The OT Magazine – Nov / Dec 2019

THE

MAGAZINE Issue 31 | Nov/Dec 19 | Improving Independence

A Space Odyssey What is the Astronaut Training protocol?

LEGO THE RAP Y The building blocks of a brilliant intervention

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COLUM N S

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PRO DUC T S

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CPD

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EVENTS

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MENTAL HEALTH

About us

The Team

Editor: Rosalind Tulloch Staff Writers: Colette Carr and Katie Campbell Designer: Fionnlagh Ballantine Production: Donna Deakin Sales: Jacqui Smyth Contributors: Kate Sheehan, Suzannah Pegler, Ann Barthorpe

Get in touch

2A Publishing Ltd, Caledonia House, Evanton Dr, Thornliebank Industrial Estate, Glasgow, G46 8JT 0141 465 2960 ot-magazine.co.uk The OT Magazine @ot_magazine

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 2019 © 2A Publishing Limited. All Rights Reserved. ISSN-2056-7146

This month’s issue...

T

he busiest OT event of the year is upon us: The OT Show. We are already getting geared up for the two-day event that will see an estimated 5,000 OTs descend upon the NEC, Birmingham on 27-28 November. You will find us excitedly talking to every OT that passes and giving out sweets at stand G28. Please come and see us to tell us about your work, give us feedback on the magazine or simply steal some sweets!

This is the biggest issue of the year, packed with information and articles on emerging roles of OT, innovative products, self-care and much more. Our cover image highlights a feature in the paediatrics section on occupational therapists in the States who have developed an intervention called the Astronaut Training protocol to help children experiencing problems with their vestibular system. Find out more on page 56.

We explore the benefits of goal setting with patients who have Alzheimer’s disease and we look at the impact of intergenerational living and how it can improve the lives of people young and old.

Dr Camilla Hawkins has worked with patients living with HIV for over 23 years and here she shares her experience of the changes she has witnessed in both her patient’s lives and in her role as an OT. You can read the interview on page 32.

You will also find our regular column from Kate Sheehan, a low-down on everything happening at The OT Show, a guide to surviving the HCPC audit when it comes round again and we hear from a great mix of OTs in different settings too.

We will hopefully see many of you at The OT Show in November, but if you can’t make it there please do get in touch at any time to share your OT story with us, email ros@2apublishing.co.uk.

The OT Magazine, Editor

SUBSCRIBE TODAY Further your career and enhance your CPD by subscribing to The OT Magazine

Subscribe for only £9.99 Go to: ot-magazine.co.uk/subscribe -magazine.co.uk

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What’s inside 07 What’s New

Bringing you up-to-speed with all the latest news from the health sector

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12 Kate Sheehan Columnist Kate asks: should we pay more for specialist seating, or commit to false economy?

15 Being a Goal-Getter Can goal setting help patients with Alzheimer’s disease live more fulfilling lives?

19 Product Focus The latest must-have products on the market

25 Day in the Life Meet Suzannah Pegler, an OT who works as a research practitioner

27 Upstairs,

Downstairs

Stairlifts could be a lifesaver for clients who aren’t yet ready to leave their homes

32 From Hospice to

Hospital

Dr Camilla Hawkins explains how her role has changed as HIV has become better understood

36 Product Focus More of the latest must-have products

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39 Cooking up a Storm The kitchen is the heart of the home, so make sure it’s accessible to all

42 Home Sweet Home An accessible home can be a stylish home, too

45 Intergenerational

Living

Could intergenerational communities solve social issues?

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65 Giving Kids a

Power-Up

Meet the charity bringing the power of play to children’s hospitals

67 Inclusive Sport Sport for Confidence focus on getting everyone active

73 The Occupational

Therapy Show 2019

Are you ready for the biggest OT event of the year?

77 Independent

Practice

Are you considering taking the leap to private practice

79 ’Tis the Season

(For Self-Care)

Take some time off at Christmas for you

82 Take a Seat

Product

Focus

49 Sweet Dreams How can OTs improve the lives – and the sleep – of people with insomnia?

53 Cyber OTs It’s time for occupational therapy to go digital

56 A Space Odyssey What is the Astronaut Training protocol, and how can it help children?

58 Not Quite

Child’s Play

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Paediatric OT Aaron Preston explains the highs and lows of working with children

62 Paediatric Products Innovative products for your younger clients

Kate Sheehan highlights the importance of getting seating right for people living with Parkinson’s disease

85 Raising Profiles “Sorry, what exactly is an OT?” should be a question of the past

87 Myths vs Reality Ann Barthorpe shares her experience of moving from the NHS to case management

93 Events Calendar Essential dates for your diary

94 Are You HCPC

Ready?

Making sure you are prepared to face the HCPC -magazine.co.uk

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Moving & Enabling, Protecting & Saving.

Visit the Handicare professionals at the OT Show and discover how Handicare can help to make everyday life easier by moving & enabling, protecting & saving.

Stand H40

NEW Small Changes, Big Impact CPD module It is often the small changes we make that can significantly contribute to an individuals enablement.

Join Handicare at the OT Show’s Innovation Theatre for a taster workshop.

Visit the new Handicare blog:

www.handicare.co.uk

Small Changes, Big Impact 15 minute Skills Workshops During the OT Show, visit the Handicare stand to learn one small change that could make a big impact, in just 15 minutes.

WIN an Essentials Assessment Bag worth over £580

We’re giving OT Show visitors the opportunity to win an Essentials Assessment Bag each day! Simply visit the Handicare stand during the show to find out how.

We explore what’s happening in the healthcare sector, from new products and services to inspirational stories

What’s new?

DR ANN WILCOCK DIES AFTER LONG ILLNESS Occupational therapists around the world mourned the passing of Dr Ann Wilcock, who was regarded globally as one of the greatest academics and scholars to contribute to the fields of occupational therapy and occupational science. Her 1999 paper Reflections on Doing, Being and Becoming came to be a keystone text in the academic field, and is the most cited paper in the Australian Occupational Therapy Journal.

Born in the UK, Dr Wilcock was raised in the Lake District. She graduated from the Derby School in 1961, where she received her occupational therapy diploma,

before taking the opportunity to become a “Ten Pound Pom” and migrated to Australia in 1964.

In Australia, she would turn her attention to the world of academia, lecturing in occupational sciences and OT. Dr Wilcock was an exemplary figure, who was credited with the introduction of the occupational sciences to Australasia, and in 1992, she founded the Journal of Occupational Science. Her pioneering approach to occupational therapy will continue to inspire new generations of OTs, and her mantra of “do, be, become” will continue to be one of the tenants of occupational therapy.

Baroness Blackwood, the minister for rare disease at the Department of Health and Social Care has announced a national survey which aims to gather the opinions of healthcare professionals and people who live with rare diseases on the major challenges they face, which will influence the framework that makes up the UK Strategy on Rare Disease.

SCOTTISH GOVERNMENT SURVEY ON RARE DISEASES

Jillian Hastings-Ward, chair of the 100,000 Genomes Project participant panel, said: “Patients and their families living with rare conditions are ‘experts by experience’. We frequently have to navigate health, social care, education and other services whilst carrying the burden of health conditions that affect everyday life.

“This survey is a welcome opportunity for everyone in this community to tell the government what we face, and in doing so, to help to identify the key priorities for the framework to follow the UK Strategy on Rare Diseases.”

The survey will run until 29 November 2019.

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CLOSOMAT LAUNCH NEW OT-LED GUIDE Supplier of wash and dry toilets Closomat have launched a new OT-led guide to assist professionals who are involved in the provision of toilet adaptation equipment in both domestic and residential care settings.

The new guidance document Single Handed Care – Toilet Guidance for Professionals applies the personenvironment occupation model in order to help establish how to adapt the bathroom environment, changing it from disabling to enabling. The guide details how to use technology like hoists and wash and dry toilets, and may help to potentially reduce or even eliminate the need for intervention.

Robin Tuffley, Closomat marketing

manager, explains: “On average we go to the toilet eight times a day. It is one of the five key ADL criteria.

Choice of appropriate equipment can make a huge difference in enabling someone to deal with a very intimate activity with little or no help from another person, be it a family member or care worker.

“Our guidance aims at providing an easy-to-use tool for anyone involved in delivery of care packages - in domestic or residential care environments - to get the best practical solution, balancing cost of care and the client’s health and wellbeing.”

Download the guide for free from Closomat’s website: closomat.co.uk

GREAT WESTERN HOSPITAL OPENS NEW SERVICE FOR STROKE PATIENTS Stroke survivors in Swindon will find themselves supported by the newly opened Early Supported Discharge programme, newly opened at Great Western Hospital.

The new service is set to provide intense therapy performed in the patient’s home post-stroke, therefore enabling patients to leave hospital faster. It will be available for patients deemed medically fit, and whose homes have been assessed as appropriate for the therapy. The programme will provide patients with intensive occupational therapy,

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physiotherapy, and speech and language therapy.

Alex Christiansen, therapy lead on the adjacent Forrest ward, told the Swindon Advertiser: “This service will be great as Forest patients will now have daily therapy when they go home.

“Not only will it dramatically improve a patient’s experience, by bringing the care out of hospital and helping to get them home quicker, but it will also really benefit us internally by freeing up beds and improving the flow of patients through the hospital.”

CHARITY RESPONDS TO CQC ANNUAL REPORT Mark Ospedale, director of corporate services at United Response, has commended the recently released Care Quality Commission’s annual report but notes that while the care sector should celebrate its achievements, it should not be ignored that vulnerable people are still unable to receive imperative care.

“This year’s CQC State of Care report rightly highlights overall good quality care across the sector despite significant challenges over the past year. But these achievements should not mask the fact that far too

many vulnerable people are still not receiving the care they need nor getting it in time.

“The CQC is correct to this year focus on learning disability services and highlight the critical role of local and community-based care, the absence of which can lead to devastating and lasting consequences. At United Response, we are showing the clear value of providing tailored support to people in the communities in which they belong.

“Without the right support at the

OTs brighten up Basildon hospital An occupational therapy team have given Basildon Mental Health Unit a new lease of life after encouraging patients to engage with art therapy which everyone can enjoy.

The installation of five colourful paintings in the courtyard of the hospital has brought some positivity to the hospital’s outdoor space. The OT team encouraged patients to engage with the art project in an effort to boost morale and selfesteem.

Clinical lead Jacqui Sullivan told the Basildon Convey and Southend Echo: “This art project has served so many functions.

“Not only has it much improved the

right time, vulnerable people across the country are put at real risk of needing immediate and costly intervention. Aside from obvious damage to the individual, this places even greater financial strain on an already beleaguered system.”

The United Response director expressed concerns “around the prevalence of outdated and institutionalised hospital care settings for people with learning disabilities or autism,” and acknowledged the issues of staffing and skills within the care sector.

Looking for an OT job? outdoor environment we are able to offer, it has helped improve patients’ social and group working skills and provided them with a sense of ownership.

“Encouraging patients to get involved in projects like this helps to sew a seed of positivity and productivity, resulting in improved mental wellbeing and an ability to cope with everyday challenges. Being able to show friends and family what they have created also promotes a real sense of achievement.”

ot-magazine.co.uk/jobs

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LEICESTER CITY COUNCIL PUTS OTS THROUGH UNI Leicester City Council has become one of the first local authorities in the UK to put two apprentice occupational therapists through a four-year university degree in order to nurture talent and skills in its workforce.

The council are working in partnership with Coventry University to offer further education to apprentices Zahira Ravat and Heidi

Askam.

Councillor Sarah Russel, deputy city mayor for social care, told AMP: “Nationally there is a serious shortage of occupational therapists, which are vital in delivering care to vulnerable adults, children and young people across the city. By offering staff the chance to qualify as occupational therapists, we are helping to ‘grow our own’ skilled workforce rather

Landmark study links football and neurodegenerative diseases Research carried out at the University of Glasgow has shown that former professional footballers are at a significantly higher risk of developing dementia than the rest of the population after investigating fears that heading the ball could be linked to the development of brain injuries.

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The study, which compared the health of 7,676 Scottish exfootballers born between 1900 and 1976 against 23,000 members of the general public. It began after the death of West Brom striker Jeff Astle, who died aged 59 in 2002 after developing chronic traumatic

than having to rely on external providers.

“It also means that by investing in these apprenticeships, we are offering staff the chance to train while also helping recruit muchneeded skilled workers. We are one of the first councils in the UK to take this apprenticeship approach, and we are very pleased to be working with Coventry University on this course.”

encephalopathy.

Findings showed that footballers were 3.5 times more likely to die as a result of neurodegenerative diseases. It is thought that the heavy leather footballs that were used until the introduction of ‘Buckminster’ style footballs in the 1970s were a contributing factor in the trauma that was inflicted on their brains.

However, as the NHS has pointed out, the study also found that the same footballers were less likely to die from heart disease, owing to the positive contribution of exercise to overall health; and that the study did not look at any footballers born after 1977, so there is no certainty that this is still an issue which would affect those who play football today.

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We run courses throughout the UK and at our Headquarters in Ledbury, Herefordshire where we share the Innovations and Therapies used during the study and how we were able to Remove all Pressure Issues and Improve Range of Movement/Mobility for ALL Participants.

raining Events T E E R F r u o n o n o ti For informa nagement Study a M re u ct a tr n o C e th or your FREE copy of mmetrikit.com sy @ a m m e : at s u l ai em 31 635388 or please call us on: 015 Symmetrikit Postural Care is a Division of The Helping Hand Company – a Market Leader in British Design, Innovation and Manufacture. For over 50 years, we have been designing ‘Game Changing’ solutions for the Worldwide Healthcare Markets.

We have been providing CPD Training Courses to Health Professionals for over 15 years and have trained over 800 people in 2019 alone.

This year, we were thrilled to receive the Queen’s Award for Enterprise.

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Is cheap cheerful in the long run?

Following on from my last ramblings around recycling and the campaigning of Greta Thunberg for us to change the way we live and look after our planet, it made me think more about how in my small way I can make a difference.

“We need to remember that this is a client’s home and they need to feel it fits their lifestyle”

Kate Sheehan Director, The OT Service

The OT Service 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 its handpicked network of occupational therapists.

For more info email kate@theotservice.co.uk

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R

ecently I was involved in a chair assessment for a client, discussing the client’s goals, what she wanted to achieve in the chair and the functions required to support her to reach them and meet her posture and pressure needs. We discussed and I measured the seat width, depth and height, the need for head support and, due to poor skin integrity, the need for a more suitable cushion than the one usually offered with a riser recliner.

We then went on to cost. Her son had completed a huge amount of research online and stated he could get one for around £500 and showed me the advert. He was right; you could, and we even found one for £249. It really made me think as often the chairs I prescribe, from a number of well-known suppliers who are all BHTA members, range from £800 up to £1,500. Are they really worth it?

The son wanted to know why the chair I was recommending was twice as much as the ones he had found, which led to us trying to break down the reasons. Here are some interesting points we discovered: 1 A lot of the cheap chairs are only for online purchase, so you cannot go and see the chairs themselves. This is critical if a client is going to be sitting in it for a long period of time.

2 The cheaper options do not give a wide choice of fabrics and styles. We need to remember that this is a client’s home and they need to feel it fits their lifestyle. They are already coming to terms with some physical difficulties and therefore choice and control over the ‘equipment’ we are recommending needs to fit their décor and be acceptable to them.

3 The cheaper chairs come in standard sizes. Human beings are not all the same size and we need to make sure the chair fits them to prevent pressure problems and provide a supportive seated position.

4 The products have limited warranties.

5 There are no options to vary

the cushions to meet individual pressure requirements.

