ISSUE 16 MAY/JUN 2017
What is values-based practice? Find out inside...
Night Terrors Can OT have a place in the terrifying nightmare disorder?
Alcohol & the elderly The elephant in the room
EV E NT S
R E C R U I TM E NT & T R A I N IN G
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24/04/2017 13:16 12:03 27/04/2017
Welcome LISA MITCHELL
Hello About this issue... This issue of The OT Magazine sees us halfway into 2017 already. How time ﬂies when you are having fun This also signiﬁes a happy time for our student su scri ers who will e ﬁnishing up for the summer or sitting their ﬁnal e ams and heading towards a right future as the ne t generation of young Ts starting to ﬁll our hospitals and clinics with new motivation and new ideas.
...we look at how many of the adult population are living with a number of debilitating sleep disorders, such as sleep paralysis, night terrors and sleep apnoea...
s the num er of Ts grows so does their role. There are countless fresh avenues for occupational therapists to e plore and potentially help with and here at The T agazine we also help to e plore a few. n page we look at how many of the adult population are living with a num er of de ilitating sleep disorders such as sleep paralysis night terrors and sleep apnoea. e also reached out to two people who feel their daily lives are eing affected y the trou les they face in the dark. hat can T do to help e would love to hear your views on this topic please email firstname.lastname@example.org to discuss it with us. e also like to hear a out your theories. ontri utor aul itken gives an interesting insight into the autistic spectrum prompting us to rethink how lack and white diagnosing someone with autism really is. Turn to page to ﬁnd out more. ight along with the profession we don t shy away from uncomforta le topics and this issue is no different as we take a closer look at an T s role in the relationship etween alcohol and the older population. ead more on page . s well as many more fascinating features we showcase all the latest products and catch up with all our regular columnists. e hope that the latter half of is as equally as successful for you and your clients with hopefully a little more sun ee you all in uly
The OT Magazine, Acting Editor
Disclaimer The OT Magazine is published by 2A Publishing Limited. The views expressed in the OT Magazine are not necessarily the views of the editor or the publisher. Reproduction in part or in whole is strictly prohibited without the explicit written consent of the publisher. Copyright 2017 © 2A Publishing Limited. All Rights Reserved. ISSN-2056-7146
Editor: Lisa Mitchell Staff Writer: Colette Carr Staff Writer: Niki Tennant Designer: Stephen Flanagan Marketing: Sophie Scott Sales: Robin Wilson Contributors: Kate Sheehan, Dawn Blenkin, Adam Ferry, Paul Aitken, Anava Bruach, Yvonne Thomas, Jo Webb
2A Publishing Ltd, Caledonia House, Evanton Drive, Thornliebank Industrial Estate, Glasgow, G46 8JT
T: 0141 465 2960 F: 0141 258 7783 E: email@example.com
@ot_magazine3 The OT Magazine www. -magazine.co.uk
07 What’s New?
Bringing you up to speed with the latest news from the healthcare sector
27 The Autistic Spectrum We’re all on it, argues Paul Aitken
13 Insured or NOT?
31 Splish, Splash
15 Mental Health
35 Product Focus
Kate Sheehan explains professional indemnity insurance The sixth instalment of our mental health series turns the spotlight on schizophrenia
19 Product Focus
The latest must-have products on the market
25 A Day in the Life Of…
Community OT Helen Bence talks us through a typical day
Housing OT Anava Baruch explains the importance of clever bath design More innovative products to aid independent living
49 Down’s Syndrome An OT’s role
50 Activities for Children with ADHD
The eneﬁts of sport as an occupation
53 Kids’ Products
Colourful and fun products to improve the lives of your younger patients
40 To Sleep Perchance to Dream
Lifting the covers on sleep paralysis and nightmare disorders
44 Values-Based Practice What is it and why is it important?
Looking for a
new job 74
58 Are You Sitting Comfortably?
The eneďŹ ts of correct seating for people living with untington s disease
61 Older People and Alcohol
ow Ts are responding to pro lem drinking
65 A New APProach
70 Sensory Integration new approach to mental healthcare
75 Student Advice
awn lenkin s guidance on how to make the most of your summer reak
77 Single-Handed Care hat are the arriers
inding the right app for stroke and rain injury recovery
69 Hot Topic
o e weighs up e learning in moving and handling techniques over traditional methods
e meet ueen argaret niversity graduate ynsey o ertson lannigan
80 Find Events for You pcoming events in summer www.
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What’s new? e e plore whats happening in the healthcare sector from new products and services to inspirational stories.
The simple smartphone
he new amplicomms M9500 is the ﬁrst smartphone that turns into a remotely controlled device so care givers can support operation of the phone or help in an emergency. pecially designed to help older or disa led users connect to the wired world the new amplicomms offers all the eneﬁts of a smartphone with some exceptional features.
HELP Button for Remote Access or the ﬁrst time family mem ers can support a loved one y remotely operating their phone as if it were in their hands. ushing the help utton on the M9500 will give a choice of authorised contacts to receive an automated link via email te t or hatsapp ena ling a screen share for complete control of the phone. pps can e loaded settings changed emails constructed etc.
Care Giver Function sing the are iver function selected relatives can initiate a remote ‘ all n and have a two way hands free
conversation remotely activate ‘ ind y hone check the attery or signal status or do a complete restart.
Emergency Service The utton can e programmed to call up to ﬁve contacts with a pre recorded voice message followed y a text containing a oogle ap link of the phones location. In an emergency this could e a lifesaver.
Press and Hold Operation The menu is displayed as large slices with a ‘ ress and old long click function to avoid accidental touching speed adjusta le when navigating the menu making it easier for people with de terity issues or those not used to a touch screen.
Simple to Use The ﬁve inch touch screen has ig app icons and an horizontal keypad with the option of voice assistance or message dictation facility. essages of any type te t emails notiﬁcations and images etc all arrive in the phone s essage entre making it less confusing. dditional features include hearing aid compati ility ampliﬁed sound
vocalised aller dou le sided camera ual card slot and uilt in music player radio torch calendar etc. The new amplicomms M9500 helps avoid isolation and depression. . free from www.hearingdirect.com Tel
Phone Features •
utton for elatives to remotely access and operate the phone • utton on the rear calls or te ts with oogle ap location • ual operating systems ndroid . and amplicomms • oud call volume up to d • tra loud ringer up to d • orld s highest standard of hearing aid compati ility T for super clear sound • i ration lert for incoming calls • ive inch touch screen • ight megapi el rear ﬂash camera and two megapi el front camera • emory can e e panded • quad and for world wide use • ual card slots • i i and luetooth • lass and ilm Touch anel supports multi-touch • attery life appro imately eight hours talk time four hours video time eight days stand y • imensions . mm
Onion T Roll Voices to be Heard Voices to be Heard, a committee of adults with learning disabilities supported by the charity Hft, have given their views as part of an NHS review into the Accessible Information Standard. The Accessible Information Standard was published by NHS England, following approval as a new ‘information standard’ for the NHS and adult social care system, in July 2015. Over 20 members of Voices to Be Heard took the opportunity to respond to the survey. Whilst many noted that the new standard had improved their overall understanding, there were still concerns that people were missing out on important information, particularly when receiving medical care in hospitals. Cynthia Webb, convener of Voices to be Heard, commented: “The Accessible Information Standard was designed to ensure that people with disabilities and their carers have access to clearer health information. Whilst we are pleased to see that many members of Voices to be Heard are receiving improved care from their GPs, it is worrying that many are still not completely understanding the information they are being given in hospital visits. “We hope that this consultation will encourage the Department of Health to review how information is presented to people with learning disabilities, and that staff are sufﬁciently trained to e conﬁdent to meet their communications needs.”
For years, therapists have been using T Rolls to help position clients who have bad postures caused by complex neurological conditions such as MS, cerebral palsy and acquired brain injury. Posture care felt that patient outcomes would be limited due to the cushions being static, cumbersome and heavy, identifying the need to develop a dynamic alternative. “Invariably a patient suffering with neuro illness or injury will likely turn to one side at the hips and no two legs ever present the same, so a traditional T roll might only provide limited support to the user.” said managing director James Leinhardt. The Onion can be built up to accurately ﬁt the users postural. esigned to control posture and aid in positioning, lying in supine, it can help with the maintenance or correction of adduction and contractures in the lower limbs. With this innovation therapists no
longer need to worry a out ﬁnding the appropriate T roll to suit the height of the user or consider their range of movement at the hips and the knees. It’s covered in vapour permeable fabric for ﬂuid correction and easy wipe cleaning.
“Following initial trials and ﬁling our patent we started selling into the NHS and social services. So far the feedback from OTs and physios has been fantastic. The layered approach of the Onion makes it a corrective tool and a traditional therapeutic aid,” said James. The onion complements osture ares ﬂagship product the Hugga Sleep system, with extremely positive results so far. For more info contact the team on 0161 283 9480, firstname.lastname@example.org www.hugga.co.uk.
Get online with The OT app...
t The OT Magazine we are always looking for new ways to develop your favourite occupational therapy magazine. Out every two months, the app features all the latest products, in-depth features, industry news, personal profiles and up-to-date information on events and exhibitions that you find in the magazine but you can download it to your mobile phone or tablet to read on the go. The app is available free of charge and can be downloaded now and read at your leisure.
The fourth exclusive OT Practice Conference opens its doors to new recruits for the first time
n its fourth year, The OT Practice Conference is a unique opportunity for associates of The OT Practice to gain the latest industry insights, CPD training and new product knowledge from a host of specially-selected speakers and exhibitors. This year, the impressive Old Thorns Estate in Liphook, Hampshire plays host to the event on the 17th and 18th May, which promises to be even bigger and better than before. It will include an extensive programme of inspirational and informative speakers and workshops alongside an exhibition of equipment and service providers offering the latest product demonstrations and information. The theme of the conference is ‘Delivering Professional Excellence’, a topic that The OT Practice holds close to its heart. Among the speakers will be renowned author Michael Madelstam, who will be addressing the conference on the subject of Independent Practice and the Law, as well as leading a
workshop on ‘Safeguarding’. He will also be joined by a number of other key industry ﬁgures covering topics such as supervision, pain and fatigue management, and EHCPs and tribunals. The conference will be closed by an inspiring talk by Alex Lewis, whose remarkable story of tragedy and triumph was recently featured on Channel 4. or the ﬁrst time this year The T Practice are opening the conference to new recruits, so for any OTs with over ﬁve year s post qualifying experience thinking of a career in Independent Practice, this is a unique opportunity to join the conference at no cost to them and eneﬁt from this free learning opportunity. Anyone requiring further information can call the OT Practice on 0330 024 9910 or email email@example.com. For companies looking to advertise at this dedicated occupational therapy conference, there are still limited opportunities available, please email firstname.lastname@example.org for details.
Quantum launches 1450 Bariatric Front Wheel Drive The Quantum 1450 bariatric front wheel drive is one of the most popular choices of bariatric power chairs within the industry. The Quantum 1450 Power Chair front-wheel drive bariatric power chair features innovative design that provides exceptional outdoor performance while delivering outstanding tight space manoeuvrability. It has a 42 stone 9 lbs weight capacity.
Register for The OT Show
Taking place on 22-23 November this year at the NEC, Birmingham The Occupational Therapy Show is an event you will want to schedule into your diary early. Free registration is now open to all those interested in attending, simply visit www.theotshow.com to ﬁll in your details and you will be up-to-date with all the latest news and plans for the event.
Looking for a new job? Keeping up to date with all the latest jobs in the OT sector can be an arduous affair. Now at The OT Magazine we’ve made it much easier for you to bag that dream job with our new careers service. This can be found on our website (otmagazine.co.uk/jobs) where we have a constant stream of the most up-to-date jobs from across the UK. You can sign up for a mail out as well and we can email you directly every two weeks with the latest jobs. If you want to ﬁnd jobs easier then get across to the website and check out what’s on offer.
More information about Quantum® products can be found at www.quantumrehab.co.uk.
COTSSIP SW Regional Study Day Independent OTs from the South West met at Gypsy Hill Hotel in Exeter on 14 March 2017 for a study day which included discussions on mandatory training for independent OTs, tax issues and business insurance, an equipment demonstration by Wealden Rehab and a presentation by a photographer who specialises in working with people with body image challenges. The buffet lunchtime gave the group of fourteen OTs an opportunity to network with each other, test out Wealden’s products and continue informal discussion of issues raised during the morning session. The COTSS-IP South West group has a regular attendance from Independent OTs from a wide variety of practice including paediatrics, medico-legal, local authority and housing association contract work, learning disabilities, vocational rehabilitation and equipment provision. There is also a mix of newto-independent practice and more than 10 years in the private sector – and everything in between! The group meets three times a year (next meeting in June email cathy sﬁluk.co.uk for more information. We are making initial plans for a Look Before You Leap course to be presented in the South West during 2017 and invite anyone considering leaping into independent practice and interested in attending a course this year to contact Elizabeth Waterman at email@example.com.
Soap star turns out for Safehands holidays
roup organiser Paul Marks and branch manager Christine Green returned to the Esplanade Hotel Ilandudno with members of the ociety orth taffordshire for the ﬁfth time since its opening in April 2015. This time the group chose to stay for Safehands Soap Star Special midweek breaks. Each evening the hotel provides an entertainment programme with a great selection of entertainers. The group always play their own bingo prior to entertainment, encouraging all guests to join in. Wednesday night is party night! Fundraising takes part throughout the year at their MS clubs to help make the holiday extra special. At dinner time guests are welcomed with a glass of wine, to help get the party started! Then it’s bingo time. Some of the group danced their way through to the bar lounge; clearly the wine was starting to do its job.
