OT Magazine - May / June 2018

Issue22

magazine

THE

May / J une 18

w o Hoes your d rden a g w?

Improving Independence

g n i n e y d p r a Gather +

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COLUMNS

/

PRO DUCTS

o r g

The cial o s f fits o bene erapeutic th e and ultur c i t r ho

/

EVENTS

/

RECRUITMENT & T RAINING

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About us

The Team

Editor: Rosalind Tulloch Staff Writers: Colette Carr and Katie Campbell Designer: Stephen Flanagan Marketing: Sophie Scott Sales: Robin Wilson Contributors: Kate Sheehan, John Callas, Hannah Rogers, Neil Bindemann

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 2018 © 2A Publishing Limited. All Rights Reserved. ISSN-2056-7146

This month’s issue...

T

he therapeutic nature of gardening lends itself seamlessly to the profession of occupational therapy to be used as a tool that promotes social interaction, improves wellbeing, provides focus and feelings of accomplishment among many other benefits. We explore these benefits further on page 16 and look at organisations that could offer you advice for setting up your own gardening project for a group of patients.

We speak to Catherine Gray, an OT who has set up her own social enterprise to offer a service addressing the mental health and wellbeing of those living in rural Norfolk and we find out more about the work Tess Stanton does as an OT in the non-traditional OT setting of the fire service - find out more on page 66.

Did you know that boxing could actually help people living with Parkinson’s? Neither did we until we came across the work that OT Charles Delve is doing to empower people living with the disease, turn to page 30 to read more on this.

Japan has the oldest population in the world and an incredibly high number of people diagnosed with dementia. However, they have a very different and interesting way of looking after those people compared to the UK, this insight on page 38 is well worth a read.

Our paediatric section this issue is all about playing and role playing.

From techniques to help keep young children distracted during hospital appointments and operations to how the tabletop role playing game Dungeons & Dragons can help young people open up and find confidence.

We hope you enjoy this issue, please don’t hesitate to get in touch with any ideas for future features. ros@2apublishing.co.uk.

The OT Magazine, Editor

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

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

01/05/2018 12:41

What’s inside 7 What’s New? Bringing you up to speed with all the latest news from the healthcare sector

16

13

13 The Fight For

Our Profession Kate Sheehan is calling on you to help defend occupational therapy’s position in the healthcare sector

16 OT and Gardening How you can take OT into the garden

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

23 OT Approved John Callas reviews the MIP Swift Ultraslide System

25 Day in the Life Sarah Welsby gives us an insight into a day in her work in a Rapid Response Unit

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26 Hands On Learn about the 3D printers who change people’s lives every day

26

30 The Gloves Are Off OT Charles Delve takes the fight against Parkinson’s into the ring

35 Maintaining

Hydration

The importance of maintained hydration in those living with dementia

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What’s Inside

50

60 Kids Products The latest must-have products on the market for younger clients

62 A Cut Above

The Rest

38 The Oldest

Nation In The World Discover how Japan treat dementia in their growing elderly population

40 Product Focus More latest must-have products on the market

43 Band of Builders Meet the tradesmen transforming the homes of their colleagues in need

47 A Real Pain

for Some

Tackling chronic pain

Your Voice Counts P82

50 Fancy A Cup-O-T? Supporting young people with mental health conditions in rural areas

54 Play Therapy Supporting children through difficult hospital procedures through the medium of play

57 SpecialKids Discover the adapted clothes created and designed with children in mind

58 Dungeons &

Dragons

How can a fantasy board game become a real-life intervention?

Learn how a stand-up wheelchair is helping one hairdresser make the cut

66 OT and the

Fire Service Find out more about an OTs role in the fire department

69 Student’s Hopes Learn how a home lift enhances one student’s life

70 Building

Mental Fitness

Exploring how mental fitness is just as important as physical

72 Role Emerging

Placement

Meet Hannah Rogers, whose role emerging placement led her to a homeless hostel

75 Sport For

Confidence Discover that boccia isn’t just a funny word

76 Find Events

Near You

Upcoming dates for your diary

79 Care Expert Reports Jacqueline Webb explain the role of their Experts when writing a Care Expert report

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

What’s new?

One stop online shop A

new marketplace and app, WeMa Life, is the new source for healthcare professionals and carers to book, source and pay for healthcare and wellbeing services.

Users can book everything from social care, domiciliary care, nursing, domestic help, personal care and hygiene, to nutritionists, physiotherapists and more.

Numbers

Ahead of its launch, WeMa Life surveyed more than 2000 adults to

understand what issues needed to be addressed with startling findings.

Users can book one-off and ongoing sessions, as well as services from multiple providers in one transaction, while tools on the online portal also enables businesses to improve management and delivery of their services, opening them up to a nationwide marketplace. wemalife.com

15% 53% 46% of UK adults currently act as informal carers (7.85 million people)

say the role has had a significant emotional impact on them

believe it is difficult to source reputable healthcare providers

Sally speaks Award-winning actress Sally Phillips will speak at the UK’s first national festival dedicated to specialist learning on 2 June.

Sally will deliver a keynote session at FestABLE which brings professionals, parents and young people together to tackle issues facing young disabled people, hosted by National Star, looking at SEND reform, the Children and Families Act, and whether services count more than choice and aspirations.

National Star chief executive David Ellis said: “There is a growing desire to talk about what will work better for young people with disabilities and learning difficulties and how all of us - professionals, parents and the young people - can make difficult things possible.” festable.org

More articles on next page

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What’s

new?

NHS Pledge Push NHS England have renewed the push for the Stopping Over Medication of People with a Learning Disability (STOMP) campaign, by asking more health care professionals to sign up to stop the overmedication of people with a learning disability, autism or both.

The government backed drive targets NHS trusts, CCGs and the independent sector to review and

seek alternatives to psychotropic drug prescriptions, opening more scope for treatments like occupational therapy.

An estimated 35,000 adults with a learning disability, autism or both are prescribed an antipsychotic or antidepressant, with long-term use leading to weight gain, organ failure and in cases death.

Allied Healthcare facing closure

Looking for an OT job?

With jobs updated regularly and email updates, you can make your next career move by visiting: ot-magazine.co.uk/jobs

Allied Healthcare could face closure unless creditors back a rescue plan.

Numbers

Allied Healthcare, who care for over 13,500 people through 150 local authorities and out-of-hours GP services for the NHS, have filed for company voluntary arrangement on Monday. The CVA would give owners Aurelius four weeks to agree a new repayment plan with

creditors, including landlords and pension trustees.

Allied Healthcare is the latest domiciliary care provider to be hit by local authority cuts to fees paid for home care visits and rises in the minimum wage

13.5k 83 13.5k people cared for by Allied Healthcare

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branches facing closure

people employed by Allied Healthcare

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01/05/2018 12:43

What’s

new?

Toyota challenge mobility Toyota challenging outdated mobility devices in new campaign Data from an international study of wheelchair users by ComRes and the Toyota Mobility Foundation highlighted the need for investment and innovation in the development of assistive technologies for people with limited mobility.

The Toyota Mobility Foundation launched a $4 million global challenge to seek teams to create game-changing, person-centred technology to improve the mobility and independence of people with paralysis.

The research found 90% of wheelchair users in the UK say they have experienced pain and discomfort as a result of their mobility devices and more than a quarter have felt frustrated because the design of their mobility device felt outdated.

The challenge rewards the development of personal mobility devices incorporating intelligent systems from exoskeletons to artificial intelligence and machine learning.

To tackle this, the top five suggested improvements were, to be able to move around faster (41%), perform

regular day to day tasks more easily (40%), feel more relaxed and comfortable with a device that feels more natural and like an extension of themselves (34%), feel more confident and able to socialise with friends (31%) and feel a sense of spontaneity and independence (29%).

Home Sweet Home Six high-quality, wheelchair accessible, affordable new houses have welcomed new residents in Inverness.

The development was completed after work began in March 2018, with each featuring wider doors and halls, level access showers and height adjustable sinks, suitable worktops, an oven housing which can accommodate a traditional oven or a microwave at waist height and a loc-bloc driveway providing parking close to the front door.

The living areas boast windowed walls and glazed doors that open onto a back patio.

The houses, developed and designed by the Highlands Council and NHS Highlands’ occupational therapy team, costing £846,000 with £342,000 grant funding from the Scottish Government and the rest coming from the council.

Entries close on 15 August 2018, and the winners will be unveiled in Tokyo in 2020. mobilityforall.com

Let us know what you think...

We want to hear from you. Please take the time to share your thoughts and ideas with us and shape The OT Magazine

Take our survey on page 82

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What’s

new?

ETAC offer Kidz CPD E

tac R82 are presenting a freeto-attend CPD-accredited seating seminar at Kidz to Adultz South.

As part of the renowned Kidz educational programme, Etac R82’s Paediatric Postural Seating Assessment Tips will be led by clinical manager and OT Joanne McConnell.

Joanne’s 25 years of paediatric and complex disabilities experience will see her seminar

focus on motor development looking at milestones and the early signs of impaired movement.

It will review posture and the need for specialist equipment for disabled children, discussing specialist “Paediatric seating and how to assess Postural Seating symmetry vs asymmetry Assessment Tips alignment, hip and leg positioning, posterior will be led by clinical manager pelvic tilt, deformities of the spine or scoliosis, and OT Joanne muscle tone and McConnell. “ spasticity. etac.com/uk

Home hub hopes Hubs hopes to help people return home and McKillop Gardens in the town.

A new communitybased care hub in East Kilbride is set to springboard a new £18 million plan to support service users to return home in South Lanarkshire.

The council’s capital investment is part of their new plans for social care in the area by creating a community-based care hub after a similar model was trialled in Meldrum

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“The council’s capital investment is part of their new plans for social care in the area...”

The three-year scheme will see three of the four care homes requiring investment scrapped and replaced by a new Blantyre hub which will provide intermediate care for older patients including OT, in the hope of getting more people home to adapted and supported properties.

Rementia studies gain traction New studies are highlighting the increased knowledge and benefit of the “rementia” model in occupational therapy when living with the early stages of dementia.

A Barry nursing home has used the new process developed by New Yorkbased clinical dementia specialist Dr Dan Nightingale to support residents to relearn simple tasks.

Nightingale believes the brain can heal itself by retraining undamaged parts of the brain to restore lost functions, as latest neuroscience findings highlight enabling new links between neurons to work in place of the damaged ones.

However, critics argue that results can only be seen in some people and more research must be carried out.

-magazine.co.uk

01/05/2018 15:35

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Is your Authority working on a Single Carer Project?

Single handed care projects can be a challenge to implement, overcoming the barriers to working as a single carer or reducing the number of carers for a client can be hard.

Handicare have helped lots of authorities to make single handed care projects work for them.

Working hand in hand to assess and help identify products required, providing CPD accredited training and support on equipment and techniques to enable therapists and carers to simplify and overcome the challenge of single handed care in their area.

Hampshire, Dorset, Somerset, Gwynedd, Sheffield, South Gloucs, Norfolk, Birmingham, Herts and Bedfordshire‌‌ just some of the councils we have worked with to help make everday life easier.

Contact us, to see how we can help you with your project: T 01384 40 57 92 E mhbsenquiries@handicare.com www.handicare.co.uk

Adverts_OT-Iss22.indd 12

www.handicare.co.uk

01/05/2018 14:00

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

This issue Kate talks about defending the good name of occupational therapists

The fight for our profession

E

arlier in the year the government appointed the University of West of England (UWE) to carry out an independent review of the Disabled Facilities Grants (DFG) in England. Shelia McIntosh from the UWE is working with, Dr Rachel Russell (OT), the Building Research Establishment, Ferret Information System and Foundations to look at both the delivery of the grant, financial limits and means testing and the wider delivery of home adaptations to promote independence and dignity of disabled and older people living in their own homes.

The grant sits in primary legislation which was placed on the statute book in 1996 under The Housing Grants, Construction and Regeneration Act, part of the act states that the local housing authority ‘shall consult the social services authority’ this has been the role of the occupational therapist and their duty after an assessment of need is to clearly define what is ‘necessary and appropriate’ to meet the needs of the disabled person.

