Residential, Nursing & Care Winter 2018 Newsletter
DISABLED LIVING'S 2019 TRAINING DIARY Moving & handling, supporting plus size people, legal workshops & much more...
CONTINENCE CORNER Constipation part 2
LAST MINUTE GIFT IDEAS Suggestions for relatives
THE OT GURU Reminiscence therapy
FREE JUST CAN'T WAIT CARD Accessing toilets when out and about
Charity number: 224742
A World of Affordable Healthcare Solutions Apollo Healthcare Technologies Limited (AHT) is a leading manufacturer and supplier of: Pressure Area Care Devices. Moving and Handling Equipment. Specialist Seating. Profiling Beds AHT sells into the NHS, Community and Nursing Home sectors as well as an increasing number of international markets. Based in West Yorkshire, our purpose built Head Office along with strategically placed engineers and partners ensures a guaranteed level of unprecedented support for all of our customers. Our extensive product portfolio offers clinically tested healthcare solutions. New product development will always be at the forefront of AHT’s vision, this in line with a comprehensive understanding of legislation changes, ensures all of our products are in keeping with the market requirements. No matter how big or small the organisation, it is AHT’s commitment to help all our customers deliver both a more effective and efficient care.
Apollo healthcare Technologies ltd, Holme Street, Liversedge, West Yorkshire WF15 6JF www.apollo-ht.co.uk Tel: 01924 614567 Fax: 01924 607480 Email: Sales@apollo-ht.co.uk
Explore Our Key Features
Disabled Living's 2019 Training Diary..............................................................................................4 A workshop for healthcare professionals.........................................................................................5 The latest product news...................................................................................................................7 Reminiscence therapy......................................................................................................................8 Free Just Can't Wait Card..............................................................................................................13 Treatment and management of constipation..................................................................................14 Visiting your relatives at Christmas time.........................................................................................18 Last minute Christmas gift ideas for the family...............................................................................20 Disabled Living's achievements over the last 12 months...............................................................23 Learn more about Disabled Living..................................................................................................26
The Disabled Living will be closed from 4.30pm on Friday 21st December and will reopen on Wednesday 2nd January 2019 at 9.00am.
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Disabled Living Training Diary 2019-2020
Disabled Living’s 2019-2020 Training Diary has been released, take a look at all of our upcoming events and courses online via: issuu.com/disabledliving/docs/training_diary_2019 -2020_final?e=0 Don't miss out and book now to register your place on one of our training courses in 2019!
Tel: 0161 607 8200
Email: info@disabledliving.co.uk
Web: www.disabledliving.co.uk
Disabled Living Training Dates for Your Diary Moving and Handling, Trainers and Assessors Course Date: 9th, 10th, 16th, 17th & 24th January 2019 Venue: Disabled Living, Burrows House, 10 Priestley Road, Worsley M28 2LY Price: £650 + VAT (includes light lunch and refreshments, Open Awards registration and extensive handouts). The trainers and assessors course will give you knowledge and confidence to perform your role as a manual handling trainer and assessor. More information and dates can be found here. Emergency First Aid
Price: £95 +VAT
This bespoke course will enable you to deliver effective emergency treatment before professional help arrives. This course is the 1 day Level 3 Award in Emergency First Aid at Work (RQF) and complies with HSE requirements. Accredited by Qualsafe. For more information please contact: training@disabledliving.co.uk or call: 0161 607 8200 4
In the Dock: A Workshop for Healthcare Professionals
Your competency is under question Your record keeping is being scrutinised Healthcare professionals working in the care environment this includes you! There are different scenarios which could end up with someone being summonsed as a witness. Whether it is a coroner's court or a civil negligence case this workshop will help you to understand what will be required and how to improve your practice so that a court appearance will be less intimidating. Using real life scenarios, expert witnesses and solicitors will lead you through the process and highlight areas you can improve and share good practice in. On this interactive day you will work on a project which culminates in you appearing in the dock in front of a Judge and Jury. Find out how to protect yourself in your reporting and recording at work, what your responsibilities are and how to be confident in your work and not be afraid of being taken to court. Please visit our website to book your place and for more information. If you require more information please email: training@disabledliving.co.uk.