Amy Walsh aka Tracy Metcalf. Amy was greeted by the group with a warm welcome. She interacted with all the guests, responding to various questions about her life as a soap star, with the guests trying to get some secrets of what the future holds for her and David. Following on from this, Amy greeted each of the guests individually, with in house photographer Karen Dixon to ensure all guests had their photo taken. These were then readily available to take home in a signed presentation card. This was not the end to this extra special night. Amy joined everyone on the dance ﬂoor and stayed well over her time dancing and chatting to guests, and the fantastic carers that come and support clients on their holidays.
Paul said: “The group love the bingo, and it’s a great way to start the night.” Christine added that “the food was much better on this visit than their last, there were more choices, and the new manager Jay was very nice and helpful.”
Eryl even got her up singing once she had pulled the ‘Safehands Holidays manager’s pint’: “It was certainly better than the one she had pulled at Blackpool, she must have been practising at the Woolpack.” Karen laughed. Hospitality training was provided by hotel manager Phil Clarke who assisted with weights and measures, ensuring she charged Mr Marks for his drinks as he is the cheeky one of the group.
The group were then joined by the fantastically-talented female artist Eryl estall. ithin minutes of ingo ﬁnishing she had them all up dancing and cheering, ready to welcome soap star for the evening,
Phil said “It’s such a great place to work, the management and staff all interacted on the evening with the guests and this made it one of the best nights I have had at this hotel.”
Could you be somebody’s buddy in 2018?
his year, residential outdoor centre The Lake District Calvert Trust launched a new proposition for visitors with low-support needs who wanted to enjoy a residential stay without the need for a carer or family member to accompany them. The Lake District Calvert Trust is a residential outdoor centre with over 40 years’ experience in delivering challenging outdoor adventure holidays for people with disabilities. With an increasing number of adults visiting the centre on the breathtakingly beautiful shores of Lake Bassenthwaite, this option of an unaccompanied stay helps visitors develop independence, conﬁdence and self reliance. Justin Farnan, business manager at the Calvert Trust explains: “Many of the disabled visitors that come to the centre have quite signiﬁcant care needs and have to be accompanied. However, there are also many potential visitors who are independent in their day-to-day lives, but may just need some help and prompts through the course of their stay.” To provide this support, the Trust recruited a small number of ‘buddies’ - adults who were looking to take a working holiday in the beautiful surrounds of the Lake District, but also had some experience of disabled adults or children in their work or family life, or were students over 18 studying subjects such as occupational therapy, nursing or teaching.
Due to the success of the 2017 programme, they are looking to expand it next year and are now looking for 2018 recruits! Taking place over the spring / summer school and college holidays, ‘buddies’ will be provided with full board and accommodation, as well as reasonable travel expenses from within the UK. They will be helping visitors with things like getting their kit ready in the mornings, giving advice about what to wear and what to take on activities (any medication they need, spending money, etc.), giving prompts for meal times
There will be plenty of opportunity for buddies to have fun and take part in the daytime outdoor activities as part of the group they are supporting. and activity start times, providing physical support for those unsteady on their feet, advising centre staff of any concerns or issues an individual may have, supervising the swimming pool in the evenings and accompanying visitors to the games room. There will be plenty of opportunity for buddies to have fun and take part in
the daytime outdoor activities as part of the group they are supporting. Guests who are to be supported by a volunteer buddy during their stay are required to be independent with regards to personal care and medication. Buddies are not required to assist with personal care such as dressing, using the bathroom, taking medication (aside from reminding someone to take medication) or deal with any signiﬁcant ehavioural issues. The dates for 2018 buddy-supported breaks are: • 6th - 13th April • 28th July - 4th August • 11th - 18th August • 3rd - 10th September If you’d like to know more about taking a working holiday as a ‘buddy’ in 2018, please contact the Calvert Trust on 017687 72255 or by emailing firstname.lastname@example.org. org.uk For more information on supported breaks for adults as an attendee (including dates, prices and suitability for the support provided) visit www.calvert-trust.org.uk/lakedistrict/new----buddy--supportedbreaks
Making everyday life easier
Back to basics Back injuries cost the NHS £400M per year. This is a significant amount but the cost to the individual is not just financial. The solution to preventing back injuries consists of training, education and equipment. Handicare’s Ethos education programme offers solutions through formatted learning and practical handling techniques; coupled with 30 years of innovation and product development.
For more information contact www.handicare.co.uk/backtobasics
Adverts_OT-Iss16.indd 12 Back_to_basics_A4_AW.indd 1
27/04/2017 21/04/2017 13:17 11:44
Columnist KATE SHEEHAN
Insured or not. Is it important? A very serious topic this time, do you have professional indemnity insurance? Do you need it? Does it cover what you do?
recently lectured to third year students and asked the above questions. It was interesting to note that the majority did not understand why I was asking, it led me to think ‘how many of the 36,000 already registered occupational therapists are insured?’ By law, occupational therapists must have a professional indemnity arrangement in place as a condition of registration with the Health and Care Professions Council (HCPC). The Health Care and Associated Professions (Indemnity Arrangements) Order 2014 made it mandatory for all OTs to have the insurance in place from the 1 April 2015. The HPCP states on their website that all OTs with the HCPC must make a professional declaration that they have insurance in place when applying or renewing to maintain their place on the Register. The Health Care and Associated Professions (Indemnity Arrangements) Order 2014 was introduced by Government as part of implementing new European Union legislation. (Don’t ask me what happens post Brexit I have no idea). The Order was introduced
so that if a client was harmed in any way by our intervention, they could apply for compensation via the courts and we may be in position of having to pay for their losses. This does not mean that you must all rush out and buy insurance today as many of us are already covered. This could be through our employer, our College of Occupational Therapists membership or our own private professional indemnity arrangements through an insurer such as Balens. Looking at the above options, I would suggest you should however check to make sure you are covered.
Your employer Have you checked with your HR department that you are covered and have you discussed with them the question that if you were responsible for an incident that resulted in a claim, will the employer then counter sue you for their losses? The NHS paid out £1.4billion in 2015 for medical negligence claims and according to NHS managers this is not sustainable. Will you be covered?
This is an individually taken out or through your incorporated business that provides full cover for what work you undertake. I can feel a huge number of you breathing a sigh of relief. I am covered through my employer and a back up of COT membership cover. However a word of caution, have you checked that what you do is actually covered? For example medical legal work is not covered by the COT membership. Also those of us who work in the emerging sectors of T may ﬁnd that our work may not be covered.
ast cto er T made signiﬁcant changes to the indemnity cover they provided via the membership by Novae. This included cover of up to £6million. Full details of the cover and the T rieﬁng note on professional indemnity insurance can be found on their website. Final word... make sure you have your insurance cover note stored safely but accessible just in case and never assume you are covered, check it out.
By law, occupational therapists must have a professional indemnity arrangement in place...
Kate is director of The OT Service. The company provides high quality advice, consultancy and training to manufacturers, retailers and service providers. It also provides occupational therapy clinical services in housing and equipment to case managers, solicitors and private individuals via their handpicked network of occupational therapists. For more information email email@example.com
’ g n u h l l a Helpful ‘w s n o i t u l o s g n i toilet
Quality • Service • Heritage www.clos-o-mat.com Tel: 0800 374 076 Email: firstname.lastname@example.org Adverts_OT-Iss16.indd 14
THE LAST TABOO: SCHIZOPHRENIA S chizophrenia is a severe, longterm mental health condition which causes a range of different psychological symptoms. Doctors often describe schizophrenia as a type of psychosis. This means the person may not always be able to distinguish their own thoughts and ideas from reality.
Symptoms of schizophrenia include: hallucinations (hearing or seeing things that don’t exist); delusions (unusual beliefs not based on reality);
muddled thoughts which are based on hallucinations or delusions; and changes in behaviour.
more vulnerable to developing schizophrenia and certain conditions can trigger the symptoms.
Some people think schizophrenia causes ‘split personality’ characteristics or violent behaviour. This is not true. The cause of violent behaviour is usually drug or alcohol misuse.
It is usually treated with a combination of medication and therapy tailored to each individual. In most cases, this will be antipsychotic medicines and cognitive behavioural therapy.
The cause of schizophrenia is unknown, but most experts believe the condition is caused by a combination of genetic and environmental factors.
Many people recover from schizophrenia, although they may have relapses – but the chances of this are reduced if schizophrenia is well managed.
It is thought that some people are
INTERVIEW Marion Findlay M arion Findlay is Director of Services at Volunteer Edinburgh and is responsible for a range of services which promote personal development through volunteering. She is a member of the public affairs committee of Support in Mind Scotland, a national charity with particular expertise in understanding schizophrenia and psychosis and the impact this has on families. Marion previously worked as an occupational therapist in a variety of mental health settings in Lothian. Volunteer Edinburgh works in partnership with a number of voluntary organisations across the city, all working on a recovery-based model. In olunteer din urgh ecame the ﬁrst volunteer centre in cotland to speciﬁcally work with people who have experience of mental illness and support them to be active volunteers in the community.
How would you describe public perception of schizophrenia? Schizophrenia is the last taboo. It is an illness that conjures fear and misunderstanding of what the condition is about. Many of the misconceptions have been shaped by exaggerated portrayals of the condition in books and horror movies, which can be damaging. Schizophrenia is a term that is often misused to describe or depict the illness in a dangerous or thrill-seeking way. People who have schizophrenia often require a different type of support from those who have other mental illnesses. Everyone feels down or anxious at times, but not everyone can empathise with what it is like to hear voices in your head or have paranoid beliefs that affect your thinking about yourself and about other people. It is an illness that can really cut an individual off from other people and society. Recent years have seen a sea change in the perception of and attitudes to mental health. The involvement in recent months of the Duke and Duchess of Cambridge and Prince Harry with the Heads Together
charity has made great inroads in the campaign to end stigma around mental health and change the national conversation on mental health and wellbeing.
National charity Support in Mind cotland has speciﬁc e pertise in understanding and responding to serious mental ill-health. It campaigns for a stronger voice for anyone whose mental health problems or mental illness has a serious impact on their life and on the lives of family members, friends and supporters. Support in Mind Scotland knows that stigma and discrimination is still one of the biggest barriers people face to getting the support they need when they need it, so raising awareness and understanding is an important aspect of its policy work.
How do OTs assist people with schizophrenia? Much of what we do at Volunteer Edinburgh is intrinsically linked with OTs working in psychiatric hospitals and within community teams to ensure people have meaningful days and a clear purpose in the occupations in which they are involved. Studies have shown that occupational therapy is a key component in the successful treatment of schizophrenia, as well as other serious mental health disorders. Alongside psychiatrists, psychologists, nurses and social workers, OTs offer patients essential help navigating social and work situations and so bolster patients’ conﬁdence and independence to integrate into their communities. Effective assessment by an OT provides information on the occupational functioning of a person. By assessing, intervening and advocating for a person, an occupational therapist can contribute to developing a central role in the ﬁeld of early psychosis. The key ways an OT can assist people with schizophrenia is to help them to identify the occupations and relationships that matter to them and the skills and abilities they require to lead a purposeful life. OTs help to establish basic community-
The key ways an OT can assist people with schizophrenia is to help them to identify the occupations and relationships that matter to them and the skills and abilities they require to lead a purposeful life. living skills, having a meaningful routine and being engaged in activities that support social inclusion. This can prevent isolation, give individuals a stronger sense of worth and self-esteem and enables them to live the best life they can.
How does your OT-directed work impact the lives of people with schizophrenia? Our team at Volunteer Edinburgh work with people to identify volunteering activities they would like to do and to support them to get involved. This can be in the community or in hospital if they are an in-patient. Psychosis strips people of their sense of self-worth. Volunteering is a way they can become a ‘contributor’ rather than always a ‘recipient so has massive eneﬁts for self esteem and conﬁdence. For the past 30 years we have been running our health and wellbeing project and have been inspired and humbled by the way that people with schizophrenia have become active citizens helping their local community in numerous ways. The personal eneﬁts are e tensive – improvements in their health and wellbeing, increased employability, a wider circle of contacts and networks. Some people have relapses and have to stop volunteering for a period, but in many cases build a resilience and have a role to return to when things improve. Another of our services is the Volunteer Hub at the Royal Edinburgh Hospital, where in patients who have ﬂuctuating health or cannot leave the hospital for legal reasons get involved in inpatient volunteering opportunities. We also manage a strong team of public volunteers who are invaluable. Occupational therapists are the conduit for virtually everything we do at the hospital. They set the direction for how we engage with the patients. You could say that everything we do has the ﬁnger print of occupational therapy on it as they have the e pertise to identify patients skills and talents and the support they need on an ongoing or short-term basis.
They also help people to take positive risks in trying out new and varied activities.
hat are the first steps to helping a client who has schizophrenia? I’d say it’s getting to know the individual and getting to know what inspires them or inspired them in the past. What have they done in their life that has given them a sense of worth, or what would they like to do to achieve that? t s a out ﬁnding the potential to take things forward, such as being independent in daily living, shopping, cooking, cleaning and forming good relationships with people and taking part in activities like learning a foreign language, playing music or sport or developing new skills in IT or arts. OTs work with patients to identify how they will do that and give them the support they need, working in a graded way – small steps to bigger, long-term aspirations.
How important is OT to people with schizophrenia and how does it benefit the client? Massively important. It is so person-centred and purposeful. They can help people with schizophrenia be engaged in the kind of everyday things everyone does - purposeful occupation in its true sense. I have a real belief that as individuals, we really need to have purpose. It is very difﬁcult to motivate yourself to function if you do not have a reason to get out of bed or if everything you do is slightly meaningless or tedious. People who have schizophrenia often e perience this. As OTs, we have a real ability to help people with schizophrenia build conﬁdence and have a sense of worth that has a positive impact not only on themselves but on other people as well.
