Skip to 0 minutes and 9 secondsThe aim of Step 2 is to introduce the tool for every resident. This tool will help plot changes in the resident's condition over time and visually show you whether a resident's condition is improving, deteriorating, or just the same. It can start at any time. The tool should be completed every month by carers or nurses who care for the resident on a regular basis. If no changes have occurred over the previous month, this is indicated by a straight line. The 'Mapping Changes in Resident's Condition' tool shows deterioration and improvement in a resident's physical condition. The tool helps staff to be able to visually recognise a resident's changing condition over months or weeks.

Skip to 1 minute and 10 secondsBy completing the mapping changes tool every month, or every week when the resident is in the last phase of his or her life, it will help support you to identify changes that can be seen in a resident's condition and viewed over a period of time. The tool plots changes over time from left to right against how you think the resident's condition is from the top, a better condition, to the bottom, a worse condition. We will now show you how to complete this chart using the example of Marissa. Marissa had been living in her own home, but over the past few months, her mobility had declined and she has been struggling to care for herself.

Skip to 2 minutes and 1 secondIn January, she moved into a nearby care home. It took her a couple of months to settle into the care home, and she was really starting to enjoy the company of other residents and staff. However, in April, she fell on her way to the toilet, broke her hip, and was admitted to hospital. This is shown with a downward change on the chart. Following surgery to repair her broken hip, she developed a chest infection, which delayed her recovery and meant that she had to remain in hospital for three weeks. In May, she was transferred back to the care home but she was a lot less well than when she had initially arrived at the care home.

Skip to 2 minutes and 49 secondsHer condition is shown as better than when she fell but not as good as before she fell. After a couple of weeks back at the care home, Marissa started to improve. She was eating better and starting to walk around by herself again. At the end of June, she had a wonderful visit from her sister, who lived in Portugal. The chart now shows an upward improvement. Shortly after her sister's visit, she developed a very bad chest infection, and despite all efforts to treat the infection, Marissa's condition slowly deteriorated over the next few weeks. Marissa's condition continued to deteriorate over the next few weeks, and she died at the end of August as shown by the decline in the chart.

Skip to 3 minutes and 44 secondsNow we would like you to complete the following case study exercise on your own.

Mapping changes in condition - theory and exercise

In this video we will hear more about mapping changes in condition.

First watch the video and then move to the next step to complete an exercise based on the experience of George.

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This video is from the free online course:

Improving Palliative Care in Care Homes for Older People

Lancaster University