6 You cannot change the cushions at a later date to allow for changing skin integrity needs.

7 You cannot remove the covers for washing.

8 You cannot remove fibres from the back cushions to accommodate spinal changes now or allow for changing needs in the future.

9 You cannot get replacement fabrics, arm rests, castors or chargers if there is damage in the future.

10 You do not have the back up of experienced customer service teams to support you with queries and answer your calls.

11 The chair cannot be sent back to be reupholstered in different fabric if you change your lounge décor or for repair due to wear and tear.

A good supplier will always be able to visit and bring a range of chairs, have good quality training on how to discuss the client’s needs now and into the future, be able to measure accurately and articulate why they measure where they do, be able to discuss pressure and posture needs, and if they feel a client needs a professional assessment, refer them to an occupational therapist for an assessment.

On discussion with the client and her son, it became very apparent that it was wise to spend more to make sure the product was going to be fit for purpose and meet the client’s long term health needs.

However the most interesting comment came from the 89-yearold client herself: “I may be old but I want to do my bit for climate change and if this chair will last and can be recycled after I die, then that is worth spending the extra few pounds on it”.

We need to educate the general public on what is needed when purchasing a riser recliner chair, we do have a duty to discuss sustainability with our clients and to explain clearly why the cheap route is not always the right path to go down as it may well cost more in the long run.

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Currently recruiting Occupational Therapists as Associate Practitioners

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Our courses for family carers are designed specifically for family and friends of people with dementia however we do understand that attending as a professional can be useful.

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We have an ongoing recruitment programme for Associate Practitioners to work within the multi-disciplinary Service Development Team in the delivery of evidence based therapeutic, educational and resilience building interventions for family members living with dementia.

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Being a Goal-Getter At the heart of occupational therapy is the client, and at the heart of the client is the need for independent living.

Goal setting can encourage patients with Alzheimer’s disease to live more independently.

One of the key issues that comes as part of living with Alzheimer’s is the effect that the disease has on the patient’s memory; while forgetting things occasionally, misplacing items, minor short-term memory loss and forgetting exact details are a standard part of aging, the effect of Alzheimer’s on a patients short term memory are very different. In Alzheimer’s, patients forget their episodes of forgetfulness, as well as family or friends’ names, and show confusion in situations which may be familiar to them. These changes may only be seen by close friends or family.

A

These new studies have shown that personalised goal setting can be used to not only help patients with dementia but improve the lives of the people who care for them. The methods resemble those used to assist people living with brain injuries in their recovery and seem to show that strides can be made in improving the daily function of people with mild dementia, Alzheimer’s or mild cognitive impairments. Of course, these methods will depend entirely on the patient’s needs and challenges.

While experts search for a cure for Alzheimer’s, studies carried out over the last few years have shown that cognitive rehabilitation therapy can give patients some of the necessary tools to circumvent aspects of their cognitive function which are impaired by the breakdown of highly necessary neurons and synapses in the cerebral cortex.

“In Alzheimer’s, patients forget their episodes of forgetfulness, as well as family or friends’ names, and show confusion in situations which may be familiar to them”

lzheimer’s disease is the most common form of dementia in people over the age of 65, accounting for around 70% of cases. Over time, the disease slowly but surely destroys the brain cells, which can result in a loss of cognitive functions, including memory and language skills.

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In 2017, a large-scale trial spearheaded by Professor Linda Clare was carried out by the University of Exeter, and its data showed the profound importance of cognitive rehabilitation in the lives of people with dementia, which improved patient’s ability to maintain functioning and independence. The trial focused both on the patient and their carer, and saw a therapist working with both people to establish clear-cut goals that would improve independence through technology use, improve social connections or manage daily tasks better.

The Goal-Orientated Cognitive Rehabilitation in Early-State Alzheimer’s and Related Dementias: Multi-Centre Single-Blind Randomised Controlled Trial, known also by the slightly catchier name GREAT, saw 475 participants over eight sites in England and Wales take part. The group was split into two: one half received ten sessions in cognitive rehabilitation over three months, then took part in four topup sessions over six months, while the control did not.

Researchers found that those who took part in the cognitive rehabilitation showed significant

improvement, and both the patients and their carers said that they were pleased with the participants’ progress in tasks related to their goals.

Professor Linda Clare said: “We now know that cognitive rehabilitation effectively supports people to achieve the everyday goals that matter to them. The next step is to quantify benefits such as whether this approach delays the need for people to go into care homes by supporting them to live independently for longer. This could have important financial benefits for social care. We must also assess whether the therapy can be integrated into how practitioners routinely work, so that more people can have access and are supported to live better lives with dementia.”

Brian Hamilton, who took part in the GREAT trial, was diagnosed with Alzheimer’s disease in 2012, and struggled with a loss of confidence after his memory declined as a result of the disease. As part of the trial, Brian worked with a therapist on personalised cognitive rehabilitation, with a specific focus on tasks that would improve his independence – with the decline in his memory, he did not want to leave the house,

“It’s a real confidence boost.

The trial helped me find strategies that made a real improvement to my life, and I’m sure it could help others too”

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which the therapy sought to rectify.

As a result of the trial, Brian now has a sticker on his front door that reminds him to ensure the door is locked and that he takes his phone and wallet with him when he leaves the house. Before he goes out, he writes a list of what he needs and makes sure that he focuses on where he’s going.

Despite not having contact with his therapist for a year, Brian still finds himself using the techniques to maintain his level of independence.

He said: “I do a lot of shopping on my own now, and that’s really important to me. It means I get out of the house and talk to different people I meet in the shops and in the street. It’s a real confidence boost.

The trial helped me find strategies that made a real improvement to my life, and I’m sure it could help others too.”

The client-centred approach takes into account what really matters to both the client and the carer, allowing the occupational therapist to ensure that they are working positively towards a manageable and achievable goal that will enrich their life and provide them the necessary independence to live life to its fullest.

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Prices held until March 2020*

C&S seating

Contact us today for a full quotation or pricelist

01424 853331 info@ cands-seating.co.uk www.cands-seating.co.uk

Established since 1991

The C&S Product Range Our range of products has been designed to assist in the control of the posture when lying down, for use by people with little or no ability to change position independently.

Products designed and developed to aid basic postural management

Log Rolls

T Rolls

Inflatable T Rolls

Log rolls are available in a choice of 3 sizes and 2 different fabrics: dark blue Waterproof and Softknit available in royal blue, purple, pink, orange and lime green.

T Rolls are available in a choice of 5 sizes and 2 different fabrics: dark blue Waterproof and Softknit available in royal blue, purple, pink, orange and lime green.

Are available in 2 sizes and are supplied with pump and repair patch. A Softknit cover can be purchased if required.

Available in royal blue, purple, pink, orange and lime green.

Knee & Leg Supports

Alternative Positioning Supports

Available in 2 sizes. This design provides a more gentle form of support for those who are unable to use or tolerate our existing range of positioning rolls.

Available in 2 sizes. This unique product is solely produced and distributed by C&S Seating.

The APS has been designed for use where more control of the abducted lower limbs is required.

Made in UK *excludes carriage charges

Product FOCUS Every issue we bring you the latest products from across the market to help you improve the lives of your clients.

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ACORN STAIRLIFTS

Let Acorn give your life a lift If using stairs has become a struggle, let Acorn Stairlifts help. Surprisingly affordable, an Acorn stairlift lets you glide effortlessly up and down stairs in safety and comfort, giving you the freedom of your entire home.

Call Acorn now on 0800 612 4297 or visit acornstairlifts.co.uk.

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SWIVEL CUSHION

This soft, comfortable circular cushion is designed to aid people with mobility issues when getting in and out of a car seat, bed or chair.

The cushion itself spins round easily in both directions allowing users to get into a better position for standing up or transferring.

01444 253 300 |Â clearwellmobility.co.uk 3

HIDRATE SPARK 3.0 SMART WATER BOTTLE

This water bottle syncs with an app on your phone via Bluetooth to track water intake throughout the day.

The bottle uses sensor technology that illuminates the bottle to remind users to take a drink to ensure they are staying hydrated, the app will also send reminder notifications throughout the day too. amazon.co.uk

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HANDSTEADY CUP

This innovative cup has a rotatable handle. It ensures users do not have to twist their wrist, raise their elbow or lean their head back as far when drinking a cup of tea or coffee. The cup remains upright due to the rotating handle, avoiding spills and giving the user back confidence and comfort. handsteady.com 5

COOL CRUTCHES

These stylish crutches allow a user to add a bit of personal style to their mobility aid. No need to settle for plain medical looking crutches, Cool Crutches offer a range of patterns and designs or the facility to design your own. Each design has a moulded handle, detachable arm cuff and a soft neoprene grip.

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4 IN 1 HAND WARMER

This rechargeable electric hand warmer not only keeps hands cosy but also features an LED torch function, has a vibrate massage feature and acts as a power bank as well. The smooth pebble shape is ideal for carrying in your pocket or bag and great for the winter months.

Available in a variety of colours. amazon.co.uk

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Any chair…

Any colour…

Any size…

The answer is…

Yes! visit us online at www.primacare.co.uk or call 01685 845900

THE ROLE OF

TheSTAND AID IN MAINTAINING ACTIVE USERS

The use of a stand aid is a way of helping a person maintain an active stand and transfer whilst supporting activities of daily living. Stand aids can also be a very effective rehabilitation tool.

As health professionals, we know that the process or ability to stand can be affected by illness, disability or even the environment quite significantly. For example, a lengthy hospital stay can make standing very difficult and increase the need for carers to assist with ADLS. Here, a good stand aid can help ensure the individual returns to their normal level of functioning.

NON-MECHANISED STAND AIDS These are essentially framing which a person can pull up on. Some varieties have seating pads for greater safety and user confidence, some are simply frames that facilitate a transfer. They can help a person pull themselves forward in a seat and use their arms to pull up reducing the strain when initiating a stand.

Once standing, a carer can then turn the device 90 degrees so that the person can sit on an alternate surface such as an armchair or commode.

MECHANISED STAND AIDS Historically, only hospital mechanised stand aids or stand assist devices promoted the normal pattern of standing, leaving therapists discharging patients from hospital or providing community rehabilitation with a quandary, as mechanised stand aids available in community stores did not promote normal movement.

Now however, manufacturers such as Invacare are building mechanised stand aids that not only promote a normal pattern of movement but are also small enough to be used in a person’s home, also coming in line within the budget of residential care homes and community equipment loan stores.

When to use a mechanised stand aid or stand assist?

If your client cannot pull themselves forward into standing, then a mechanised stand aid may be the option.

For this to work the client must be assessed as having the ability to activate muscles to some extent to facilitate a stand. Effectively the client needs to be active within the stand for this to have any benefit.

Many mechanised stand aids do not promote normal patterns of movement, relying instead on the 22

user having good core strength.

This lift can be very uncomfortable, particularly on the lower leg as it is this area that is taking pressure during the movement.

Until recently nothing compact, domestic friendly, and promoting a normal sit to stand movement existed. In some instances, patient rehabilitation goals have been set back due to a lack of appropriate equipment.

However, there is light at the end of the tunnel.

Modern mechanised stand assists

such as Invacare’s ISA are set up in such a way that the arm movement and leg positioning support the sit to stand pattern from the first point of moving forward to engaging muscles, all the way to an actual stand. This can lead to supporting safe transfers using normal patterns of movement but also as a rehabilitation tool in the community.

The Invacare ISA Stand Assist supports the user to complete an ergonomically normal stand, moving the centre of gravity forward so that the musculoskeletal system engages appropriately. This type of mechanically supported stand could have a significant impact on discharge planning, communitybased rehabilitation and long-term health and well-being.

About the author: John Callas is a HCPC registered Occupational Therapist with over 18 years working in various clinical fields.

John has spent time in acute and rehabilitative settings acquiring the foundations to support knowledge on impairment and disability. He is a former Community OT Team Lead, Moving and Handling Advisor and National Back Exchange member.

Discover ISA

™

Heading here

The innovative new stand assist lifter

The new Invacare ISA is a fully adjustable and ergonomic stand assist lifter offering a natural pattern of movement.

For more information, please contact your local Business Development Manager to arrange a demonstration or contact Customer Services on 01656 776222.

Find our all new ISA on

All the latest information is available on our website www.safepatienthandling.co.uk @InvacareSPH

www.linkedin.com/ safe-patient-handling

@InvacareUK

Safe Patient Handling

-magazine.co.uk

23

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Restoring Mobility, Dignity and Independence The Rota-Pro速 will help restore mobility and independence to people who are weight bearing and able to walk, but struggle with moving from a lying to a sitting position in order to get into and out of bed independently. The Rota-Pro速 promotes improved quality of life within the home environment and reduces the cost of care packages at home for most customers. Let the Rota-Pro速 do the work and help you get back to sleeping soundly in a bed, without the worry of independently getting up in the morning or throughout the night.

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ler g e P ah as an n n a z Su zannah qualifieerdapist in

n i y a d A .

Su l th ationa nt ten occup e then spe tient Sh pa 2001. rking in in iatric o h w y s s yp c year munit moving m o c ore and rvice, gs bef settin r liaision se heir t are to a c ing carers in t r suppo roles.

What is your current role?

I currently work at The Great Western Hospital in Swindon as a research practitioner. I coordinate and facilitate clinical trials and health research within the rheumatology and oncology departments. I recruit and support the patients in these studies and the clinicians running them. I complete all trial-related assessments as required by the research protocol.

I also line manage a multi-specialty research delivery team who support medical, nurse or AHP-led research activity across the Trust. I contribute to feasibility assessments to ensure that the Trust can realistically open new studies that we are approached for, utilising my knowledge of patient pathways and activity analysis to do this. I also facilitate research related training to staff and patients. I am the Trust’s CAHPR representative and have contributed to the research and AHP strategies.

Describe a typical day…

A typical day starts by checking my team are all in and well, and able to cover their workload for the day. I then check emails for any developments. I will check my data collection systems to see that

. f o e f i l e th

Each month ..

we talk to a differen occupati onal thera t pist to see wh at a typic al day is for the ma a little mo nd explain re about their role.

h a n n a z Su Pegler

they are up-to-date and there is no outstanding data or data queries that will require answering.

actions, writing notes, and preparing for tomorrows patient appointments.

I will attend patient appointments and support an informed consent discussion to facilitate a patient signing up to a trial. I will then coordinate research activities – these can range from taking bloods, doing observations and ECGs, carrying out functional assessments and questionnaires and other outcome measures. I will then educate the patient on the requirements of the study, whether that would be taking a new drug, engaging in a new therapeutic activity or other intervention.

I collect the data from these appointments and submit it to the research sponsors for analysis.

What’s the best part of your job?

I also meet regularly with clinicians to support them carrying out their principal investigator responsibilities and research patient commitments.

If they want to open a new trial, I will discuss with them how the trial requirements fit with their patient pathways and what resources are required to support the research.

I wrap up my day ensuring that none of my research patients have been admitted as this requires additional

The best part of my job is that I get to work with a variety of patients, clinicians and clinical specialities and know that we are working towards improving the future of healthcare.

Through research we are able to offer patients treatment options that they might not ordinarily get. No day is the same, I get to utilise my practical knowledge, communication skills and clinical reasoning.

What’s the hardest part of your job?

The hardest part of my job is dealing with the bureaucracy and volume of administration that working in research and the NHS brings. We have to be constantly mindful of resources and the impact that our work will have on our patient population and clinical infrastructure. This can mean that we may have to say no to cutting edge research or deny a patient an opportunity.

