I am currently working with two wonderful sisters who are in their 90’s. Neither ever married, neither had children and all other family has pre-deceased them. These ladies have been completely independent, living on their own in a rented apartment, where they have lived since the building was constructed almost 30 years ago. Neither used any mobility aids or was in receipt of any community based medical/social services.

I did not know these ladies until receiving a call from their financial POA (one of the large financial institutions) advising me that the younger of the two had fallen, broken her hip, had surgery and had already been transferred to a rehabilitation setting (one week later). I was asked to meet with them and discuss how I could assist them moving forward. I met both sisters at the rehab facility. These women have lived together their entire lives. Having a sister, I know that sisters can have a special bond. These two wonderful ladies rely on each other and seem to have their own way of communicating; practically finishing each other sentences. Being separated was difficult but the older one would visit and stay with her younger sister for many hours daily.

A day later, the younger sister called me in the later part of the afternoon, very concerned that her sister had not yet arrived. She was expected several hours earlier. I was propelled very quickly into ‘sister finding’ mode. Of course there was no answer at the house. The taxi company, who I knew they used, refused to tell me if she had been picked up or not, citing breach of confidentiality. They referred me to the Police, who were extremely helpful. The Police called both the taxi company (to verify pick up) and the ambulance services to verify if an ambulance had been called to her home. Yes an ambulance had been called but I was told they had taken a gentleman and not an elderly woman to a hospital. The next step was to request the Police go to her apartment to see if she had fallen inside her home. While on hold with the police, my colleague started calling emergency departments. Thankfully she was located at the emergency department of their local hospital. The police were cancelled. The nurse at the emergency department advised that she had fallen outside her building, while waiting for the taxi. She had been stitched as she had cut her forehead very badly and she had a CT scan. She was conscious and alert and as the scan results were normal, they were preparing to send her home. I don’t know how a 95 year old injured person is expected to return home alone but in communication with her sister, I was able to arrange for a personal support worker to meet her at the emergency department and remain with her- either at the hospital or at her home.

There is a happy ending to this story. Both sisters are on the road to recovery and are now both using walkers. They have accepted that a convalescent stay at a retirement residence is the preferred discharge plan and they are both looking forward to sharing a suite at a neighbourhood residence where they will have their care needs provided.  The timing of this move is important as they are both able and well enough to participate in the activities and amenities available.

What is there to take away from this story?
 If you are the POA, make sure that your contact information is readily available
 The system works; not perfectly but the police were ready to quickly assist
 Getting the correct details on the ambulance call report still needs work
 Having the ‘circle of care’ expanded in an emergency situation would be an improvement; ie the taxi company could have indicated whether she had been picked up or not.

There are many other ‘sisters’ who have outlived friends and family. I believe that ensuring our older clients have a support network to care about them, to advocate for them and then to act on their behalf, is critical. These sisters are lucky to have each other and a great POA!