At a recent Fix The DFG event, a number of questions were asked

“We were challenged about whether there is a need for an occupational therapist assessment...” and the delegates opinion sought, unfortunately there was little time to debate due to time constraints and the set up of the day, however two areas really made me sit up, think, respond and latterly reflect on.

1

We were challenged about whether there is a need for an occupational therapist assessment; this seemed to stem mainly from the fact that there was, for some authorities, a long waiting time for an OT to visit and also that simpler adaptations don’t require a degree in OT to assess and create a specification for the necessary works.

I would agree that some adaptations could be undertaken by occupational therapy support staff under the guidance of a qualified

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01/05/2018 12:46

Kate Sheehan

member of the team and there could be some simple ways of creating effective specification templates to potentially speed up the process, however is that solving the underlying issue which is that there are not enough OTs? No it is not.

I would also suggest that the three years we train for and the experience we have enables us to make informed decisions on a clients need based on our client’s individual experiences of their condition, their physical presentation, our understanding of their medical condition now and in the future, the psychological impact of their condition and their anthropometrics. I can describe numerous occasions where I have gone into a privately funded housing modification, to have to very gently explain that we need to re-do it due to a number of mistakes rendering the space unusable.

When challenging the premise that you don’t need an occupational therapist in the session I was told, “you would say that, you are an occupational therapist.” My statement wasn’t borne out of protectionism as was indicated but out of the client receiving the best outcome to meet their needs now and in the future.

2

The second issue was about funding, over the last few years the budget for the DFG has increased considerably, which in a time of austerity shows how this and previous governments have valued the cost effectiveness of keeping people in their own homes (let alone the psychological).

There was a discussion about financing children’s adaptations, which tend to be more costly and time consuming. The presenters questioned the money spent on these cases and stated it was hard to justify to politicians.

My argument was, the reviewing team needs to go back to government and express we are 14

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www.

“I am passionate about my profession and the value it can add to our client’s journey following a catastrophic injury, acute or long-term medical condition or the impact of ageing.” not dealing with bricks and mortar, we are working with young peoples lives and we must allow these children to reach their full potential and not to be restricted by a built environment that impacts their independence and dignity.

I am passionate about my profession and the value it can add to our client’s journey following a catastrophic injury, acute or

long-term medical condition or the impact of ageing. Our unique skills lie in being able to understand the physical, cognitive, sensory and mental health influences on our client’s abilities to carry out activities of daily living that they want, need and have to do. In addition we are able to understand the critical interaction between the person, their environment and occupations they wish to return to being able to do.

So my plea to all OTs working in this area is to complete the ‘Consultation survey for the independent review of Disabled Facilities Grants’ promote the value of occupational therapy in the home modification process and put the client firmly at the centre of this process.

You can find the online form at fixthedfg.co.uk.

And finally, lets fight for our profession. We are awesome and must never forget it. 

-magazine.co.uk

01/05/2018 12:46

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01/05/2018 14:00

Gardening Therapy

G

w o Hes your

o d

e n d r a g row? g

ng i n e rderapy

Ga t

h

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We explore using the benefits of form of gardening as a y therapy for man different user groups.

ardening is a pastime that can be enjoyed by people from all walks of life, of all ages and of all abilities. In everyday lives gardening can bring a sense of accomplishment, it can provide a focus, have a calming effect and promote a sense of wellbeing.

The benefits of spending time outside in the fresh air cannot be denied and gardening can also be used as a therapeutic and rehabilitative tool to improve physical and mental health. It can encourage people to mix socially, build confidence and learn practical skills that will help people live independently.

Social and therapeutic horticulture is a practice that uses plants and gardens to address physical and mental health problems, communication difficulties and improves overall wellbeing and it can be used with patients who are living with dementia, who have learning difficulties, who are working through mental health issues, recovering from physical or emotional trauma or who have sensory impairments.

Being at one with nature can have a

The benefits of spending time outside in the fresh air cannot be denied..

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01/05/2018 12:47

Gardening Therapy

profound effect on participants and Thrive are one organisation that uses gardening to help people.

Thrive

Thrive is an organisation that uses gardening to change people’s lives.

They run gardening projects headed up by their horticultural therapists many of whom have completed specialist training in social and therapeutic horticulture.

Health and wellbeing is at the heart of Thrive’s work and they cite the following benefits that can be seen through a sustained and active interest in this green fingered hobby: • Improved physical health through exercise, muscle strength can be built and mobility can be improved • Improved mental health through a sense of purpose and achievement • The opportunity to connect with others, reducing feelings of isolation or exclusion • Acquiring new skills to improve the

chances of finding employment • Improving independence • Feeling better for being outside and being in touch with nature Thrive run gardening projects across the country and welcome people who are referred from healthcare professionals or people who come independently. There are over 600 projects running in the UK so you are likely to find a project close to you. There are many different types of gardening programmes but they all use a garden setting and can be found in allotments, on hospital grounds, in prison grounds, at schools or they may share facilities at a garden centre.

Thrive run specialist horticultural training and education programmes and a Professional Development Diploma in conjunction with Coventry University. If you would like to find out more about these visit thrive.org.uk.

Trellis

Trellis is another gardening organisation that has a focus on therapeutic gardening and operates in Scotland. They have over 230 gardening projects running throughout Scotland and their website hosts a wealth of information on therapeutic gardening, from

factsheets and research to useful tips on planting flowers and vegetables.

A survey Trellis conducted in 2013 broke down the user groups of their gardening projects and it revealed that the largest group was adults with additional learning and support needs (22%) followed by those who had mental health issues (18%).

The rest of the user groups broken down included people with sensory impairments, patients rehabilitating from illness, those with physical support needs, people with autism, offenders/ex-offenders, people living with dementia, homeless people, exservice personnel and many more.

Gardening and Dementia

Trellis have some great insight into the therapeutic benefits of gardening for people living with dementia. They stress that the right level of support must be considered to ensure the activities are manageable and they must appeal to the participant too.

Gardening is also a great social activity to do with family and friends so including them in the process can be a really enjoyable way for them to spend time together.

Spending time outside gardening can provide stimulation through 

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01/05/2018 12:47

Gardening Therapy colours and smells, it can alleviate tension and frustration as it has a calming effect and can provide a peaceful space for personal reflection as well as an opportunity for self-expression.

Garden Design

When considering the layout and functionality of a garden for people living with dementia ease of use should be at the forefront. The garden itself should provide structure and reduce anxiety and confusion.

Trellis recommend the following tips for creating an appropriate gardening experience for those living with dementia: • Access from the garden to adjoining building should be obvious and visible eg. visible, accessible doors, porch and path leading to garden or building entry.

• An enclosed garden may be useful to keep wanderers in and provide shelter. The fencing and walls should be visually inconspicuous and can be disguised by planting.

• A returning path system is useful to lead you on a journey through the garden returning back to the house or building (Kennard 2006), eg. a figure of 8 or a more freeform loop.

• Sturdy, comfortable seating, ideally with line of site from one seating area to another to provide opportunities to admire, rest, contemplate, socialise and continue the journey around the garden.

• Easy visible access to the toilet from the garden.

• Consider the mood and feeling of the garden. Create areas for communal activity and areas for being alone or in smaller groups.

Include places to sit, shelter from the sun and the wind. Bushes and trees provide structure and can direct movement around the garden.

• Think about garden access in all weathers. Provide protection from the extremes of weather with conservatories, greenhouses, 18

16-18_Gardening.indd 18

pergolas, parasols or an indoor/ outdoor activity room with access to the garden.

• Think broadly about who will use the garden. Plan for a range of ages and abilities. Include activities and play facilities that allow generations to interact, for example, a slide, a games table, garden or BBQ. Think about visibility and observation so caregivers can still relax if they use the time for separate pursuits.

• Incorporate bird feeders or a bird table or bath, with opportunities to sit comfortably and view the bird activity.

Start Your Own No matter what setting you work in a gardening project can offer a multitude of benefits for users. Why not start a project of your very own?

Perhaps you have access to a small outdoor area at your place of work that you could utilise or perhaps a local garden centre or allotment would offer you a space to use.

Once you have found a suitable space you can tailor it to the individual needs of the group you work with. If they have physical disabilities or mobility problems you can source equipment like table top beds or potted benches that allow easy access for wheelchair users to

do planting. If your client group has sensory impairments consider plants that are tactile or have a strong scent, use signage with braille, large text or ones that contrast against soil and vegetation.

Talk to your local garden centres for advice and ask if they would donate some tools and seeds or plants to start you off.

Talk to your group and discuss what everyone wants to get out of the project. Talk about what you want to plant, what you want to achieve and maybe set some group goals if appropriate.

Gardens and plants can evoke nostalgic memories for many and can spark conversations about people’s lives, people can share knowledge and offer advice or simply work quietly side by side comfortably enjoying the outdoors.

If growing fruit and vegetables this can be extended into new activities like cooking and enjoying the food you have all grown. Flowers can also be picked and pressed or pot pourri or lavender bags made. 

For help and advice on starting your own gardening project contact Thrive, thrive.org.uk or Trellis, trellisscotland.org.uk.

-magazine.co.uk

01/05/2018 15:36

e t a m i t l u The e t a m i t n i in s s e n i l n a e l c

“The Closomat is the most wonderful thing of all the living aids we have added to our home, it’s beautiful!

I now don’t have to get my wife to help me.”

Karl van Gool, Halesowen

Quality • Service • Heritage www.clos-o-mat.com Tel: 0800 374 076 Email: info@clos-o-mat.com Adverts_OT-Iss22.indd 19

01/05/2018 14:00

Product

Focus 1 Easy-Tear

Kitchen Roll Holder 03456 049 049 | johnlewis.com

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

EASY

1

tear

This innovative product makes tearing off paper towels much easier for clients with the use of only one hand, or those with strength or dexterity issues.

Using an upright tearing blade that provides a convenient edge against which to tear, its heavyweight, nonslip base provides added stability and excellent resistance.

Liquid level

2 indicator

2

0303 123 9999 | shop.rnib.org.uk Place gauge on the side of a cup, glass or jug and the sensors let visually impaired clients know when the liquid gets to the top through a series of beeping sounds and vibrations. Suitable for use with both hot and cold liquids. The prongs give off an intermittent beep followed by a faster bleep sound and continuous vibration.

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01/05/2018 15:38

3

Vision 3 Low Wall Clock 0800 255 0498 | abilitysuperstore.com The low vision clock has been designed with a bright yellow face to assist those with poor eyesight or other visual impairments. The contrasting yellow clock face and black arms and digits complements the clear simplistic features to help draw the person’s attention to it.

4

4 Shop-A-Seat

Liberator Shopping Trolley 0800 255 0498 | abilitysuperstore.com This four-wheeled trolley is easier to manoeuvre than others offering increased independence for users. It can be pushed or dragged, while the retractable undercarriage operates when the handle is lowered, giving a secure and stable seat. The insulated bag also keeps hot food hot and cold food cold, and allows clients to transport items unaided.

5

5 Sound Oasis

Miniature White Noise Machine 01737 247571 | deafequipment.co.uk The world’s smallest white noise machine is a portable sound machine helps manage tinnitus and improve concentration on the move. Fitting in the palm of your hand, the tiny yet powerful white noise machine works with the included earbud headphones, your own or with pillow speakers.

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01/05/2018 12:48

TASTE

FOR YOURSELF

Book a free tasting session and discover the joy that our tasty, nutritious meals can bring to patient mealtimes.

For your free session call

0800 524 4207 or visit wiltshirefarmfoods.com

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01/05/2018 14:00

John Callas

Occupational Therapist - M&H specialist Associate of UK Therapy Services John is a moving and handling specialist OT working as an associate of UK Therapy Services. John currently provides commercial consultancy, expert training and clinical assessment within his specialist field.

