NHS Leadership Academy Digital Team

Mr Hussein

Mr Hussein is a 78 year old Muslim dementia patient. He was diagnosed 3 years ago but his condition is deteriorating and he’s had a fall and fractured his hip. His son Jamal, who is a junior doctor, feels he needs to be taken into care. At home he is cared for by his wife Fatima who is frail and hiding the fact she’s finding it hard to cope. Mr Hussein is displaying confusion, frustration and at times, aggression. He is a retired shop-owner and often believes he’s still running his own shop.

Point of conflict

Mr Hussein has been dependent on is wife for all his care, but he is used to dominating her and this makes him angry and difficult. It is now likely that he will be moved to a care home, and his wife is reluctant to let him go. His son Jamal is in his F1 year as a Junior Doctor and wants his father to get better care and to take the pressure off his mother who is frail and not coping. Jamal has his own challenges of being a newly, qualified junior doctor aswell as having to navigate his father’s situation from afar because he works so many hours. He has also been taught to see the world as a series of problems which need solutions and fails to see the human side of the situation even with his own parents.

There are also cultural expectations around Fatima’s desire to keep on caring for her domineering husband which not everyone in the dementia care services appreciates. Fatima finds it hard to advocate for Mr Hussein.

Story Arc in Edward Jenner Programme

Series 1 starts with Mr Hussein having a fall in the bathroom at home. He fractures his hip and has to go to hospital. The result of this is that it becomes very apparent that Fatima can no longer cope with caring for him at home and the issue of moving him to a care home is raised. The hospital geriatric ward and mental health consultants and his own GP are involved in the decision, but his son Jamal feels he also has a stake because he’s a junior doctor. What this raises for NHS healthcare professionals is how to lead across systems when there is a multi-disciplinary team involved? In Series 2 Mr Hussein is placed in a long-term geriatric/dementia ward and given physiotherapy while decisions are made about the next step. What is not initially considered is how the health care system provides for the bereft, unsupported wife who is being criticised by her community for not doing her duty. It takes an understanding Muslim community nurse to appreciate what she is dealing with and advocate on her behalf.