For more information please visit www.supportin indscotland.org.uk or www.volunteeredinburgh.org.uk
Do you have an innovative product you think we should feature? If so, get in touch! Contact us at email@example.com
Gripeeze® Price £19.99
ith more ﬂe i ility and support provided y the ycra ﬁnger sections and the patented strapping system ripeeze ﬁngerless gloves are perfect for weight training racket sports rowing ta le tennis, cross training and free weights. They can also e used y people with reduced hand function including people with arthritis, repetitive strain injury or patients taking part in a stroke recovery reha ilitation programme or sport injury therapy sessions. The strapping system ena les users to hold the equipment lock their ﬁst in the correct position and e ercise without any discomfort as any tension is immediately removed from the wrist and forearm.
Wheelchair Gloves Gel Palm Prices from £16.49
Leather and gel technology are used in these wheelchair gloves designed y wheelchair users. The dura le gloves include a full length thum and leather palm with gel pad to ease discomforts associated with pushing your own wheelchair. The elasticated wrist allows a user to easily put them on and take them off aiding in growing independence and providing reatha le comfort. vaila le in seven sizes in grey.
Ability Superstore 0800 255 0498 abilitysuperstore.com
Madita-fun Modular Seating Price available on request
The Madita-fun is a high quality modular seating system suitable for children with various levels of postural needs and is easily adjusta le whilst the user is in situ. The system is available in four different sizes and will accommodate from early intervention right through to secondary school age. The Madita-fun offers a unique pelvic support section as standard. om ining the width adjusta le pelvic pads with the lap belt creates a perfect anchor point for the pelvis. This then supports a great easily maintainable pelvic position which acts as the foundation for further correction. The compact height adjusta le ase provides up to 37 degrees of tilt in space and also goes low enough to accommodate a standing transfer across all of the sizes. Being compact it is ideal for use and storage in smaller spaces.
Stroke Touchpoint Cards Price: £12.99
Stroke Touchpoint Cards are designed to empower patients by allowing them to see the common issues raised by others affected by stroke and give ‘permission for potentially difﬁcult su jects to e discussed and not avoided. The cards, which aim to make appointments more effective, can be used by any members of the multidisciplinary team involved in stroke reha ilitation. peciﬁcally designed for stroke patients, the cards feature simple designs to aid cognition and communication, and are divided into four categories, each containing cards representing common issues faced after a stroke: 1. Health 2. Feelings 3. Daily living 4. Effects of stroke. The cards are very easy to use, non-threatening and portable.
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27/04/2017 02/03/2017 13:18 09:21
Heat-Resistant Silicone Oven Rack Guard
lthough this seems like an odd product to review I felt that it was important not only to consider larger pieces of equipment but also smaller, simpler aids that I have come across which have had huge positive impacts on a client. The Original Heat Resistant Silicone Oven Rack Guard is one such product. I was recently speaking at a conference in Jersey about occupational engagement with visual impairment and saw the product on an exhibitor’s stand. Immediately I considered it within the context of my talk, thinking about how the colour provides contrast between the edge of the hot shelf and the rest of the dark interior. Since stumbling across the product I have recommended it twice for clients who have feed back that as their conﬁdence in eing a le to see the risk has increased so has their engagement
in the task, increasing independence and productivity. AmaziPro8’s Original Heat-Resistant Silicone Oven Rack Guards do heat up but reduce the risk of that glancing burn and more importantly for someone with a visual impairment provides them with a colour contrast. Other types are available online but I picked these for the colour as I was using in the context of visual impairment and, for a pair on Amazon, they are very good value for money. This particular set online comes with a Mini Silicone Keychain Cup and eight digital cook books. These oven rack guards are easy to clean, just place the guards in the dishwasher or handwash them. They are 100% waterproof so theres no need to worry about getting the guard wet or spill hot liquid or oil in the oven unlike fabric or other material guards.
Adam Ferry UK Therapy Services
Adam Ferry is an occupational therapist in both the statutory and independent sectors. He is also co-founder of UK Therapy Services. With combined experience of over 30 years, UK Therapy Services specialises in providing high quality occupational therapy assessment, rehabilitation and consultancy packages for the private, statutory and business sectors. In this regular feature, Adam explores and reviews products he experiences in practice, giving insight and reﬂection to those who may eneﬁt. You can contact Adam on email@example.com or visit www.uktherapyservices.co.uk for more information.
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Adverts_Pos_Apr-May17.indd 38 EB1024039_VCUK_Motability_Q2_2017_Press_210x297_national_CC.indd 1
28/03/2017 15/03/2017 17:18 17:36
Day in the
eny l e H t munit uth a com o Abeleon Bu ence is t for Portsm is m
A day in . . f o e f i l the
H therap ing fro tional es. Graduat St John a p u c c o York Servic ’ Social f Ripon and many years o d e a l g h a e s Coll n ha physic , n 0, Hele eld of in 199 nce in the ﬁ rehabilitatio ie s, e r r ie e a r e p inju erly c ity, eld itation, hand ed il b a is s d a rehabil er unit-b stroke munity and ttling into h e s m o e c r o f e b itation rrent role. rehabil cu
Helen e c n e B
What is your current role? The team is comprised of OTs and rehabilitation assistants who work from 8am to 8pm over seven days. At the moment referrals are received via OT and social work colleagues although there is a plan to broaden this to include community physiotherapists and community nurses. Examples of referrals include clients who may have lost their conﬁdence or a ility to complete tasks due to ill health, an accident, disability or period in hospital; clients who are moving from a nursing home or residential home back to their home or a new environment (such as Extra Care); clients who require new packages of care but their level of functioning needs assessing and clients who have started to ﬁnd difﬁculty with every day tasks inside and outside the home. Interventions last for up to six weeks and treatment plans are regularly reviewed to ensure progress if changes are required. If ongoing care is needed then we are able to put this in place. Areas of intervention could include personal care, meal preparation, shopping and accessing social activities.
Describe a typical day: The day can involve a variety of different client visits. These may be new assessments or review visits to ensure treatment plans are progressing. These visits may be done alongside a rehabilitation assistant. Examples of recent interventions include:
1) A client who following a stroke and re housing to a second ﬂoor tra are ﬂat was unable to access the lift, restaurant and gardens ecause she has lost conﬁdence using her electric wheelchair. A rehab assistant visited daily for four weeks to work on the clients conﬁdence and safety using her wheelchair and her orientation around the building and local area, accessing the shops and parks.
Areas of intervention could include personal care, meal preparation, shopping, accessing social activities. Road safety and practicing routes until they were familiar to the client were all part of the programme. Changes were made to the organisation inside the ﬂat so the client was a le to access her wheelchair more easily and a referral was made for an automatic door opener to enable the client to maximize her new living environment independently. 2) An elderly client who fell fracturing her humerus returned to her home to live alone downstairs with a package of care four times a day and walking with a frame.
...we talk to a differe nt occupatio n to see wh al therapist at a is for them typical day a a little mo nd explain re about their role.
The client’s wishes were to sleep back upstairs and make herself a hot drink. The rehab programme involved stairlift transfer practice on a daily basis for two weeks and re-organising her bedroom so that the client was able to sleep back upstairs. When she had achieved this goal the programme then progressed to kitchen skills work and assessing what she was safely able to achieve. This intervention wasn’t about reducing her care package but about the client having more independence within her home and within the limits of her abilities. 3) A client had stayed with a family member for some months after a period in hospital post surgery and she was anxious about returning home to carry out activities of daily living on her own. The client returned home with three visits a day, seven days a week for three weeks. The rehab visits focused on conﬁdence and independence with personal care tasks, stair mobility and meal and drink preparation. This intervention plus a minimal care package (to empty a commode) reduced family stress and the time they now have with their relative when they visit is quality time rather than carrying out carer duties.
Best part of the job: Achieving greater independence for a client and relieving stress on the care system and a client’s family, which cannot be achieved without being in a client’s home and seeing them function in their own environment.
Each month ..
Everyone is on the autistic spectrum By Paul Aitken Paul Aitken has a Masters degree in psychology and works directly with individuals with complex impairments. Drawn to OT because of an appreciation of the work, this has led to him to writing a series of articles bridging the conceptual gap between ‘healthy’ and ‘unhealthy’ indivduals.
e still don’t know much about autism. If you ask those expected to know the most about the subject, they are likely to tell you that it is still not known how much of ‘autism’ is ‘caused’ by upbringing or genetics or to what extent the condition can be attributed to ‘physical’ or ‘psychological’ factors. What does seem apparent is that there are individuals whose behaviour lies outside the range of ‘healthy’. We categorise these individuals based on similar patterns of behaviour, give this category a name and then begin to think of ways to treat individuals categorised by that name – often with drugs, often without informed consent. This article argues that there is no separate ‘autistic spectrum’ but instead,
those we classify as autistic lie on extreme points of personality spectra upon which we all sit. ndividuals tend to e classiﬁed as autistic if they exhibit some of the following characteristics: repetitive or stereotyped gestures or behaviours; over or under reaction to sensory stimuli difﬁculty unwillingness or inability to engage in or initiate social interactions, including eye contact or reciprocal body language; the absence of desire to form relationships; a lack of empathy inﬂe i ility towards change or an insistance on sameness, order and regularity. These characteristics are often accompanied by intellectual difﬁculties. The Diagnostic and Statistical Manual of the American Psychological
Association: Fifth Edition (DSM – V) tells us that if social development is at an ordinary level for the age of the individual under scrutiny, but they exhibit some of the other traits, they might just have intellectual development disorder or global development delay. If they only exhibit the social problems then it might just be social (pragmatic) communication disorder or pervasive developmental disorder not otherwise speciﬁed. ne thing should be abundantly clear; there seems to be no difference present in terms of the types of behaviours exhibited, only in the extent to which they are exhibited. A quick skim through the DSM – V would - in my opinion - allow you to diagnose all your friends and family with one thing or another. www.
Traits involved in the classiﬁcation of autism are involved in normal social and personal development. ye contact can make or reak deals and relationships. ho doesn t know someone who insists on order and regularity ho doesn t sometimes envy another persons social skills ome of us e hi it idiosyncratic and repetitive ehaviours. for instance sometimes pinch the skin etween my inde ﬁnger and thum with my other inde ﬁnger and thum . often don t realise m doing it until it hurts. This is known as generating proprioceptive feed ack an an ious response which helps us to remind ourselves that we are whole alive and not disintegrating. any people ite their lips or ﬁngernails compulsively click their ﬁngers or their tongues or even display more sinister or self injurious compulsions such as cutting themselves or taking dangerous drugs. utistic individuals tend to engage in repetitive proprioceptive feed ack ehaviours.
The percentage that it is generally elieved that autistic spectrum disorders directly affects although it has een reported as high as .
There are some individuals for whom daily life is so stressful unpredicta le and difﬁcult that they present a danger to themselves and others requiring special care or under current conditions drugs and institutionalisation. e can follow this curve through people who have a it of difﬁculty engaging socially right through to the other e tremity those who seem capa le of engaging with anyone striking up relationships and emanating an air of conﬁdence totally a le to engage in society. ome people are e tremely adapta le and need How many people do follow no structure whatsoever.
you know who try to appear more socially capable than they really are? How many people suffer from fatigue, anxiety and depression on account of their efforts to fit in?
utism is typically diagnosed around the age of three or four around the time that people ordinarily develop a Theory of ind T the a ility to conceptually put yourself in someone elses shoes. The concept of ‘autism camouﬂaging has een raised to account for late diagnoses of autism proposing that some children learn socially appropriate ehaviours without understanding them memorising jokes consciously maintaining eye contact and imitating ody language. This can lead to fatigue an iety and depression on the part of the individual on account of all the effort it requires. ow many people do you know who try to appear more socially capa le than they really are ow many people suffer from fatigue an iety and depression on account of their efforts to ﬁt in The world and autism are always changing. u lic awareness and the frequency of diagnosis of autism have een
steadily increasing for years. It is generally believed that autistic spectrum disorders directly affect about 1% of the population, but it has been reported as high as 2.6%. Hansen and colleagues sought to determine the reasons behind this increase in Denmark in 2015. They found that the reasons were primarily non-etiological – based on factors such as public awareness and changes in reporting practices and diagnostic processes. A number of factors have been cited to account for this increase, most infamously vaccines inﬂuencing parental decisions regarding their children’s healthcare. Denmark saw a decrease in the uptake of mumps and measles vaccinations. This was not accompanied by a decrease in the prevalence of autism, just an increase in cases of measles and mumps.
son didn’t seem interested in talking or playing with the other children; kept to himself and hadn’t undertaken to read, write or do arithmetic - suggesting that a clinical psychologist visit their home. Laing wasn’t concerned about the social aspects, but pointed out to Max that he might run into trouble with the school if he insisted on not doing his classwork. Laing went to the States for six weeks, when he returned, his son had developed an interest in computers – an interest which had forced him to read and write. Four weeks later - and only a few months after ever having pursued one of his idiosyncratic, personal interests a presented his dad with a irthday present his ﬁrst literary effort. It read:
The eminent psychiatrist and psychologist Iain McGilchrist told me at a conference that many teachers approach him after talks to explain that they need to teach whole classes of children about facial expressions. As we move towards an increasingly digitised and depersonalised society, the brain is going to rewire to this effect – particularly in the very malleable brains of children. Recognising and responding to face-to-face social cues is not as important for the current, digitally-native generation, as in prior generations. Arshya Vahabzadeh – a psychiatrist – enthusiastically explains that new eye tracking solutions can help diagnose children with autism as early as 18 months old. While such early diagnoses could help families and carers to prepare for the future, it should also be clear that the aetiology of autism is not as clearly deﬁned as that of other disorders and perhaps should not be ascribed to children so young. A diagnosis of autism will hugely affect these children’s lives. They will grow up in a world where they are quantiﬁa ly different from their peers likely accentuating these differences. A child’s upbringing and surrounding environment may lead them towards clinical diagnoses. A case in the West of Scotland involved the diagnosis of two brothers with Asperger’s syndrome. They regularly met with a clinician who followed standard practices. When the boys reached high school, their symptoms disappeared. They appeared to engage in normal social and cognitive interactions. Eventually, their father was diagnosed with Asperger’s – hailing from a generation in which childhood diagnosis was less likely. Their upbringing made them appear as if they had a clinical disorder, when in fact they didn’t.