In this month’s feature, John explores a more affordable bed positioning system

OT Approved

MIP Swift Ultraslide System

P

ositioning patients in bed to aid with personal care, toileting or making them comfortable can be very difficult. The number of plus size/bariatric patients we are seeing being treated in our hospitals and homes is increasing. This often presents carers and nursing staff with moving and handling challenges, particularly when using slide sheets with specialist airflow pressure mattresses or working at a low level. Often just getting slide sheets in position is challenge enough.

put through pressure mapping tests by the manufacturers and has high breathability, which reduces the build-up of heat and moisture.

Bed positioning systems have been used in the community for some time to tackle this. Due to costs however, they are often considered much later; for example, single slide sheets often must be tried first and ruled out, even though you may suspect it will be troublesome. The MIP Swift Ultraslide System retails at only £30 (bariatric size) - much cheaper than more established products on the market. This is a washable product, which is ideal for community use, but due to its relatively low cost, it could be used in hospitals and be considered single patient use and disposable.

I recently had the opportunity “I recently had the to try out the MIP Swift Ultraslide System and have opportunity to try recommended its use to colleagues in the community out the MIP Swift as an alternative to other Ultraslide System and positioning systems. In practice, I found the MIP Swift have recommended Ultraslide System was just as its use to colleagues in effective at moving patients onto their side and up and the community as an down the bed as existing alternative to other more expensive systems. I would definitely recommend positioning systems...” this product to trial with a suitable patient and as a great tool for any OT to have access to, potentially something community equipment stores could keep on the shelves and hospital wards in their store room.

The MIP Swift Ultraslide System has been

store.mipinc.info

-magazine.co.uk

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01/05/2018 16:49

A day in the life

ah r a S t Abou

A day in . f o e f i l the Sarah Welsby

...we talk to a diffe rent occupatio n to see wh al therapist at a is for them typical day a a little mo nd explain re about their role.

the 08 at g in 20 qualified in in a r dt nce starte ntral bria. O Sarah f Cum er at the Ce HS o y it s r N e r e ls a iv a c n it r U p e y Hos gan h nd 5 she be ter Universit began a Ba s t an h e a h t. Sar tions a Manc n Trus pleted rota spiratory, io t a d com Foun te Re n then re Unit, Acu ab, gaining a rotatio eh C R nd e y t r edia Elde o a Ba Interm eadics and essed her t m a e T r p ponse itals Ortho rience prog p id Res e s p p o a x H R e the this hing d. l Teac she is base ition in 6 pos h Blackpoo e r e h w wit st (RRT) ndation Tru ou F S H N

Describe your role…

I am currently a Clinical Specialist OT with the RRT which is an integrated community based team who treat acutely unwell patients at home who otherwise without our treatment would be in hospital. We treat a large variety of conditions within the team and a large portion is COPD. I have completed courses in consultation and physical examination which allows me to complete a range of assessments such as respiratory, neuro and cardiac. I have also completed advanced CBT interventions for anxiety and depression.

I work four shifts over seven days.

I begin my shift by collecting my allocations; we do not hold our own caseload and we may not see the same patient twice. I will complete initial assessments for new patients in the morning and complete follow up visits later in the day.

For a COPD patient I will complete a holistic assessment similar to that of most OTs, however in addition I

Each month ..

The best part of my day is always changing a patient’s life for the better.

will complete a set of observations (BP, pulse, Sp02, temp, RR). I will complete a chest examination including auscultation, followed by ACBT, collect sputum samples if needed and provide/demonstrate how to safely use a nebuliser. I will discuss inhaler regimes, when to stop nebulisers and provide a range of breathing exercises. Equipment assessment will be completed and equipment provided to maximise function at home whilst conserving energy for those important occupations. I can complete the full OT process in one day. A large part of my role is to provide anxiety

management, this is when I utilise a CBT approach to reduce their anxiety levels maximising their occupational performance and participation whilst increasing QoL.

What is the best part of your role?

The best part of my day is always changing a patient’s life for the better. It’s providing the support they need at that time to manage the crisis, preventing a hospital admission and keeping them at home with loved ones is the best reward.

What’s the hardest part of your job?

The worst part of my job is providing support for patients with a poor prognosis or who are ‘end of life’.

Working in the community we are so fortunate to see people in their own homes with their family and being part of this stage in their life is a privilege but not always an easy one to see.

-magazine.co.uk

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01/05/2018 15:41

Heading here

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-magazine.co.uk

01/05/2018 12:51

3D printing

Hands on A global movement that is changing people’s lives every day

T

he e-NABLE Community is made up of an incredible collection of volunteers who offer their time and talent to providing 3D printed upper limbs to those who need them most.

There are many people in the world who have either been born without upper limbs or have lost them due to war, accidents or natural disasters. Many of those people don’t have access to suitable solutions that could help make their everyday lives a little easier.

A 3D printed prosthetic hand could allow a child to throw a ball, help a mother to feed her baby or simply make everyday tasks like washing and dressing that little bit easier.

donated two - one for Ivan and one for the carpenter. Ivan taught himself how to 3D design and turned the metal hand into a 3D printable file and then shared it opensource online so that others could take it and improve it. A few months later, the e-NABLE Community formed with a few dozen volunteers who had 3D printers and wanted to help make hands too.”

In a very ‘pay it forward’ deed, Ivan decided not to patent his design, he saw its potential and he hoped that others would use it and improve on it, helping people across the world who could truly benefit from it.

“He chose to share it open source so that others could take the original design and improve In a very it and hoped they would We spoke to Jen Owen, ‘pay it forward’ share their improvements owner and founder of back into the community. deed, Ivan e-NABLE to find out how He didn’t want to profit decided not to this amazing movement from his design. He began. patent his created it because there design...

“In 2011 Ivan Owen was a need in the world created a metal puppet for low cost prosthetics and hand for a cosplay costume wanted to ensure that no one and afterward uploaded a photo else could patent the design and to YouTube to show how it worked. keep the maker community from helping Not long after, a carpenter in South those who were in need.”

Africa who had lost four of his fingers in a The community of volunteers started off woodworking accident saw the design and with around 70 members, but as people contacted Ivan to ask if he could help make shared their knowledge and innovative a single finger for him. They collaborated work stories, interest grew and in just a few over the internet for almost a year and met in person in South Africa along with a family short years the community had attracted thousands of talented people willing to of a young boy named Liam who was born missing his fingers. Ivan took a small version share their expertise, time and creativity, all to help people who needed it. of the metal hand with him to SA and they created the first prototype for Liam out of metal. It was wrist driven.

“They knew he would outgrow it so Ivan approached a 3D printing company and asked if they would donate a printer. They

“It grew from about 70 volunteers to over 20,000 globally over about four years. In the beginning, recipients would contact the e-NABLE Volunteers and ask them to make the devices for them but now, there are 

-magazine.co.uk

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3D printing

Making A Difference Few could imagine working for a cause that makes such a difference to people’s lives and for Jen, seeing the smile on a child’s face when they receive their prosthetic hand is something she could never tire of.

“There are a lot of things I love about my job. But I think my favourite is when I get to see another photo shared of another child who has gotten a 3D printed hand in a country where there is little to no healthcare and where they literally have no other option for prosthetics.

“I love all of the stories and photos - but those ones really hit me with pride in knowing that I am part of this amazing community of people from all walks of life that are eager to help make a child they may never meet, feel like a superhero with something as simple as a brightly coloured plastic hand.”

CHRISTMAS GIFT: She asked Santa for a 3D printed hand after discovering them online

more and more families and individuals who are making them by themselves and for themselves.

Now it has gone from a group of 3D printing enthusiasts who found something exciting to use their printer for, to a global movement of makers who are sharing their ideas and designs open source all over the world with the hopes that their contributions will change a life for the better.

one hand that a class delivers, there are 10-30 kids who are being inspired to think of ways they too can use technology to help others.”

When asked about the incredible global reach that the e-NABLE Community has achieved Jen admits that she could see the potential but knew that a lot of hard work would be needed to let people know about it. This is why she created the website and has been tirelessly populating and sharing stories on it ever since.

There are volunteers in over 100 countries worldwide

“I have been amazed at how widespread this community has grown. There are volunteers in over 100 countries worldwide, many of them are school children who have teachers who are using e-NABLE as an example in their STEM based learning projects. A real-world example of how they can use their ideas and imaginations to make a difference to the lives of others.

“I am overwhelmed with joy every time I see another image of another child getting a hand from one of our volunteers, but especially when that hand or arm has been created by a classroom of other kids. Knowing that for every

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“When Ivan released the first design and we sat back and watched the e-NABLE Community form around the idea, I knew it was going to find its way to where it needed to go. I also knew that without someone sharing the stories about it, it wouldn’t get very far. My work on the website and for the community over the past few years has been a result of knowing that a great idea is a great idea but if no one talks about it - no one is going to know about it.”  enablingthefuture.org

-magazine.co.uk

01/05/2018 15:43

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BROUGHT TO YO U BY

BOXING The noble sport of boxing

vS

PARKINSON’S The life-changing condition

“THE GLOVES ARE OFF” 30-32-Boxing.indd 30

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Boxing Parkinson’s

Sometimes dangerous.

Sometimes enthralling.

Always divisive.

B

oxing both inspires and distresses the masses.

Whether they go by boxer, fighter, bruiser or pugilist, the focus, skill and mental tenacity runs deep.

We often see images of boxers falling to their knees in defeat, crashing down from a pedestal they propped themselves upon before the bout, a literal and powerful depiction of pride before a fall.

But boxing can be empowering, and what if it can be used to raise people who are on the ropes up?

Former Under-19s British champion and Coventry Uni OT graduand Charles Delve is doing just that. Using a blend of evidence-based OT and non-combat boxing training, Charles is going for the jugular, aiming for the total knockout of Parkinson’s disease with the sweet science.

“I started boxing at fourteen and it instilled the importance of hard work and dedication in me. I began to help my coach, coaching noncontact boxing at schools and pupil referral units at 17 and this is when I first witnessed other people experiencing the same feelings of empowerment.

While popular in North America and Australasia, the practice of infusing boxing training into occupational therapy in the UK currently begins and ends with Charles, who is the only qualified Counterpunch Parkinson’s coach in the country.

A Bristol gym hosts classes for those living with Parkinson’s, but it was down under where Charles was first exposed to it.

“I saw on social media that sessions were being advertised for people with Parkinson’s in a gym that I was coaching at in New Zealand that were called ‘Counterpunch Parkinson’s’, the sister organisation of ‘Rock Steady Boxing’ in America. I contacted the Counterpunch director Lisa Gombinsky Roach who has over 20 year’s experience in prescribing exercise for people with Parkinson’s.

“While she was in the UK in October she put

Boxing serves as the perfect catalyst for OT intervention in those living with Parkinson’s disease, with Charles tailoring exercises to support functional and occupational performance as well as supporting boxers in other areas of meaningful occupation.

“The OT process has informed the programme planning. There is a Parkinson’s specific initial assessment. Goal setting will take place regularly and outcomes will be measured by re-assessing and using regular videos and boxing tests,” he told.

Boxing serves as the perfect catalyst for OT intervention in those living with Parkinson’s disease...

“As I learnt more about occupational therapy and grew in my role as an OT assistant I have been able to clinically reason why the meaningful activity of noncontact boxing can be used as a therapeutic intervention,” the 27-year-old explained.

“I was aware that boxing was being used as an intervention for people with Parkinson’s in America,” the Bromsgrove native told.

me through the training. Since then, I have been working with people with Parkinson’s disease and developed my knowledge and professional network, talking with other healthcare professionals specialising in Parkinson’s from around the world.”

“The unique point of this is I will be a qualified OT providing a specialised service. Take the boxing stance for example - I can ask someone to set up in their boxing stance without giving instructional prompts. Already, I am carrying out an activity analysis, analysing their cognition – looking at whether they can remember the stance I have shown, analysing their co-ordination and I am also analysing their muscle strength and postural stability.”

Preparing to qualify in the summer has also been on the OT assistant’s mind. Setting up the Box Positive programme has opened up a post-studying pathway for him, but the hard work isn’t over yet.

“I am looking for other OTs interested in delivering the programme nationwide and partner venues particularly boxing gyms that would like to host it.