-magazine.co.uk

25

Award-winning innovative stairlifts available from your local dealer.

innovative stairlifts

Visit Access BDD at the OT Show, Stand D21 to learn more.

UPSTAIRS, DOWNSTAIRS We take a look at the independence that can be offered by installing a stairlift or home lift

O

ur regular columnist Kate Sheehan touched on a very important subject last issue when she shared the difficulty her mum faced in leaving her home and moving to a retirement flat. It took her mum three years to come round to the decision and Kate admitted that getting to that stage had been “traumatic”.

The prospect of leaving a home that is filled with precious

memories, familiarity and a lifetime’s accumulation of ‘stuff’ is daunting and can have a detrimental effect on a person’s mental wellbeing.

It is also sometimes unnecessary as there are many solutions out there that can keep your client in their own home, independent and happy.

The conversation of moving home often comes up due to mobility issues, medical procedures and concerns over falls. If your client

lives in a house that is over two floors or more, it can certainly pose a challenge in accessing the upstairs.

This is also where the bedroom and main bathroom are usually housed, so access to them is vital.

But moving is a hasty option and the upheaval of it all could cause significant emotional damage.

Stairlifts and home lifts are an excellent solution to keep your client in their own home with a level of independence that allows them to safely access all of their home.

Stigma Many people resist the idea of installing a stairlift or home lift in their home. This can be due to the stigma some people feel around getting older causing them to resist products and devices associated with ageing.

As OTs it is important to get across the value of these devices and the independence that they can offer individuals. It can be the difference between remaining at home and moving to a care facility. It can be daunting making a such a drastic change in a home your client may have lived in for the majority of their life, but it could transform their quality of life.

There may also be concerns that a stairlift would not be a viable option on their staircase or that it may damage the interior of their home or look unsightly. Home lifts are generally dismissed due to the assumption of high costs and huge structural works that they believe would have to take place to install a domestic home lift.

This is not always the case and as OTs it is so important to provide your clients with all the information, the pros and the cons, to help them make an informed decision.

Stairlifts -magazine.co.uk

27

Stannah The lift experts Bright and spacious two person cabin Self-supporting structure Neat, space saving footprint Quick and easy installation Luxury features and upgrades Full Stannah guarantee

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With more than 150 years of experience in the lifts business, we understand the dilemma you face when you can no longer manage the stairs.

That’s why we developed the Stannah Salise. A homelift that requires no big building work or expensive home extensions. Just a stylish solution to help you move freely in your home.

Cleverly engineered and beautifully styled, the Salise will carry you safely and comfortably from one floor to another and thanks to a self-supporting structure, it can be easily fitted almost anywhere.

Whisper quiet and reassuringly smooth, the Salise is also fully customisable with a range of luxury options such as mood lighting and bespoke cabin colours to suit you as well as your home.

So when you are thinking of ways to make life easier at home, you can rely on Stannah for better choice, better features and better all-round, up and down.

We won’t pressure you, it’s not our style. But we will give you the best products, value for money, support and servicing. Choose Stannah for freedom and total peace of mind.

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ADVE R T ORIAL

Did you know you can rent stairlifts?

Leodis Stairlifts are the largest independent supplier of stairlifts to homes and businesses throughout Yorkshire, Lancashire, Humberside and Cheshire for the past 28 years.

We specialise in installing a wide range of new and reconditioned stairlifts, all from leading UK manufacturers. From the simplest model to fit the standard straight staircase to the latest, easy-to-use, curved models that will take your patient up and down stairs quietly and effortlessly.

Need one for only a short time?

Consider renting At Leodis, we also rent stairlifts for those that may only need one for a limited time, following an operation, injury or for a relative who’s only staying for a short period.

These are available with next day installation.

Why Choose Leodis?

We have a wealth of experience dealing with the occupational therapy community to provide exactly the right solution for your patient’s individual health requirements.

They will get a free no obligation survey, installation within 24-48 hours and nothing to pay until they are completely satisfied. As well as a comprehensive, no quibble two-year warranty on all installations, which can be extended on request.

We are always on call 24 hours a day, every day of the year. We are Trustpilot ‘excellent’ recommended with over 150 five-star reviews, so your patient is in very safe hands.

For genuine advice and a prompt, professional service, call 0800 542 6045 or visit leodisstairlifts.co.uk.

-magazine.co.uk

29

Stairlifts

Home Lifts

The benefits of a stairlift far outweigh the negatives. Whether your client is completely unable to walk or is struggling to climb the stairs and poses a severe fall risk, a stairlift would be the most obvious answer. Staircases can be lethal to those struggling with balance, frailty and mobility problems and preventing potentially lifethreatening falls by choosing to install a stairlift can avoid major injuries and hospital admissions.

Home lifts, or through floor lifts as you may know them, are a surprisingly realistic solution nowadays. You would be forgiven for thinking installing a home lift is a very luxurious, expensive and slightly futuristic option, but they can be a more reasonable solution than you initially realise.

The choice of stairlifts available on the market nowadays is vast. You will find stairlifts that can negotiate tight turns and corners, curved staircases, narrow staircases and even outdoor staircases.

Style is also something that is considered by manufacturers now. They appear to have finally received the memo that people would rather adorn their homes with items that are both beautiful and functional. As a result you will now find sleek and stylish options of stairlifts that are designed to be discreet and complement any room.

30

-magazine.co.uk

Growing ever more popular, you will find more and more people are considering installing home lifts because not only do they provide a solution to access problems, but they also blend in seamlessly to their homes, can be installed with minimum fuss and they can even add value to a property as it has been future proofed for potential future owners.

Options are endless depending on your client’s needs. You can install lifts that can carry two people, lifts that can carry wheelchair users, larger lifts that can accommodate wheelchair users and other people – even the family dog if you need to.

Depending on the structure of your home, most lifts are installed in the corner of a room, keeping it discreet and out of the way. It will transport

its passengers through the floor to a room or hallway upstairs, the great thing about them is that if you do not want to have the lift sitting in your living room all day, perhaps if you are entertaining guests, you can just send it upstairs and out of sight. It does not leave a large unsightly hole in the living room either, this area is left clear and in keeping with the rest of the room.

Intelligent technology is used with many of these lifts which avoids any real structural damage, some are selfsupporting and some use hydraulics to ensure a smooth, quiet and seamless journey between the levels in your house. Some are even simply powered by a domestic 13 amp plug.

If your client is looking for a stairlift or a home lift, you can be safe in the knowledge that today there are so many options and solutions to overcome different adaptation challenges that you will no doubt find the right solution for your client.

Many of these manufacturers will be showcasing their stairlifts and home lifts at The OT Show in November which gives you a great opportunity to see these working in situ and you can find out everything you need to know.

Area we cover

Testimonial - Mrs Christine Bailey The staff from Leodis were first class from the beginning. Very pleasant and accommodating.

Arrived on time and talked us through the process. Nothing was too much trouble.

Explained everything, answered all our questions honestly with no sales push. The fitter came when arranged, and again was very pleasant, explained how the stairlift worked and left the stairs as clean as when he came. Also, they were the best for price and quality. Thank you everyone!

ü Supporting Occupational Therapists since 1991 ü Next Day Installation ü 24 Hour Call Out, Every Day of The Year ü 2 Year Warranty on All Curved Stairlifts ü Free No Obligation Survey – No Pressure! ü 5* TrustPilot Recommended ü Curved Stairlifts Rental Available ü Curved Stairlifts from £2,495

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0800 542 6045

From

Hospice to

Hospital In the 23 years she has worked as an occupational therapist treating patients living with HIV at Mildmay Hospital, Dr Camilla Hawkins has seen a great deal of change in both her own role and her patients’ lives.

P

er the Terrence Higgins Trust, at last estimate, there were 101,600 people in the UK living with HIV. London, as the most populous city in the UK, is where the bulk of people living with HIV stay; in 2018, 38% of people who received care for the effects of the virus were living in the city, and 34% of new HIV diagnoses were made in the capital.

Some of those people may have found themselves visiting Mildmay Hospital, a 26-bed specialist unit, located in East London. It is a rehabilitation and assessment centre for people living with HIV, and the only one of its specific nature in the UK, but it accepts referrals from across the country. While there are occupational therapists working in HIV-specific roles in acute or

32

-magazine.co.uk

outpatient settings across the UK, as well as many occupational therapists who work with people living with HIV in other specialties, Mildmay is one of the few inpatient and day therapy services with a multidisciplinary team offering rehabilitation including occupational therapy.

Mildmay Hospital’s origins go back to the mid-1860s, and its purpose changed several times before its closure in 1982. Six years later, it was reopened, in Dr Camilla Hawkins’ deliberately chosen words, as “an AIDS hospice.” People admitted to Mildmay were commonly there for end of life care; at this stage in the timeline of the scientific understanding of HIV, there was still a great vast hole in their knowledge of the virus. Before 1982, it was known as GRIDS – gay-related immune deficiency syndrome – highlighting the lack of understanding around the illness and its ignorant classification as a “gay cancer.” Indeed, by the time Camilla started working at Mildmay in 1996, 15 years after the first confirmed case of HIV/AIDS in the UK, the interventions she offered as an occupational therapist were still often influenced by the awareness that people’s health would deteriorate as opportunistic

“The changes that Camilla has seen in the last 23 years are incredible and reflect the phenomenal leaps that have been made”

DID YOU

KNOW? At last estimate there were

101,600 people in the UK living with HIV

infections led to declining health, and ultimately to shortened life expectancy and death.

“A large part of my job when I first started here was relaxation and stress management, along with facilitating equipment provision and adapting environments to enable people to either function more effectively or to die at home,” she said. “People were quite often limited in terms of their function as their health deteriorated, so I wasn’t necessarily assessing wider ADLs, such as participation and function in the community. Where appropriate I would of course, but it wasn’t as common as now. Now the expectation is different, and the endpoint is different. We’re setting that target of working with people to promote their return to as much independence as possible. In this non-acute setting, we expect them to be stable or improving, whereas before, without such effective antiretroviral therapy you often had to factor in that there would be a deterioration at some point in time.”

The changes that Camilla has seen in the last 23 years are incredible and reflect the phenomenal leaps that have been made in the treatment of the virus in that time. Since she has worked at the facility, it has gone from being a hospice to a hospital.

“At our largest, we were a 42-bedded unit,” Camilla said. “The change in the number of beds required, and the difference in the services required very much reflects changes in the evolution and management of HIV. The most notable of which would be combination or highly active retroviral therapy – HAART or CAART – basically, a cocktail of a number of drugs that effectively controls the replication of the virus. If people are tested in a timely manner,

“Since she has worked as an occupational therapist at the facility, it has gone from being a hospice to a hospital”

if they start treatment in a timely manner, obviously the goal is that they don’t become symptomatic as a result of having HIV within their body.

“However, the cohort of people who tend to need to come to Mildmay, they’re not the many thousands of people living well with HIV within the UK. They’re the people that are often late to diagnosis, or they may be people who have difficulties with adherence, so they’re not able to take the medication sufficiently or effectively in order to control the virus and then they have opportunistic infections or other health conditions.”

Many of the patients Camilla sees at Mildmay live with HAND as a result of HIV. HAND, she explains, is a research term that is also used with caveats in clinical practice, representing a group of three HIVassociated neurocognitive disorders: HIV-associated asymptomatic neurocognitive impairment, HIV-

“. . . HAART or CAART – basically, a cocktail of a number of drugs that effectively controls the replication of the virus.”

associated mild neurocognitive disorder, and HIV-associated dementia. The virus can cross the highly permeable blood-brain barrier, and by doing so it can affect cognition. “That’s not to say that everyone with HIV has a cognitive impairment, certainly not,” she adds, “but obviously there is that possibility.”

There was a time when the patients with cognitive impairments that Camilla worked with – “it was described as AIDS dementia at that point,” she explains – were near the end of their lives.

“Whereas now,” Camilla says, “probably 75% of the people I work with have a cognitive impairment and I certainly am not expecting them to be dying any time soon.

I’m working with them from the perspective that they have a cognitive impairment, and in HIV, with effective medication, there is a possibility for reversing that. Unlike some other causes of cognitive impairment, in HIV especially if someone hasn’t been on effective retroviral therapy, you’ve got the prospect of reversibility.”

The changes to treatment of HIV have resulted in changes to the type of interventions Camilla employs in her work: the population of people with HIV is getting older.

The improvements in medical management treatment have resulted in HIV becoming, for many people living in resourced settings, -magazine.co.uk

33

a long-term chronic condition. There are issues Camilla sees now that she did not see in the 90s thanks to the incredible progress and developments in the treatment of HIV. Camilla said: “People living with HIV are facing issues such as frailty. For example, at the Royal Free Hospital, there’s a physiotherapist and an occupational therapist working within a frailty clinic now. Maybe we never really thought we would be doing that kind of work, but people are being diagnosed at an older age, and they are living longer with HIV, so you’ve got long-term survivors going into their 50s, 60s, 70s, and even 80s. You’ve got older people who are still sexually active.

That’s a definite trend – people are getting older and living with multiple comorbidities.”

As the population of people living with HIV enjoy longer lives, statutory and non-statutory services dwindle and healthcare professionals working in environments specific to HIV move away from providing a service to people with a specific diagnosis.

Camilla asks: “It’s a question even for our unit as we stand: why do you need to have an occupational therapist that solely works with people living with HIV and HAND if it’s more like a chronic condition now? Why can they not receive the same services as other people?”

She recalls when she began working at Mildmay that there were between three and five London boroughs who had an occupational therapist within their social services team out of necessity: there was no time to wait on a list. There were also a number of HIV-specific occupational therapy posts within major London hospitals, only one or two of which remain, and the number of HIVspecific occupational therapist and physiotherapist posts has reduced across the UK. Camilla answers her own question: for all that’s changed, there is still stigma attached to HIV. 92% of people in the UK are aware of their HIV status, 98% of those people are on a treatment schedule for HIV, and 97% of them are virally 34

-magazine.co.uk

suppressed, meaning there is no risk of them transmitting HIV. People living with HIV are living fuller lives; for the first time in 2017, the mortality rate for people living with HIV aged 15-59 who were diagnosed early were at no greater risk of death than the general population. In spite of this, there is still prejudice against those living with HIV. “In some communities, cultures and for some members of the general public there can be an element of ‘it’s only gay men and people from black African communities that are at risk’. Or if you’re diagnosed with HIV, you’re ‘basically a prostitute’.

Stigma and discriminatory attitudes, unfortunately, remain, even within health services. People I work with here, sometimes they’ve told nobody else. They might have been living with HIV for a range of years, but meeting with other people living with HIV in one of our day therapy groups might be the only place where they feel they can talk openly about their diagnosis.

“Sometimes people don’t want referrals to be made from here, because Mildmay is an HIV-specific service. I need to be aware that if I make a referral from Mildmay, even if I include no other details, it is an effective disclosure of status. It’s likely – we will never necessarily know – that some people don’t come here in the first place because they don’t want to come to an HIV-specific service. Some people are wary of other people knowing.

Sometimes people will be happy to come here, but they won’t want anyone in their family, or anyone close to them to know that they’re here. That’s another psychological challenge and stressor for some of the people who use our services.”

Despite the challenge that stigma presents to people living with HIV, people are living longer and better thanks to the strides made in finding a cure, as well as the kind of interventions offered by Camilla and the team at Mildmay. Those who are newly diagnosed with HIV can live a full, long life, safe in the knowledge that they can participate in life as they see fit.

DID YOU

KNOW?