Date: Thursday 25th April 2019 Venue: Manchester Price: Cost: ÂŁ65 + VAT (includes light lunch and refreshments)
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Product News The team at Disabled Living want to draw your attention to new and innovative equipment which will support you to provide the best possible care for your residents. All of these companies can be found via our Supplier Directory. The airBody Dryer The ultimate all-over body dryer, using innovative technology to effortlessly dry you before you leave the shower. The perfect way to stay warm and get dry gently and fast; with no effort required. Click here to learn more.
Boutique 750gsm Towels Available in a range of contemporary and classic colours to suit all tastes. Care instructions: Machine washable; Fabric conditioner should be used sparingly as this can decrease a towel’s ability to absorb. Click here for more information.
The ProMove Sling Easily used in unpredictable situations to provide a safer more secure transfer where a hoist is unavailable or impractical. Provides safe and comfortable manual handling solutions in crisis situations. Used in confined or outdoor locations where a hoist cannot be used. Models for all sizes from children to bariatric adults. Click here for more information. Motion Activated Memo Reminder When people are a little forgetful, this movement activated voice memo player can help by using family recorded messages or instructions. You simply record a voice message then switch the alarm on. When a person is detected by the photoelectric beam the memo is played back. Click here for more information.
Ultima Bath Seat The Ultima bath seat from Special Orthotic Services Ltd offers comfort and security for both client and carer. The seat is height and angle adjustable with independent calf and backrest movement. Click here for more information.
GH3 Modular Ceiling Hoist The groundbreaking GH3 modular ceiling hoist system from Simply Moving and Sleeping – you’ve never seen anything like it. Click here for more information. 7
The OT Guru - Reminiscence Therapy
It’s that time of year again, when the leaves have fallen and the nights are drawing in. Christmas is just around the corner. For some residents, it is an exciting time of the year however, for others it can be a very emotional time; missing loved ones or feelings of loneliness as families rush around busily shopping and getting organised for the festivities. Reminiscence can be a great approach to help your residents remember all of those happy childhood memories and times spent with their friends and families. Recalling their own children or grandchildren growing up and seeing the delight on the children’s faces light up on Christmas morning.
Reminiscence - A story told about a past event remembered by the narrator. - The enjoyable recollection of past events. Origin Late 16th century (denoting the action of remembering): from late Latin reminiscentia, from Latin reminisci ‘remember’.
Little girl holding Magnetic Molly gift at parcel distribution from Disabled Living's archive. 8
Reminiscence is an activity widely used in dementia care, although can be beneficial to everyone.
The OT Guru - Reminiscence Therapy
People with dementia usually have better preserved long term memory and therefore an activity focusing on their past events seems a suitable activity. Recollecting past events and experiences is enjoyable for residents, it will reinforce to them who they are and where they come from. Reminiscence can encourage interaction and communication, often initiated by the residents and can help staff to build rapport, learning more about their history and personality. This works well as a 1:1 or in a group setting, with little to no expense needed.
Christmas/Winter activity ideas Local school to come in and sing Christmas carols, hand outs with lyrics (large print if required) Charades Reminiscence boxes (nuts, fruit, packs of trifle/custards, conkers/string, Christmas hats, crackers, schooner of sherry) Christmas reminiscence quiz Christmas movie nights Food tasting sessions This is a great sensory activity if someone has limited communication and interaction skills. Some ideas are: cherry trifle, prawn cocktail, melon, baking/cooking sessions, cookies, rice puddings, turkey and stuffing apple sauce, cranberry sauce, snowballs, Quality Street, Christmas cake/puddings, nuts. Consider risks factors such as choking risk, food allergies, etc. 9
The OT Guru - Reminiscence Therapy Ensure reminiscence is relevant to the younger residents Decades – Planning Chart Guidance (Example)
Age now
Born
At age 10
At age 20
88
1930
1940
1950
78
1940
1950
1960
68
1950
1960
1970
58
1960
1970
1980
Things to consider when planning reminiscence activities
Reminiscing and life history work can also be a powerful way of communicating with a person with dementia. It can be the basis for enjoyable time spent together and a way for the person with dementia to feel empowered. This can contribute positively to their well-being. Alzheimer's Society 10
Preparation, have some prompt cards, pictures, quotes, topics of interest Cognitive levels, physical skills, sensory need. Does the resident have their hearing aids, glasses? Staff involvement/support and involve families and carers, visitors, young children. Time of activity - No rules! And have no expectations – remembering 5 minutes reminiscence is better than no engagement. Residents may prefer to sit in the background and listen only... Most importantly - have fun, laugh, cry, offer hope and festive joy. Angela Christian Occupational Therapist, Disabled Living
For more information and to see a comprehensive range of ideas for reminiscence activities, you can order a copy of the booklet 'Memories are made of this: Reminiscence activities for person-centred care' (from Alzheimer’s Society). www.alzheimers.org.uk/dementia-professionals/resources-professionals/memories-aremade-reminiscence-activities-person-centred-care This book includes specific suggestions of music and other resources. It includes a useful introduction on reminiscence approaches, clear instructions, illustrations and case studies. Practical advice is given on choosing appropriate activities for individual and group reminiscence and how these can help achieve learning outcomes related to person-centred care. References Alzheimer’s Society BJOT 2005 68(8) Variability in response of Older People with Dementia to both Snoezelen and Reminiscence. Baillion et al.