“I would like to combat problems with sedentary lifestyles and reduce the number of falls. Once the programme is well established I would like to work with the NHS to reach as many people as possible and I would like the programme to provide the opportunity to carry out further longitudinal research studies into the impact of non-contact boxing,” he shared.

Anyone interested in the programme can contact Charles by emailing charlesdelve@boxpositive.co.uk.

MORE ABOUT PARKINSON’s BOXING ON THE NEXT PAGE -magazine.co.uk

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Boxing Parkinson’s Charles talks us through boxing as an intervention

Sparring Parkinson’s

Environment

Boxing serves as the perfect catalyst for OT intervention in those living with Parkinson’s disease...

Overall, it promotes falls prevention, leading to potential savings to the NHS. Socially, participants are referred to as boxers not patients, taking a strength-based approach, while forming a community for people to engage with health care professionals and fight the condition alongside others sharing a similar experience.

Occupation Classes are aimed to maximise a person’s independence.

People that engage in group boxing had an improvement in physical competence, confidence and ability to complete ADL’s independently.

I encourage explosive, fast punches requiring fast twitch muscle fibres to counteract bradykinesia/slowed movement. If a person is finding daily living activities difficult such as turning in bed, we focus on rotational strength, with over-exaggerating hooks, building strength and endurance in muscles and specific mobility enhancing movements in both the lower and upper body.

Person - Physical New research is proving there are many neuroprotective benefits of high intensity exercise. Exercise and mental activity can lead to increased blood flow and cerebral growth such as brain derived neurotrophic factor (BDNF). Boxing is rhythmic, and dancing is an effective activity for people with PD. Classes involve shadow

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boxing to music targeting gait pattern to reduce freezing.

Movements are designed to make participants stretch to the target to improve posture and the target can be moved to a higher position.

Physical competence can be measured easily with boxing specific tasks, shouting or talking whilst punching to exercise speech and the voice system. Soft voice disorders are common in people with Parkinson’s.

Person - Cognitive The classes are also ‘cognitively complex’, so tasks require mental focus and multi-tasking. Footwork drills such as skipping or agility ladders improve balance, mobility, gait pattern and build confidence therefore reducing the risk of falls, while classes include tasks that aim to improve hand-eye co-ordination and reaction time.

Person - Affective Relaxation strategies can also be taught if required such as diaphragmatic breathing which reduces cortisol levels and videos can also be an empowering outcome measure allowing people to see improvements. Boxing requires a positive mental attitude and Box Positive has a deep meaning. Low mood, apathy and chronic depression are some of the non-motor, neuropsychiatric symptoms of the condition.

-magazine.co.uk

01/05/2018 15:47

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01/05/2018 16:48

Dementia & Hydration

Maintaining

HYDRATION

in dementia patients Words by Repose Furniture and The OT Service

T

he human body needs water to function to perform various and numerous physiological functions including regulating the body’s temperature, removing waste from the body as well as carrying out cell functions to survive. Hydration is crucial, yet extremely challenging in an individual with dementia.

Dementia Anybody can become dehydrated.

In basic terms dehydration means your body loses more fluids than you take in. Risk factors for becoming dehydrated include the following and are often combined: older age, residing in long-term care, requiring assistance with foods and fluids, incontinence, cognitive impairment or confusion, impaired functional status and assistance required for feeding, inadequate numbers or appropriately trained staff to assist, depression, multiple medications, particularly diuretics, decreased thirst, acute illness, diarrhoea and vomiting.

something that may hold water or that they could drink from. The signals that would ordinarily inform the brain of thirst can be altered with dementia reducing initiation to drink in the first place. Various medications can exacerbate dehydration, particularly diuretics and laxatives. ď ľ

Dehydration The risk of dehydration is much higher with older people, rising even higher when the person also has dementia. People with advancing dementia are increasingly vulnerable as they may simply forget to drink or then forget they have made themselves a drink or where they have put it.

The memory cues may prove unsuccessful; they may not recognise the cup or glass as

-magazine.co.uk

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Dementia & Hydration Improving hydration

Subsequently, many people then limit their fluid intake for fear of incontinence.

Dehydration and malnutrition Dehydration and malnutrition are often observed together and pose particular risk to those with dementia. Both have significant negative impacts upon health and wellbeing and are observed in the community, in care settings, as well as in hospital.

If not recognised or treated in a timely manner, the likeliness of hospital admission and ultimately

mortality are increased with dehydration. Even with mild symptoms, cognitive function is further impaired and can affect mood and motivation. Physically, individuals can become weak and dizzy and at increased risk of falls.

Development of pressure sores and skin conditions, urinary tract infections and acute kidney injury are possible.

In a wider sense, this then impacts greatly on the wider health economy with much higher demand on GP services and ultimately hospital admissions.

So, what can be done to improve hydration for individuals living with dementia? Making an event of having fluids can help. Why not organise an excuse for a drink together and raise some valuable funds too by visiting www.dementiauk.org/ support-us/fundraise/timefor-a-cuppa.

1. Provide staff training regarding the importance of hydration 2. Provide a daily fluid intake goal for the individual 3. Make available the individual’s preferred fluids 4. Ensure fluids are available all the time 5. Ensure the drink is appealing visually as well as the taste 6. Ensure fluids are actually offered or given to the person regularly throughout the day 7. Use opportunities at specific points of the day such as routine appointments or activities 8. Make available a variety of fluids, some hot and cold 9. Provide some assistance if required or suitable receptacles/drinking aids 10.Always give a full glass of fluid with any medications to be taken 11. Put up notes or reminders 12. Make the process easier and more visual – put a jug of water and glass out 13. Include hydrating foods in diet

WARNING SIGNS • The person is warm to the touch • The person seems more confused than usual (this can be challenging to distinguish in later stages of dementia) • Lips appear dry or cracked • The skin is a lot drier than usual and may peel or shed

36

• The person may complain of headaches • A person’s blood pressure is lower than usual • A person’s pulse is faster • The person’s urine appears darker and has a strong odour • Eyes can become sunken

About Kate Sheehan Kate Sheehan works with seating specialist Repose.

You can find out more about their products and services at reposefurniture.co.uk.

-magazine.co.uk

35-36_DementiaHydration.indd 36

01/05/2018 12:54

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Anti-slip and grip for independent living

01/05/2018 14:01

The Oldest Nation in the World Japan is facing a crisis in its elderly population: An overwhelming number of its elderly citizens have dementia. How can the UK learn from Japan’s treatment of people living with dementia?

I

n the UK there are 850,000 people with dementia. This is set to rise to over 1 million by 2025, and 2 million by 2051 according to Dementia UK. These are worst case scenario figures, made under the assumption that no public health intervention takes place. The cost of dementia care in the UK is £26.3 billion, with the NHS picking up £4.3 billion and social care £10.3 billion. 311,730 people living with dementia over 65 are living in care homes, and 493,639 are living in the community.

These figures may sound large, but they are nothing compared to Japan. Japan is facing a social and care crisis the likes of which have never been seen by any nation on Earth. There are 4.6 million people in Japan living with dementia, with the number expected to rise. Every year, 100,000 people in Japan leave their jobs to give care to someone with

dementia. As life expectancy increases in Japan, and with the nation being as healthy as it is, the number is not expected to decrease.

The Japanese government saw these figures and panicked: how were they going to tackle the so-called dementia crisis that the country was facing? The conventional methods of care that the West used were failing them; the Japanese government and its people did not feel that these methods provided adequate care, and the people living with dementia did not like the care.

They felt that being lumped into a home dehumanised them. They wanted to stay at home, with their families. The sense of filial piety that permeates Japanese society, and has done since the time of the Nara and Heian periods of the 7th century, pushed for children to look after their aging parents. To leave them in care homes went against the Japanese societal feelings of working hard and looking after your family.

So Japan changed the way it tackles dementia. The word for dementia was changed from chihō, formed from

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the characters meaning stupid and senile, to the more respectful ninshishō which simply means cognitive disorder. It was a small but important step in recategorising people with dementia not as stupid, slow old people, but as friends and relatives who simply happen to be living with the effects of a degenerative cognitive condition.

The country began the Dementia Friends program, a model which has been copied across the world.

Its aim is to train everyone to help people living with dementia in constructive ways – how to help them if they’re confused or lost.

“In Japan, the Dementia Friends program started nearly a decade earlier than the UK, and we now have almost 10 million dementia friends. There are some areas which might be ahead compared with the UK as the kind of models available in Japan are a wider scale,” said Professor Mayumi Hayashi, who studies the differences in the treatment of people with dementia in the UK and Japan.

“For example, people with dementia want to live at home as long as possible, and they want to be included in the society like other people. In Japan, we have a kind of community-based dwelling which

-magazine.co.uk

01/05/2018 12:54

is halfway between home and an institution. In the UK, you mainly have a choice of living at home or going to the institution or care home, which is very much disliked and people dread to go there.”

These community-based dwellings house six to nine people, all of whom live with caregivers like a large family. There are no locked doors. Residents can come and go as they please, and are expected to help out with household tasks like cooking, cleaning and shopping.

Despite the fact that they are functionally in care homes, they function more like family homes.

The power dynamic is completely different from that of a care home: the power does not lie with the staff, but with the residents. The homes are wide spread and publicly funded, so anyone who wishes to stay there can.

In Machida City, west of Tokyo, there is a residential facility called DAYS BLG! During the day, the residents work in the local community, with many working at the local Honda dealer washing cars for a few thousand yen a day.

Japan has a reputation, which is not unfounded, for working hard through every stage of life.

Japanese people who cannot work feel useless, and as if they have no purpose. The DAYS BLG! facility manager didn’t want to take away the resident’s sense of humanity, and wanted to help and encourage them. He asked the residents what they wanted from their care, and what they said was a purpose. He took to the community to ask if anyone would employ the residents to fulfil this need, and now they work not only at Honda, but staff sweet shops for local children, among other things. They give back to the community that cares for them while still finding purpose in their work.

“In the UK, day centres think that the centre is providing a variety of

Japan has a reputation, which is not unfounded, for working hard through every stage of life...” services to residents,” said Mayumi, “but what the Japanese centres are doing is talking to the service users first, finding out what they want to do, then achieving that goal with them.”

In 2005, the Nationwide Caravan to Train Ninchisho Supporters was launched, with the aim of training volunteers to help people in the community as part of the Dementia Friends programme. These volunteers are trained to look out for people with dementia who may be wandering in the street or lost, as the Japanese people do not believe in locking people with dementia in the house. The Caravan volunteers look out for people who may have wandered into an unfamiliar place, and instead of asking if they have dementia, they are trained to converse with them and establish it through their training.

There is also a transferal of responsibility from the individual to the community: everyone comes together to look after people with dementia, not just their family. In 2013, a 91-year-old man living with dementia died after he stepped in

front of a train in Nagoya, Tokyo.

The courts ruled that his family had to pay damages to the train company as they weren’t looking after him well enough to prevent him wandering.

The local authority, however, disagreed vehemently. They stepped in and responded by decreeing that if a person with dementia caused damage to property or was killed, the authority would pay the charges. If something happens to a person with dementia, it’s the community’s problem.

How then can the UK learn from Japan? It may not be possible to implement the Japanese model in the UK, but the advantages of taking an approach based on the individual’s needs shows a better quality of life can be achieved for people living with dementia.

These people have hopes, wants and dreams, and leaving them to die in care homes does not fulfil them. 

-magazine.co.uk

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01/05/2018 15:52

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01/05/2018 14:01

Band of Builders

Band of

Builders W

hen an illness takes hold, whether curable or terminal, comfort is of paramount importance, and nowhere more so than in the home.

Home is where the heart is. A house makes a home and a suitably adapted one for someone to feel at their safest, most comfortable and most at peace is invaluable.

Housing adaptations

can be the trickiest, most expensive and most labouring stage of a diagnosis, but a group called the Band of Builders, a self-styled ‘by tradesmen, for tradesmen’ community of trade workers, give up their time to help those in their industry and give back.