As patchy, as quilt As forgetful, as nightmares As wild as can be.”
R.D. Laing – one of the country’s most engaging and controversial psychologists - once recounted a story about his son, Max, at the age of nine. The head mistress of his school explained to Dr Laing that his
The writer of this poem is as dreamy as inﬁnity
Laing – in my opinion – correctly asserted “He would never have written that poem if I had sent him off to a clinical psychologist”. This ties into the aspect of our culture which Laing referred to as “psychophobia”, our fear of our own minds. He linked this to a mass campaign of homogenisation of experience, which cows us into experiencing the same thing at the same time, or else. The DSM-III – as it was in Laing’s time – classed “any unusual perceptual experience” as a criteria for mental disorder. We should perhaps rely less on the development of more effective means of classifying people and instead understand that people are different and this is what makes the world work. We should extend and develop our own empathy, compassion and understanding towards those who have trouble with these faculties. This practice would empower and enrich the lives of individuals with more extreme tendencies and behaviours, and may reduce our reliance on drugs and institutions for their treatment. We tend to view autistic people as inherently different from ourselves, on a different level and indeed a different spectrum. This perception is not only damaging to the relationship between ‘autistic people’ and ‘healthy people’, but is also damaging to our relationship with ourselves. It is important to realise that the autistic amongst us demonstrate traits and characteristics exhibited by all of us. There is a lot that we can learn from one another so as to develop a more peaceful, fruitful and enjoyable co-existence. There is a little bit of autism in all of us, we should endeavour to learn from it so as to become better people.
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Smirthwaite’s new stander - Chi-Chi is an entry-level vertical stander, designed for children around 6yrs to 12yrs (guide only).
Smirthwaite’s mobile base for your Juni, open up a whole new world.
Low to moderate levels of support whilst weight bearing.
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Manoeuvre from class to class or around the home.
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Daily Living Aids to Help Maintain Independent Living
• Provides firm grip and hold • Non-toxic and chemically inert • Phtalate plasticiser free • Autoclave safe to 250°C • Antimicrobial • Fully washable and long lasting Buy via the website or contact us using one of the methods below Tenura Ltd Churchill Road Industrial Estate Brinscall PR6 8RQ
Silicone anti-slip and grip daily living aids www.tenura.co.uk
T +44 (0)1254 832266 F +44 (0)1254 832476 E firstname.lastname@example.org
Anti-slip and grip for independent living
Accessible design for independence
Housing occu pational ther apist Anava Baruch is part of the team behind the award-w inning Ideal Standa rd Concept Fr eedom Bath. Here sh e explains ho w she used task anal ysis to design the perfect access ible product.
By Anava Baruch
couple of years ago I was asked to work on a project designing unique residential units for people with Alzheimers. The property development company wanted to create a beautiful environment that did not look ‘disabled’ and assembled a team of designers from a range of backgrounds including complex care experts, architects and myself. The developers searched for accessible products around the world but didn’t ﬁnd everything they were looking for. I was approached to help with
the layout of the units, advise on equipment ﬁ ture and ﬁttings and also the design of a new accessible bath. As an OT, I knew that while many people prefer a bath to a shower, there are few products on the market which support safe transfer. If more baths were designed correctly, people would be able to bathe independently and safely for longer periods of time. It was an absolute pleasure to use my core OT skills to design the perfect accessible bath. As a housing OT I have observed thousands of people getting in and out of their baths. www.
Anava Baruch talks accessibility design
The ins & outs y ﬁrst task with the design team was to make everyone aware of the difﬁculties people e perience while athing. These might arise from weakness in the upper or lower lim s issues with joints alance pro lems and issues relating to the height and weight of a user. ro lems encountered can include
uring my assessments always ask decrease in the width of the internal my clients to show me how they have ath provided a sense of security and adapted their methods of transfer control. once they start to struggle. nalysing very aspect of the design was the task in hand and understanding carefully o served and measured and the effects of different medical once the key features were agreed we conditions on a client s a ility to worked closely with deal tandard transfer led to this unique design. during the manufacturing process. ne of our ﬁrst priorities was to The ﬁnished provide a product is comforta le thoughtful in Being able to use my area for people every detail to sit on while skills and knowledge with a highly transferring their to have an impact on a functional legs in and out design which person’s day-to-day life the ath. e looks as good created a wide is immeasurable as it performs. ﬂat reinforced The oncept rim at one end reedom ath and carefully is different in many ways not least calculated the ath s ecause it is eautiful and does not height to ensure that most users can compromise aesthetic for accessi ility. sit comforta ly with their feet ﬁrmly eople with disa ilities want on the ﬂoor. The width of the ath lu urious athrooms too a fact that allows users including tall people some manufacturers have een slow to turn onto their knees from lying to acknowledge. while a very slim rim at the tap end ma imises space. n arch we were delighted to learn that the design had scooped n addition to the unique design the a prestigious industry award after rim itself is slip resistant and supports eing named as athroom roduct grip. e also designed a unique nnovation of the ear at the internal foot ledge to provide people eview etail and esign wards of short stature and those with weaker in ondon. t was a real privilege to upper odies a method of controlling e part of such a talented multi their posture and movement while in disciplinary design team and to use the water. my skills as an T and ergonomist The new ath was put through to design a product which not only e tensive trials and from these we looks good ut will give people real realised that the wider rim at the freedom in their everyday lives. head end with a corresponding 32
eople struggle to get over the side of the ath from a standing position as this requires shifting the weight of the ody from one leg to another and lifting their legs higher than the side of the ath.
ome aths are too high to allow a user to sit on the side and place their feet ﬁrmly on the ﬂoor and some are too low preventing the user from moving from sitting to standing when trying to get out.
ome rims are too narrow to allow the user to sit safely on them and transfer their legs into the ath whilst sitting.
ost aths don t have any rails to hold onto whilst completing the manoeuvre.
nce the user s feet are inside the ath people with weak upper odies struggle to lower themselves down into the ath slowly and safely.
etite people struggle to control their odies whilst in a ath full of water ecause there is nothing to hold them in place.
GETTING OUT •
eople with joint and muscle pro lems usually struggle to move from a lying position to standing ecause they don t have adequate strength or range of motion to push themselves up against the water.
• The majority of people try and turn in the ath onto their knees. owever most aths are too narrow for this manoeuvre. •
nce on their knees the ath rim is too narrow and slippery to grip onto when trying to move from knees to feet.
nce a user is standing in the ath there are no rails to provide support when transferring their legs over the side of the ath.
This T task analysis was vital in informing the unique features of the new aptly named oncept reedom ath.
The only shower chair you will ever need RAZ shower chairs are feature packed and provide a full range of benefits: A stainless steel frame that eliminates rust. A supportive seat offering best-in-class pressure reduction. An adjustable chassis that meets changing requirements. And a wide range of accessories to aid each user.
In fact, we’re so confident in RAZ that we provide a 5 year warranty as standard.
Watch a video at wealdenrehab.com/raz or call us on 0845 658 8411. wealdenrehab
...at our annual conference: the leading UK event for professionals working in the field of posture and wheeled mobility. Conference prices start from £155 (+VAT); exhibition only from £25 (+VAT)
Innovative care equipment with professional installation
Posture & Mobility Group Conference PMG 2017
Motorpoint Arena, Cardiff Monday 17th - Wednesday 19th July
www.pmguk.co.uk email@example.com @posturemob
Book before 5th May to save money on ticket price
Get online with the OT app... At The OT Magazine we are always looking for new ways to develop your favourite occupational therapy magazine. Out every two months, the app features all the latest products, n de th featu es ndust y news e sonal oďŹ les and u to date nfo at on on e ents and e h b t ons that you ďŹ nd in the magazine but you can download it to your mobile phone or tablet to read on the go. The app is available free of charge and can be downloaded now and read at your leisure.
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Do you have an innovative product you think we should feature? If so, get in touch! Contact us at firstname.lastname@example.org
General Purpose Gripping Aids Price: ÂŁ49.95
General Purpose Gripping Aids are essential for a wide range of tasks. Whether a client has had a stroke, has had a spinal injury or has any condition which reduces hand function, these aids could unlock any number of activities. The gripping aids are also useful for those with dexterity issues and offer greater independence in day-to-day tasks.
Active Hands 0121 247 9152 www.activehands.com
Product focus Backfriend Price: £109.99
roviding ﬁrm and shaped lum ar support the contoured ackfriend is in two pieces and can e easily adjusted to ensure the curved ackrest is always at the correct angle. asily stored and transported with a uilt in handgrip it is ideal for a client who is permanently sitting and can e used at home in the ofﬁce or even the car. ingle padded mm is supplied in oatmeal and dou le padded in lack.
Ability Superstore 0800 255 0498 abilitysuperstore.com
Twister Jar Opener Prices from £2.95
This simple ru er jar opener is ideal for those with de terity issues and allows independence in the kitchen. The cone shaped ru er moulds have ﬂuted ﬁnger grips on the outside to allow the user to get a good grip and the ri ing on the inside ensures a good ﬁrm grip on the lid. asy to use a simple twist should see even the most stu orn lids released.
Complete Care Shop 0845 5194 734 completecareshop.co.uk
The latest OT products reviewed for you
Argent Bath by KingKraft Price available on request
Designed with the appearance of a standard bath, the Argent is available in two lengths (1.7m or 1.8m) and has been designed to be height adjustable. What’s more, when set at the low end of its height range, the bath can still be used by all the family, just like a regular bath. The Argent offers a generous bathing space ideal for any supports that the user may require. This product has been designed as a cost-effective alternative, particularly for those relying on a Disabled Facilities Grant where local authorities usually recommend a shower bath based on cost alone. The rgent can e ﬁtted for a similar price to a level access shower, allowing both children and adults the enjoyment and eneﬁcial therapy of a bath.
www.kingkraft.co.uk 0114 2690697 email@example.com
Easy Grip Two Key Turner Prices from £1.45
This key turner can safely and securely hold two keys and provide greater control when locking or unlocking. The curved handle provides an easy, secure grip on the keys for the user and good leverage for turning aiding independence. The thickness of the handle supports those with tender joints, arthritis or weak grip. The two keys, for a yale or mortice type door key, are held by a brass screw ﬁtting and fold into the handle.
Complete Care Shop 0845 5194 734 completecareshop.co.uk
The latest OT products reviewed for you
Secure Turn Patient Turner Prices from £429.95
The Secure Turn Patient Turner is an economical, secure and easy-to-use solution for transferring individuals where mobility is restricted between beds, chairs and wheelchairs. A hand operated locking device enables the carer to rotate the Secure Turn to any of ﬁve positions whilst controlling the turning speed. The non-slip turn disk glides easily in both directions and counter balance points provide stability throughout the transfer. The Secure Turn atient Turner is ﬁtted with housekeeping wheels so it is easily moved, minus the client, where required. This makes it ideal when transfers are required in several areas. Stable and easily manoeuvred, the high tensile steel unit is ﬁtted with two ru er castors for easy portability. The curved support frame helps to reduce the risk of falling and ensures a safe, comfortable transfer.
Complete Care Shop 0845 5194 734 completecareshop.co.uk
Bucket in a Bag £14.99
Completely watertight, incredibly versatile and very durable, the Bucket in a Bag holds 11litres but collapses down to a compact, handy, easily-to-store, space-saving bag. Available in purple or green.
Spring Chicken 01865 339366 www.springchicken.co.uk
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sleep perchance dream To
Here at The OT Magazine, we are constantly thinking o ore le t field areas of healthcare that may have not been considered before. In this issue, we look at how occupations are a ected by the dark and terri ying night are disorder and sleep paralysis phenomenon.
f a dream elicits or evokes negative emotions such as fear, anxiety, disgust, sadness or anger it is a nightmare.
While nightmares are more common in childhood, it is natural for less pleasant thoughts to creep into our dreams at night. While unenjoyable, they usually happen upon us for a reason. Nightmares have been said to be the most informative dreams we can have, and despite leaving us somewhat shaken due to their nature, are vital in understanding our own state of mind. Bad dreams alert us to the possibility of our mental states faltering and provide us with invaluable information on how to reassess and amend ourselves, occasionally with psychological and occupational intervention. So all in all, nightmares generally aren’t just the monsters under our beds or in our cupboards disturbing a good night’s sleep, but rather our own demons revealing themselves in our subconscious’ to help us onto the road back to good mental health. For others though, nightmares carry their presence through to their waking hours and can have devastating impacts on daily functioning and be detrimental to occupations. Formerly known as ‘dream anxiety disorder’, the Diagnostic and Statistics Manual (DSM) recognises nightmare disorder as a REM sleep phenomenon “including repetitive, extended, extremely dysphoric, and well-recalled
dreams that involve threats to survival or security, or physical integrity; episodes usually occur during second half of the sleep period. Typically, the individual becomes rapidly alert and orientated. Emotional manifestations of fear, anger and sadness may predominate.” Generally traced to other psychological disorders, stress and trauma the identiﬁes frequency as important criteria in diagnosing nightmare disorder – it must be experienced at least once a week for a diagnosis, but in severe cases, it can occur nightly. Characteristics also include being awoken y frequent nightmares instantly orientated and aware of their surroundings and vivid details of the dream, and leaving the dreamer unable to get back to sleep, resulting in serious sleep deprivation, disrupting and impairing daily occupations. Such realistic and horrifying episodes of nightmare disorder or sleep paralysis carry trauma through to someone’s waking hours and so changes the ability to carry out occupations. Psychological interventions such as Image Rehearsal Therapist may help ease the nerves associated with sleep while living with nightmare disorder. This cognitive behavioural therapy technique sees a dreamer recall the nightmare and record it, changing the theme, story or ending to a positive one and rehearsing it to displace the distressing content
when the dream reoccurs. The Journal of Clinical Sleep Medicine describes this as “IRT acts to inhibit the original nightmare, providing a cognitive shift that empirically refutes the original premise of the nightmare. This technique is practiced for minutes per day while awake. While this intervention and deeper psychological understanding and investigating can identify the source of the disorder and hopefully work towards recovery, OT may be useful in helping a sufferer carry on in their day to day lives. Healthy sleep is vital in functioning daily lives, but the exhaustion and emotional stress and trauma associated with nightmare disorder impairs our occupational performance and capacity. Can some interventions associated with PTSD nightmares help people live with the terror of the night creeping into daytime? Can OT sleep recommendations be useful on a road to recovery? Think about what areas of OT practice can be transferred into nightmare disorder treatment. As the debate as to whether or not sleep is an occupation rages on, it without a doubt plays its part in OT. While conditions such as nightmare disorder and sleep paralysis are more commonly found under the psychology or GP umbrella, can you see a place for OT after dark?