Individual Employer Funding
If you employ your own care and support staff (through a personal budget from health or social care or using your own money), you can apply for funding to train you and your staff. If you work with individual employers please share this ‘Money for training’ leaflet with them – you can email Skills for Care to request printed copies on marketing@skillsforcare.org.uk.
www.skillsforcare.org.uk/Learning-development/Funding/Individual-employerfunding/Individual-employer-funding.aspx?
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Do Your Residents Need to Access the Toilet Urgently When Out and About?
Bladder and Bowel UK (BBUK) have launched a new Just Can't Wait Card Recognised and supported by many retail and service organisations, giving you access to toilets not normally available to the general public. FREE pocket sized plastic card BBUK confidential helpline Available from BBUK - a charitable service Get your card from: bladderandboweluk@disabledliving.co.uk www.bbuk.org.uk Registered Charity No: 224742
Continence Corner Constipation Part 2: Treatment and Management
SEPTEMBER 2017 Constipation is not a disease, but a symptom of an underlying condition. We do know that people's perceptions of 'constipation' can vary greatly and it is not an uncommon complaint to be seen across a wide group of adults and children and young people. If left untreated, constipation may lead to individuals struggling to evacuate or empty their bowel completely, rectal loading or faecal impaction and faecal incontinence. Individuals may also report pain and discomfort, along with the negative impact constipation has on their general well being and quality of life. Constipation in the elderly person may also cause confusion so needs to be very closely monitored. Most adults give little or no thought to their bowel functioning. Individual routines change, resulting in people experiencing changes in their bowel habits. Having a bowel movement is a most private affair. It is only when things start to go wrong, that the complex sequence of events, which enable us to successfully empty our bowels without any difficulty, pain or discomfort or maintain continence, are then no longer taken for granted.
time. It is not uncommon for care home staff to be the first to identify they have a problem with constipation. Whilst for others, they may already be on an established bowel management programme, that needs reviewing or maintaining by staff in the care home environment.
Constipation affects people differently, for example it may present as an acute or short term episode, alternatively it may present as a longer term chronic problem, where symptoms last for more than three months. When an individual enters a care home environment, they may have actually been self managing a bowel problem for a long
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Care home staff are in an ideal position, to help identify and improve the management of constipation for the people they care for.
Continence Corner Constipation Part 2: Treatment and Management Tools to help staff assess individuals presenting with constipation
Once a cause of constipation has been identified, an individual plan of care can be implemented. Consideration should also be given to assess the need to involve other professionals, such as GP, dietitian, community/specialist nurses, OTs, thus taking a proactive approach to managing an individual's bowel care routine. The key to successful treatment and management of constipation is largely dependable on a detailed bowel assessment being undertaken, which will enable those caring for residents to plan an individual treatment and/or management bowel programme.
There are a number of guidance documents available to help support practitioners in practice, directing to evidence based guidelines that follow a structured approach to assessing any form of bowel dysfunction. Assessment tools are also useful, such as a bowel diary which can record episodes of incontinence, frequency of defecation, stool type using the Bristol stool scale, which is a helpful visual tool, listing differing stool type from hard stools through to diarrhoea.