Trustee Richard Patchesa tells The OT Magazine all about their important work. ď ľ -magazine.co.uk

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01/05/2018 12:56

Band of Builders

Interview

Richard Patchesa WHAT IS THE ETHOS OF BAND OF BUILDERS?

about 11 or 12 of us and it was the best time any of us had spent working It started with Addam the on a construction project founder, when one of his employees and close friend because everyone was on the same rate of pay, which was diagnosed two years was nothing, so there was ago with terminal cancer. no egos and we took away He asked Addam, who from it as much as Keith was also a landscaper, if he and his family did. There could finish his fence, and was a demand so to speak basically Addam had vented for it to continue because on a Facebook group about of that feeling of giving how cancer sucks and back, so we kind of knew got a lot of engagement that it wasn’t the end. So, it from other tradesmen and snowballed and grew from about 50 of us went to there. help in what turned into YOU ARE ALSO A like a complete house TRUSTEE IN THE renovation.

PROJECT, WAS THAT AN The ethos I suppose is, ORGANIC STEP FOR YOU? it’s a group of builders It was pretty organic. for builders, trying to give We were all keen for it back and pay it forward because any of us could be to continue so I set up a Facebook page because in the same situation and it needed to carry on and need the help so its to try when we started talking and give the construction about other projects we industry the credit it were keen to help out with deserves because those, so it took the next you only hear about the cowboys not the step. guys who give up a ARE THERE ANY week to go help the PARTICULAR PROJECTS THAT RESONATED other guys in the WITH YOU OR DO YOU trade.

GET AN EMOTIONAL YOU TOOK PART INVESTMENT IN ALL OF IN THE VERY FIRST THEM? PROJECT, DID YOU You couldn’t single any one EXPECT IT TO GO project, I wouldn’t have FURTHER AND thought, but the standout KNOW STRAIGHT AWAY YOU WOULD project for me was for Dan McIntosh, who was WANT TO BE INVOLVED IN FUTURE younger than me and was PROJECTS? diagnosed with a terminal brain tumour, and I went That is why it continued, to meet him in August of it was the best time that last year to do a recce and any of us had. There was whilst the other projects about 50 of us across the all have their benefits so to period of the week, and speak, that one was purely on any one day there was

“The ethos I suppose is, it’s a group of builders for builders, trying to give back and pay it forward because any of us could be in the same situation...”

44

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-magazine.co.uk

01/05/2018 12:57

Band of Builders

for making memories because we knew his time was limited.

HOUSING ADAPTATIONS ARE SO IMPORTANT WHEN THESE THINGS HAPPEN IN LIFE WHETHER IT’S CURABLE OR TERMINAL THOUGH AREN’T THEY? A lot of that project was designed around his physical needs. Because his was terminal and not curable, there was a point coming where he would need a wheelchair so we put in artificial grass and levelled all his back garden. He has three young girls so we did that for them to wheel him out and we built a man cave to make memories. Its really important that they could make memories, especially the girls, one of them is at an age where she wouldn’t know any different, but the other two were very much at an age where it would be devastating for them.

YOU HAVE OVER 25,000 LIKES ON FACEBOOK, HOW HAS THE SUPPORT BEEN

FROM OUTSIDE THE PROJECT? We’ve had huge support.

The last job we did was for a girl called Sadie whose dad is a plasterer and the social media from that went viral from our perspective. We had a help from a construction based social media group that has about 7 million followers who saw what we were doing and wanted to get involved.

They produced a piece on it but recently we’ve had lots of support from radio stations and the BBC, but I think it resonates with people within the industry because there isn’t a great deal of support for trade and we provide that.

“The last job we did was for a girl called Sadie whose dad is a plasterer and the social media from that went viral from our perspective.”

YOU BEGAN IN 2016, AND AS MUCH AS YOU HAVE ACHIEVED DOES IT STILL FEEL LIKE ITS IN ITS INFANCY? IS THERE MUCH IN THE PIPELINE? It is in its infancy but what I would say is, it has grown at a rate

we couldn’t have predicted.

We didn’t start forming the Band of Builders till about May or June and Keith’s original project in the Easter so about 18 months or so we have been going and we didn’t ever envision that we would be at this point. You have to keep feeding the monster, its demanding and we have a lot of volunteers and the more media coverage the more people come forward. We are at this point where in the next four or eight weeks we are hoping to get charity

status which would give us access to funding which we previously couldn’t.

Large manufacturers who do a lot for us and want to be involved are limited in what they can do because we are not a registered charity.

Unfortunately, there is a need for something like the Band of Builders, but we are limited to the money we raise from the clothes we sell and fundraising and we need to bridge that gap. At the moment we have plenty of ideas to do that.  -magazine.co.uk

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01/05/2018 14:01

Chronic pain

A real pain for some John Tetlow and his team at the Walton Centre in Liverpool are bringing an occupational therapist’s perspective to the common issue of chronic pain.

C

hronic pain is a pain condition that has been present for three months or more, and usually it’s been unable to be treated by conventional approaches like medication or surgery. A lot of people we see in our clinic have had pain for a long time; it can be ten or twenty years in some cases,” said John Tetlow, lead occupational therapist with the Pain Management Programme at the NHS’ Walton Centre in Liverpool. The programme has been running for 36 years and sees a team of OTs, physiotherapists and psychologists working together to help patients manage chronic pain.

John is one of the few OTs in the UK who specialises in the treatment of chronic pain, where his interventions allow people to move on in their life in spite of their pain. The source of the pain varies, but there are more common issues that John and his team deal with at the Walton Centre.

“We see a lot of people with lower back pain, and in the UK that’s one of the largest causes of chronic pain conditions,” John said. “We also see quite specific pain conditions in our clinic, like fibromyalgia, or complex regional pain syndrome, which is

BACK PAIN: Back pain is a common issue that people suffer from and that John deals with at the clinic

“Complex regional pain can come from quite a simple injury, usually like a sprain or something like that. probably a less heard of condition but a difficult condition for people to deal with.

“Complex regional pain can come from quite a simple injury, usually like a sprain or something like that. It’s usually a hand or a foot, it constitutes a neuropathic pain condition accompanied by physical conditions like swelling, changes in skin texture – it’s one of those conditions where

there’s not an awful lot to know about it, but our clinic is trying to find out more about it and how to treat it.”

The Walton Centre provides balance in treatment: when a patient enters one of their programmes, they are supported by a team of OTs, physiotherapists and psychologists who in turn support each other. The team shares an office, and John calls the environment a “true MDT” workplace.

“The programme is designed so that all the sessions link in with each other, and there is that overlap between the role of the physiotherapist, the role of the psychologist, and the role of the OT,” said John.

“Quite often we will have those kind of ad hoc conversations  -magazine.co.uk

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47

01/05/2018 15:53

Chronic pain where I’m working with someone who’s setting a target. I was working with someone whose goal this week was to play around with their grandchildren, they really would like to get on the floor, so that’s something you can pick up in the gym sessions and the physiotherapy sessions and help them with that.

There’s a good connection between what we do as a profession and the kind of overlap between what we do as well.”

Chronic pain is not just something that affects people physically, but has a huge overall effect on their lifestyle and emotions. While John and his team of OTs teach mindfulness and meditation as part of their programme to help centre emotions, they couldn’t give a comprehensive treatment without the help of psychologists who help with the emotional aspects of chronic pain. In this, the programme provides wellrounded treatment for patients with chronic pain.

The centre has a number of different programmes for patients who require different types of care. John explained: “We’re fully involved in all programmes that we run, so we have an intensive programme which is 16 days, we have a short programmes which is five days, we have some specialist programmes for specific conditions like pelvic pain or facial pain, we have a young adults programme for people aged 18-30, and we also offer individual sessions to people who maybe can’t come to a group session.

“If people are referred to our programme, we work with them on different practical skills they can develop as part of their pain management skills. What we aim to do is help people cope better with their pain and self-manage their pain better in the future, and to improve their quality of life as a result of that.”

As OTs, John and his team are involved in teaching and having patients set themselves targets on a weekly basis, and to apply activity 48

47-48_ChronicPain.indd 48

SORE SHOULDERS: Chronic pain can be treated with a number of interventions like meditation

“If people are referred to our program, we work with them on different practical skills they can develop as part of their pain management skills.” management principals to think about how they can successfully engage in activity in a way that doesn’t flair up their pain, and helps them to improve their engagement.

Alongside this, the team examines values and values which are important to the patient, and how to express these through activity.

The team teaches mindfulness and meditation, and uses workshops to address how pain has affected the balance of their life and how it can be rebalanced. There’s a focus too on the long-term, and how they can ensure they can manage their pain after the programme.

“The way I see pain management,” said John, “is we’re addressing the psychological, the physical and the practical impact pain has on people’s lives. If you imagine those three circles that interlink each other, for the person in the middle there’s the overlap between those areas.

“When you start the programme it can be quite overwhelming because we are looking at so many different areas, but what patients often say as they move through the programme, they see the bigger picture and things start to come together, so as they leave the programme, they can see how to move forward with how they manage the pain.”

John and his team have recently developed a clinical form for OTs who work within a chronic pain setting, which is part of the Royal College of Occupational Therapists under the specialist section for trauma and orthopaedics. He’s keen to encourage OTs who work within chronic pain settings to network and share ideas.

“One thing I do find is that we get pain services saying when they find out we have a team of OTs, they’ve tried to recruit OTs and not been successful,” said John, “and I do wonder if there’s a feeling of doubt in OTs being able to work in the chronic pain setting.

“I believe we have great transferable skills and services to offer to patients with chronic pain. If you see opportunities to work in pain management, don’t shy away from them, because it’s a great opportunity for OTs to make a difference.” 

-magazine.co.uk

01/05/2018 15:56

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01/05/2018 16:51

Heading Mental here Health

Interview

Fancy a Cup-O-T? Catherine Gray is an occupational therapist who has worked in mental health settings for the last eight years. She has recently branched out on her own to start a social enterprise called CupO-T, to help young people living in rural Norfolk with their mental health and wellbeing. We spoke to Catherine to find out more about the service.

I

t’s for 14 year olds upwards and its providing one-to-one, group, couple and community projects for people to manage their mental wellness. So it’s looking at early stage mental health support particularly focusing on rural areas.

I am based in south Norfolk/Suffolk and what I was finding is that people would either really struggle to come to the clinic because of the poor transport and the distances or that they were too anxious to 50

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leave the house but it’s still not ideal to sometimes do intervention, especially when talking about difficult things, inside someone’s house. The idea of a mobile clinic came up so that people could still be near the house, especially if anxiety is a problem but have a separate space to contain that.

We are trying to fundraise at the moment, as we are a very new startup, we will be looking at sourcing either a minibus or a long wheel

base van and then my husband will convert it because he is a carpenter, so I am quite lucky that way!

WHAT PROMPTED YOU TO START THIS SOCIAL ENTERPRISE? I think partly because the referral rates were so high and lots of people would get turned away either because of the number or the waiting list. It was through a conversation with a friend of a friend whose son has been on the waiting list since May last year to

-magazine.co.uk

01/05/2018 15:58

Mental Health

get mental health support from statutory services and it’s kind of a common theme that’s coming out - that it’s not easy to get early help.

If you’re at the point where you’re really mentally unwell, the support is there, but these pre-cursors and the preventative mental health work was a bit lacking or not that accessible in this area.

WHY A SOCIAL ENTERPRISE? So the people who have kind of fallen through the net, it didn’t feel right to charge everyone and it kind of put another barrier in the way of people accessing early help if they couldn’t afford to pay private fees because they are expensive. The idea of the social enterprise is so that I could reinvest and offer free or discounted sessions for people who didn’t have the funds to pay to be seen privately and also do community projects which I love doing and that sense of community is good for people’s wellbeing, so to be able to run those projects and not charge and encourage people to come along, it makes it really accessible.

CAN YOU TELL US MORE ABOUT ANY COMMUNITY PROJECTS? When I was working in the youth service we had a joint project at the Boston Lodge in Lowestoft and it was an 18 month project where the young people designed a mural and they put it out to the people who use this community centre for them to vote on the design and then we sourced all the materials, people like Crown and Dulux gave us lots of free paint and the young people then created this huge mural of the Lowestoft sealine and the beach and then they all hid a little character of themselves, so for me it was a little

cat, and everyone had a symbol that represented them in the picture.

