Case studies (individual) - Activities - Upstream

Case studies (individual)

Mary (not her real name; this is a composite example) lost her husband and had been in hospital after two falls. She lacked confidence and missed the community she’d known through the shared activities of her marriage. She was depressed, resigned to going into a residential home and to steady decline thereafter. 

Referred to Upstream by the occupational therapist and others in the multi-disciplinary team who were unable to make much progress with her, Mary was visited by an Upstream mentor and was gently encouraged to try out a small Upstream activity group in the village. The mentor arranged transport initially and introduced her to the group. At first, she was reluctant to talk much or to participate but, encouraged by the others, who had all joined the group in a similar way, she took a tentative interest in recording memories on tape, using sketchbooks and doing gentle Tai Chi.

To her surprise, she started to make friends and found she had an aptitude for painting. ‘It wasn’t what farming families did,’ she said, ‘we just worked.’ She took her sketchbook home and her daughter wanted to see more. ‘There you are,’ she said with satisfaction, ‘they want to keep me working!’ The mentor continued to keep an eye on Mary but the group dynamics gradually took over as people began to enthuse each other, share their skills and exchange ideas about things they wanted to learn and to do. They maintained contact with each other outside the regular activity group.

The OT, health visitor and daughter all noticed a more positive attitude. Mary began to discuss how to manage for longer in her own home. ‘It isn’t good to shut yourself away,’ she said. The group now organises its own activities and Mary is helping to promote an exhibition of all their art in their local surgery.

As a result of the mentor’s intervention, Mary will be confident enough to stay in her own home for longer. The social and stimulating activities that she is enjoying will largely replace the need for reassurance visits to her GP and health visitors to her home. Her balance is improved alongside her confidence and greater mobility, which will reduce the chances of subsequent falls. Now that she is taking greater interest in life, she is taking greater interest in her food as well. She is a more interesting person to be with, which has increased her social contacts, with her family as well as the village. She has a role to play in the community. The mentor will maintain occasional contact with Mary and others in the group to ensure they are happy with what they are doing and to watch for any signs of decline that might need to be referred back to the multi-disciplinary team before they become more serious. All these changes represent real economic benefits that greatly outway the investment in the initial mentor intervention and long-term monitoring in the community.

Janet (not her real name) had moved back to the town a few years earlier. Because of past problems, she was anxious and nervous. She knew no-one of her own age in the town, although some of her family live there, and she was frightened to go out on her own. She did not sleep and was a frequent visitor to her doctor. The health professionals referred her to Upstream to help her gain confidence.

The mentor visited her and listened to her story. After a cautious but enjoyable first session at a local Upstream group, the mentor persuaded her to join the group on a regular basis, and arranged transport. Janet has gone to the group regularly since then. She has become a very relaxed and outgoing person at the group, joking and laughing, and has made friends with another lady in the group who lives in a nearby town. They phone each other.

She has not felt secure at home but she says that the group has been a life-saver for her and she enjoys it so much. In the evening, after the weekly Upstream group, she is so down that her sister rings her to cheer her up and she lives for the next week when she can join the group again. This is the first time in years that she has had some good nights’ sleep. The mentor is trying to help her to another activity to break up the week but she is nervous to walk to the venue, and the mentor may drive her to her first session.

Nancy (not her real name) had been a teacher but now was feeling very frail and dependent on occasional visits from friends and neighbours. Her only son and his family live abroad. After being knocked down in the street and later, falling badly at home, she was feeling physically unconfident.

She became a regular member of an Upstream group and has now moved on with a few friends to meet independently. Not particularly dexterous because of her injury and unable to sit for long because of the “ironmongery” in her hip, she enjoyed the opportunity to move around as one of the regular tea and coffee makers at the original group.  She excels at memory work, taking part in the BBC People’s War project along with many other Upstream participants, as well as singing and weaving sessions. She is now a key figure in the small group of ladies that meets independently. With its own budget, this group has so far organised sessions led by a local artist, a herbalist and a Tai Chi teacher. One of the neighbours comes in to make and clear away tea and coffee.

Rosemary (not her real name) took quite some time to warm up to the idea of coming out and joining in with activities. Living with one of her family on a steep hill, she felt very isolated and was reluctant to leave the house. She had recently had a serious operation, which left her with some short-term memory loss and an inability to walk up hills.

Her occupational therapist introduced the Upstream mentor and Rosemary gradually started to come to an Upstream group, brought and fetched by the daughter who lives a few miles away. Gradually she found that others in the neighbourhood also came to the group and she agreed to be collected with them by community transport.  One of the others uses the town bus, which comes along their road, and so the lady occasionally did the same. She took part in the weekly activities of the first group and has now joined a small independent group that meets at the home of one of the members. She is happiest when there is an activity arranged in which everyone can become involved and which reduces the need for continuous talk

Beryl (not her real name) was new to the town, bereaved, depressed , on a low income, not seeing enough of her family and very distracted by her lack of health. However she did use the bus and was able to summon her courage to try something new. She started to attend an Upstream group on a regular basis. She has made friends there and enjoys the variety of the creative work they are doing on some exhibition craft pieces.

With greater confidence, she started moving into other activities in the community. She took herself to a singing rehearsal at the parish church but found ‘all that Latin’ wasn’t for her. Upstream helped her to join a friendly local group that sings popular songs from musicals. She was grateful for this help, although after a while she moved on to an art group, introduced by Upstream. She is justifiably proud of some of her achievements.

She has attended various exhibition events and enjoys days out with Upstream friends. She is feeling a lot happier and speaks less of her stress and health problems.