92% of people in the UK are aware of their HIV status

98% of those people are on a treatment schedule for HIV

97% of them are virally suppressed, meaning there is no risk of them transmitting HIV

“. . . in spite of this, there is still prejudice against those living with HIV”

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sales@QuadraBuild.com | 02086 445 434 | www.QuadraBuild.com CASE STUDY | QuadraBuild Easiaccess Ramp | Private household, funded by Disabled Facilities Grant After receiving an enquiry from the local authority responsible, we carried out a detailed survey of the property to check dimensions, levels, obstructions and anything else that could affect the proposed design.

This information was then used by our in-house team to design the ramp to meet the requirements of the user.

A proposed design was sent to the authority for approval by the

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Product FOCUS Every issue we bring you the latest products from across the market to help you improve the lives of your clients.

1

1

EKO BIN

The Deluxe Phantom Sensor Recycling Bin is stylish and intuitive.

The butterfly lid opens with a simple wave of your hand over the top allowing you to access the bin if your hands are full or unclean. A hygienic and efficient solution that can also increase independence in the home. ekohome.co.uk 2

ESSENTIALS ASSESSMENT BAG

Handicare believe that the right tools are required in order to deliver a comprehensive assessment.

Each product within the Essentials Assessment Bag has been selected by their clinically professional team, ensuring your everyday kit helps make everyday life easier. *Launch offer only £270 (RRP over £580) 01384 405792 | handicare.com 3

INBETWEEN BOOK

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3 36

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4

PARAVAN PR40

Precision Rehab is launching the new Paravan PR40 standing powerchair on stand F21 at The OT Show. By combining the superb specification and multi-function options of the PR50 and Biolution, the PR40 takes powerchair technology to the next level with electric tilt, standing and lying positions fitted as standard along with a redesigned adaptive seat shell system.

4

01256 300111 | precisionrehab.co.uk 5

SALISE HOMELIFT

The Stannah Salise is a discreet, through-the-floor homelift that requires no downsizing, no big building work or expensive home extensions. Cleverly engineered and beautifully styled, the Salise will carry two people safely and comfortably from one floor to another. With a self-supporting structure, it can be fitted almost anywhere in the home.

0800 028 6033 | stannahhomelifts.co.uk 6

5

PENARTH CHAIR BED

The Penarth Chair Bed offers an excellent seating solution for those who want to enjoy the benefits of a rise and recliner chair but also need the option to lay flat or sleep in the chair. The easy-to-use handset allows users to find the perfect sitting and sleeping position and helps them retain their independence in their own home.

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6 -magazine.co.uk

37

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Cooking up a storm The kitchen is often referred to as the heart of the home. A bustling hub of busy family life with wonderful smells, where a hot cup of tea can always be found when friends pop round for a chat.

“Having the capability to make a cup of tea or coffee, make yourself a simple lunch and cook a nourishing meal is something many people take for granted”

who must rely on family members or carers to prepare food and drinks for them, because of an inaccessible kitchen, can find it frustrating and difficult to have that independence taken from them. This can have a huge effect on the mental wellbeing of that individual.

The positive thing is that there are plenty of kitchen aids to help those who have a disability or impairment: 1 Kettle tippers – these handy kitchen aids take the strain out of lifting a kettle full of boiling water. Ideal for those with limited strength in their arms.

2 Chopping board with spikes – designed to hold food in place to be sliced and chopped. Great solution for those who only have the use of one arm. veryone uses the kitchen in some capacity, whether that be to whip up gastronomic delights to impress guests at a dinner party or simply to heat a tin of soup up for your lunch, everyone’s kitchens skills vary. However, no matter how little a patient may say they cook or use the kitchen, in reality they will use it a lot more than they realise. If you are working with a patient who is recovering from a stroke, going through rehabilitation or living with a disability, losing the ability to make a cup of tea themselves can have a profound impact on their independence and mental wellbeing.

3 Jar openers – non-slip cones that are placed on top of jars to make it easier to ease a jar open. Ideal for individuals with arthritis or limited strength.

4 Liquid level indicator – a device that can be placed over the edge of a cup, pot or jug that will indicate to people with a visual impairment that the water has reached a maximum level.

5 Adapted utensils – knives and cutlery that have differently angled handles to allow people with grip problems to hold them properly.

Having the capability to make a cup of tea or coffee, make yourself a simple lunch and cook a nourishing meal is something many people take for granted. Individuals

-magazine.co.uk

39

“Specially designed kitchens can transform people’s lives”

Dream Kitchens The layout and functionality of standard kitchens are often inaccessible and can pose a great deal of problems to wheelchair users and those with mobility problems.

Specially designed kitchens can transform people’s lives, the installation of rise and fall worktops and cabinets can allow wheelchair users safe access to cook and prepare food at a height that works for them. Space underneath counters and sink areas allow wheelchair users to get suitably close to wash, cook and chop, and storage cabinets that have shelves that extend out and lower allow people to access storage areas that were once off limits.

Nadir is from Worthing and he sustained a spinal cord injury at the age of 16 and uses a powerchair. He has lived with his parents most of his life and has had to rely on them and his carers to prepare his meals. He has recently moved into his own house and is revelling in the joy of cooking for himself in his inclusive kitchen that was provided by Ropox.

“My new home is just amazing and the kitchen from Ropox is literally the icing on the cake! I worked with the architect throughout the design and build process to ensure everything met my requirements and the kitchen was paramount as I have never been able to cook independently. In my previous house, my mum, dad or carers had to do all my cooking for me and I was determined to do this myself in my new home”.

Caroline Wright, Nadir’s OT from South Coast Occupational Therapy and Peter

Davies from Ropox met with Nadir to listen to his ideas and put together a proposed plan for his kitchen. An electrically adjustable corner worktop which included the induction hob, a preparation area and the sink was the focus point. Above this, a diagonal wall unit system would bring down the wall units to the preparation area to ensure Nadir could easily reach the contents.

Nadir’s American style fridge also needed to be included within the design and then as much storage as possible which included a mobile drawer to provide some additional flexible storage and an extra ‘put down’ area when needed.

The outcome has transformed Nadir’s life: “The worktop and cupboard are just brilliant, I can lower the worktop to the perfect level for me so I can prepare meals from my chair but if a friend, family member or carer is here they can raise it to their level if they are helping me.

The cupboards are equally as amazing, I can actually use the wall cupboards in my new kitchen as I know I can access them easily and the controls for both are so user-friendly and easy to operate.

Being able to cook for myself has helped with my general confidence and selfesteem as I no longer have to rely on other people when I am hungry. I would not hesitate in recommending Ropox to anybody who uses a wheelchair and is looking for a kitchen which will enable them to cook independently. I just wish there was more funding available so others in a similar situation to me could have the independence within their own home which I now have.”

Nadir’s occupational therapist Caroline Wright was equally delighted with the installation and style of the kitchen, as she explains: “I am very pleased with the finished result. When I first met Nadir one of his goals was to be able to prepare meals, and to see him now undertaking this is very rewarding. The height-adjustable design of the worktop with hob and sink has enabled both Nadir and his support worker to use the kitchen while the wall cupboard has been a real revelation for Nadir, as he can now access items stored in cupboards above his head, a task which would have been impossible without the use of such an item. I will definitely be recommending Ropox to my clients, and look forward to working with them again.”

To discover more about the solutions Ropox can provide visit ropox.com.

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HOME sweet HOME Making an accessible house, a beautiful home

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our client’s own four walls should be their safe haven, their space, and their own cocoon of comfort, warmth, love and security. There really is no place like home. It should be an extension of themselves, a space solely for them and their family and the one place in the world that truly feels like yours.

But sometimes, if a client is living in an accessible home or has to fill it with necessary, but oft-times clinical looking, equipment, it can be difficult to make a house look like a home. A humble abode may need to house some things to make your client’s life easier, but your furnishings or design shouldn’t have to take too much of a hit.

From simply adding a few photographs to the mantlepiece or strategically placing them on the walls, to splashes of personality shining through, anything from a solitary slogan placard, to fluffy cushions, you can make small steps to help your clients enjoy home sweet home.

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The kitchen

Kitchen real estate is always at a premium regardless of access requirements or adaptation needs.

Kitchens are often a hot hub; busy, cluttered and full of work. But this is a room of creativity. Cooking isn’t just a necessity, but can be a means of expressing thoughts and feelings through rustling up whatever takes your fancy. Clients can make this space inspiring by decorating it with bits and bobs that will whet their whistle. Lowered worktops, accessible ovens, and adapted sinks will all make a difference, but it’s the little touches that will make it, so get accessorising.

The living room

Whether it is for relaxing in your own time, or inviting guests into your house, the lounge is for many the focal point of a home. It’s where you gather, chat and relax in whatever way you choose. No matter how much space is available, there are loads of ways to make the living room accessible and cosy.

Throws and cushions add extra comfort and can support good posture. Strategically placed coffee tables can help with space saving, but also can be decorated with bits and bobs that reflect personality.

Mirrors also give the illusion of maximised space, so get reflective.

The bedroom Your bedroom is your final refuge. It’s where you begin and finish your day, so ultimate comfort is key.

Your client’s bed may have to have been adapted or make use of motorised aids or handles, but that doesn’t mean it can’t still be beautiful. There are so many options to make it not only a beautiful spot to rest your head at night, but also comforting and sensory. Why not invest in a beautiful weighted blanket. The pressure from it may support any aches, pains or sensory requirements as they recharge the batteries and come in many stunning designs now. Bedside furniture can be clunky, and if space is at a minimum or you are trying to minimise obstructions, smaller shelves that can be reached may add ease of access and reduce clutter.

Sliding doors for wardrobes also maximise space as they don’t swing out into the room. They are also easy to open and look sleek.

The bathroom For many disabled people, getting the bathroom spot on isn’t only a matter of accessibility, but also one of paramount safety importance.

With any bathroom, there are numerous things to consider regardless of the level of accessibility and adaption required. Occupational therapists advise with regards to flooring, bath or shower adaptations, lowered sinks and toileting equipment, but there are other steps you can take to combat any worries about it becoming a bathroom reminiscent of a hospital ward.

Wall hung cupboards, sinks and ledges aren’t only accessible options you can take, but they can really help shape your look for the bathroom. These can be chosen in a range of shapes, textures, colours and sizes and can help you make your bathroom your own. Choosing a colour palette that compliments your choice of texture will tie it all together nicely. Wall hung features don’t only look sleek and modern, but also are a clever way of creating and maximising your space, and removing further obstruction without appearing aesthetically accessible.

Like any other room, mirrors create further depth and the illusion of more space. Naturally, bathrooms house mirrors, so get creative with sizes, shapes and placement. Wire baskets come in a range of sizes and can be an easy way to spruce up your storage options while being easy to use and move when necessary.

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Intergenerational

Living Could this help to solve two social problems?

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he concept of intergenerational living is an interesting one.

Our ageing population is putting pressure on an underfunded and understaffed healthcare system and while there have been many technological advances in telecare and assistive technology to keep people in their homes for longer, these solutions are not always viable and the care and companionship of a human being cannot always be rivalled.

“If they do not have family living nearby or close friends in the vicinity, which is often the case, injuries and illnesses can go unchecked�

Many older people who are living on their own can struggle with certain tasks, they are also at a higher risk of falling in their home and in inclement weather getting out and about to the shops can be difficult. If they do not have family living nearby or close friends in the vicinity, which is often the case, injuries and illnesses can go unchecked. Another concern for many older people is a lack of companionship and communication resulting in loneliness and depression.

A report by Age UK in 2016 stated that there are over 1.2 million chronically lonely older people in the UK and 500,000 older people go at least five or six days a week without seeing or speaking to anyone at all. Loneliness also comes with its own health risks and can put an individual at a higher risk of dementia, heart disease and depression.

On the other end of the spectrum we have the younger generations struggling to get on the property ladder and struggling to even be able to afford rising rents in most major cities.

Students and young graduates are not always in a position to afford the high rents that are commonplace now and this is resulting in many remaining at home with their parents, which is not an ideal situation for either party.

DID YOU

KNOW?

1.2million chronically lonely older people live in the UK

50,000 older people go at least five or six days a week without seeing or speaking to anyone

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So could intergenerational living be the answer to helping solve these two social problems, and how does it work?

The idea of intergenerational living is cropping up in different formats across the world. The idea being that an older person who is living on their own and has a room to rent out in their home offers it to a young person at an affordable or reduced rate. Some contracts state a certain number of hours of care or companionship is required, but some simply request that the lodger looks out for their host. This set up can often offer family members who live far away some peace of mind that someone is there on a daily basis and can help in the case of a fall or illness, as well as offering companionship and conversation.

This can also be a beneficial arrangement to young people who have moved to a new city, a time that can be very difficult to make new friends. To live in a more homely environment with a friendly

face to welcome you home and that is affordable, must be a more appealing option than living on your own in an expensive city centre flat with no one to talk to.

An innovative new programme has started at the University of Sydney called the Gold Soul Companionship programme.

Coordinated by occupational therapist Dr Sanetta Du Toit from the Faculty of Health Sciences at the university, it offers accommodation to four allied health students the opportunity to live in an aged care facility in exchange for volunteer hours with its residents. It has been designed to expose the students to the realities of ageing and the benefits of intergenerational friendship and it is proving very successful.

Early findings from the programme, presented at the National Occupational Therapy Conference, highlighted the positive impact the program is having on residents, their families, the staff and the students.

“It has been designed to expose the students to the realities of ageing and the benefits of intergenerational friendship and it is proving very successful”

Intergenerational Communities Throughout the UK there are developments that have been built to provide affordable housing options for all ages. The premise behind most of these developments is to provide accessible, affordable housing that have specific areas for socialising with neighbours, whether that be through an onsite café or a development that includes communal areas for cooking and dining, children’s playrooms and shared outdoor spaces.

By creating fully accessible accommodation that includes increased door widths, level living areas, ample turning spaces in rooms and hallways, it ensures that these homes are future proofed for any age or ability.

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Encouraging varying age groups to live in these developments goes against the idea of segregating generations and really focuses on the benefits that can be brought by bringing generations together. It also helps to dispel stereotypes of older people and can help teach children that it is natural to help and interact with older generations, building positive relationships between generations from a young age which can be really important. Other benefits that have been recognised for children living in intergenerational situations include social maturity, increased self-esteem and confidence and an increased sense of belonging in a community.

Benefits to older generations have

been seen time and again to increase mental health, improve cognitive function, decrease the chances of depression and feelings of loneliness and isolation. Physical health benefits have also been reported as they are generally being more active and inadvertently exercising more regularly, in turn this can also reduce the chances of falls and increase independence for longer.

These communities and developments have been seen to offer so many benefits to people of all ages and abilities, that they could make a real impact in tackling the social care crisis we are facing, as well as offering young people affordable living spaces in vibrant community and person-centred environments.

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SWEET DREAMS If a good night’s sleep is the best thing we can give our bodies, how can occupational therapy help those who live with sleep disorders?

S

leep is a powerful but underutilised ally in the daily fight to restore our mental and emotional energy, as well as repairing our bodies. While it’s become commonplace for many people to brag about how much sleep they’re not getting in order to fit more work into the day, this is an extremely dangerous practice which can have significant knock on effects on both our long- and short-term health.

For those who live with sleep disorders like insomnia, poor sleep is less the fault of their desire to slave away working all hours of the day. In these cases, the intervention of an occupational therapist can assist in identifying the factors that prevent a client from drifting off for a peaceful night’s sleep, which will improve their life tenfold.