It was a really lovely long project and we did it on a six week rotation so people could either stay for the whole thing or just come and chip in for six weeks, depending on what their need was.

WHAT IS IT YOU ENJOY MOST ABOUT WORKING IN THE MENTAL HEALTH SETTING?

Yes! I think it’s because I don’t have any business background so that is a huge learning curve. I attended an eight week course for setting up a social enterprise to see if it’s the right thing for you to do and that was really helpful for looking at finance and accounting and business plans all those scary things that OTs don’t normally have to deal with!

HAS IT BEEN WORTH IT?

I think, especially working with younger people in mental health, there is so much hope. It’s challenging but it’s always different and you are working with your feelings as well as other people’s feelings, that relationship and role modelling and just helping people who have had a pretty rough time just have a bit of normality and take control. It’s quite empowering for myself and also for those people, it’s different work and being an OT you get to do really creative work with that.

Definitely, I mean we still have a long way to go. It’s just making sure you have all the right policies and that you have got a really good foundation and obviously I am doing it on my own, I have got a really good group of people who are supporting me but at the end of the day it’s not having as many people to bounce ideas off. I help run an OT peer group which any OT in any setting – independent/NHS – can attend so that’s been really useful for that peer supervision and just getting together and bouncing ideas off.

HAS IT BEEN DIFFICULT SETTING UP THE SOCIAL ENTERPRISE?

To find out more visit cup-o-t.co.uk.

-magazine.co.uk

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01/05/2018 16:00

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01/05/2018 14:01

All the latest from the world of paediatrics

n o i t c e S

p54

Enter the world of play T

p57

his issue we explore the wonderful world of play.

Play is a huge part of growing up, from babies in prams playing with hanging bright, soft toys, to teenagers taking to intellectual computer and board games.

Play is a vital part of development and learning, but its benefits can run far deeper.

In hospital settings, the reality of situations can be too much for young patients. Fear and confusion can be rife amongst children facing procedures, but through play therapy techniques such as normalising the environment, distraction, reward and role playing, the whole experience can be a little less daunting.

Games aren’t just for young kids though. Table top games can be used as a form of intervention. We learn how the role playing element of the cult classic Dungeons & Dragons is helping OTs let clients open up.

p58

We also meet SpecialKids, the company that make adapted clothing for children and showcase innovative products for your younger clients.

We love to hear your experiences and stories, so please get in touch with any paediatric stories you would like to share! Email us at ros@2apublishing.co.uk.

p61

Read on to find out more...

-magazine.co.uk

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01/05/2018 16:01

Section

Using

play

therapy P

lay therapy isn’t a new idea, more so an evolved one. It can be traced back over 60 years, with the Lady Greens in 1957 in St Bart’s and St Thomas’s Hospital in London first pioneering the practice.

Since then, the impact of keeping children occupied and amused has moulded treatment plans, with the changing ways children play also moving the practice along. At Bristol University Hospital’s Play Centre, a team of 21 employees and 20 volunteers head up the centre dedicated to making trying times as easy and enjoyable as possible.

A manager, seven senior health play specialists, six Band 4 health play specialists, six play assistants, one trainee and a sensory play practitioner make up the crack team in Bristol. They operate in 15 wards, their specialist play centre, with out patients, in theatre, in radio therapy, the dental hospital and in the eye hospital to make these intimidating situations as comfortable as possible.

54

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-magazine.co.uk

01/05/2018 16:02

Section

build resilience for future treatment. Distraction techniques such as breathing and relaxation exercises, guided imagery, music and singing, conversation, the use of an iPad, DVD, bubbles, Normalising Play sensory equipment, word games, cause and Ahead of surgery or treatment, children will effect toys and puppets can all be utilised. meet with the team and begin to settle into the Offering small rewards can help environment and create a relationship and trust motivate the child to cooperate and in the play practitioner. see a tangible end result or reward and is effective alongside distraction By laying these early foundations in the new in being useful for long term patients setting, it maintains development and helps or ongoing treatments. Sensory avoid regression at a basic clinical level, but rooms and play offer calming and moreover, normalising play increases the comfort of the child by maintaining the links to distracting environments, stimulating their ‘normal’ home and school life, making the the children. Bristol operate a mobile hospital setting less intimidating. This also begins unit for children who can’t get to the sensory room with specialist toys and the initial distraction and motivation stages. equipment as well as having their Preparation own sensory room.

Ahead of admission, sessions to help children Post Procedural prepare are offered in the shape of preFollowing surgery or a procedure, admission programmes. Children can ask play again is used. It allows time to talk questions and have a tour of the hospital.

Puppets, stories and toys can be used to explain about hospital experience and correct any misunderstandings ahead of potential follow procedures in safe and understandable ways alleviating misconceptions, reducing anxiety or ups. Post procedural play also gives time for stress and facilitating informed consent, choice, reassurance and reward. control and co-operation.

At the heart of their intervention is distraction from pre to post procedure, with a tailored plan for each individual child created.

“At the heart of their intervention is distraction from pre to post procedure, with a tailored plan for each individual child created.”

Choice and Involvement

CASE STUDY: MICHELLE B

Through bright imagery, role play, and stories, children can grasp a better concept of the procedures they face and can take a sense of control and ownership over the situation.

Marking out plans with the child using, cartoons, simple language such as “magic cream”, and a step by step plan reinforcing the importance of staying still, pain management and control, can help. Posters, traffic lights and stories can also help with this.

My daughter has absolutely loved having regular visits from the sensory play practitioner during haemodialysis treatment three times a week. Initially she had an aversion to playing with materials with gooey, ‘wet’ textures following an extended stay in hospital.

Through sensory play, she now loves playing with paint, play-dough and other similar textures! This is so important as she is exclusively tube fed and is unlikely to eat food properly until after kidney transplantation so contact with food-like textures is very important.

Distraction and Reward Distraction is at the heart of the process - it helps the child to cope during the procedure, enables the nurse or doctor to work as quickly and as effectively as possible, and helps to

-magazine.co.uk

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CH IL DRE N’S C LOTH ING

Section

ADAPTIVE

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pecialKids.Company produce a range of clothing that is adapted to suit children with additional needs. The range caters for 2 – 14 year olds and offers specialist bodysuits, vests among many other garments.

Thought has gone into the practicality of the clothing, the materials used and the overall style and look of the items, ensuring that they are functional and stylish. Undergarments are secure to prevent kids getting access to their nappies but there

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Ideal for school uniform, no one would ever know that these polo shirts are actually bodysuits. Great for kids of school age, they are also easy to clean and to put on.

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For more information please visit specialkids.company to view the range of adaptive clothing on offer.

-magazine.co.uk

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01/05/2018 16:05

Section

Dungeons & Dragons The cult tabletop game has filled many roles: geeky past time and occult device, but now it finds a use as a therapeutic tool.

T

here’s a sad and unfair stereotype of people who play Dungeons & Dragons of large, geeky, spotty teenagers huddled in darkness around an old table in the basement of their mother’s house arguing over how to deal with the imaginary dragon in their path as they wipe food stained fingers over the central board. Dungeons & Dragons gets a bad rap. There are over six million players of the game worldwide, from stereotypical nerds to professional NBA players and actors like Robin Williams. You don’t need to be a geek to get involved, you just need to enjoy losing yourself in an imaginary world of heroes and magic.

For the uninitiated, Dungeons & Dragons, or D&D as the cool kids call it, is a pencil and paper tabletop role playing game. That sounds complex, but it’s not. You create a character with a class (warrior, mage, monk and so on), and assign them “skills” that form a kind of personality. You can make them brash and abrasive, or calm and collected. That’s the “role” in role playing: you become the avatar you choose and act as they would.

The game is managed by the dungeon master – the DM – who

58

guides you through the story, which may have come from one of the adventure books, or a tale of their own creation. The aim of the quest can be anything, but it’s often a heroic adventure: slay a dragon, save the princess, get the ancient jewel. The rules come from the standard D&D rulebook, which is published by Wizards of the Coast, and its fifth revision was released in 2014.

“It may not sound like something that could be a powerful tool in the arsenal of an occupational therapist, but the practical uses of D&D may surprise you.”

It may not sound like something that could be a powerful tool in the arsenal of an occupational therapist, but the practical uses of D&D may surprise you. In the United States, there are a number of professionals and organisations using D&D as a type of play therapy.

In Seattle, Washington, counsellor and psychologist Dr Raffael Boccamazzo is using Dungeons & Dragons to teach social skills

-magazine.co.uk

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01/05/2018 17:16

Section

with children who have autism. He began playing D&D while stuck in a new friend’s house during a freak Seattle snowstorm.

After he graduated, he opened a private practice and began working with Aspiring Youth, and is now spending his Friday nights as he was as a youth – playing D&D with high school kids. He spoke to Wizards of the Coast’s official Dungeons & Dragons podcast about how it’s helped the children he’s worked with: “Role playing as a therapeutic tool has been used for decades and decades and there’s a lot of different schools of psychology that use role playing as a means of social rehearsal, of working out unconscious issues, really any number of things. It seemed like a logical extension to use role playing in a targeted way to build perspective, because that’s really what we’re doing here, and we’re taking another person and imaging what their motivations are, imagining what their behaviours would be, and holding ourselves to that, and we’re doing it within this really well-defined framework that isn’t as ambiguous as regular social interactions. It doesn’t happen with the same rapid pace that social interactions happen.

“For a lot of our folks that we work with, many of them have autism spectrum diagnoses, many of them are suffering from social anxiety, many of them are just introverts who want to get better at making friends. This presents a real challenge, but also a really safe space in which to practice.”

A lot of the children know they’re in a social skills programme, but they try to avoid lecturing. They try to covertly install these skills. The majority of his group are boys. The group aims to tap into something they’re already invested in, while giving them more opportunities to socialise without the ambiguity

of standard social conventions. It’s taking a creative and imaginative approach to a therapeutic role.

There’s an automatic safety net in the interaction in that it isn’t really them doing the interaction, it’s their characters. They can act out however they like, because it isn’t them, it’s their characters doing the talking. The stories are carefully woven and work at a slower pace, and the participants always have the DM, Dr Boccamazzo, to fall back on if it gets a bit too much.

In watching the patients interact through the course of their D&D sessions, he’s noticed patients who began very socially phobic taking on leadership roles in the game, and no longer struggling to make eye contact with himself and the other players.

Wheelhouse Workshop is also based out of Seattle, and founders Adam Davis and Adam Johns operate D&D sessions similar to Aspiring Youth’s and for much the same reasons. Speaking with gaming website Kotaku, Adam Davis told of a young man who, at the beginning of his time with Wheelhouse Workshop, was a shy, lanky teen who spoke in whispers.

He acted as if he was a burden taking up the space he occupied.

His parents and teachers saw that his body language made him seem stand-offish, and they enrolled him with Wheelhouse Workshop.

Davis told Kotaku: “The character he chose was a dwarf barbarian.

He was really loud and bumbling and unapologetic. It was a really obvious opportunity for this kid to play with qualities other than his.”

The young man would sit at the table completely in character, spreading his legs and bashing his arms on the table. It allowed him to explore that aspect of his personality as only role play can.

In an AMA (ask me anything) on Reddit, Davis also recounted his favourite gaming therapy moment:

“One of my favourite sort of recent ones is one where the players needed to get the help of a dracolich [an undead dragonmonster] to help them defeat the plants that were taking over the continent. The players needed to find out how this dracolich (the last remaining of its kind) had defeated the plants before, ending the ‘Age of Green’ to usher in the ‘Age of Dragons’ centuries before.

“This dracolich was reticent to offer help to some fleshy adventurers, asking the players, ‘Why should I help to save a world in which I am the last of my kind? I have no family, no kin. I am alone.’

“Role playing as a therapeutic tool has been used for decades and decades and there’s a lot of different schools of psychology that use role playing as a means of social rehearsal...”

