Cairn
A worked example
Ninety days of ABC records. Fifteen questions. One honest answer.
Arthur is a fictional resident with dementia. Over ninety days his team recorded 34 incidents on the ABC form Cairn provides: what happened before, what he did, what staff did, how it ended. Cairn then asked the fifteen questions a good formulation always asks, and answered each one only from those records.
- 18 of 34incidents were during or just after personal care, most of them in the early morning.
- 6 of 6times that care was continued after refusal, or two staff went hands-on, the distress escalated.
- 12 of 12times that care was deferred, slowed, or a different carer returned later, Arthur settled.
- 4 of 5incidents where pain signs were assessed showed moderate or severe signs.
- 0 of 8PRN doses were recorded as fully effective.
Two hypotheses surfaced with that evidence attached: a personal-care association and possible pain. Seven more were flagged for the reviewer to rate. Six were not supported by the records and say so. The care plan that follows is built from the same numbers: what to watch for, what to do first, what to avoid, what to do if it escalates, and how the team will know it is helping.
