred and seemed to make her tired. Family told staff that they would only call her in the afternoon because earlier in the day she was ‘too drugged up’.
Despite her weakness and mobility issues Katy would spend hours just screaming non-stop and would assault any staff that were within her reach. When she was in communal areas other people would become very tense and need support to retreat to their bedrooms. The other people living at Lewis Road were beginning to suffer as more staff had to manage Katy, meaning they lost out on some of their support time.
Staff were tired and stressed, if they were not dealing with an incident, they were writing it up. Short term and long term sickness was increasing and Lewis Road had become a difficult place to live and work.
Dimensions staff raised concerns about the amount of medication Katy was on at team meetings and together with Katy’s doctors and family began a plan to reduce the first of her medication, closely monitoring Katy’s reaction to the reduction, both in her seizure activity and her behaviours.
Following further reductions staff began to notice Katy changing. She became more alert and wasn’t spending the whole day in and out of sleep. She wasn’t behaving in a way that concerned staff at all and had started talking and joking with them, staff discovered that Katy had an Irish accent.
Katy started to eat and built up her strength so much that she began to self-transfer to her wheelchair and eventually she began walking. Over the weeks staff were able to build up a strong relationship with her, finding out her likes and dislikes. Katy trusted the staff and started going out in the community with them.
She began going to community based groups and a day centre. Katy enjoys going to a music group and staff have discovered that she knows the lyrics to lots of songs – her favourites include ‘yellow submarine’ by the Beatles and ‘mama mia’ by Abba.
Katy now walks around her home with minimal support and on a recent visit her family were speechless with her progress. She now weighs more than seven and a half stone and enjoys picking her own clothes, perfume and make up.
Katy is looking forward to moving out of the high dependency unit soon and joining a much smaller Dimensions service where she will continue her medication reduction journey.
For more information visit the Dimensions website.