Sleep hygiene is a confusing concept for the layman: while most associate the concept of “hygiene” with keeping our bodies and food clean, hygiene simply identifies practices which are conducive to maintaining health. The practice of sleep hygiene was developed in the late 70s as a method to help clients with mild to moderate insomnia, however modern studies on the topic have expressed concern that the methods employed in the intervention may be “limited and inconclusive” in their helpfulness; these trials have only taken place in a clinical setting, however. As an overview of a client’s sleep issues, it can be an extremely useful tool in which can help OTs assess environmental and lifestyle issues which may have an effect on the client’s quality of sleep.

SLEEP HYGEINE Is your client: Going to bed at the same time every night?

Engaging in calming rituals, like reading books or meditating before bed?

Removing electronics like phones and laptops from their bedroom?

Keeping their bedroom cool and dark?

Only using their bed for sleep and sex?

Getting up and out of bed if they cannot sleep?

Keeping naps short during the day?

Going to bed at a reasonable hour?

“In these cases, the intervention of an occupational therapist can assist in identifying the factors that prevent a client from drifting off for a peaceful night’s sleep, which will improve their life tenfold”

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Assessing sleep hygiene gives a broad overview of a client’s sleep as a whole: are they using their bed appropriately? Are they only going to bed when tired, and not using electronics when trying to fall asleep? Are they consuming alcohol or tobacco products too close to bedtime, resulting in their neurobiological systems maintaining wakefulness?

conditions worsened by sleep may benefit from having aids introduced into their sleep routine. This could include the introduction of resting splints into the sleep routine of a client with rheumatoid arthritis, or the use of sensory compression blankets for clients experiencing significant stress or anxiety while

trying to sleep.

In an era where sleep deprivation is expected of all workers – even the lowest on the rung – occupational therapy can step in to ensure that the sleep clients are getting is both healthy and enriching, especially for those who struggle with sleep disorders such as insomnia.

As an OT, you will be all-too aware of the issues caused by sleep deprivation, which can slip over into a client’s daily life. A lack of sleep can affect their ability to function in activities of daily living, and can affect their performance in school or work, as well as exacerbating stress.

With sleep disorders like insomnia, anxiety, stress and depression can not only cause the issue, but make it significantly worse. OTs can therefore use their skills and knowledge to pinpoint these issues, and work with their client to improve these issues. Insomniacs whose issues are caused by stress may find their sleep significantly worsened by the stress that sleep deprivation causes, resulting in a vicious cycle of stress and lack of sleep making each other worse.

In these instances, occupational therapists can teach their clients relaxation techniques to help them regardless of their age or the amount of perceived free time that they have; parents can be taught how to massage babies to promote good sleep, those living with sensory processing disorders can learn sensory modulation techniques, and the stalwart techniques of CBT and meditation can help those living with mental health conditions like anxiety and depression. To complement this, OTs can also work with the client in order to address issues with their psycho-emotional state, which can include stress management techniques, and identifying specific factors which contribute negatively to their mental health.

Adding to this, if the client has comorbidities which may affect their sleep, such as conditions which affect their joints or cause them pain, the occupational therapist can assess the sleeping position of the client. Those who find their other

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“A lack of sleep can affect their ability to function in activities of daily living, and can affect their performance in school or work, as well as exacerbating stress.”

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CYBER OTS As we rely more on technology in our everyday lives, services take themselves online for the ease of the consumer. How can occupational therapy take itself into cyberspace?

E

veryone’s going digital these days and happening instantaneously; you can have a birthday present delivered on the same day you ordered it, and have your weekly shop delivered by a nice person in a van after you log on to your supermarket’s app.

Between consumerism being transferred to the online space and our overwhelming comfort at technology facilitating our every action, more and more services are moving into the digital space because it’s what people want.

Occupational therapy will soon have

to straddle the line between reality and cyberspace – as if it doesn’t already – so what will OT look like in a digital environment?

Take Appointments Online Much like GP appointments, you may soon be finding your face-toface appointments separated by a screen. Many OTs already offer this service, which can be facilitated by a number of existing apps and websites, including calling your client via Facebook, Google Hangouts and

Skype. If this is a viable option for the type of OT you deliver, you may want to consider going down this route sooner rather than later; not only does it get you ahead of the curve, but it actually hugely increases the scope of people you can offer treatment to, thanks to the reduction in location-based obstacles and the ability to open your services up to people who may be disabled.

Digital Learning and Auditing Universities are now regularly offering courses online, and while the practical aspects of OT are always better taught in person, this opens the profession up to people who aren’t geographically close to a facility that offers courses in occupational therapy, as well as disabled people. As well as courses moving online, the auditing process could find itself being transferred to a digital setting too. It’s more than likely that you already do your CPD on computers or phones, so being able to submit your CPD for auditing would be considerably easier if it were taken online.

Networking This one is likely the easiest to imagine, considering the already massive prevalence of occupational therapists in an online setting. If you’re not already networking online, you’re hugely missing out – get yourself a Twitter, a Facebook, and make sure you’re on LinkedIn. Twitter and Facebook are perfect for networking, and weekly “meetups” like #OTalk allow you to not only make a name for yourself within your profession but share invaluable advice between fellow OTs that could benefit all of you. LinkedIn is perfect for advertising your credentials and previous experience, and it’s likely that CVs will become a thing of the past in a world where we’re all on LinkedIn.

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‘The emphasis is on positive change through mobility’

P

aul is a Senior Occupational Therapist at QEF, a disability charity that provides expert services enabling children and adults to maximise their independence.

“Occupational therapy is very important across the range of services at QEF. My role is focused on our Mobility Services and although it is a pure occupational therapy role, the emphasis is on positive change through mobility to enhance, create and maintain occupations.

This could include driving a car with specific adaptations, using public transport, cycling or being a passenger on a plane. Basically, all outdoor mobility that is meaningful to the person and beneficial to immediate family and friends.

“We work alongside other specialists such as driving advisors and therapists such as physio, speech and language, psychology, neurology, and paediatricians. We also carry out more specialist work with case managers and solicitors and develop unique relationships with organisations such as the DVLA medical advisors, adaptation specialist engineers, equipment suppliers and organisations for sourcing funding.

“Chester University. The findings and conclusions from the university course have been invaluable to improving and influencing the work we carry out.

“There are always new developments and projects at QEF to get excited about - it’s a great place to work.”

Find out more at www.qef.org.uk

“Personally, I really look forward to talking to specialist teams and groups in the community and presenting at training courses, which is a key part of the occupational therapy role at QEF. “Continuing Professional Development is also key – it’s impossible not to learn something new every day when working on the ground in this role, but the academic work never stops either and all assessors have to attain an ‘outdoor mobility and driving’ diploma at

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All the latest from the world of paediatrics

Paediatrics

SECTION s scared as we are to admit it, it’s beginning to look a lot like Christmas, and we are finding ourselves thinking a lot more about the children in our lives. The little ones will soon be back on holiday and needing to be kept occupied. For some families, it’ll be a more difficult affair to keep their children busy as they spend long periods in hospitals.

A

That’s where Scottish charity Get Well Gamers come in: no-one on the children’s wards will be bored after the charity donates a games console and a sack full of games to them. You can read more about the amazing work that they do on page 65.

One person who will have the welfare of children on their mind this festive season is paediatric

occupational therapist Aaron Preston. He told The OT Magazine this month about the giant highs and crushing lows that come with working with children. You can read the fantastic interview with him on page 59.

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If you’ve ever dreamed of taking a journey far into the infinite blackness of space, the Astronaut Therapy protocol might be the intervention for you. On page 56 we take a shuttle into the world of Astronaut Therapy to discover strange new worlds and bold new treatment protocols.

As always, our Paediatric Products have all the latest in quality goods for your younger clients. If there’s anything you would like to have featured in the paediatrics section, please don’t hesitate to get in touch with us at ros@2apublishing.co.uk.

Read on to find out more...

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A Space Odyssey What is the Astronaut Training protocol, and how can it help children who are experiencing difficulties with their vestibular system?

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pace; the final frontier.

Not for occupational therapists, however, as they’ve already mastered Astronaut Training, a sound-activated vestibularvisual protocol that’s especially useful for children. The Astronaut Training protocol was designed by American occupational therapists Mary Kawar and Sheila Frick, who have a combined clinical experience of well over 90 years.

The pair are recognised for their work in sensory integration and developmental movement patterns, which culminated in the creation of the Astronaut Training protocol around 25 years ago.

Astronaut Training aims to integrate the vestibular, auditory and visual sensory processing centres in children through exercise and stimulation of the vestibular system. Despite not being listed as one of the traditional senses, the vestibular system, located in the middle ear, contributes vital information to the brain regarding motion and orientation. The vestibular system contains

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Astronaut protocol is a specific, neuroanatomically based therapeutic procedure which is designed to precisely activate each of the five linear and rotary vestibular receptors bilaterally when the vestibular function has been found to be under or overresponsive to movement.

“A lot of children have histories of ear infections, which is one way that the vestibular system can shut down,” Kawar said. “If the vestibular system is not doing its job then neither the auditory system nor the visual system can work effectively. They are both dependent on the vestibular system.”

An ill-functioning vestibular system, which can be caused by any number of ailments, diseases, and disabilities, results in a disconnect between senses that require information relating to orientation, balance and sound. The vestibular system modulates and balances sensation, so by breaking this connection, issues arise whereby children may become overwhelmed and overstimulated. By stimulating the five vestibular receptors in each ear – the three semi-circular canals and two otolith receptors – while simultaneously providing auditory and visual input, Astronaut Training seeks to unify the vestibular-auditoryvisual triad.

a number of labyrinths, tubes, and canals which detect movement, not only of the head, but of linear acceleration, tilting and gravitational forces. The vestibular system is a vital component in maintaining balance, special orientation, maintaining posture and stabilising the body’s overall movement.

Speaking to the Advance Healthcare Network in 2015, Kawar said: “The

The intervention was inspired by a friend of Kawar’s who said that the interventions she was providing as an OT greatly resembled the training that they had received in the space program, except using less sophisticated equipment.

There are a number of activities incorporated into the Astronaut Training protocol; in one, the child lies or sits on a disc which is covered in cloth featuring a space motif. Their eyes are closed and the room lights are dimmed to simulate the darkness of outer space, while music is played in the background, and the board is spun, allowing

“Astronaut Training aims to integrate the vestibular, auditory and visual sensory processing centres in children”

the therapist to learn whether the child is over- or under-sensitive to motion by checking their eye movement after being spun. In another, which Kawar calls The Twirling Robot, a child stands with their arms extended and turns counterclockwise; they then do the same action clockwise, trying not to lose balance or become too dizzy.

The activities employed in Astronaut Training distract the children by playing a game and speaking to them about it, while simultaneously performing activities designed to stimulate the five vestibular receptors. Children find themselves having fun playing Galaxy Bowling, Dusting their Moonboots, or playing Asteroid, all while the occupational therapist running the session is able to easily evaluate their needs.

In these activities undertaken as part of the Astronaut Training protocol, the child’s vestibular system becomes better able to balance and manage information that it is presented with, which results in the child’s vestibular-auditory-visual systems becoming more effectively integrated and their daily function improved.

However, the protocol is not without its criticisms; in 2011, occupational therapist Dr Christopher Alterio, author of Clinically-Oriented Theory for Occupational Therapy, wrote on his blog that the protocol was a “fad” intervention and noted that there was no clinical research that had yet been done to support the specific protocol. While anecdotal evidence exists to support the protocol, there is also anecdotal evidence that questions its effectiveness.

Kawar notes however that the Astronaut Training protocol has proven to be popular amongst occupational therapy courses for continuing education and that she and colleague Sheila Frick have qualified over 10,000 occupational therapists to perform the protocol through their company Vital Links.

If you’d like to know more about the Astronaut Training protocol, visit vitallinks.com for more information.

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NOT QUITE CHILD’S PLAY Working in paediatrics takes a certain type of OT, it can be an incredibly rewarding and satisfying role but it also comes with emotional challenges and heartbreaking cases. We talk to paediatric OT Aaron Preston who has been working with children for over ten years.

A

aron has recently branched out on his own and started his own paediatric OT practice called The Great Little OT Practice, where he treats young people aged 0-19.

Whilst studying at Coventry University he did a paediatric course and admits he knew instantly that he wanted to work in children’s services because “it was incredibly rewarding working with families, every day was different and there was a lot of play involved!”

Following his degree Aaron entered the NHS and worked for ten years in local children’s services throughout Essex, before deciding on a change and entering independent practice where he worked with an independent children’s OT company for three years. Last year he took the leap and started his own practice which, as Aaron explains, has enabled him to marry his two great loves of practicing OT and spending time with his family.

“I wanted a bit more flexibility with family life, I have a four-year-old daughter and being my own boss enables me to strike a really good balance between doing the thing that I love, being an OT, and family things as well. Also, I really wanted to be doing things which set me apart from other companies, I wanted to try to take my own practice in a way that I felt was the right fit for me and the families that we see.”

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not unusual treatments but they are treatments that are potentially not seen that often by OTs. Aaron explains: “We have a lot of different treatments, we offer something called bimanual therapy. For treating children with unilateral cerebral palsy we do a lot of goal-specific and task training and paediatric coaching, trying to get children to be influential in setting their own goals, then lots of repetitive task practice to try to get them to where they want to be.

“Some of the more specialist services that we offer include constraint induced movement therapy (CIMT) which is a good approach to hemiplegia, it involves teaching children to improve bimanual hand skills by essentially taking away the good arm. So you are casting it with a mitt to eliminate the good arm, and then you try to get them to improve their skills in the arm that is affected, with the hope that over time we are going to improve their bimanual hand skills.”

“The functional electrical stimulation is something that we are also trying for people who have had a stroke or for young people who have loss of function or loss of range of movement we apply low level electrical current into their muscles to try and stimulate a movement and then we combine that with a functional task and hope that those two combined will improve the neurological output and function moving forward, so that is something we are quite proud about as a company.”

I wanted to try to take my own practice in a way that I felt was the right fit for me and the families that we see

A FAMILY AFFAIR Aaron confides that some of the families he sees have known him for almost ten years, from his NHS days, something he feels quite privileged to be able to say and this has allowed him to build up really good relationships with them. He stresses the importance of encouraging the child to set their own goals and of ensuring the family are involved in all aspects, from assessment to treatment, he also shares the benefits of having family members involved in sessions.

“I always try to involve the young person with setting their own goal, it doesn’t matter to me if they can’t talk or if they can’t write we will try to find a way in which they can have a choice in what goals we work on.

We are going to get more out of therapy for goals that are dictated and led by the young person, they are going to have more motivation to try to push that forward. Then within their therapy I always try to involve a carer or a parent – that way if they are involved in the therapy with myself, once I have gone and left for that day they will hopefully carry those sessions on until we see each other again.”

MAKING THERAPY FUN Phoebe is ten years old and Aaron has known her since she was 18 months old. She has quad cerebral palsy and struggles to use her left hand without her wrist flexing. They are currently working on two handed skills to help her improve her independence and play the piano.

Aaron has been using the SaeboStim GO go on her left arm during an activity as it stimulates her extensors and improves the position of her wrist making activity easier.

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RESILIENCE Working with children can be one of the most rewarding roles in occupational therapy, almost a calling for those who feel the pull of paediatrics. The progress that can be seen as a direct result from applying the right OT intervention, that will set a child up with skills they will use for life, is a hard rush to rival.