Read sleep paralysis case studies on next page
Bad dreams alert us to the possibility of our mental states faltering and provide us with invaluable information on how to reassess and amend ourselves... www.
Case Study Adam* The ﬁrst time e perienced a night terror was . started shouting and ecame violent screamed at my girlfriend and almost choked her ut had no memory. have had several episodes of sleep paralysis night terrors and sleep apnoea. The ﬁrst remem er having sleep paralysis woke up was conscious ut completely una le to move. didn t know what was happening and felt trapped. could hear strange noises my heart started racing and struggled to reathe. s soon as my reathing stopped the paralysis went away jolted up and could move. started to do a little research and started to read a out sleep paralysis. found no way of stopping it. t appeared that sometimes it just happens.
The ne t morning it happened again. woke up una le to move with an uneasy feeling as if someone was watching or preventing me from moving. knew what was happening and focused all my energy into moving a ﬁnger. s soon as did snapped out of it. t frightened me and dreaded falling asleep. also have e ceptionally vivid night terrors where wake up heart pounding reathing quickly and completely terriﬁed. The most vivid was when was at a cottage in a large forest. dreamt was at the ack door and spotted two red eyes at the edge of the forest. uddenly some east pounced and started to attack me. y girlfriend was sitting in the living room and fought to keep it away from her. started lashing out.
Case Study Amanda* hat happens to me is when m lying on my ack ll open my eyes fully conscious and start to hallucinate. t s nothing like dreaming you are awake. ou see your surroundings then hear and see things. The ﬁrst had saw a demon woman come out my cup oard and walk to my ed. he then sat on my chest and felt everything. he put her hands
around my neck and could feel the pressure. ou re completely paralysed and can only move your eyes. ou can t scream or move it s like a horror movie. ventually it disappears and you re disorientated and terriﬁed ut a le to move again. t really is terrifying and puts me off sleeping make a conscious effort to sleep on
didn t realise was doing it in real life. was kicking punching and shouting at my girlfriend. he managed to wake me and my heart was pounding was terriﬁed couldn t sleep again that night. The following night had a feeling of dread and didn t want to fall asleep. get creepy visions and sensations of something touching my feet. swear once was completely awake and felt something gra my foot. t really affects me. try to sleep and can t give up and get angry then the ne t day am completely shattered. ometimes manage a couple hours on the couch ut when it gets to edtime m scared and don t want to even try. think the fear makes it worse ut can t stop and nothing makes it etter.
Names have been changed to protect privacy
my side ecause feel it s less likely to happen then. The last time sounded like someone was trashing my kitchen then walked into my edroom. had a panic attack after was no longer paralysed and convinced my kitchen would e trashed when checked it ecause it s that realistic. m left completely shaken.
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What is values-based practice in occupational therapy?
Dr Yvonne Thomas, Principle Lecturer at University of Worcester asks: do we know what values-based practice in occupational therapy really is?
alues-based practice is frequently identiﬁed as important for all health professions and services, and is something that all occupational therapists would aspire to. The importance of values in the healthcare delivery has recently been highlighted as a major inﬂuence in the quality of service delivery and has been the driving force for valuesbased recruitment (VBR) in the NHS (HEE, 2014). The underlying premise of values-based practice and valuesbased recruitment is that improved
health care is directly related to the values of healthcare staff. As occupational therapists we frequently face difﬁcult choices and challenges in our practice. We know that occupational therapy is a complex intervention and the decisions that we make in practice are inﬂuenced by a range of factors regarding the person, their occupations and the environment. There is no ‘one size ﬁts all’ in our profession and this requires occupational therapists to adapt and design interventions to meet the needs of every service user or family in
unique ways. To do this occupational therapists use professional knowledge and reasoning, as well as guidelines and standards to decide how to act when there is no clear right or wrong way. In addition, we bring our personal and professional values to that decision-making process in different ways. But do we really know what our professional values are? When I arrived back in the UK in 2013 after working overseas for 25 years, the importance of values-based practice and values-based recruitment in the UK was very obvious.
‘The six Cs’ were being widely discussed in NHS services and the HCPC made it a requirement for all health professional training programmes to embed values-based assessment in selection criteria for students. This imperative led me to learn more about the historical and current values of occupational therapy and to explore the values framework more closely. My research left me feeling slightly uncomfortable, because it highlighted a gap in the occupational therapy literature. The more I researched the clearer it was to me that there is very little known about the professional values that underpin our profession. Professional values can be seen as the shared enduring beliefs about what is good or desirable in life. We learn our values through a process of socialisation and therefore while we enter the profession with our personal values, through the education and working experiences our personal values are adapted and added to as we begin to develop and become established in our professional identity. It seemed to me that it is important to be able to identify and discuss professional values in order to strengthen our professional identity, especially as the profession moves into increasingly diverse roles. With this in mind I decided to submit an application to UKOTRF to fund a two-year project to explore the professional values of occupational therapists in UK. Together with my co-investigator Professor David Seedhouse, we developed a research design that aims to identify common and shared values that are used in professional decision making in occupational therapy. The research uses an on-line platform called Values Exchange, which has been develop by Professor Seedhouse, as an educational and communication tool for people to reﬂect in depth a out social issues via colourful interactive screens. Values Exchange has been used widely in other professions and internationally, and has proven to be an effective method to encourage users to think through ethics and social issues in depth. I was extremely lucky to be awarded the UKOTRF funding and was
Professional values, can be seen as the shared enduring beliefs about what is good or desirable in life.
proud to be presented with the award by HRH Princess Anne in 2016. For this research study a special site was developed within Values Exchange to explore a broad range of occupational therapy professional scenarios. The scenarios were developed by a group of occupational therapists and service users who came together for a one day workshop to explore the values of practice and to write the scenarios. Following the workshop a pilot page was developed, where the development team could review and edit the speciﬁc wording for each scenario and go through the questions to check utility of the webbased data collection tool. Five scenarios that related to a range of professional practice areas have been agreed for use in the research project. It is important to note that each scenario is based on the views and experiences of the scenario development team of practicing occupational therapists and service users, with lived experience of occupational therapy. There is no right or wrong answer to any of the scenarios leaving participants to decide for themselves what they would do in the situation and why. As soon as each respondent submits he or she has immediate access to everyone else’s comments and this discussion promotes in depth reﬂection on values as it applies to practice decisions.
The site is now ready and open to any occupational therapist practicing in the UK. Our aim is to recruit between 200 -300 practicing occupational therapists across the to reﬂect on their professional decision ased on ﬁve case scenarios. To access these scenarios all you need to do is go to an online site; www.otresearch.vxcommunity.com/ register (you can register under a pseudonym if you want), read the scenarios and make decisions about how you would act (polling) and give comment on the reasons related to your decisions. While this is a research study, approved by the University of Worcester ethics committee, it is also a great opportunity for in depth reﬂection on values. f you complete all ﬁve scenarios we will send you a certiﬁcate of completion which can be used as evidence of your CPD. e elieve that reﬂecting on your values and professional reasoning will strengthen your practice and professional identity. The collective results will inform values based practice education and recruitment in occupational therapy. For further information including information on hosting a values based practice seminar in your region please contact me at email@example.com.
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Paediatrics n o i t c Se P50
ummer is almost here and I’m sure lots of your paediatric clients are chomping at the bit to have school over and done with for another academic year and spend their summer months playing outside in the warm air and kitting out their parents schedules with play dates, activities and events before going back to school This issue we another year older and another year look into some of wiser.
the activities that
This issue we look into can keep children some of the activities with ADHD busy.. that can keep children with ADHD busy and active when they aren’t in the classroom. We have picked a number of sporting ideas for you to recommend that will help give them a focus and an all-important sense of fun over the holidays, including a sport that the greatest Olympian of all time, Michael Phelps – who also has ADHD – took to with great proclivity. Read more on page 50.
We also discuss the importance of an OT’s role regarding children with Down’s syndrome. What is it and why is it so important? Find out on page 49. Page 53 sees the usual selection of all the latest children’s products on the market to aid you in a number of different areas. If you have any paediatric stories or products you think deserve to be featured, please let us know by emailing firstname.lastname@example.org.
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An OT’s role in Down’s syndrome D
espite many people living with Down’s syndrome leading independent and healthy lives, some, particularly children, require some intervention due to associated medical conditions and complications to accomplish this. Children with Down’s syndrome are likely to have reduced or low muscle tone or muscle weakness that may result in difﬁculty carrying out occupations at home or school. Children with Down’s syndrome may also need intervention in assisting with possible hyperﬂe i ility poor grip poor handwriting co ordination difﬁculties or delayed development of the ﬁne and gross motor skills, in cases where they may not achieve milestones, skills or degrees of independence at the same rate as other children. OTs can assist families in managing any conditions associated with Down’s syndrome by identifying ways in which reduced muscle tone or learning difﬁculties are affecting a childs occupational performance. Challenges in functioning due to health issues or muscle tone may include delayed landmarks such as sitting, rolling, holding, standing, behavioural concerns, struggling to carry food and drink without spilling and difﬁculties in sensory processing speech, eating, learning, understanding abstract concepts or concentration. In order to help parents aid their child to
meet developmental stages and achieve as high a level of independence and quality of life as possible a number of interventions may be applied. ross and ﬁne motor skills intervention may e the ﬁrst port of call for many OTs working with children with Down’s syndrome. Often the low or reduced muscle tone or loose ligaments affect the early development of motor skills. If a child is presenting problems with gross motor skills in balancing, walking or
Gross and fine motor skills intervention may be the first port of call for many OTs working with children with Down’s syndrome. running, an OT will identify this and recommend treatment to improve this and in cases work closely with physiotherapists to develop gross motor skills. Through the building of gross skills, OTs can begin to look at hand and arm movements to set the foundations to facilitate ﬁne motor skills. hildren with owns syndrome may struggle to adapt to ﬁne motor skills and movements due to either shorter ﬁngers cognitive or neural developmental difﬁculties or decreased strength and joint ligament
la ity. ntervention may e used in play by assisting children in opening, building, e perimenting with crayons or using buttons and knobs or by recommending adaptations and helping set achievable goals to ensure constant and realistic goals. This may also take place in the classroom through programmes on printing, cutting and writing amongst others. The size of desk and surroundings may also become pivotal in developing these skills and adaptions may increase performance levels, and may help in intervening in attention and concentration problems. OTs may also prove useful in helping children with Down’s syndrome develop self-care skills and build independence. Many children with Down’s syndrome can develop skills such as toileting, dressing and feeding themselves naturally, however, others can be reluctant to learn. The development of motor skills can enhance self-care, but by identifying what they are struggling with and why, an OT can advise certain routines, equipment or strategies or provide one-to-one sessions to develop the occupation. The OT possibilities with children with Down’s syndrome are endless and the opportunity for occupational development can also grow into the formative teenage years and adulthood, but with early OT intervention, a child with Down’s syndrome can build the foundations for a more independent life.
ust as every child is different, so too is every child with attention deﬁcit hyperactivity disorder (ADHD) in turn meaning OTs need to ﬁnd different interventions to help support and develop each child. Children with ADHD may need support to improve their organisation, coordination and in controlling their energy levels and one method that lends itself well in many cases is sport. Sport as an occupation brings several eneﬁts to your clients and their families, but certain sports can be invaluable in helping a child live with their condition and learn how to control and channel their energy and enthusiasm in their daily lives. So here are The OT Magazine’s recommendations:
g n i m m Swi Not only an important life skill, swimming can introduce a variety of opportunities and environments that children with ADHD can thrive in. Bustling, warm and noisy enough to engage a youngster, the pool is an ideal environment for a child with ADHD. After initial excitement, the calming and soothing blue of the pool can help calm nervous energy or excitement. A safe release for bounds of energy, the pool offers many sensory possibilities and can act as a mood improving, stress relieving and relaxing space. The parameters found in the pool may be effective also. The presence of lanes and the need to keep to them may help your client develop greater concentration, focus and discipline while undertaking an enjoyable activity and increasing understanding of spatial awareness.
alone to get from one end to another can remove that rigorous regulatory element, cause less distress and hold attention, while providing a positive situation in which to to channel their energies into. While eliminating the need for structured competition or rules, swimming can still provide a routine as structured, rigorous or guided as the child would like or need, and still lead to a competitive sporting career. A routine will help a child learn the skill of swimming or how to control their energy at their own pace and build
For some children with ADHD, trying to understand game concepts, strategies and rules can be a little too much and result in attention being lost. Swimming for you and you
What are the best activities for kids with ADHD?
concentration, discipline and interest in achieving milestones from sticking with something and the lack of physical contact may be appealing due to the individual nature of swimming. espite the ehavioural eneﬁts rought on from the discipline developed, many other skills can be built through swimming. Gross motor skills will be called into action while in the water as it requires organisation, time management and encourages planning. The whole technique of swimming brings about sequencing in the movement of the stroke. From the stretching arm through the water to the breath to the kick, swimming’s sequence may prove valuable for children with ADHD. The structure of swimming will also encourage prioritising, working memory, sustaining attention, inhibiting and a wider attention span. The most decorated Olympian ever, Michael Phelps found himself in the pool at a young age in a bid to cope with his ADHD. So, why not recommend it to your clients?