“I had created this dracolich to be a hard bargainer, one that would have the players have to deal with someone resistant. To my surprise, one of the players who himself was struggling with isolation and depression, responded to the dracolich by saying, ‘That sounds like me. I also have no friends, and I feel alone a lot. It’s really hard.’

Suddenly the dracolich became a sympathetic character, who struggled with his isolation too.

The players normalized his feelings, and helped this newly sympathetic dracolich corrupt a nest of dragon eggs to make a new generation of dracoliches—his new family.

“When I asked this player at the end of the session to reflect on his experience, he said, ‘I never expected to have empathy with a dracolich.’” 

-magazine.co.uk

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Product Focus

As part of our Paediatrics Section, we take a look at the products on the market that can help improve the lives of your younger patients.

GoSili Siliskin Straws £6.95 | gosili.co.uk 0203 137 6668 An ideal alternative to now-banned plastic straws, these are made from 100% silicone.

Non-toxic and free from bisphenol-A, PVC and phthalates, they’re completely safe to be used by anyone regardless of age and dishwasher safe.

The straws come in packs of six, and are available in three sizes, making them perfect for any cup.

Ribcap Prices from £64.17 gelovationseurope.com 01454 285071 Gel Ovations Europe are the proud UK Distributor of the Ribcap Range of Stylish Head protection.

Ribcap is the first fashionable, non-stigmatizing, soft protection headgear that comes in a large range of styles for young and old users. The baseball-style cap is comfortable to wear and keeps the wearer’s eyes shaded.

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Body Sock Price from £32.99 | 0289 031 9360 learningspaceuk.co.uk Made of soft and stretchy Lyra, this fun body sock provides a highly tactile deep pressure experience for children to play in. The body sock is ideal as part of sensory diets to reinforce resistive awareness, and promote creative movement. The body sock comes in a number of colours and sizes.

Weighted Blanket £74.99 | amazon.co.uk Weighted blankets can help children with anxiety, ADHD, sensory integration disorders and autism to find a sense of calm and is also ideal for children who have problems sleeping. The weight in the blanket promotes sleep and relaxes the child’s body, ensuring that they’re able to get a good night’s rest.

Dart Ball Games Prices from £18 | 0300 999 0004 livingmadeeasy.org.uk Hang the inflatable dart board on the wall or position it on the floor to start a fun game of ball darts. The fabric cover features strong Velcro to which the colourful tennis balls will attach to, and a removable and wipeable fabric cover to keep the board clean.

-magazine.co.uk

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H A IRDRE SSING

A CUT

ABOVE the

rest

A stand up wheelchair allows a young man to pursue his career in hairdressing

F

our years ago, Mitch Chalmers from Midsomer Norton near Bath, was employed as a plasterer and spent most his spare time and weekends taking part in motor cross events throughout Europe. Following an accident on the track Mitch was left paralysed from the chest down and had to re-evaluate his life and plan for the future.

Mitch

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“I loved plastering as no two days were the same in terms of location and projects but accepting I would also probably never ride a motor cross bike again was a huge blow, because I had been riding bikes from the age of eight. But I was determined that just because I was paralysed I would still have a career which I enjoyed.�

Mitch admits that after being discharged from hospital he shut himself away for a while as he came to terms with the lifechanging effects of his accident.

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Mitch Chalmers

STANDING TALL: Mitch has the full capability of a non-disabled hairdresser thanks to the standing wheelchair

However, after a while and with the help of family and friends he started thinking about his next career.

“I had always had an interest in hairdressing and thought this might be a good career, but there was one issue – how would I be able to cut hair from my wheelchair?”

Determined to find a solution, after enrolling in a hairdressing course at nearby Bath College and arranging a placement at nearby Jo Jo’s hair salon, Mitch got in touch with the team at Gerald Simonds to see if they had any suggestions and was delighted when he was told about the LEVO active-easy that is a wheelchair which converts from a sitting to standing position.

“As soon as I tried one out for myself I knew I had found the answer and that I could forge a career in hairdressing, so set about raising the money to buy one”. Mitch created a

local fundraising page and with the help of friends and family arranged various fundraising events. Bath College, where Mitch is studying hairdressing also helped with events and within four months Mitch was contacting Gerald Simonds to order the wheelchair which he knew would change his life.

The LEVO has been designed to smoothly elevate the user from a sitting to standing position of up to 85 degrees with the minimum amount of effort, to enable users such as Mitch to interact with people from a standing position.

“Not only has the LEVO enabled Mitch to start training to be a hairdresser, it has also had a profound effect on him physically...”

Prior to taking delivery of his LEVO, Mitch had been using a standing frame as he was required to stand for a certain amount of time each day as part of his ongoing physiotherapy programme but often found this uncomfortable.

“When I was using a frame, I could only stand for about 10 minutes at a time, but since using my LEVO I can now stand for up to two hours, which is not only great for my  -magazine.co.uk

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Mitch Chalmers

regular and continued use of the LEVO to allow him to stand for longer periods resulted in them cancelling the procedure.

Mitch couldn’t be happier at the independence the LEVO offers him and is enjoying the ability to pursue a career he loves:

“The LEVO is just fantastic “The LEVO is just and has literally fantastic and has literally changed my life! It changed my life!” is extremely easy to

STUDIO: Thanks to the standing wheelchair and Mitch’s resolve he can now work as a hairdresser

hairdressing training, but also my daily physiotherapy, as it means I can kill two birds with one stone,” continued Mitch.

Not only has the LEVO enabled Mitch to start training to be a hairdresser, it has also had a profound effect on him physically as he further explains: “As anybody with a similar spinal cord injury will know, managing the bladder can be a major issue.

However, since I started using my LEVO wheelchair and standing for

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longer periods of time my bladder has started to act in a completely different way. I can now hold much more urine which is great and being stood for longer has also meant I never have any leaks, which can be another common occurrence for people with my injury”.

Mitch was recently due to undergo another series of botox injections in hospital to help stop his bladder wall from spasming, which can cause leaks, but his

use and manoeuvre when in the sitting position, and transferring to the standing position is quick and effortless and literally takes seconds. In addition to my hairdressing, the LEVO allows me to cook, make drinks and just talk to people face to face and enables me to feel ‘normal’ and remain independent which is all anyone in a wheelchair wants. It is also incredibly comfortable in comparison to my previous chairs. The seating position is substantially higher than most wheelchairs and I no longer have to endure the back ache which I had to previously. I also love the fact that the LEVO is so lightweight and stylish, and would not hesitate in recommending one to anybody who is looking for a wheelchair in which they can also stand”.  For more information on the full range of solutions available from Gerald Simonds or to book a no-obligation demonstration call 0800 220975, email webenquiry@gerald-simonds. co.uk or visit www.gerald-simonds.co.uk.

-magazine.co.uk

01/05/2018 13:07

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VISIT

If you’re in the market for a new OT job then get on to our website. We’ve got all the latest OT jobs in our Careers section.

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01/05/2018 16:51

Fire Service

FIR E S A FE T Y

OTs in the

FIRE SERVICE Interview Tess Stanton Tess Stanton, an OT in the fire service, talks to The OT Magazine about her role and how she helps vulnerable people to live a safer life

T

ess Stanton is an occupational therapist working with the Braunstone Blues, a team working in the Braunstone area which is comprised of a number of personnel from three emergency services: Leicestershire Fire and Rescue Service, Leicestershire Police and the East Midlands Ambulance Service. Within Leicestershire and Rutlands the area has recorded the 66

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highest 999 call demand, and the service aims to reduce this.

“The way we do this is mostly through home visits,” said Stanton, “in which they share health safe and security messages, so I do some of these but also I get referrals from partner agencies and referrals within the team, so people who are at risk of lots of things, really, because it’s a proactive project, so we’re trying to support people before these things become an issue, as well as those who are calling a lot.”

Stanton works with the Fire Service and is in a unique position to bring occupational therapy concepts to aspects of the team’s community work. The aim of OTs working within the fire service concentrates on prevention: they aim to enhance the safety and wellbeing of vulnerable

people within communities, work with partners to effectively improve efficiency, and to address factors within patients’ lives which may contribute risk, such as alcohol and smoking.

“We do some door knocking anyway just to spread the messages within the area,” she said, “and then sitting down and chatting with them. If you see that there are other issues you might bring that up, but a lot of people volunteer concern. We also have a social prescription for GPs in the areas, so if they feel that one of the patients might be socially isolated or could do with a bit of support, they can refer to me for that as well.”

Tess interacts with a vast variety of people, but many of the people to whom she speaks are elderly, and they are mainly affected by social

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Fire Service

isolation and falls. However, the fluctuating nature of both her client base and referral types makes no day the same.

“Because I don’t have a set client base, it’s pretty much whoever comes through the door,” Tess said, “so it depends on what it is that day. I can do things from providing adaptive equipment within the home, if there was a socially isolated individual, it might involve getting them involved with groups in the community within the area, I do graded interventions for those who are just on discharge from hospital, mental health support.

“There was one lady who was six months pregnant, she had previously experienced post-natal depression and was finding it very difficult, so it’s sort of getting strategies in place to get her through the day and manage things without getting too overwhelmed.”

Fire services across the country are well-known for their community visits, where they assist vulnerable people with fire safety in their home; be that fitting fire alarms or giving generalised advice to help prevent a fire. This is something Tess assists with:

FIRE SERVCE: The Fire Service OT Team play a vital role in keeping vulnerable people safe

“Fire services across the country are wellknown for their community visits, where they assist vulnerable people with fire safety in their home...”

“At the moment Leicestershire Fire Rescue Service are looking to develop their home fire service into the Safe and Well programme, which a lot of other fire services are doing across the country, so I’m supporting them across that transition, other things to look out for, in-house training for their community educators who do some of the home visits, and also providing them with a referral list, so if any issues are identified they know who to refer to.”

a placement:

OTs in the fire service are a rare sight, but a number of fire services across the country have begun employing OTs in similar roles to Tess’. She began working with the fire service while at university on

“Because I already knew how it worked, I developed some referral pathways, and then also, because they hadn’t worked with OTs before being emergency services, a bit of inhouse education with them. It

“It was my third-year placement, I was placed with the project, and then made such a good impression that they thought it would benefit them to have an occupational therapist.

was great!”

While the role of the OT is traditionally one that would be in hospitals, the importance of OTs in non-traditional and emerging roles is equally as important, allowing OTs to help vulnerable people and those in need with skills that may not have been present before their recruitment to the role. It’s something Tess is very aware of: “I just think it’s important for the world to know that OT can support non-traditional roles, so not just working within hospital settings or with healthcare professionals, how OTs can be used to identify links between lifestyle, environment, and then the things that they do, especially in the fire service, it’s making those connections which are natural to OTs but not something they would have thought of.” 

-magazine.co.uk

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Crelling Harnesses Ltd.

Ionian Bed

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The vehicle harnesses are designed to be worn in conjunction with the existing safety belts to provide additional postural support and/ or to offer a certain degree of restraint when used for those passengers with behavioural problems or learning difficulties.

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Products designed and developed to aid basic postural management.

T Rolls T Rolls are used to control position of the body in supine lying.

See our web site for our full range of postural control & support products.

Alternative Positioning Support The APS is designed for use where more control of the abducted lower limbs is required.

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Calvert Trust Exmoor enables people of and to experience exciting, challenging, and enjoyable accessible activity holidays with family and friends.

11/07/2017 09:19 01/05/2018 16:53

Stiltz Lifts

CASE S TUDY

STUDENT’S

hopes

Helena Stone from Islington in London has Complex Regional Pain Syndrome (CRPS) – a condition usually triggered by an injury – which is poorly misunderstood by doctors. The skin of the affected area can become so sensitive that a mere droplet of water, a change in temperature, even a gentle breeze, can provoke intense pain.

T

he 21-year-old was diagnosed with CRPS just over three years ago after a kayaking accident when her foot became caught in the boat in 2013. Helena was on crutches for two weeks and expected to recover fully but her leg, including her foot, remained in persistent pain.

She was in and out hospital for most of 2014 until she was diagnosed with CRPS the next year after a follow-up steroid injection saw her knee turn bright red and swell up. Worse was to come as the pain and swelling spread to the other leg too.