However, a role this rewarding must also have a downside. Working with children who have life-limiting and degenerative conditions can be incredibly difficult and Aaron reflects that as an OT and a parent he can relate to some of the difficulties the parents are facing. In circumstances where a child is not going to live past two or three years old the therapy takes on a very different dynamic,

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and when that child passes away it can be difficult for an occupational therapist who has worked closely with them to process. The personal nature of the role of a paediatric OT makes it difficult to move on from the loss of a child that has been in your care. Aaron explains it is something he has learned to deal with over the years and has built up his resilience in handling difficult circumstances, as well as leaning on a good support network. “I remember when I first started in paediatrics I saw a couple of children with quite significant progressive conditions and unfortunately they both passed away before they were two. It’s inevitable you are going to take things like that home, you are going to think about it, but now I think I have just gotten

better at compartmentalising it and really dealing with it slightly differently. My wife is also an OT so we might talk about some things together, obviously not confidential information, but we will talk about some things that are particularly challenging and then although I am in independent practice I also still have quite good MDT links with some of my old NHS colleagues who both have two independent practices locally, a physio and a speech therapist, so we meet together and offer MDT assessments to clients as well so I do have a bit of a support network in private practice which is good.�

To find out more about The Great Little OT Practice visit thegreatlittleotpractice.co.uk.

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Stand C20

GIVING KIDS A POWER-UP

Charity Get Well Gamers are bringing some muchneeded escapism to children and teens in hospitals across the UK through the power of video games.

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eing in hospital is pretty terrible. Only being able to receive visitors at predecided times, hospital food, and the general horrors of being ill or receiving treatment is unpleasant at best and awful at worst. For children and teenagers, it can be even worse, as their illness or treatment removes them from their friend groups and hobbies – which frequently includes relaxing and playing video games.

and teens could benefit from the power of play. Get Well Gamers also consult regularly with play specialists at hospitals, and liaise with staff to ensure every venue is getting gaming equipment that suits their needs and requirements. The charity even accepts donations of 18-rated games which are sent out to carefully vetted wards and hospitals so that gamers in their late teens can still enjoy games suitable for their age group while being confined to the hospital.

Get Well Gamers UK, the UK arm of the North America-based charity Get Well Gamers, aims to bring a little joy and happiness to children and teens in hospital through the power of video games. The Glasgow-based charity donates video games and consoles to hospitals, as well as raising money using video games to facilitate the purchase of brand-new equipment to donate, too.

The charity is run by a small, but tightknit team of passionate volunteers who support the charity both at their Glasgow-based vault and at events held to raise money and the charity’s profile. Moving forward, they’re hoping to expand their reach, so if you think you have the means to help or fundraise for Get Well Gamers, what’s to stop you getting sponsored for that marathon gaming sesh you were going to have anyway?

After a thorough clean and some testing, the consoles are laid to wait in the charity’s vault. It’s then that Get Well Gamers begin sending consoles and games out to hospitals and wards for children and teenagers, groups for disabled children, or anywhere else they feel that children

To learn more about Get Well Gamers, including how to donate games and equipment, visit getwellgamers.org.uk, follow them on Twitter at @gwguk, or check out their Facebook page: GetWellGamersUK.

The charity is run by a small, but tight-knit team of passionate volunteers -magazine.co.uk

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It’s the taking part that counts

A look at the importance of inclusive sporting opportunities

“. . . participation in sporting activities has dropped a staggering 10% since the London Paralympic Games in 2012”

T

he health benefits of sport are undeniable, we know sport and activity not only keeps our physical health in check but it also has a tremendous impact on our mental health.

However, according to the Activity Alliance’s Active People Survey in June 2016, less than 17% of disabled people participate in sport once a week. It has also recently been reported that disabled people’s participation in sporting activities has dropped a staggering 10% since the London Paralympic Games in 2012.

There are barriers to taking part in sport and exercise for disabled

people. These are not just physical barriers like access to buildings and equipment, but psychological barriers that stop disabled people feeling that they can join a sports club or gym. A lack of opportunity and understanding on how to involve disabled people in sport is a very real problem that must be tackled.

Sport for Confidence is a unique organisation that focuses on placing allied health professionals in leisure centres to support and deliver meaningful activity or sport sessions to anyone facing a barrier to participation.

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Their team is comprised of dynamic allied health professionals (AHPs), mainly occupational therapists, and motivated and experienced coaches. The AHPs use their knowledge and expertise in these mainstream environments of leisure centres to help facilitate reasonable adjustments and break down barriers that people are experiencing to participating in sport.

Their aim is to create environments that are truly inclusive and that allow everyone to participate in sport and exercise on a local, grassroots level. The coaches work with the AHPs to ensure they are delivering sessions that are active, fun and can be adapted to include anyone who walks through their door.

Sharing knowledge

Sport for Confidence were recently granted funding from Sport England to offer 40 Coaching Practice Placements (CPP). These placements offer an opportunity for any professional working in this arena, from swimming teachers to social workers, to work alongside an OT or AHP in real situations to learn how to apply the Sport for Confidence model across venues in Essex.

Sophie Garratt, occupational therapist at Sport for Confidence and Coaching Practice Placements lead, says: “The CPP provides each participant with a flexible, personalised programme of learning that develops understanding, experience and skills in holistic coaching plus accessible and inclusive sport provision. Participants are invited to select four modules from a possible seven, enabling a high degree of tailoring to suit individual needs.”

Garratt adds: “Participants who complete the placement will be able to integrate learnings into their own coaching practice, enhancing their skills in the delivery of inclusive sport. Just some of the areas we cover include; how to identify and eliminate barriers to participation, the impact of skill development on occupational performance across all aspects of lives and how to embed person-centred practice through collaborative goal setting.”

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Projects

Other projects that Sport for Confidence have successfully maintained include Swim for Confidence and inclusive sports camps that run over school holidays.

Swim for Confidence is designed help people of any age or ability to enter the water for the first time. This programme focuses on removing physical and psychological barriers that individuals have around accessing the pool and the support offered through Swim for Confidence has been vital for many people who have been involved.

Operations manager Jake Turner comments: “Our programme offers the personal support of a coach and allied health professional to help more people enjoy the many physical, mental and social benefits of time in the water. The sessions have been designed to support anybody who appreciates a little extra support when in the water, from dementia sufferers to those with learning disabilities or mobility issues. For most individuals, support means either physical help entering and leaving the pool, a hand to hold in the water, maintenance of a quiet, calm environment or simply a presence to reassure them that somebody is aware of their needs and is looking out for them.”

The charity Action for Children recently awarded funding for Sport for Confidence to continue to run inclusive sports camps in the Essex area. This followed successful camps that were run during the summer, they are now secured to run until March 2021.

Sporting Success John has a diagnosis of mild learning disability, recurrent depressive disorder, obsessive compulsive disorder and agoraphobia. At the time of referral to the occupational therapy service, John had been unable to leave the home environment for several months due to high levels of anxiety associated with going out (including a severe phobia of public transport). John was also uncomfortable with his weight.

John began meeting an occupational therapist at home and cycling to the venue to engage in a variety of sports. He became increasingly confident, less anxious and more positive.

Weekly attendance contributed significantly to the ongoing assessment and development of John’s occupational skills, and allowed teaching around healthy lifestyles and weight loss.

To attend climbing sessions, John began to independently manage travel via a combination of public transport and walking, giving him a sense of independence which translated into other areas of his life.

John took part in a Steps to Independence group to develop his functional skills in using public transport, money skills, use of a mobile phone and budgeting skills. John now gets involved with cooking sessions, he joined a local Kung Fu club, and is undertaking a bricklaying course at college.

John actively promotes the Sport for Confidence Group, which has involved him jointly presenting for funding for the boccia group.

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WHAT IS REBOUND THERAPY?

By Eddy Anderson and Paul V Kaye

The phrase ‘Rebound Therapy’ describes a specific method of use of a full-sized trampoline to provide therapeutic exercise and recreation for children and adults across a wide range of additional needs.

Rebound Therapy offers a huge number of potential benefits, including the improvement or development of: Strength of limbs, numeracy, patience, communication, coordination, independence, self confidence, balance, muscle tone, reaction speeds, selfimage, eye contact, relaxation, freedom of movement, sense of achievement, stamina, spatial awareness, body awareness, social awareness, consideration of others, trust and confidence in teacher, colour recognition, height and depth perception, and most importantly: FUN & ENJOYMENT.

Rebound Therapy has a huge number of benefits for people across the whole spectrum ofdisabilities.

It is also used to facilitate movement, to promote balance, to increase or decrease muscle tone, to aid relaxation and sensory integration, and as a highly effective cross curricular teaching tool.

The work is intrinsically motivating and enjoyable and returns high value in therapeutic terms for the time and the effort involved, the fact that the activity is so enjoyable can enable it to be used as a motivational aid to learn. Many teachers also report increased concentration and willingness to learn in the classroom following a Rebound Therapy session.

‘ReboundTherapy.org’ are the UK governing body and international consultancy for Rebound Therapy.

They are responsible for the development and provision of certificated training courses throughout the UK and overseas.

These courses are accredited by the Professional Development Board for Physical Education a division of AfPE For further information about Rebound Therapy and Training courses, contact: www.ReboundTherapy.org info@ReboundTherapy.org Tel: 01342 870543

PRIMACARE A dynamic and established bespoke seating company.

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rimacare have been making bespoke seating for the last twenty years from their factory site in Tredegar, in Wales.

When they started the company the aim was to work with healthcare retailers to supply and support them with rise and recline chairs. Today, Primacare are one of the very few manufacturers that does not employ a sales force to sell directly to clients.

There are now over 200 nationwide healthcare retailers that stock and sell Primacare rise and recline chairs to the requirements of their clients.

Many occupational therapists will be completely unaware of the existence of Primacare as a bespoke seating company due to the fact that they primarily distribute through healthcare retailers. This presents an opportunity for both a healthcare retailer and an OT to work more diligently together locally, to quickly resolve seating issues.

Recently, healthcare retailers have mentioned they have experienced a growth in the demand of more specialised seating, also clients are often well researched and aware of the seating options available to them. The combined experience of the healthcare retailer and the knowledge of an OT, as a result can

“The rise and recline chairs are all manufactured by hand and every seating range is available in multiple size combinations� deliver the perfect seating solution for any client.

At the heart of the Primacare operation is David Tomlin the managing director who is always looking for a problem to solve. He leads a dedicated team committed to providing healthcare retailers with the latest rise and recline chairs and regularly shares innovative technology updates and specialist seating knowledge with the healthcare sector.

A process of continuous development and improvement is practiced within Primacare, which has resulted in a comprehensive range of rise and recline chairs now offered. Over the last three years the specialist seating range has developed into a wide-ranging offering that satisfies the needs of many clients with complex seating issues. This has been the result of being proactive and focused

on the design process, which has engaged the experience of industry professionals, on-going market research and in-house expertise.

The rise and recline chairs are all manufactured by hand and every seating range is available in multiple size combinations to fit the requirements of every individual. So what makes Primacare different?

One key aspect, is they use creative engineering to deliver excellent, high quality rise and recline chairs. By resolving even the most difficult seating solutions and with increasingly challenging conditions, Primacare is able to provide bespoke seating and comfort in a chair that exactly fits client’s needs.

With the increase in demand for chairs with higher weight limits Primacare developed the BLTR action, which is used in the Bariatric seating range and the Penarth Chairbed. Additional innovations include the use of a single common base for three different rise and recline chairs such as, Adelphi, Florence and Cabaret. This makes maintenance in an institutional setting more cost effective and the reissue of seating more practical.

Primacare will be exhibiting at The OT Show at the NEC on 27-28 November on stand C14 where they will be unveiling some exciting new products for 2020.

For more information about the range of seating solutions Primacare offer call 01685 845900 or visit primacare.co.uk.

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THE OCCUPATIONAL THERAPY SHOW 2019

The unmissable event for occupational therapists

O

n the 27-28 November this year, The Occupational Therapy Show is set to return with an impressive 5,000 members of the occupational therapy profession attending the NEC, Birmingham over the course of two jam-packed days to take advantage of the outstanding exhibition floor and world-renowned programme, all for free.

This year The Occupational Therapy Show is set to be our biggest show yet, offering hundreds of trade suppliers, thousands of products, on-stand training, cutting edge innovation, as well as first class education, renowned speakers, 80+ hours of accredited CPD and regulatory updates, meeting the needs of all occupational therapists and exhibitors from across the UK. Free for delegates to attend, the atmosphere at the Birmingham NEC comes alive once again as the doors open the show’s 7th anniversary event.

“This year The Occupational Therapy Show is set to be our biggest show yet”

Thousands of OT professionals will pour into the NEC, to make the most of the extensive trade exhibition with hundreds of manufacturers, suppliers and training providers in attendance. These include AKW, Etac, Essex County Council, Invacare, Otolift Stairlifts, Prism Medical, Sunrise Medical, to name just a few. Delegates have the perfect opportunity to discover new innovations and the latest products, materials and technologies to reach the UK market. There is also plenty of live demonstrations of products and on-stand learning for delegates to make the most of.

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EDUCATION PROGRAMME

AWARD TIME The Occupational Therapy Show Awards, in partnership with the OTCoach are a regular instalment at the event, adding to the networking and social opportunities on offer.

These awards return again this year to provide an afternoon of celebrating and recognising the achievements of well-deserved occupational therapists who are going above and beyond in their roles.

To complement the major exhibition, The Occupational Therapy Show will host an education programme with streams for all OTs including mental health, moving and handling, neurology in practice, paediatrics, housing, equipment services and governance.

Among the highlights on the educational programme, our Keynote Theatre will deliver sessions covered by the likes of Dr Mary Birken, Anne Addison, Jennifer Creek, Julie Barnhouse and Adam Ferry, among many others. There are also another six theatres packed full of informative lectures which have all been developed to actionable inspiration to enhance your daily practice.

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Sponsored by Freedom by Symphony, the Housing Adaptations Trail is designed to help OTs source products and information to help their clients achieve independent living at home. This was a huge success last year, with over 30 exhibitor’s participation to support the launch and hundreds of OTs taking part. The Exhibitor Product Launches webpage was also launched and went down a storm with both delegates and exhibitors alike. This has been enhanced for 2019.

PAEDIATRIC TRAIL A firm favourite amongst our delegates and exhibitors and back for another year is the Paediatric Trail, highlighting exhibitors and seminars that OTs could visit in order to give them greater exposure to all the latest learning, products, services and technologies on the paediatric market, enabling them to bring an enhanced service to clients.

THE OCCUPATIONAL THERAPY EXHIBITOR AWARDS Introduced last year, these awards celebrate and acknowledge successful exhibiting companies and the products or services they supply to the OT audience. Judged by a panel of respected OTs put together by Jen Gash of The OTCoach, these coveted awards are back again this year.

THE POSTER ZONE The Poster Zone, has once again been inundated with submissions and is set to be more popular than ever.

This area allows individuals and teams within the OT profession to share best practice and network with colleagues from across the UK, discussing the presented works and posters.

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GOING IT ALONE M Are you toying with the idea of stepping out into independent practice?

aking the move into independent practice can be a huge decision, one that should not be taken lightly.

There are many pros to becoming an independent OT, but you must prepare yourself for hard work and unexpected challenges. It does take a certain type of person to make it in independent practice, you must be determined, creative, motivated to work on your own, flexible and open to challenges. If you put your all into branching out on your own, you can reap the rewards.

So, what are the most important things to think about.

1 PLANNING You must have a clear idea of the services you want to offer.

Create a business plan that lays out exactly what you want to offer. Research the area you are looking to target and identify any prospective business links you could make with organisations in your area. Get some figures down on paper that show your set up costs, marketing costs, equipment costs and anything else you can think of that will cost you to get up and running.