Martial Arts Another positive outlet for energy is martial arts. Complex movements and sequences in martial arts utilise and build the neutral networks in the brain and allow children with ADHD to practice respect, discipline and self-control. While martial arts are often taught to provide children with selfdefence and control the eneﬁts run deeper for children with ADHD. It develops strength and coordination in movements, while placing the focus on personal growth, rather than comparisons with other children’s progress. Kids often don’t have the chance to be distracted in martial arts classes thanks to the constant nature of the lessons through step by step instruction and great attention to the participants is paid by the leader. Lessons in accepting daily routine and respect can also be found in the rituals these classes practice, such as bowing to instructors.
g n i l t s e r W Wrestling is a sport that allows children to release any pent up or misguided aggression or boundless energy in a safe, positive and fun way. This acts as more than a sport for children with serving also as a conﬁdence uilder. Developing conditioning, balance and skill, wrestling is suitable for children of all shapes and sizes and no real experience or skill is necessarily required. The shorter matches and individual nature keep children Other sports suitable for engaged and wrestling also provides the same discipline and kids with ADHD are: control learned in swimming tennis, horse riding, football, and martial arts. rugby, gymnastics, track and cross country.
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All the latest kids products on the market
Kids Product Focus
As part of our Paediatrics Section, we take a look at the products on the market that can help improve the lives of your younger patients.
Privacy Partition Help children concentrate at home and school with this cardboard partition that offers a distraction-free environment and privacy. deally used only at speciďŹ c times, this partition should allow a child to remove themselves from the situation and focus solely on the task in hand. The plain design provides a calming presence and does not serve as a distraction itself. Selfstanding, the tri-fold design allows for quick and easy set up and storage.
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Sip ‘n’ Sound Straws Bring the farmyard indoors with the new Sip ‘n’ Sound Straws. These cute straws liven up meal times with lifelike animal noises. The reusable straws burst into life with sound as liquid passes through them. Children aged three and above can choose from four different animals a ﬂuffy sheep a pig thats clearly had too much fun in the mud, a horse chomping on his lunchtime carrot or a moo-tastic cow. Each straw uses batteries making the hours of fun endless and after snack time children can remove the animal from the straw for continued play. The Sip ‘n’ Sound straw is a great way to encourage kids to drink healthier drinks and dentists say there are health eneﬁts to drinking through a straw too, including stain protection, reduced exposure to ﬁzzy drinks that could cause cavities and even protection against sensitivity.
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Smirthwaite’s new stander - Chi-Chi The colourful Chi-Chi stander with a panda designs is an entry-level vertical stander designed for children around six to 12 years (guide only), designed for children who require low to moderate levels of support whilst weight bearing. Chi-Chi is slim line, easy to use and manoeuvre and will ﬁt well in many environments allowing your child to perform activities without feeling isolated. Chi-Chi has numerous adjustability in the soft and comfortable knee supports, chest and pelvic bands. The sandals can also be adjusted to be either closer together or further apart depending on your child’s needs. Another feature of the Chi-Chi is the tray which can be tilted and also removed allowing for easy cleaning, or for activities such as sensory wall play.
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Twist and lock wooden blocks Suitable for children with autism, ADHD or other sensory or concentration conditions, these twisting and locking blocks are a fun and addictive toy with a calming element. Strung together by the elastic string, children can shape the blocks however they like and calm and distract themselves from anything causing distress. The bright colours also add a secondary sensory component and a sense of fun.
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oraNurse Unflavoured Toothpaste ora urse is an unﬂavoured toothpaste specially formulated for people sensitive to strong ﬂavours. t doesn t foam thanks to its lack of sodium lauryl sulphate. eveloped for children and adults with autism or spergers syndrome and other learning difﬁculties and those who do not like the taste of mint some children with learning difﬁculties also associate mint with a ‘ urning sensation. ormulas have een developed for children and adults.
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oraNurse Fingertip Toothbrush hildren with sensory processing disorders and other sensory disa ilities may ﬁnd rushing their teeth with this soft silicone ﬁngertip tooth rush far easier and more comforta le. oung teeth and gums can e tender and require gentler care and this ﬁnger rush is made from super soft class silicone and is safe non to ic odourless tasteless late free and free. t is easily cleaned in the dishwasher or using sterilising ﬂuid.
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G N I M CO SOON
The benefits of using correct seating for people living with Huntington’s disease Huntington’s disease (HD) was first written about by George Huntington, a practicing GP working in New England in 1872. Originally a European disease, it was spread around the world by European sailors and travellers. But how can appropriate seating help?
t is a genetic disease with people carrying the gene having a 50% chance of passing it onto their children. A brief review of the number of patients cared for by the Huntington Disease Association in the UK indicated that approximately 6,700 individuals are currently living with HD. This means that 12.4 per 100,000 persons or one out of every 8,065 individuals may be affected by HD15, although these numbers at best provide a minimum prevalence estimate in the UK. Mike Wooldridge’s passion is working with people with HD and he has an enormous amount of knowledge in disease with over 30 years experience. Mike is also a member of the European Huntington’s Disease Network as he explains: “I started working in large mental institutions in and the ﬁrst person met with Huntington’s was a woman in her 40s. “As I walked around the building and came to the room where she was the person showing me round said: ‘pay no attention to her she’s got Huntington’s, there’s no hope for her, she knows nothing about what’s going on so don’t trouble yourself’. I was
new to nursing and I could not believe that a human being would have no understanding of what was going on. This experience made me want to e plore the disease and ﬁnd out what help and support could be provided to maximise the quality of life of patients with Huntington’s. Healthcare wasn’t like it is today and
In the mid-70s people started looking at solutions that might help people with Huntington’s and one of the first things they looked at were chairs... we didn’t have any equipment that supported people with different care needs. In the mid-70s people started looking at solutions that might help people with untington s and one of the ﬁrst things they looked at were chairs that would accommodate their individual needs. People with HD have strong involuntary movements and a suitable robust chair was needed that would stop them sliding down or falling out.
Hospitals in the ‘70s used to put them in what were called geriatric chairs which were big chairs that had a table on the front screwed into place, the idea being people would not fall out as the table would prevent this. However, they would just slide down under the table. You could also tilt the chairs back as another way of trying to keep them safe but that didn’t deter them, if they were determined to get out, they would”. Over the intervening years, Mike has seen various new developments in seating solutions and has recently been working with specialist seating company Repose Furniture and its resident occupational therapist Kate Sheehan in the development of the Harlem Porter Chair which Mike believes to be one of the best seating solutions he has seen for people with Huntington’s. “To have input from someone with Mike’s knowledge and experience is invaluable to us as a manufacturer and I know our customers will eneﬁt from this when they see the Harlem Porter chair for themselves,” commented Lisa Wardley, Repose’s managing director. Kate Sheehan explains how she
CHAIRS worked with Repose and Mike and what should be considered when looking for suitable seating for someone living with HD: “When I joined Repose, the initial design work on the Harlem had taken place. I reviewed it with Helena from Repose and suggested some alterations to ensure the chair’s frame was structurally robust enough to take the involuntary movements associated with Huntington’s and provide the necessary levels of support. A demo model was then taken to Mike at Rapkyns Care Home in Sussex to gather feedback from him and his staff with regards to how the patients found the chair in terms of comfort and practicality.
What should be taken into consideration when designing furniture for someone with Huntington’s disease? “The involuntary movements associated with HD can be extremely powerful despite the patient appearing frail, and their constant movement puts a huge amount of pressure and wear and tear on all parts of the chair. There are also issues with pressure sores from force and friction. The constant movement back and forth and repositioning means that someone with HD might need up to 5000 calories a day just to maintain body weight due to the constant movement to give you an idea of their strength and how much they are moving. Weight loss can be signiﬁcant which puts the client at greater risk of pressure related issues. “It is extremely important to provide people with HD with the correct level of support around the head, neck and body to prevent them getting into positions which do not support good posture. There are also issues regarding manual handling as when they stand up they will not necessarily follow exact instructions due to
their involuntary movements. All these concerns were taken into consideration during the design of the Harlem. For example, reinforcing the footrest was to ensure it could withstand somebody standing on it without it moving. The original structure of the chair was also reinforced so when someone moves
eventually wear out the fabric, so we designed each part to be easily replaceable if required. “It is also important that carers can move the patient whilst they are still sitting in the chair from one room to another to enable them to engage in as many activities as possible, so the Harlem has been designed to be extremely manoeuvrable. “We also adjusted the seat width and depth to make it slightly longer with longer arms to accommodate movements, as people tend to slide forwards, so it was about allowing that movement without causing extra pressure on the body. It was very much a compromise between what you can achieve whilst still producing a chair that is aesthetically pleasing as HD is such a complex condition. There is nothing else like it on the market”
Helena Greaves from Repose (left) with Mike Wooldridge
in an unusual way they would still receive the core support from the chair with their body shape maintaining a good position. Another factor we took into consideration was maintenance costs. People with HD put an incredible amount of stress on furniture. For example, if someone continually puts their leg over the arm of the chair it will
ﬁnal word from ike have worked with people with HD for over 30 years and I would certainly recommend the Harlem to people who are looking for a seating solution that meets the needs of someone living with the disease”. Available in small, medium and large, the Harlem Porter has a maximum user weight of 20 stone. Standard features include an independent back rest recline with a range of angles and seat angle adjustment to reduce the risk of a patient falling out due to severe involuntary movements. There is also a deep padded seat area for additional safety and comfort, a choice of six interchangeable back styles facilitating different pressure management and posture solutions and four different seat cushion options to accommodate different comfort and pressure management solutions. Further safety features include high arms and a sliding padded footplate for ease of patient movement.
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Older people & alcohol: The elephant in the room The growing prevalence of alcohol-related health problems in older adults has prompted a study which has highlighted gaps in the knowledge and beliefs of occupational therapists working in physical health care settings.
he research,* led by Dr Fiona Maclean, senior lecturer at Queen Margaret University in Edinburgh, found evidence of a belief in OTs’ role when considering alcohol and older people in physical health care settings and suggests that therapists in this area tend not to consistently refer to occupationfocused theory. As well as documenting the beliefs of OTs relating to alcohol use and older people in a physical health care setting, the research aims to record the theory and assessment skills used by OTs working with older adults to support practice and understanding of issues associated with alcohol. The harmful use of alcohol is a global problem, resulting in 2.5 million deaths each year. In Europe, harmful drinking is the second leading risk factor for premature mortality,
disability and loss of health and in the UK, it is widely acknowledged that physical harm related to alcohol has increased over the last three decades. In comparison to the rest of the UK, Scotland has a particularly unbalanced relationship with alcohol with adult sales of alcohol north of the border up to 21% higher than in England and ales over the past ﬁve years. While older people generally drink less than younger generations, the prevalence of alcohol-related problems in older people is increasing due to the ageing population and changing patterns in alcohol consumption. In Scotland, approximately one in four alcohol-related discharges from hospital between 2006/7 and
2010/11 involved an elderly patient. While examining trends in hospital admissions for older people with mental and behavioural disorders, secondary to the use of alcohol over a 10-year period to 2012, Alcohol Concern detected a 150% increase in admissions among the 60-74 age group. There is growing recognition that the relationship between older people and alcohol needs to e redeﬁned and that there should be an increased role for nursing and allied health professionals in alcohol disorders. Those priorities underpinned one of the ﬁrst pieces of research in the to
Previous research highlights that 20% of men and 10% of women in the UK aged over 65 exceed recommended drinking guidelines...” investigate alcohol-related current knowledge, beliefs, underpinning theory and assessments used by OTs working with older adults in physical care settings in NHS Scotland. Previous research highlights that 20% of men and 10% of women in the UK aged over 65 exceed recommended drinking guidelines and 3% of men and 0.6% of women aged 65-74 are alcohol dependent. Because the normal ageing process can exacerbate the potential for harm and the biological, psychological and social changes accompanying the ageing process can make older people vulnerable to the effects of alcohol misuse, the pattern of alcohol consumption in older adults is of concern. Despite this, academic research has highlighted that a diagnosis of substance misuse in the older population can be missed due to the increased incidence of anxiety, depression, dementing and physical illness, or ageist attitudes and a lack of knowledge and awareness among health professionals. There is evidence that alcohol use disorders in older people related to physical, social and cognitive health challenges and from an occupational perspective, substance misuse in older people has been linked to impaired function, resulting from injury, selfneglect or social isolation. Fiona says there is growing recognition that, as we age, our alcohol intake declines, but there is a tendency among older people to have a drinking pattern in which they drink every day. “The affordability, the availbility of alcohol means that drinking habits
have changed in older people, especially for women. Women have more disposable income and the social acceptance of going to the pub has changed,” she explained. “What we have found in our study is that in hospital settings there was recognition that alcohol misuse was a problem with older people, yet occupational therapists were not tending to ask older people about their alcohol intake. “Tentatively, it might be seen as someone else’s job – for example, the nurse or doctor at time of admission. If someone had a diagnosis of alcohol dependency, they were seen to have an issue and there were other support services that dealt with that.” As part of the occupational therapy initial assessment, 57.4% of respondents stated they would occasionally ask older adults about alcohol intake, 33.6% stated they would never ask and 9% said they would always ask. Continued Dr Maclean: “We are trying to raise awareness and raise the visibility of having this conversation because what you want to say is that older people who are seen in an acute hospital may be developing a problematic relationship with alcohol for the ﬁrst time in their lives. It is everyone’s concern and
should not just be seen from a medical perspective. “OTs practicing with older people in a physical health care setting and especially in the community need to have an understanding and awareness of the potential relationship between older people and alcohol.” She says there is a group of ‘late on-set drinkers’ who begin drinking in later life, often in response to disruption in lifestyle, such as retirement, bereavement, or physical and emotional pain. And the normal transitions we go through in later life can lead to decreased social engagement with others and increasing feelings of isolation and loneliness. For OTs, says Fiona, those transitions could e ﬂags to harmful levels of drinking in an older person. This may mean helping older persons to reconsider their social or family support mechanisms. Fiona argues that the redesign on social and/or family supports should be through empowering and sustaining meaningful occupation that emphasise social interaction with others. “In older age,” continued iona these inﬂuencers in disruption and decrease in social engagement can mean a person can drink more in the house and that can lead to a problematic relationship with alcohol.” Often older people who are seen by an OT do not have a diagnosis of alcohol misuse. Yet, the normal ageing process means that the body is less able to tolerate alcohol, putting an older person at greater risk of alcohol-related harm. “The older you get, the more likely you are to experience chronic and long-term health problems,”
explained Fiona. “And if an older person is drinking every day, how might that react with diverse medication for different conditions?” The Institute of Alcohol Studies suggests that the current generation of older people may be drinking more heavily than previous generations. And due to social acceptance and the fact that people are living longer, they are maintaining that habit throughout their life course. The emerging need to prioritise understanding and professional knowledge of older people and alcohol misuse remains an area that could be strengthened in the profession, insists Dr Maclean. Her current, on-going work explores the relationship between alcohol misuse in older adults and ideas connected to ‘healthfulness as deﬁned and considered by academic supervisor Professor Brendan McCormack, of QMU’s Centre for Person-Centred Practice Research where this work is situated. Maclean accepts this is ambitious, because at present the international literature exploring alcohol misuse and older people in occupational therapy is sparse. The study concludes that there is a lack of educational and continuing professional support to enable the profession to effectively address gaps in knowledge and, by extension, limits a ility to uild professional conﬁdence when working with older people and alcohol. The study identiﬁes a elief that alcohol is an issue when working with older people and the profession has a role in this area, but that role is not supported by undergraduate education. t ﬁnds that occupation focused theory and assessment were not prioritised when considering alcohol and the older adult. The study has also identiﬁed a need to develop pre and post qualiﬁcation education for occupational therapists in order to enhance understanding of theory, assessment and knowledge of this area.