SEPTEMBER 2017
A food and fluid diary is helpful There may be an indication as part of the bowel assessment, to undertake a digital rectal examination. The Royal College of Nursing have produced guidelines to support nurses in practice in regard to this and can be accessed on the RCN website. NICE have produced guidance on faecal incontinence and constipation and there is a wide amount of publicised literature available to support staff in practice on constipation.
Some common causes of constipation: A diet that is insufficient or lacks adequate fibre/fluid intake. Delay in colonic transit time Nerve injury or disease that may include patients with spinal injury, multiple sclerosis, Parkinson’s disease and stroke Hormonal changes e.g. menopause, pregnancy, hypothyroidism, and diabetes Drug induced, e.g. opiate analgesics, anticholinergics and iron, antidepressants Evacuation difficulties caused by hard impacted stools or nerve damage Anorectal conditions, e.g. haemorrhoids or anal fissure, rectal prolapse Bowel disorders such as IBS, Diverticular disease and carcinoma Cognitive impairment Surgical/diagnostic procedures Environmental factors may be indicated – consider correct toileting posture Habit/routine such as ignoring the call to stool
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Continence Corner Constipation Part 2: Treatment and Management Assessing individuals with bowel symptoms – examples of what should we be asking? What is the current problem (faecal incontinence, struggling to evacuate, difficulty fully emptying the bowel, feeling not fully emptied bowel after defecation etc.) How long has the constipation been a problem for you? What are the symptoms that bother you? Frequency of defecation, including past and present bowel function Any unexplained changes or red flags reported e.g. rectal bleeding, pain, unexplained changes in bowel habit, unexplained weight loss, diarrhoea? This may trigger further urgent medical assessment General health, medical/surgical history Medication history, including laxatives, rectal interventions and over the counter preparations. Current bowel care regime. How does the individual usually manage their bowel care/routine? Impact of bowel problem on the patient’s life? Does this stop them for undertaking activities. Are there any changes to normal diet or fluid intake? Poorly fitting dentures Are there any changes in mobility, independent or needs assistance, poor manual dexterity? What has been tried previously, if a long standing problem and for how long? Toileting facilities. If newly admitted to a care home becoming accustomed to new facilities can daunting. Any new bladder problems
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Treatment and management options NICE advice that the dose, choice, and combination of laxatives used depends on the person's symptoms, the desired speed of symptom relief, the response to treatment, and their personal preference. The first step is to identify the underlying cause. Is it due to a recent illness or admission to the care home? Many people self manage their bowels and loss of independence may affect their bowel functioning. It may be that simple modifications in lifestyle, reassuring the individual, dietary changes including review of diet/fibre intake (although note, that a high fibre diet may not be practical or appropriate for all) and review fluid intake. Assessment will also consider if the presenting constipation is an acute or chronic problem. It may be that the individual is taking regular opiates or is requiring palliative care. Individuals may also present with requiring longer term bowel management intervention. In these situations multi-disciplinary working is necessary. It is important to relieve the faecal/loading impaction if present.
Continence Corner Constipation Part 2: Treatment and Management Summary
Discussion or referral with or to a local continence, bladder and bowel service or dietitian should be considered. Ongoing assessment and evaluation is key. NICE recommend that referral to a gastroenterologist or colorectal surgeon for specialist investigations and management should be arranged if a serious underlying cause such as colorectal cancer is suspected. Or if an underlying secondary cause of constipation is suspected, which cannot be managed in primary care or if symptoms persist or recur despite optimal management in primary care.
