Ben, a service user at the Priory Hemel Hempstead

Ben* was admitted to the Priory Hemel Hempstead with a complex history of psychiatric and physical problems. He suffered from schizophrenia and as a result of violent behaviour required detention in hospital under Home Office restrictions. Ben is currently on conditional discharge.

In addition he had complex medical problems including type 2 diabetes, recurrent Urinary Tract Infections (UTI), incontinence, and leg weakness due to a cerebro-vasular accident.

Our care programme focused on educating Ben about how to better manage his physical health problems and to developing greater insight into his mental health problems.

Our multidisciplinary team worked with Ben to further develop his already strong self-motivation and independence and to encourage his interest.

A major part of his care was to help him manage his diabetes; Ben has a very sweet tooth and found it difficult to maintain a low sugar and low fat diet.

Through persistence and education both with Ben and his family he learnt how to make better choices; to satisfy his craving for sweets by purchasing diabetic alternatives. Throughout his treatment he was encouraged to increase water intake, and as a result Ben did not suffer any UTI complications while at the Priory Hempstead. He did not require urinary bottles and remained continent. He also became totally independent in taking care of his personal hygiene.

Ben's mental state has stabilised since his admission and he does not present with any psychotic symptoms or violence. His interaction with staff and other patients is pleasant and appropriate.
Although Ben does not seem keen on in-door Occupational Therapy activities, he displayed a considerable degree of self-motivation and independence. He enjoys going into the town centre and local Sainsbury's. To encourage his interests, the OT and nursing staff escort Ben to shops such as WHSmith and other Art bookshops. He enjoys reading about legendary artists and collects literature about them.

Through education and the many alternative foods offered to Ben, his diabetes is now managed much better. He occasionally has relapse episodes but responds well to re-education. On his town centre trips, the OT staff also take Ben to Boots and other health food shops where he buys diabetic sweets, chocolates and biscuits to help control his cravings for sweet foods whilst reducing his sugar intake. His family have also been educated about Ben's condition and dietary needs.

The physiotherapist visits weekly to assess and meet Ben's mobility needs. He uses a walking stick around the ward. When he is in his room however, Ben manages to walk independently without the walking stick.

Ben is due to be discharged shortly. He is stable and settled enough to be managed in a care home environment within the need for low level security that the Priory offers. He has developed a great insight into his mental health and physical health conditions and is therefore much more willing to be compliant in his ongoing treatment following the education offered to him during his admission with us.

*  Please note, where necessary, the names used within case studies have been changed to protect confidentiality.