Drew Pritchard (98) & his sister Lily Simpson (86) and her grandson Jack Simpson (15)

Drew Pritchard (98) & his sister Lily Simpson (86) and her grandson Jack Simpson (15)
Drew Pritchard is a 98-year-old gentleman who was admitted to your ward 4 weeks ago following a Left-sided Cerebral Vascular Accident (CVA). He has had a mild CVA in the past and some evidence of Transient Ischemic Attacks (TIAs) but was managing at home with help of one carer twice a day and support of his family.
He has a long-term history of Asthma and still uses inhalers. No documented issues of concerns around asthma whilst in hospital. He has had one treated chest infections but that was over 2 years ago. He has been troubled by constipation in the past and he was taking Laxido sachets for this prior to admission. He has had recorded episodes of faecal incontinence whilst in hospital.
Drew has been assessed by Speech and Language Team (SALT) and they have documented that they are satisfied that he is not suffering with dysphagia. But have recommended a soft diet. Whilst in hospital Drew the staff report Drew has needed prompting to eat his meals and drink fluids this has needed monitoring as well as ensuring the position of the utensils so that Drew can manage to use his left hand. He has lost 2 kilograms in 4 weeks. He has been prescribed Ensure supplements twice daily by Dietician. His BMI is currently 20.5. He has managed to take medication in liquid form and there is no evidence of Drew refusing medication.
Drew has had some speech difficulties that he is working on with SALT he was using a picture board on admission to hospital but has been able to verbalize but can be incoherent particularly when Drew is tired. The nurses who know Drew best feel that they can understand his needs through his non-verbal cues. Sometimes it can take quite a while to assess through feedback whether Drew has understood the information given to him.
Drew can become anxious when he feels he is not being understood and needs reassurance from the staff, is making basic choices and give consent using his picture board and his skills with communication. He has some difficulties remembering when tired. Staff are concerned that it may be hard to assess if Drew can make more complex decisions due to his difficulty communicating. He will often nod as though he understands but is not relay information back. It is difficult to assess Drew memory due to communication difficulties.
This recent CVA has resulted in a deterioration in Drews mobility, currently he is not safe to weight-bear and will need hoisting. Drew has no recorded falls whilst in hospital.
Drew is on indwelling urinary catheter since admission to hospital this is due to the fact, he developed a category 2 pressure ulcer to his sacrum shortly after admission this is improving now. His Waterlow is 21. He is being nursed on high-risk mattress and cushion. He is being regularly repositioned.
He is now medically fit for discharge and will need a care package to support him when leaving hospital. Prior to his hospital admission he had 2 visits per day by social services to assist him in the morning and in the evening. Drew funded this care himself using money he has in savings. His care needs have changed whilst in hospital.
Prior to his recent admission he was living with his 86-year-old sister, Lily Simpson and her 15-year-old grandson, Jack Simpson. Lily suffers with Left Sided Heart Failure, following a myocardial infarction 5 years ago and is finding it increasingly difficult to cope. Jack has poor attendance at school due to frequently supporting his grandmother and great uncle Drew. His recent mock exam results resulted in several poor grades. He had hoped to study at college and become an engineer, although he is feeling low in mood and has stopped going out with his friends.