Liz is a 79 year old woman who was widowed and previously lived alone in her own home. She has no children and lives with mixed dementia, including Alzheimer’s disease and vascular dementia. She also has a history of pancreatic cancer and has struggled with low weight. Despite these challenges, Liz has always placed great importance on her independence, her routines and her ability to remain actively involved in the community. These values have remained central to who she is and how she wants to live.
Before receiving care, Liz was managing her day-to-day life independently at home. A turning point came when she was involved in a car accident and subsequently lost her driving licence. This had a profound emotional impact. Driving had been Liz’s main way of accessing the community, maintaining social connections and preserving her sense of autonomy. Losing this independence led to increasing frustration and distress and concerns about her safety and wellbeing were raised by her cousin, who holds power of attorney.
Shortly afterwards, Liz experienced a fall on the stairs and fractured her wrist. This incident marked a clear change in her needs and highlighted the growing risks associated with her dementia. Visiting care was introduced to support her at home, but as her condition progressed, it became clear that live-in care would provide the consistency, reassurance and safety she needed. Live-in care commenced in February 2025, allowing Liz to remain in her own home while receiving continuous, personalised support.
At this stage, Liz faced several overlapping risks. These included reduced safety when using communal stairs, increasing anxiety linked to memory loss, nutritional concerns related to her low weight, and the risk of social isolation. Liz was open about how distressing her memory difficulties felt and often needed frequent reassurance to help her feel secure and supported throughout the day.
The care team worked closely with Liz, her cousin and a range of professionals, including her GP, dementia navigator, occupational therapist, physiotherapist and pharmacy. Together, they focused on enabling Liz to remain at home while managing risk in a way that preserved her dignity, independence and sense of control over her life.
From the outset, Liz was clear about what mattered most to her. She wanted to continue accessing the community, remain safe at home, receive support with her medication and continue using her diary to organise her day. These wishes were carefully documented in her care plan, written in Liz’s own words and providing clear, personalised guidance for carers.
To support Liz’s independence while reducing risk, a number of thoughtful and creative solutions were introduced. An AirTag was added to her house keys, offering reassurance if she chose to go out independently. A door alarm with a recorded message from her cousin was installed to gently remind Liz not to leave the apartment alone when it was unsafe to do so. These measures were designed to promote safety without restricting Liz’s freedom, providing peace of mind for Liz, her family and her care team.
Daily care focused on prompting, encouragement and reassurance rather than taking over. Liz was supported to mobilise safely using her walking stick, complete her physiotherapy exercises and remain active within her building and garden. Carers also supported her to continue accessing the community, including visits to museums, art galleries, lectures, cafés and lunches out, activities that Liz values deeply and sees as an essential part of her identity. Nutrition and hydration were carefully monitored, with carers encouraging a high-calorie diet and supporting regular intake.
Over time, Liz’s confidence began to grow. With consistent and familiar support, she became less anxious about appointments, phone calls and leaving the house. She continued to enjoy social outings and cultural activities, describing them as vital to her sense of self and quality of life.
Feedback from Liz and her family has been overwhelmingly positive. Liz has shared how grateful she is for the time carers spend supporting her to go out and remain active, saying that it “means the world” to her. During a care review attended by Liz and her cousin, her cousin expressed how impressed they were with the care provided, commenting that, “if necessary, Nikki would go to war for Liz.” This feedback reflected the trust, advocacy and commitment shown by the care team.
This case demonstrates how thoughtful, relationship-based and person-centred care can support someone living with dementia to remain independent, confident and safe. By listening closely to Liz, adapting care creatively and working in partnership with her family and professionals, the team has enabled her to continue living a meaningful and fulfilling life in her own home.
CQC KLOEs demonstrated:
- Caring
- Responsive
- Well-led