I would feel embarrassed asking patients about their alcohol intake.
People have the right to use alcohol as they wish.
I do not feel I have the appropriate skills to intervene where alcohol is an issue with older people. Agree: 27.9%
My own profession has a role to play in brief interventions when alcohol misuse is suspected in an older adult. Agree: 88.5%
I have the skills and knowledge required to play in brief interventions relating to responsible drinking. Agree: 35.2%
My own undergraduate education prepared me for working with older people who misuse alcohol. Agree: 7.4%
Survey of 122 OTs across 13 participating NHS Boards in Scotland
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A new approach to therapy T
his website is aimed at helping people ﬁnd the right app for their recovery and rehabilitation. The website, which can be accessed at www.my-therappy.co.uk, offers a database of apps that have been tried and tested by a network of expert therapists and patients. The apps also come with a star rating and genuine user feedback. The we site is the ﬁrst of its kind
in the UK and is designed to provide a rehab and recovery resource for patients and clinicians across the country. The project and the website have just been shortlisted for a National Advancing Health Care Award. The project was started by the Stroke and Neurology team from Northern Devon Healthcare Trust in conjunction with their patients. The testing team now forms a national network of NHS Trusts and expert patients who test
NHS specialists and patients have joined forces to launch the s first reely accessible app review website specifically aimed at stroke and brain injury.
the apps using mytherappy’s unique critiquing system. Ruth Siewruk, advanced practitioner occupational therapist for neuro and stroke and clinical lead for the project, said: “We are delighted to launch the mytherappy website and that is being so well received. “We want to empower patients to manage their health in the way that is right for them and this new website helps those who are recovering from
APPS The website is the first of its kind in the UK and is designed to provide a rehab and recovery resource for patients and clinicians across the country. a stroke or brain injury to do exactly that.” The mytherappy team have spent four years developing the project, which was started as a result of the high number of patients asking for advice on which apps can help them. The response to the website has been very positive:
“In love with the fantastic website … recommending it. Great Job!!" (Different Strokes)
“Will make a real difference." (Stroke Association)
“Excellent.” (Headway) NHS clinical specialists in stroke, neurology and head injury review the apps, including occupational therapists, physiotherapists, speech and language therapists, nurses, psychologists and support workers.
Patient app testers include stroke patients who face a variety of difﬁculties with which the different apps can help with. ach app comes with a proﬁle which includes information to help the patient, family member or clinician decide if it suits the needs of the patient. This includes cost, clinician rating, user rating, app description, feedback from users and a named category that shows what the app can help with. The different categories are thinking, communication, arms and ﬁngers vision my mood eating and drinking, doing things, being active, relaxing, pain and got questions, a category that groups together information apps.
Academic Health Science Network. Following demand from the therapy community the mytherappy team will also be running a one day workshop on using apps and digital health for rehab in May 2017. You can book your place by contacting them at email@example.com Visit the website at www.my-therappy.co.uk
Find the best app for your client
ach apps proﬁle also includes links to the App Store and Google Play so that users can easily download the app to their device. The website has been launched with funding from the Trust and from the
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Moving & Handling Who really cares?
The only conference of its type Don’t miss out on the most important CPD moving and handling event of the year. The role of National Back Exchange NBE is to promote excellence in all aspects of moving and handling in order to reduce potential injury to patients, staff and carers. The Conference brings together an inﬂuential group of people and visitors to learn, debate, network and reﬂect and is the T TT key event in the oving and Handling calendar. It is an excellent opportunity to meet within a multidisciplinary environment, with those working to promote the health, safety and welfare of staff and patients.
Put the dates in your diary NOW
This includes moving and handling advisors, ergonomists, academics, therapists, nurses, occupational advisors, social care and industry, all in one venue. The Conference and Exhibition will feature strategic plenary lectures, practical workshops, streamed presentations, equipment evaluation workshops and exhibitor interactive workshops. The exhibition affords delegates the opportunity to have a ‘hands on’ experience of all the latest moving and handling equipment.
For further details and booking forms email firstname.lastname@example.org or call 01327 358855
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A hands-on resource
Can a multimedia online resource reduce practical skills training to safely update manual handling skills?
he safe moving and handling of people is a practical skill that is used throughout health and social care, with occupational therapists often being called upon for complex assessments in community and acute settings. The recent economic downturn has resulted in the mandatory training in people handling skills, often considered a drain on resources, being reduced to save money. Rather than the recommended annual updates or refresher training, recent requirements are more in line with an update every two or three years with this training often lacking standardisation in frequency, quality or duration. Training has often been delivered in an adhoc and unstructured manner with techniques failing to transfer from the classroom environment into the workplace. Training with undergraduate occupational therapy students, feedback from both placement educators and students themselves reinforced this. tudents lack conﬁdence and educators comment that students on placement simply do not have the skills to assist competently with safe moving and handling. Lack of skills and any resulting failures during handling tasks can have life changing effects on employees, those being handled and the organisations in which they work. Considering the limitations of traditional hands-on training, what is the solution? Various e-learning packages are available and a multitude of videos can be found on YouTube. However, the quality of these can be questionable. Competency assessment is a model currently being used in Scotland, following traditional induction training. Competency is described as having the knowledge, experience, skills and ability to apply these to perform a task safely. A study on online training and risk management systems identiﬁed a signiﬁcant increase in skill level safety and levels of conﬁdence in a student cohort across three years of
their undergraduate studies. These ﬁndings led to a signiﬁcant change in the style of teaching of practical skills, removal of yearly practical sessions/refresher training which was replaced with access to the online multimedia system from A1 Risk Solutions. This is not simply an ‘e-learning system’, it provides a blended approach to learning and the use of the system monitors skills development using a competency training approach. This saves direct staff to student time whilst improving skills, reduces manual handling
This is not simply an ‘e-learning system’, it provides a blended approach to learning and the use of the system monitors skills development errors and increases levels of safety. A follow up longitudinal study continues to explore the impact on errors, skills and risks when using a classroom-based competency model combined with the use of an online system, replacing traditional yearly ‘refresher’ training, and to date is demonstrating very encouraging and signiﬁcant results. As a previous advocate of ‘hands on’ skills development, this change in practice challenged my beliefs. The longitudinal study is half-way through and results have been amazing with students accessing the system regularly, without prompting. Skills have improved along with levels of conﬁdence and safety with a marked reduction in student anxieties, particularly in the weeks prior to placement. The application of the online learning system could go somewhere to bridging the gap between traditional training and
often poor engagement with mandatory update sessions. A combination of access to the system to complete tests and quizzes, reﬂecting on set pro lems or particular hot topics within a work environment offer an alternative and often more engaging approach to . The system is ﬂuid and is continually updated. Staff engagement is easily tracked and provides evidence of access to safe techniques, this could be useful if any incidences need investigation. It helps identify which staff are not engaging with the system who may need additional prompts to demonstrate their level of competency. Rather than ticking the box for mandatory training attendance every two or three years, this system offers support whenever the member of staff needs it, acting as an aide memoire to encourage safe application of skills, support clinical reasoning and providing an evidence based, 24/7 multimedia risk assessment tool encouraging active engagement and regular skills updates for a full range of healthcare practitioners. Why look anywhere else when a complete system has been created to support a range of needs and ensure safe moving and handling across a range of providers and care environments?
Jo Webb is senior lecturer and co-ordinator of moving and handling training. Working with OT undergraduates, she debates how well e-learning can be put into practice over traditional methods.
Sensory integration: A new approach to mental healthcare
When OT Ruth Vickerstaff signed up for the SI Modular Pathway Master programme, she never dreamt she would be able to bring about fundamental changes in mental healthcare.
ut seven years into her training, with the last two years at Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), SI is now a consideration of care-giving to her patients and at the centre of future plans at the Trust. To those occupational therapists involved with Ayres’ Sensory Integration (ASI) the impact of its interventions on mental health are widely known. However, within the wider healthcare environment, SI is a relatively unknown approach. Having recently achieved Advanced Practitioner status through CPFT, Ruth has now introduced, and is in the process of embedding, SI into the Adult Directorate. The SI approach centres on the understanding that the wrong sensory input or problems with integration, disrupts their ability to function. Conversely, creating the right sensory environments and supporting patients to
get their sensory needs met appropriately, means they are able to engage with their occupational performance components more effectively. In an inpatient setting, the difﬁculties that service users could e perience include ﬁnding the right sensory input or needing to minimise sensory information to avoid sensory overload. This is particularly helpful in a mental health setting as patients can become easily overwhelmed and SI works to reduce these stress indicators. As with any healthcare giving body, it was important to have buy-in from key parts of the Adult Directorate including the Medical Director and Lead Allied Health Professional. Ruth was part of the Working Party to secure funding to train 100 MDT staff which was delivered by the SI Network. The training was delivered twice in the same week (Monday, Tuesday, Wednesday and Thursday) to 50 people per workshop.
Sensory Integration Training As a direct result of their Sensory Integration training, CPFT now offer:
• Specialist assessment and intervention for people with identiﬁed sensory integration difﬁculties who have high need or are considered high risk y the T. They provide very specialised and goal driven individualised intervention and sensory care plans for these clients.
The training was attended y psychiatrists senior nurses ward managers clinical nurse specialists staff nurses health care assistants physiotherapists psychologists and occupational therapists and two peer support workers. These staff came from across si different wards including the adult and adolescent inpatient services. said uth year later there are several fantastic results to share. The dult irectorate has appointed an dvanced pecialist ccupational Therapist to take a lead on developing a sensory integration service within the adult mental health service. The post will e a le to highlight the value of sensory integration to inform care delivery at every level from sensory friendly wards and development of personalised sensory self regulation strategies to highly specialised assessment and treatment for adolescents and adults with sensory integration and mental health
difﬁculties. s for the future uth is enthusiastic a out the role of in ental ealth. There are so many possi ilities and interest and demand is ever growing. rom having conversations in corridors, to requests to deliver awareness training in other areas such as older adults mental health forensic and referrals from the community teams for formal assessments there are certainly more areas across the trust where sensory integration services would e eneﬁcial. The multi disciplinary approach is key and the results speak for themselves. f you are interested to ﬁnd out more a out ensory ntegration in general or speciﬁc to mental health setting please visit www.sensoryintegration. org.uk. ou can also follow the link elow to ecome a mem er of the etwork free of charge and access a li rary of related resources and training courses. www. sensoryintegration.org.uk/join
• oth the inpatient female personality disorder service where the average length of stay is 9-12 months, and the adolescent services, have a sensory room and run weekly ‘ plore y enses groups. They offer sessions focusing on developing personalised self regulation plans which clearly reﬂect each individual client s sensory preferences promoting the development of more effective and proactive coping strategies during times of distress. • ensory ased strategies are eing used alongside and in conjunction with talking therapy on the female personality disorder service to help get clients ‘talking therapy ready with sensory coping skills em edded efore they address the trauma associated with this diagnosis in their T sessions. •
ithin the inpatient service they are developing sensory rooms for the treatment and recovery wards these sensory safe spaces can e accessed y the ward staff to support patients. They will have ean ags swiss alls and other sensory self soothe equipment availa le hours a day following a risk assessment.