Explore what business grants and loans are available to you and familiarise yourself with your responsibilities as an employer if you are looking to employ staff.

2 SUPPORT NETWORK

It is vitally important to build a network of peer support and personal support from family members and friends. If you have been working in the NHS you will be used to having a team of allied health professionals to turn to for advice and to discuss particular problems or issues. When you are working on your own you can become very aware that you do not have a team there to bolster your confidence or offer alternative ideas. It is therefore very important to build up a network of OTs and other AHPs who will be on hand to offer advice and act as a good sounding board for ideas.

3 CPD As we all know it is very important to keep up our CPD portfolio, for both personal growth and for requirements for your HCPC registration.

You may have previously had access to in-house training and learning opportunities that you won’t necessarily be able to take advantage of when you are independent. You will have to get creative and seek out CPD opportunities that will benefit you and your clients best. Look for free CPD accredited seminars that are on offer at shows like the Kidz to Adultz events and The OT Show.

4 MANAGING YOUR TIME Working for yourself and being your own boss lends you a certain amount of flexibility. You can achieve a great work life balance that works for your own personal circumstances. You can work around family commitments and decide on what events and learning opportunities you want to attend. Starting up will take a lot of time and hard work, but if you put in the work at the beginning you will be able to enjoy the benefits of flexibility and freedom in the long run.

5 ADVICE Before making the leap to independent practice, try to talk to as many people as possible to ask for their tips on making the transition as smooth as possible. Reach out to your network on Twitter, Facebook and LinkedIn to ask questions and reassure yourself that you are making the right decision. RCOTSS-IP have a comprehensive start up pack that can be downloaded and they run information days on going into private practice too.

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Dual Diagnoses:

Another Brick in the Wall, Building Competence in Complex Case Management 10th & 11th June 2020 | Hilton Birmingham Metropole

Our vibrant and inspiring speakers will share their knowledge, research and hands-on experience on brain injury and multiple diagnoses – providing essential tools for your Case Management toolkit whilst ensuring a confident, consistent and professional approach to brain injury and complex case management for clients, at all times.

Covering the following topics:

Further details can be found at: www.babicm.org/events Tickets are available through the BABICM website: www.babicm.org/events

‘Tis The Season (for Self-Care)

If you’ve got a little time off at Christmas, take the opportunity to be kind to yourself and perform a little self-care in advance of the New Year.

T

his may be news to you, but Christmas is fast approaching.

It’s the season of goodwill to your fellow man, but what about you? If you’re lucky enough to have time off this festive season, hopefully you’ve designated a day – or even a few hours – to looking after yourself and topping up your mental energy with some solid self-care.

There’s a pervasive understanding that self-care means “a pint of Ben & Jerry’s and a bath”, but as OTs you’ll be more than aware that it’s not always the definition of the term.

Yes – sometimes, self-care does look like a long bath and a treat from time to time, but more often than not, it’s just a series of simple steps which are designed to bring a small amount of joy and harmony to your being.

your soggy bottoms, so there’s no pressure! Christmas bakes are often warm and delightfully spiced, giving you that lovely seasonal feeling in your soul and your stomach. If you want an extra challenge, try making a Christmas loaf – kneading the bread is the ultimate act of relaxation. A personal favourite is the traditional German Christmas biscuit lebkuchen, which are soft, round biscuits flavoured with ginger, cinnamon, cloves and honey. We’ve included a recipe for you to try!

Lebkuchen

Adapted from the BBC Good Food recipe Ingredients:

In the spirit of the season, we’ve come up with a few ideas to replenish your emotional and mental energy while also being a simultaneous celebration of the season.

250g plain flour

The Great Christmas Bake Off

1tsp ground cardamom

Last issue, we introduced you to The Wee Baker, who sang the praises of the therapeutic aspects of getting your bake on. If you’ve got a few hours spare this Christmastime, why not head into the kitchen and have your own Great British Bake Off? The best thing about this is that Paul Hollywood won’t be present to judge

2 tbsp brown sugar 85g ground almonds 2tsp ground ginger 2tsp ground cinnamon ½tsp bicarbonate of soda 200ml honey 1 lemon, zested 85g butter

Method: 1 Add all of your dry ingredients to a bowl and whisk. Heat the honey, brown sugar and butter on a very low heat until dissolved together, then combine into the dry ingredients with the lemon zest and egg. Mix well until the dough becomes solid, then cover with a tea towel and leave to cool.

2 Heat oven to 180°C (160°C fan). Roll the rested dough into about 30 balls, no more than 3cm wide, then press them flat into disks. Place the disks on two lined baking trays, then bake for no more than 10 minutes before cooling on a wire rack.

3 When the biscuits are cool, mix the icing sugar with the beaten egg white and 1-2 tbsp of warm water. Using a fork, place the biscuits on the fork and dunk in the icing. Leave to dry.

4 In a bain-marie, melt the dark chocolate. Press the flat side of the biscuits into the melted chocolate, then leave to dry on a baking sheet.

1 egg Pinch of ground cloves, grated nutmeg 100g icing sugar 1 egg white, beaten 125g dark chocolate

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Be A Goal-Getter New Year is coming up, and it’s resolution time. Part of therapeutic self-care involves goal-setting and the fulfilment of these goals, but it’s about positive change, not forcing yourself to do something that makes you feel bad about yourself. Set yourself a goal that is actually reasonable – everyone always says they’re going to quit smoking cold turkey or something equivalent, and that’s more pain than you really need in your life, to be quite honest. Be fair, be forgiving, and be loving towards yourself. Maybe your goal for 2020 should be to meditate for half an hour a week, or sleep better. Set a goal about selfimprovement that leads to a sense of empowerment.

A Time for Family and Friends At Christmastime, there’s a sense that we should reconnect with family and friends. For some people, the season is a hard reminder that our family are maybe not the people we want to connect with. That is totally ok. This Christmas, take time to surround yourself with the people you want to be around, and the family you have made for yourself.

There’s nothing that replenishes the soul quite like spending time with the people you love, so take some time to be with friends and family who lift you up and encourage you this year.

The Spirit(uality) of the Season As much as Christmas is obviously the celebration of the birth of Jesus Christ, the meaning of the season has become a quagmire of religious, spiritual and cultural celebrations. Kwanza, Yule, Saturnalia, Hanukkah and many other celebrations occur in December. Even if you don’t have a religious connection to the season, take the opportunity to top up your spiritual energy this season. Prayer and meditation make a huge difference and can help promote clarity and calm thought, but so does remembering to be kind to yourself and offer forgiveness where you can.

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TAKE A Kate Sheehan highlights the importance of ensuring the correct seating for people living with Parkinson’s disease.

M

any visitors to this year’s OT Show will have worked with or be currently working with clients who are living with Parkinson’s disease and will therefore be all too aware that providing the correct seating for someone with this condition is vital. Repose Furniture will be exhibiting its range of specialist chairs on stand A40 at this year’s event and we have been talking to their retained occupational therapist Kate Sheehan about what to take into consideration when specifying a chair for someone

with Parkinson’s.

Parkinson’s disease is caused by the death of specific neurons in the brain area called the substantia nigra. These nerve cells produce a substance called dopamine, which is therefore lacking in people with Parkinson’s disease. Dopamine is a chemical that is responsible for the normal working of the part of the brain that controls movement. Dopamine deficiency leads to the following symptoms of the disease.

1 Tremor, generally more pronounced whilst resting, 2 Slowness of movement, 3 Stiffness of movement, making initiating movement difficult, 4 Impaired balance.

The cause of Parkinson’s disease is not yet fully known, however both genetic and environmental factors are considered to be involved. The disease is a degenerative condition which will present differently for everyone and as there is currently no cure, symptoms are treated as and when they appear.

Due to Parkinson’s disease causing a number of movement problems, including difficulty or delay of initiating movements, this can make getting comfortable in or rising from a chair difficult.

The movement from sitting to standing is more complex than we often appreciate. It requires us to gain sufficient propulsion from a resting position to move forwards and then upwards out of the chair.

Then follows the change in centre of gravity as we lean forward to generate initiation of movement.

This movement requires a certain amount of force and speed, and difficulty or slowness initiating movement can result in insufficient momentum to rise from the chair then mobilise safely.

In the early stages of the condition, strategies to improve position and momentum can help, such as moving first to the front of the seat, tucking the feet in under the knees and having the arms positioned to push up can help prepare a client to coming forwards and upwards.

Rocking back and forth a few times before trying to rise can increase the momentum and force to continue the movement. Cuing your client (“ready, steady, stand”) can also help to prepare and initiate the movement.

As the condition deteriorates initiating movement can be so difficult or slow that standing even from a previously useable chair can be challenging. A chair such as the C-air with a rise function, may provide extra support and propulsion which is perfect for helping to initiate standing. Most riser chairs work by slowly tilting and elevating the seat to lift and angle your pelvis forward.

Sometimes just a small angle on the riser function is enough to initiate a natural stand. Otherwise, the seat angle can be elevated until you are almost in an upright position, allowing you to finish with a small stand and walk off from the chair.

Due to the support being provided

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the rising function significantly reduces the risk of falls on initiating walking from the stand.

In the later stages of the condition when the client finds it extremely difficult or impossible to move without carers support, considering comfort and the carers abilities to work with the client to achieve the optimal position, comfort and movement is essential.

It is at this stage that considering a chair that can adjust with the clients changing ability is vital and the Boston portering chair is a perfect example of such a chair as it offers a variety of features and benefits to make it the ideal seating solution for both the client and their carer by incorporating the following:

Independent backrest By incorporating this feature, the chair can be moved independently which maintains flexibility over the client’s body position, particularly the amount of hip flexion, allowing for the optimal position for comfort.

Independent leg rest This offers the client additional flexibility over positioning, allowing them to use it in conjunction with the recline feature to create the optimal postural position for their body shape.

Adjustable footrest This feature allows the footrest to be moved away to allow clear access for the user to be hoisted from the front or obliquely

Pressure relieving Tilt in space This allows the seat back angle to remain the same whilst the whole seating system is tilted backwards allowing the angle of the hips, knees and ankles to remain unaffected reducing shear and friction on the bottom and back during this movement. It also reduces the weight on the ischial tuberosities by redistributing the weight through the back.

different and interchangeable pressure management seat and back cushion options.

Portering The ability to move a client from one room or position to another in comfort and with ease to reduce the number of hoist moves, is vital to enable the client to be involved in different activities. As well as the Boston, the Harlem Porter Chair is a great example of a chair which meets these demands and more.

All these options allow us to adapt the chair to the clients changing conditions, without impacting on their comfort, pressure issues and also to continue to encourage occupational performance.

Repose will be on stand A40 at The OT Show on 27-28 November.

For more information on the full range of bespoke seating solutions available from Repose Furniture call 0844 7766001, email info@reposefurniture.co.uk or visit reposefurniture.co.uk.

In the later stages of Parkinson’s, it is essential that a client’s skin integrity is monitored and reviewed due to the potential of pressure sores developing. A chair with pressure relieving properties built into its design, which can be up-graded as the condition changes is essential, for example

This feature can also help when transferring someone in a sling as it can support better pelvic positioning by using gravity to position the user in the back of the chair in the optimal position.

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We are recruiting Cygnet Health Care support 2725 individuals across 140 services within the UK. We are looking for people to join our team of over 150 Occupational Therapists to support individuals in a variety of different services.

We are also delighted to announce that we have exciting NEW opportunities for people to complete the Occupational Therapy Apprenticeship Programme in 2020.

Our service lines in England, Scotland and Wales: > Secure > PICU / Acute > Mental Health Rehabilitation and Recovery > Personality Disorder > CAMHS > Eating Disorder > Learning Disabilities > Autism Spectrum Disorder > Neuropsychiatric > Older Adults > Deafness & Mental Health

What we offer: > Competitive pay and company pension scheme > NHS discount cards > Expert clinical supervision and peer support > Learning and development including CPD > Free meals on duty > Cygnet Sensory Integration Preceptorship > Annual Cygnet Occupational Therapy Conference To apply please contact: Hayley Valentine hayleyvalentine@cygnethealth.co.uk

@CygnetOT

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www.cygnethealth.co.uk

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Raising Profiles “Sorry, what exactly is an occupational therapist” is a question we’d like to phase out of your life forever by raising the profile of the profession – but how?

y, what exact r r o ly is “S cc

u o patio n a n a l r e a h p t i

st? ”

W

e joke a lot (especially on our Instagram account @TheOTMagazine, shameless plug alert) about how no-one really knows what an occupational therapist actually is.

It’s probably not too wild to imagine that you’ve had to spend a significant period of both your training and your professional career explaining that no, you don’t get people jobs, and no, you’re not just a physiotherapist with a fancier title.

The question then arises: how do we raise the profile of occupational therapy? It’s a vital part of the job, as raising the profile of the job ultimately results in both more people joining the profession, and more people knowing how to get help for issues that may require the specialist intervention of occupational therapists. Much like raising awareness of a brand, there are tried and true methods of improving awareness in the modern world.

Get a Social Media Presence As OTs, you’re encouraged to maintain a good social media presence, and that’s obviously hugely important to your personal and professional brands. One of the main issues with occupational therapy Twitter (and the profession) that you might want to aim to resolve is the insularity: it’s all very “by OTs for OTs”. If you can produce social media content that has appeal to the layman, you’ll be well on your

way to increasing the profile and understanding of occupational therapy among non-OTs.

Consider Vlogging There’s no such thing as a face for radio – everyone’s got something to give in the online sphere. If you have access to the right equipment and materials (mainly a good camera and some editing software) you might want to try starting up your own YouTube channel. If you’re funny, engaging or informative, it won’t matter what you’re talking about, people will listen.

Community Engagement Starting on a smaller level, you could work to engage the members of your community, building trust and understanding on a more localised level, as opposed

to the global reach of social media.

If you can organise with local groups or community gatherings to volunteer your time, you don’t even have to do any occupational therapy – just people knowing you exist and what you do is enough to raise your profile.

Run a Workshop There are so many things that you as an OT know that could help everyone in their everyday life. If you’re feeling generous with your time and knowledge, pair up with some local groups – maybe there’s a support group in your area that you can offer some time to in order to divulge some of your wellguarded occupational therapist knowledge and experience? You’ll become a more familiar face in your community while raising understanding of your profession through practical means.

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MYTHS VS REALITY

really leave my NHS job of course. I decided to see if I could even get a job, and take it from there. I did get a job and left my NHS role, all in a bit of a daze.

So nearly two years later what do I make of it? This is probably a good time to comment that I can still remember what I thought it would be. This is what has surprised me the most as I moved into this new world.

Ann Barthorpe shares her experience of moving from the NHS into case management.

A

s I entered my 19th year working for the NHS, I believe I could be forgiven for sensing the need for change. Not that leaving my job was something I contemplated too deeply. The team I managed, my friendships at work and the service we provided on the stroke unit at my local general hospital was well embedded into my every day existence. Rather than think about leaving, I simply considered what else I could do. I looked for something completely different, something which would build on all I had learnt over the years, but lead me somewhere new.

Private rehabilitation case

management appeared to be a possibility, but it was hard to work out what it entailed; a kind of private social work being my initial conclusion. I decided to find out more. What I discovered was something very different in a new arena completely. The opportunity to support and coordinate care and rehabilitation for people who had sustained catastrophic injuries, involved in a personal injury claim.

I started to warm up to the idea.

As I negotiated my way through the application process to become a case manager for Harrison Associates, I was fast talking myself into this being the perfect next step. Not that I would ever actually

Firstly, if you have even just a vague interest in law or what is fair and unfair, case management is interesting. For many clients a case manager is instructed by both “sides” of a personal injury litigation case.