Constipation is a common problem Lots can be done to treat and manage constipation (and other bowel and bladder problems) in the care home environment. The treatment can be challenging, as diagnosis and definition varies between clinicians and sufferers. Constipation has a detrimental effect on the person’s social and emotional well-being. Individual assessment and promotion of bowel (and bladder) issues are vital, if services are to improve, with an emphasis on all clinicians/staff recognising bowel care as an essential to any patient’s overall health. Karen Irwin Service Manager/Specialist Nurse
For further information or signposting to services, training and education information and resources please contact the BBUK team. Telephone: 0161 607 8219 Email: bladderandboweluk@disabledliving.co.uk Web: www.bbuk.org.uk
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Visiting Relatives at Christmas Time
Most people do not discuss their bladder and bowel habits with their families and friends whether this involves constipation and taking a long time in the bathroom, urinary or faecal incontinence or urinary urgency and frequency including getting up during the night. All of these symptoms may cause embarrassment to the individual who is experiencing them and they may decide because of this not to invite family members to spend time at their home or may turn down an invitation to stay with relatives. Christmas is a special time and a time for families and friends to be together. Do not let your bladder or bowel dictate where or how you spend this Christmas! Some practical preparation and, if possible, some open communication will help you as individuals to spend time together and not allow your bladder and bowel to cause you to miss out or feel isolated. Practical tips for preparation Ask for a bedroom that is closest to the toilet for convenience. If you have a bladder problem especially at night buy a urinal that you feel comfortable to use in the bedroom to save lots of trips to the bathroom to aid discretion. Ensure you have plenty of skin wipes and disposable bags to aid your hygiene regime and discreet disposal of incontinence products. 18
Ensure you have adequate protection in the form of continence pads, underwear and bed protection. It may be advisable to buy a more absorbent pad to aid your confidence when other people are around. Speak to your GP prior to the Christmas period if you have any concerns regarding your bladder and bowels as medication may aid management of the issue. Do not reduce your fluid or dietary intake as this may make the problem worse. If you suffer with bladder urgency reduce the amount of caffeinated drinks you drink. Try decaffeinated tea or coffee, diluted cordials and fruit teas as this may help to alleviate some of the urgency. Merry Christmas! Joanne Hoyle, Specialist Nurse BBUK Helpline: 0161 607 8219
bbuk.org.uk/blog/visiting-relatives-at-christmas/
This Edition We Welcome
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Let the Family Know About Christmas Gift Ideas
Gift ideas for the family to help them remain independent and continue to do the things they love to do!
Gardening tools
Card Holder
Swivelling Car Seat
Fireside Chair
Wade Dignity Cup
www.disabledliving.co.uk/online-shop Disabled Living Equipz Team 0161 607 8200 Email: info@disabledliving.co.uk 20
Let the Family Know About Christmas Gift Ideas
The Equipz team will answer any queries you may have about the suitability of equipment for your relatives. Here are a few suggestions for practical gifts.
Lap Tray
Bath Lift
Slippers
Big Button Phone
Shopping Trolley with Seat
www.disabledliving.co.uk/online-shop Disabled Living Equipz Team 0161 607 8200 Email: info@disabledliving.co.uk
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Look... It's Out! The brand new Kidz to Adultz magazine launched at the Kidz to Adultz North show last month. Let your colleagues and the parents you support know about Disabled Living’s 48 page magazine which is packed with interesting articles including: • How Remap has provided a solution for a little girl • An innovative book launch • How crowdfunding support can help • A World Cup adventure • How one student’s USA dream has come true • A focus on finances • A look at therapeutic positioning
We would like to hear from you • If you have an article we can publish to support children and young adults with disabilities or additional needs • You are a company who would like to advertise a product You can take a look at the new magazine via our Kidz Exhibitions website www.kidzexhibitions.co.uk For more information about the Kidz to Adultz Magazine please contact magazine@disabledliving.co.uk
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Web: www.kidzexhibitions.co.uk Tel: 0161 607 8200 Email: info@disabledliving.co.uk
Kidz to Adultz Exhibitions in 2019
What Have Disabled Living Achieved Over The Last 12 months? The team at Disabled Living are delighted to share with you through our Annual Report our achievements. This year we showcase the amazing projects and events we have delivered through the ‘Donkeys to Innovators’ project where we celebrated Disabled Living providing services for 120 years. Our team offer a wide range services, some you will know very well and others which I am sure will be beneficial – take a look!
Click here to read the Annual Report via Disabled Living's website 23
Get in touch with us
For more information please visit: www.disabledliving.co.uk
Disabled Living Head Office - Disabled Living, Burrows House, 10 Priestley Road, Wardley Industrial Estate, Worsley, Manchester M28 2LY Tel: 0161 607 8200 Email: info@disabledliving.co.uk Website: www.disabledliving.co.uk