• n other wards where space is limited they are utilising multipurpose rooms in the same way adding sensory cup oards that patients and staff can again access . • They also offer or weekly ward ased ‘ plore my enses roups on the cute Treatment and ecovery wards the adapted programme for will follow soon. • uth runs ensory ircuit sessions weekly in the sports hall with the odule trained T emma arker. • They have introduced a wake up programme of vesti ular ased activities on the ecovery ard these happen every morning. • They are developing a ensory trategies course for delivery to discharged clients who attend afﬁliated ecovery olleges. The ecovery ollege allows people to access information informally preparing people to return to meaningful activities and daily living learning new ways of thinking and skills to aid their recovery.
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Summer Break Student Advice
What are you doing on yours?
You’re probably slogging away at those final ut assignments b n be oo summer will s lenkin B upon us. Dawn you lk is on hand to ta the g through makin mer um most of your s break.
re you dreaming of the summer holidays… hanging on in there with gritted teeth whilst you meet those ﬁnal assessment deadlines any c (Hons) programmes can have lengthy breaks over the summer period. You may have arranged a holiday away but have you thought about what else you may do t s a great chance to catch up with friends and family, or catch up on all those rainy day jo s you ve een putting off. Whilst recharging yourself and your bank account with a summer jo it s wise to consider how you can use any excess time to advance your career. Proactive students often ask what would be useful to do in the summer holidays… these are the three pieces of advice give them. nd ﬁnally the secret to ﬁtting it all in well it s planning of course Tweet me with what you are doing in the holidays T . As the Americans would say- ‘Happy olidays all If you are a student who would like some advice send your questions to firstname.lastname@example.org
Consolidat e your knowledge The ﬁrst thin g
is to consolid knowledge ate from the prev ious year s study. Go th rough your le arning mater and highlight ials anything yo u don t fully understand. A bit of extr a reading no will pay divi w dends later. f you re stuc then drop th k e tutor an em ail or make appointmen an t to see them .
Secondly, if after all that you still have time to spare, then some preparatory reading for the next term s will give you a great head start. Focu heck ules. mod s term rst ﬁ on the s the reading list. What are the topic ant relev any een there as covered research pu lished on t forget to al keep up to date with your profession the body. Have a good browse through College of Occupational Therapists website www.cot.co.uk The wealth of information available may feel overwhelming but why not start with the hot topics and see where your reading takes you inally keep yourself up to date with the current to news and developments in relation eing s hat care. l socia and health ny de ated in parliament right now you that s eline guid ted upda new or need to read ll this will equip you for professional discussions when you return to university for your next academic year.
Thirdly, summer is a great time to get involved in new things or spend more time on hobb ies. We often underestimate the richness that skills gained through hobbies can bring to us as occupational therapists . We work with such a diverse range of people, having a broad spectrum of experiences helps us connect with different groups and individuals. There are always opportunities to get involved in different activities what opportunities do you have locally ave you thought a out volunteering Depending on other commitments and responsibilities it can feel hard to ﬁt it in especially for students with young families. f you re in this situation, are your children involved in any local clu s s this an opportuni ty to get involved ome of my students have volunteered overseas through organised programmes. There are so many eneﬁts to your personal and professional development to be gained. This is a great experience and one would highly recommend if you have the ﬁnances and time to e involved. Getting involved in groups and organisations on a personal level will provide a variety of opportunities. ou might gain conﬁdence learn new skills, take on new challenges, have fun and be part of a different community. All of this will add a richness to you as an individualsomething very much valued in our profession.
MA, SFHEA, PGCE LTHE, BSc (Hons) Occupational Therapy
Dawn is a senior lecturer at Teesside University. She also holds external roles as a specialist advisor to the CQC and is a visitor who inspects educational programmes on behalf of the HCPC.
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What are the barriers to singlehanded care?
Single-handed care has been around for many years. It has been given any na es and its results and benefits are well known. However, many authorities have yet to adopt this change in strategy.
survey in 2016 of 15 key stakeholders explored the source of the resistance as well as key themes – an exercise that proved key to developing a face-to-face training programme and an online system by A1 Risk Solutions Ltd. The standards of manual-handling training across care agencies is often considered poor and calls for the adoption of a system with the potential to drive up the standards across local authorities, as well as reducing the resistance from care agencies. Each council pays for the tailoring of the system and then the system is offered to each of the care agencies as an effective and research-based system by providing the ongoing support and acting as an aide memoire when they have forgotten part of the training or the assessment. The themes, concerns and possible solutions highlighted by the survey include collaboration and communication, education and training, and ongoing guidance and support. 4,585 respondents from 15 groups took part in the survey which posed 23 questions. Supplementary to the questionnaire people were asked to list positives, concerns and suggestions for singlecarer handling. Thematic analysis was used to analyse this rich qualitative data. For example, when asked if singlehanded care is against the law, the survey found that most moving and handling professionals and occupational therapists were aware of the legality of single-handed care. Many of the care staff felt it was against the law, suggesting they could be the driving force behind the barriers.
Breaking down the barriers to singlehanded care
The study also found that most OTs and moving and handling professionals felt conﬁdent with their skills and a ility to assess and implement single-handed care packages. However, 31.3% of professionals would not feel conﬁdent assessing or implementing singlehanded care packages. did not feel conﬁdent with their own skills and using the equipment in this area. The qualitative data that was collected also identiﬁed that many occupational therapists, manualhandling professionals and their head of department were concerned about the lack of conﬁdence and skills to assess complex cases and demonstrate to care staff. In conclusion, the majority of respondents felt conﬁdent in their ability to counter challenges when implementing single-handed care packages. This still left a 35.5% shortfall of moving and handling professionals and occupational
therapists who disagreed or were uncertain that they feel conﬁdent. Most moving and handling advisers and occupational therapists acknowledged they would struggle to remember a new technique or how to use equipment after training. This was reﬂected within the qualitative data. The study concluded that face-toface training exploring the barriers and change management process, combined with practical training and an online approach across councils’ associated key stakeholders is the most successful approach to use.
ontact 1 isk to book onto dvanced anual Handling and ingle Handed are evel award accredited by o P ualifications via ad in a1risksolutions.co.uk or www.a1risksolutions.co.uk.
Recruitment & Training
UCLH Bank are currently recruiting Occupational Therapists What do you get by registering with the Bank? UCLH Bank offer Occupational Therapists a variety of opportunities across London to gain experience in your specialism while receiving competitive pay rates. Specialisms include: – Neurology and Neuro rehab, – Rheumatology inflammatory, – Oncology and Haematology, – Orthopaedics, – Care of the Elderly, – Acute Medicine, – Paediatrics and many more! Whether it’s flexible shifts or long term placements you’re looking for we can be sure to find something that suits you. Contact our recruitment team or visit our website to begin working with one of the country’s leading NHS Trusts committed to delivering top-quality patient care.
0207 959 1136
Housing Adaptation Courses • Reading & Using Plans • Ramps • Accessible Kitchens • Bathroom Adaptations
• Adapting for Children With Challenging Behaviour
• Adapting & Designing for Wheelchair Users
• Disabled Facilities Grants
And much more…….
Internships Lynsey Robertson-Flannigan
Internships have been widely used across business and industry to provide either graduates or students with the opportunity to undertake paid or unpaid work experience that matches the intern’s career aspirations and/or their own areas of interest.
he advantages for interns can include enhanced employability, gaining experience in a particular area that matches their preferred career path. The Division of Occupational Therapy and Arts Therapies at Queen Margaret University (QMU) launched its highly successful internship programme in 2013 in partnership with Alzheimer Scotland and Santander Universities UK. Here, we speak to Lynsey RobertsonFlannigan, who graduated from QMU with a BSc (Hons) Occupational Therapy degree in July last year – and two weeks later, gave birth to son, Teddy. Lynsey is the co-founder of the QMU Occupational Therapy Society, which she helped set up in 2014 to bring together occupational therapy students from different levels of study and offer each other support, advice and opportunities to socialise. In 2015, she secured an internship with Alzheimer Scotland as part of the Santander Universities SME Internship Programme. This summer, she starts a part-time summer internship with Alzheimer Scotland and QMU while working part-time as an OT assistant in stroke and medicine of the elderly.
How did you come to choose this course and why QMU? “I applied and was accepted to study occupational therapy at QMU straight from school, but for a number of reasons did not feel ready. I completed a business degree, then spent four years working in sales and latterly as a personal assistant in Malta for Billy Connolly’s management company, Tickety-Boo. “My grandmother is a retired occupational
therapist and has always been a massive inspiration to me. When my husband and I moved back from Malta in 2012, I had lengthy discussions with her and OT professionals and decided that OT was the career I wanted to pursue. “After some investigation, I knew that QMU was the only choice of university for me, given its location in a wonderful city, fantastic reputation and supportive approach to teaching. “The amount of innovation within the university really stood out – for example, the occupational performance room where students can practice their OT interventions in a realistic setting with real equipment.”
What was the highlight of the course? “The highlight of my time completing my occupational therapy degree was being given the opportunity to present the work I had been involved in during my internship at the College of Occupational Therapists Annual Conference in June 2016. “It was a real privilege to represent Alzheimer Scotland and QMU at such a well-respected and established event, and being able to share details about the internship, as well as the work of the fantastic Scottish Dementia Working Group to a wider audience was wonderful.”
How has the internship with Alzheimer Scotland helped your studies? “I learned so much and gained more than I could ever have hoped for. I learned a great deal about how the role of occupational therapy ﬁts into a ‘non
traditional’ setting such as Alzheimer Scotland and what we can do to help people with dementia to live well and independently. “As a result of my time as an intern, I have a deeper understanding of occupational therapy, the issues that people living with dementia face and the valuable work that Alzheimer Scotland does.”
Do you have any advice for students interested in studying occupational therapy at QMU? “Occupational therapy is a fantastic, varied career that gives you the skills to improve the lives of the people who you work with as a qualiﬁed professional. The course at QMU is, in my opinion, second to none. The teaching staff are enthusiastic, supportive and generally brilliant all round and QMU is a fantastic university.”
What’s your ‘top tip’ for making the most of being a student? “Enjoy it, as it is over before you know it! Don’t get too caught up in being stressed about assignments and try and focus on how much you are learning.” www.qmu.ac.uk/alumni_and_ friends/Santander_Internship_ Programme.htm www.alzscot.org
Find events for you
What’s On in the OT Calendar
16-18 May 2017
19-20 June 2017
Kidz Exhibitions in 2017
Housing Adaptation & Design: Parts 1-3
All Kidz exhibitions run from 9.30am – 4.30pm. The Kidz to Adultz exhibitions from Disabled Living take place across the country, dedicated to children with disabilities and special needs, their parents, carers and professionals who work with them. Over 130 exhibitors offer information on mobility, funding, seating, beds, communication, access, education, toys and much more. A full programme of CPD seminars run alongside each exhibition. For more information about each of these events call 0161 607 8200 or visit www.disabledliving.co.uk/Kidz/Welcome.
• Kidz to Adultz South: 8 June, Rivermead Leisure omple ichﬁeld Avenue, Reading • Kidz to Adultz Scotland: 14 September, Highland Hall, Royal Highland Centre, Edinburgh • Kidz to Adultz North: 16 November, EventCity, Manchester
The National Union of Teachers, London
E xc i t i n g p r o g r a m m e of H o u s i n g Adaptation & Design courses from Viva Access Ltd. Courses run from 10am -4.45pm and take place in an accessible and centrally located venue in Kings Cross, London. An array of housing topics are covered, including reading and using plans, bathroom adaptation and design, ramps, accessible lifts, adapting for children with challenging behaviours, accessible kitchens, and technical issues associated with adaptation work. More info at www.viva-access.com
Oportunity to meet peers and to hear from influential health and social care policy makers, interact with the foremost occupational therapy thinkers and practitioners, and contribute towards the discussions on the future direction of the profession and to explore new and different ways to develop occupational therapy practice. www.cotannualconference.org.uk
17-19 July 2017
Posture & Mobility Group Conference Motorpoint Arena, Cardiff
European Neuro Convention ExCel, London
The event for professionals, researchers, clinicians, surgeons and their teams working in the neuro field. Europe’s largest event of its kind will bring together neuro professionals from around the globe for an exciting two-day show in London. Free to attend. For more information, please visit www.neuroconvention.com.
17-18 May 2017
The OT Practice Conference & Exhibition
An educational programme, industry exhibition and networking opportunities for professionals. The event focuses on the posture and mobility needs of wheelchair users. To sign up for the event and for further information visit www.pmguk.co.uk.
7 September 2017
RISE4Disability Kent Event Centre, Maidstone
Brought to you by Made2Aid, this is the combined conference and exhibition for health professionals and disabled people to resource and identify suitable equipment. Free to attend and is also CPD accredited for healthcare professionals. Further information is available at www.rise4disability.co.uk
Old Thorns Estate, Liphook, Hampshire U n i q u e eve n t b r i n g i n g to g e t h e r inspirational speakers, bespoke training opportunities and innovative product demonstrations dedicated to the needs of independent occupational therapists. If you would like to ﬁnd out more or ook please email email@example.com or call 0330 024 9910. 80
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hank you for taking the time to read The OT Magazine, we hope you have enjoyed it. We are striving to produce a magazine that provides OTs with a use ul resource filled with relevant in or ation, interesting articles, innovative products and thoughts and opinions from OTs themselves. We would love to hear your thoughts on The OT Magazine to ensure we are producing a publication that you want to read.
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