Your key stakeholders are solicitors and insurers with opposing interests.

A case manager is duty bound to keep the needs of the client at heart.

However, their progress is of great significance to the legal case. If case management doesn’t enhance your skills in communication, clear thinking and diplomacy, I really don’t know what will.

Secondly, even after the years I had worked in rehabilitation, I had no idea just how much could be achieved. My previous experience was that of an ongoing challenge to allocate services to the people most in need. Case management kicks the -magazine.co.uk

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“There were cynics who questioned my decision to move into case management” ball out of the park. Funds are often available for therapy, treatment, care and equipment far above and beyond what can be provided by statutory services. The role of the case manager is to work out what is going to make a real difference and sort out making it happen. It is exciting to see the results. I learn more every day from my clients and the rehabilitation professionals I work alongside, about just what is possible.

There were cynics who questioned my decision to move into case management. Don’t people litigating exaggerate their injuries to get more money? How do you cope with this as a rehabilitation professional?

In my experience, this is rarely the case. At Harrison Associates, case managers work with people who have sustained serious injuries. In reality I seem to spend more time encouraging my clients to accept what they need than vice versa.

I have discovered a real sense of satisfaction working with people on a longer term basis. Many of the clients on my caseload I have known since I started at Harrison Associates.

I feel privileged to be accompanying them on their journey. I have been able to use my own experience and skills to help them to navigate and reduce the insurmountable stress which comes along with acquiring a new disability.

Harrison Associates also offers expert witness services. An expert witness provides an assessment and report for the court to state the lifelong care and occupational therapy needs of an individual. This work was a further challenge which I undertook a few months into my role as a case manager. As with the case management role, I was provided with extensive training. I learnt how to consider the cost of

“I have gained the courage to stand up for my opinion in a legal forum. Without my experience as a case manager, I would not have had the confidence to undertake this role” 88

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compensating a person to achieve a good quality of life; how to write in such a way that my clinical reasoning is clear. I have gained the courage to stand up for my opinion in a legal forum. Without my experience as a case manager, I would not have had the confidence to undertake this role. In effect I have two jobs now, rolled into one, which complement each other perfectly.

Most case management and expert witness roles involve working from home. Working full time I welcomed the prospect of being around at home a bit more, particularly having teenagers at home who cannot find a pair of socks in the morning.

However, working from home was an undeniable shock. I spent at least one month feeling as if I was surely being watched, and too anxious to go to the corner shop in work time.

I have settled in now. I can work flexibly and I am in charge of my life again. I have a dog now and can take time off when I need to. For me this equates to a better quality of life.

My advice to anyone thinking of a move would be: find out more.

Go for a company with a good reputation who offer training, and support and supervision and just see where your legs take you.

Designed to assist disabled people and carers in their everyday needs.

About Us Orchid Medicare design, manufacture and supply a widerange of specialist equipment for toileting, showering and bathing.

Products are created with patients and carers in mind, whether at home, hospital or in a rehabilitation centre; purchased by social service providers, the NHS, local authorities, nursing homes and the general public.

Striving to continuously add comfort and ease to people’s lives.

Bespoke solutions available upon request, as well as a wide range of accessories.

E: sales@orchid-medicare.co.uk T: 01482 820333

www.orchid-medicare.co.uk

ADVE R T ORIAL

SECRET ACCESS TO THE RESCUE

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r Chris Eliot from Richmond, is one of a growing number of people across the UK benefitting from using the portable Featherweight access ramps from Secret Access. In January this year, Chris had his leg amputated and on discharge from hospital was reliant on a wheelchair while he recovered.

The wheelchair was great for helping Chris get about but when it came to getting into his home there was the issue of two steps from the path to the front door. “The ramps supplied by the NHS were unsuitable as they were so heavy no one could lift them, thankfully we knew about Secret Access having met them at Naidex so promptly ordered 2 Featherweight ramps: 75cm and 200cm long which were ideal as when combined they reached from the path, over both steps and into our hallway. These ramps are just amazing, they are so lightweight that myself, my wife or

friends can literally lift them with one finger and you can take them out with you so there is no need to worry about accessing building on a day out. I would not hesitate in recommending Secret Access to anybody who uses a wheelchair” explained Chris.

The Featherweight portable access ramp from Secret Access is available with a width of 75cm and four lengths ranging from 75cm to 200cm and weighing between 2.6kg and 6.8kg, this ultra-lightweight non-slip ramp features a simple open and close mechanism and is easy to transport and store making it the perfect travel companion for any wheelchair user who may be concerned about the accessibility of buildings they are planning to visit.

Secret Access will be exhibiting its range of access solution on stand H65 at The OT Show.

For more information on the full range of access solutions available from Secret Access please call 0333 772 2012, email contact@ secretaccess.co.uk or visit www. secretaccess.co.uk

Rita Hunt Court Installation Steeper is one of the largest suppliers of assistive technology with over 30 years’ experience. Trusted within the industry, they are regularly called upon to provide the expertise needed for commercial installations, building long term working relationships with their clients, the NHS and the local authorities.

Rita Hunt Court is just one of Steeper’s projects completed by their experienced assistive technology team. The building was initially built to accommodate wheelchairs, with wider doorways and lifts for easy access, however, it became apparent that the doors were too heavy for wheelchair user’s to open independently and therefore they rarely used the communal areas.

To give residents the freedom to use the facilities as they wish, Steeper’s assistive technology team installed automatic doors to return 90

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independence back to the residents.

In order to provide the least amount of disruption to the residents, the whole installation was completed within one week. The installation included the fitting of Gilgen automatic swing door systems and Steeper push pads. An upgrade to a resident’s Yale lock system was also included, as was a full lock system installation to another resident’s apartment. The successful swing door installation has made for easier access for the residents’ families and carers, as they can now be buzzed in from the resident’s apartment, eliminating the need for keys.

Steeper understands the importance of providing automated solutions, as the smallest of things in life are often the most worthwhile. Simplifying processes is important to help the residents at Rita Hunt Court to retain their sense of independence.

Already, this has provided an improved sense of community and encouraged companionship amongst residents, something that is vital to their wellbeing.

To request an assessment from the Steeper Assistive Technology team, please contact assist@steepergroup.com.

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This year, we have two fantastic seminars by Michael Mandelstam Michael Mandelstam

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Mercure Maidstone Great Danes Hotel Wednesday 6th November

OTAC Cardiff

Llechwen Hall Hotel Wednesday 4th December

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has provided independent legal training on health and social care law for 23 years.

He worked previously at the Department of Health and, before that, at the Disabled Living Foundation.

He has written many legal books over the last 30 years, including on the Care Act (2017), Safeguarding adults law (2018), Manual Handling (2002), Home adaptations and the Care Act (for the College of Occupational Therapists, 2016).

10:00 – 10:30 Manual handling and singlehanded care The seminar outlines current issues in manual handling and places them within the relevant legal framework, including

Delegates receive FREE lunch and Refreshments at OTAC

the Care Act, NHS Act, Manual Handling Regulations, Human Rights Act, Mental Capacity Act. In particular it focuses on single-handed care (reduced carer handling) – benefits, pitfalls and legal implications.

15:00 – 15:45 Care Act and home adaptations This seminar considers the legal basis for the provision of home adaptations.

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Yourevents

IN THIS ISSUE we bring you this year’s round-up of events taking place in the OT calendar.

If you have, or know of, an event please email it into enquiries@2apublishing.co.uk

27-28 NOVEMBER

17-18 MARCH 2020

The OT Show

Naidex

NEC, Birmingham Dedicated solely to occupational therapists, The OT Show promises to bring you an incredible line up of speakers, seminars and workshops alongside a huge exhibition of products and services and over 80 hours of free CPD on offer. theotshow.com

NEC, Birmingham Naidex brings together healthcare professionals, disabled consumers and trade professionals. The event is dedicated to being a platform to showcase and inform the industry on independent living products and services available. With a dedicated education programme for occupational therapists and great opportunities to gain CPD. naidex.co.uk

6 NOVEMBER

OTAC Kent Mercure Maidstone Great Danes Hotel The UK’s only free Occupational Therapy Adaptations Conference and Exhibition.

At each event you will find expert seminars and exhibitors specialising in home adaptations and equipment, and invaluable CPD opportunities. otac.org.uk 4 DECEMBER 14 NOVEMBER

Kidz to Adultz North EventCity, Manchester

OTAC Cardiff LLechwen Hall Hotel

Free exhibition dedicated to children and young adults with disabilities and additional needs, their families, carers and all the professionals who support them, with over 100 exhibitors and free CPD seminars.

The UK’s only free Occupational Therapy Adaptations Conference and Exhibition.

At each event you will find expert seminars and exhibitors specialising in home adaptations and equipment, and invaluable CPD opportunities.

kidzexhibitions.co.uk

otac.org.uk -magazine.co.uk

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u o y e r

A As occupational therapists you are required to register with the Health and Care Professions Council (HCPC). This registration is due for renewal every two years and each time you renew you will be asked to sign a form to confirm that you continue to meet the HCPC’s standards, including keeping up on your CPD.

W

e are back at the beginning of the twoyear cycle before the dreaded HCPC audit is due to crop up again. On the plus side this gives you plenty of time to prepare in case you are summoned by that ominous letter to prove your commitment to continuing your professional development as an occupational therapist.

Every two years a random selection of OTs are called for the HCPC audit and even if you have been called before, this does not safeguard you from being chosen again. So, it is best to be as prepared as you can be in case lightning strikes twice.

C P C

Hready?

and take them in your own time, or take out a subscription to The OT Magazine – we are CPD-certified so you can include any of the articles you have learned from in the magazine in your CPD profile, and as a subscriber you can also request PDFs of these for your portfolio.

Collating

evidence

Finding CPD

Over the course of your career you will attend many different courses, meetings and events, you will also learn from a vast array of different situations. This means that the evidence you are to supply to support your submission can be a wide range of different documents.

First off, you need to find some CPD opportunities, a task that can sometimes be tricky in terms of time and money. There are plenty of events that offer free CPD seminars for OTs, take a look at The OT Show, the OTAC events, the Kidz disability events and many others throughout the UK.

Ensure you receive certificates for any courses or CPD seminars you attend, save copies of any materials you have produced as part of your role. Collate any feedback or testimonials from employers, peers and patients and save it all to be presented with your submission.

opportunities

Search for free online courses that could be relevant to your practice

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We are back at the beginning of the two-year cycle before the dreaded HCPC audit is due to crop up again

Create a

filing system

Whether you like to do this electronically or by filing paper copies away in folders, as long as you have a system that works for you then this is the first step to being organised.

The paperwork you will accumulate to support your CPD will be a mix of different documents. Try separating them into folders for course certificates, reflective written work, materials and leaflets that you have produced, this will make it easier to source evidence when it comes to putting together all the supporting material for your audit. Try to keep it in a date order so it is easier to trace back when you completed each task.

Write

ups

Don’t wait for weeks or even months to reflect on experiences or events attended. The excitement of a day of learning is best showcased when it is fresh in your mind. It can be a time consuming task, but it will help in the long run as it is much easier to convey what you learnt immediately after the event.

Jot down some notes on your journey home or type them up on your phone to expand on later. This will help immeasurably when you get some time to write up your reflections properly.

We asked our network of OTs if they had been through the audit process to share their advice on Facebook: MIA MOODY “I have been selected twice in a row!! Luckily not again this year! Pretty scary initially and a bit time consuming, but not as daunting once you have a plan.

I have communicated any tips, support and advice to as many of my colleagues/local OTs as possible to help since. I’m also glad to see that the guidance has in fact improved this year to being more straight forward and less ambiguous - certainly in terms of the number of pieces of evidence HCPC suggest you submit. I will always help where I can.”

REBEKAH WRIGHT “Just been through the audit process for the first time, my top tips are 1) don’t put off getting started, you’re just delaying the inevitable 2) use all the resources available to help you - the HCPC website has examples which are helpful & the booklet they send you has all the info on how to complete the audit and 3) always assume you’ll be selected & be prepared by keeping your list of CPD activities up to date!

DID YOU

KNOW? There are

39,886

registered OTs currently in the UK 2.5% of registered OTs are chosen every two years for an audit You get three months from the initial letter to complete and submit your CPD audit You will not be chosen for an audit until you have been a practicing OT for at least two years You can be chosen for audit in consecutive renewal periods If your profile does not meet the HCPC’s standards you will be removed from the register (you do have a right to appeal)

-magazine.co.uk

95

For your next challenge…

With a reputation for excellence and international quality accreditation, Harrison Associates provides case management and expert witness services for adults and children with life-changing injuries. Opportunities nationwide.

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Join our expanding team of experienced Occupational Therapists

Occupational therapists play a key role acting as expert witnesses in clinical negligence and personal injury litigation We require experienced occupational therapists to undertake case work, who are confident, have excellent communication skills (verbal & written), enjoy a challenge, are intrigued by the forensic nature of this work, and above all are keen to learn new skills.

We offer Regular work on a case by case basis to fit in with other work commitments Excellent remuneration Full & on-going training & support You will work on a self employed, flexible basis, alongside your “day job” You will be working at a senior level with a minimum of 8 years post qualification experience as an OT or/and case manager Request an information pack at admin@somek.com

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SELF-EMPLOYED FLEXIBLE HOURS FROM HOME TO SUIT YOU We currently have exciting opportunities for enthusiastic and forward thinking Moving & Handling Advisors within the South East area including Surrey, Kent, Hampshire, Berkshire and some areas of London.

The work is client centred, working with both adults and children with Acquired Brain Injury or Traumatic Brain Injury and will involve carrying out risk assessments, training employed support workers and assessing equipment needs in the client’s own home.

To become an ILS Moving and Handling Advisor, you will have: A wide range of clinical skills TBI/ ABI experience

The ability to work independently with families and carers who support our clients in the community

HCPC registered with a professional qualification and an up to date portfolio (CPD).

A train the trainer qualification or equivalent.

For more information or to discuss the excellent company benefits we offer, you can contact the ILS HR department on 01722 742442 or visit our careers page at www.indliv.co.uk alternatively, apply direct at www.jobs.indliv.co.uk

A Reputation Built on Excellence

Successful completion of the EDGE People or Children Handling and Risk Assessment Key Trainer’s Certificate courses will provide delegates with the up to date skills, knowledge and tools to teach others in safer people or children handling skills and to conduct moving and handling risk assessments.

• Healthcare Professionals All EDGE Services Trainers are nurses, occupational therapists or physiotherapists with at least ten years clinical experience and at least ten years training experience in this field.

• Fully Accredited All our People and Children Handling and Risk Assessment Key Trainer’s Certificate courses are accredited by RoSPA Qualifications to Level 4 or Advanced Level 4. They are RCOT (The Royal College of Occupational Therapists) Approved Learning Awards and are recognised for providing continuing professional development by the CPD Certification Service.

All EDGE Key Trainer events comply with the following professional training standards; • The National Back Exchange Training Standards (2010) • The All Wales NHS Manual Handling Training Passport and Information Scheme (2010) • The Scottish Manual Handling Passport Scheme (2014).

Please contact our friendly office team to discuss your training requirements in more detail.

• Invaluable Training Resources, Exclusive On-line Library and E-Learning Module Our training is supported by a professionally produced, fully illustrated and comprehensive 256-page course textbook, proposed documentation for onward training delivery, filmed practical techniques, an extensive and informative on-line resources library and a user-friendly e-learning module designed for front-line staff.

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EDGE services 01904 677853 enquiries@edgeservices.co.uk

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