Somehow, despite living with excruciating pain, Helena still managed to pass her A-levels and gain a place at Loughborough University in 2015. But her condition worsened and she was forced to drop out of uni after becoming a fulltime wheelchair user.

She had limited mobility for most of 2016 and had to be helped up and down the stairs, mostly by her parents, Patricia and Graham. The Stones decided to have a Stiltz Home Lift installed to help Helena move from floor to floor with some degree of independence.

Unlike a traditional domestic lift, the Stiltz lift requires no hydraulics or supporting walls and is powered by a self-contained motor which plugs straight into the wall using a 13 amp socket with the lift travelling through the floor on self-supporting

stilts. The Stiltz Home Lift was situated in Helena’s 14-year-old brother William’s games room downstairs, travelling directly up to her bedroom.

“It will be five years this summer since I had the kayaking accident but I just find ways of dealing with what happened to me,” she said. “I have no choice but to get on with it for now. My attitude is how can I make it possible to do what I want to do.

“The Stiltz Lift has been a life-saver as I just felt trapped. It has made the house safe again – there is no risk of me falling – and it has given me my independence back. Before I was either crawling or bottom-shuffling up and down the stairs.

“When my CRPS was really bad, I was bed bound. Sometimes I’d have to wait for either Mum or Dad to get back from work to help me downstairs. I just became reliant on whoever was around.”

Gradually, through intensive physiotherapy, pain medications and with the help of crutches, Helena is finding a way to learn to live with the constant pain. At the end of 2016, she decided to give uni another shot and was accepted to study education at

the University of Gloucestershire.

After contacting her local MP Alex Chalk, who expressed an interest in Helena’s story, he has paved the way for the student to address MPs at the Houses of Parliament about the effects of CRPS in the hope funds can be provided for research into the condition.

Helena said: “The longer my CRPS goes on, the less chance I have of it going into remission. It is the most painful condition known to medicine and there is no cure. There is no money spent on research because the total number of people who are suffering from it is unknown and therefore the spend cannot be justified.

“My aim is to take every opportunity possible to raise awareness about CRPS in the hope that the NHS will invest money into research for a cure to free all CRPS sufferers of this dreadful condition.”

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Heading here

Building

Mental Fitness

Neil Bindemann PhD Neil set up his own company Innervate, an organisation that works in partnership with healthcare professionals to produce innovative resources and support the relationship between healthcare professionals and their patients. He also runs Mental Fitness workshops and here he shares his story.

M

y life and interest in the world of neurosciences started back 1988.

After graduating from the University of Glasgow with a BSc in immunology, and a growing interest in a field that was then just beginning to take off – neuroimmunology, I started a PhD in neurobiology. I needed to gain experience in neurology. My PhD subject was perfect. I put my knowledge of immunology to work and started a project that explored how the immune system becomes involved in the process of nerve injury and regeneration.

While I enjoyed learning the neuroscience and successfully completed my PhD, working in a laboratory with animal models was not for me. During my final few months writing up my thesis, I started exploring my options and discovered the world of medical communications and education. But perhaps more importantly for me and my developing interest in psychology.

I moved into that field in 1993 and after gaining several years working with a specialist agency, I branched out to set up my own business, Innervate. The plan was to work in partnership with health professionals and patients to focus on supporting healthcare professionals, patient communication and relations.

Using my interest and experience in neurology I stimulated the creation of the Primary Care Neurology Society in 2014. Little did I know then that I would be moving across to the patient side of neurology.

In 2015 following an MRI scan I was told ‘there is a growth on your pineal gland and you are suffering from a dangerous level of hydrocephalus, we can’t allow you home, so we are getting a bed sorted out for you now’. A rather difficult phone call with my wife 70

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Heading here

ensued, who was collecting our two wonderful children from school.

The day of my surgery was Friday 13 March, I’m no longer superstitious and thankfully I have a good sense of humour. My operation went well, the surgeon dealt with the hydrocephalus and removed a chunk of the tumour. Thanks to the world-class surgeons I only needed a short period of rehab and was home within a week.

The result of the biopsy showed that the tumour was low-grade and therefore further surgery was not required and they would just watch with ongoing MRI scans.

One aspect of mental fitness, which like physical fitness, you need to work at, is to start thinking differently when challenges enter your life...”

Mental Health This is where my interest in psychology and mental health starts. For me I believe trauma comes in all shapes and sizes, and it’s a very personal experience, no matter how old you may be.

A toddler having an ice-cream snatched out of their hands by their pet dog may seem a minor insignificant incident to you and I, but the screams and tears running down their rather red cheeks should tell you that it certainly isn’t to the poor child. However, their ability to handle it and move on is perhaps not to be sniffed at. I believe we can learn a thing or two about building mental fitness from this innate ability of children to just live in the moment. Something that I have certainly applied to my life for many years.

Over the last three years, and especially shortly after coming home from hospital, and feeling rather isolated,

I believe my mental fitness (a term that entered my head as a result of my experience) has helped me through some tough and challenging times.

When I started looking into it, I came across an excellent paper

by Robinson, P et al who in 2015 defined mental fitness as “the modifiable capacity to utilise resources and skills to flexibly adapt to challenges or advantages, enabling thriving”.

One aspect of mental fitness, which like physical fitness, you need to work at, is to start thinking differently when challenges enter your life. This applies to healthcare professionals as well as patients.

To illustrate my point, I wish to highlight the wonderful work of Sarah Pullen including her book ‘A Mighty Boy’. This book, in my opinion is quite simply an education; a must read for anyone who wants to be better informed when it comes to patient and parent care. Her experience of how she was told about her son Silas’ prognosis, who was diagnosed with an aggressive brain tumour is, very sadly an example of how not to tell parents their child’s life may be cut short. She was literally told, your son will be dead in 12 months time. While I certainly appreciate the very difficult challenge to relay difficult news, keeping patients and families hopes alive should be foremost in your mind, while balancing it with setting realistic expectations. It can be done, I can assure you - it just needs the person to think differently. 

-magazine.co.uk

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01/05/2018 13:09

Student Placement

H A NNA H ROG E RS

Student in Role

Emerging Placement Hannah Rogers shares her experience of a placement within a hostel for homeless people.

A

s a final year student at London Southbank University, I was given the opportunity to complete a role emerging placement in a homeless hostel. Homelessness is an area that particularly interests me and part of my previous job before starting university was supporting people in an acute mental ward with housing issues.

The Placement Like many hostels, there was no occupational therapy service in place. I was based in the hostel with another student from my course and my educator was an occupational therapist who worked across homeless services in London.

Therefore this required myself and the other student to work largely independently and we received long arm supervision in the form of weekly face to face meetings and emails or phone calls when needed.

The setting and the client group The hostel catered for men aged 21 and over who were experiencing homelessness. The majority of the

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men had alcohol and/or drug use issues and most had previously slept rough on the streets at some point.

The hostel also had a small number of beds for men with diagnosed mental health conditions, which were linked with the local NHS trust.

Group work The hostel staff were keen for us to put together a structured activity programme for the clients and had just recruited their first activities coordinator who started shortly after us. During our first week we held an informal ‘coffee and chat’ session to gather ideas from clients as to what they would like. The contributions were amazing and the clients had great insight into the types of activities that would be beneficial for them. The ideas primarily focused on leisure activities such as cinema trips and art sessions, physical exercise sessions and opportunities to learn or improve life skills in preparation for leaving the hostel, including cooking sessions. The clients suggested numerous ideas and as we only had a limited time on placement we decided to start up some simple sessions that ď ľ

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Student Placement

“this placement proved an invaluable learning experience for me, particularly in being able to manage my time and caseload effectively�

potentially could be facilitated by hostel staff or clients themselves in the future. We ran weekly smoothie making sessions during breakfast, a walking group, a creative space session and several cooking sessions.

All of the sessions were successful however, smoothie making proved particularly popular with some clients staying in the canteen to eat their breakfast and socialise rather than just go straight back to their rooms as they usually did. This also gave us a great opportunity to meet all the clients in the hostel and identify those who would benefit from 1:1 input.

We fed back the other suggestions from clients to the activities coordinator who began to put these in place in our final week of placement.

This included a trip to the natural history museum and a series of basic life support training. When the placement ended it was great to know that all the groups we had started and many more would be continuing and would continue to benefit the clients.

There were, of course, some

challenges in running activities in this setting. Although we always had at least two clients at every session sometimes it was hard to get clients motivated to attend the session.

Often clients would come in and out throughout the session and this required us to be flexible with the structure and timings of the groups.

Individual work As well as the group sessions, we both took on a small caseload each of individual work. The needs of the clients and types of interventions varied hugely. Some examples of the types of work we did included making recommendations for social care packages due to physical health issues, medication management strategies, reducing cannabis use by re-engaging with previous leisure activities and preparing for moving on from the hostel. The individual work proved the most challenging aspect of the placement, in particular due to extensive past traumas many clients had experienced, it was hard to develop the trusting relationship needed with clients in a short space of time and consequently this

impacted upon the ability to engage in individual sessions and sessions were frequently missed. This was an area we reflected on regularly during supervision and learning to manage my expectations of clients was key.

Learning and development Overall this placement proved an invaluable learning experience for me, particularly in being able to manage my time and caseload effectively, deal with emotionally challenging situations and develop autonomous clinical reasoning skills. Having another student on the placement with me provided a support mechanism and we both helped each other through difficult situations. At the end of the placement we received some really positive feedback from both clients and staff and overall the placement was hugely rewarding. ď‚Ą

Get Involved Want to share your experience of a student placement? Get in touch by emailing ros@2apublishing.co.uk.

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At The OT Magazine we are always looking for new ways to develop your favourite occupational therapy magazine. Out every two months, the app features all the latest products, in-depth features, industry news, personal proďŹ les and up-to-date information on events and exhibitions that you ďŹ nd in the magazine but you can download it to your mobile phone or tablet to read on the go. The app is available free of charge and can be downloaded now and read at your leisure.

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Sport Therapy BOCC I A

SPORT for confidence Boccia England and social enterprise Sport for Confidence have jointly produced a publication to support the use of boccia in occupational therapy practice, which has been endorsed by the Royal College of Occupational Therapists.

B

occia, pronounced ‘bot-cha’, is a fun, challenging Paralympic sport like the game of bowls, although typically played from a seated position.

Increasing participation in sport and physical activity has been identified as a national cross-Whitehall priority for its benefits including improved physical fitness and the development of social bonds.

Sport for Confidence has embraced this priority and is championing the role of occupational therapists in delivering occupational outcomes through collaborating with leisure centres, sports coaches, and national governing bodies of sport. Their strategic objective is to place OTs and allied health professionals and sports coaches in every UK leisure centre to provide inclusive sport and physical activity opportunities that meet the occupational needs of everyone, not just those with a disability or health need.

The Using Boccia as an Assessment and Intervention Tool: An Evidencebased Guide for Occupational Therapy Practice publication focuses on supporting OTs and boccia as a therapeutic activity. The compact

but comprehensive guide offers a springboard for clinical reasoning with a range of ideas, suggestions and resources contained within it. It includes the rules of the game, case studies, an activity analysis, a summary of the evidence-base and several card inserts depicting warm-up and cooldown tips and skill practice activities.

The publication was launched on 7 March at Basildon Sporting Village in Essex, with RCOT’s Julia Skelton opening the day. Attendees also heard Paralympic boccia gold medallist Dan Bentley talk about how boccia changed his life.

Boccia England CEO, Chris Ratcliffe said: “We were delighted to work with Sport for Confidence on this guide and we are looking forward to seeing more occupational therapists introducing boccia as a therapeutic activity. Boccia provides a fun and

accessible way to improve motor skills and psychological wellbeing for everyone. We hope that more occupational therapists will use this guide to introduce this wonderful sport to more people to bring positive change into their lives”.

For a free copy email anna@sportforconfidence.com.

To support OTs following the guide, Boccia England is offering a 5% discount on boccia balls at the Boccia England Shop once you become a member. bocciaengland.org.uk.

-magazine.co.uk

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Your events 25-27 May

6-7 June

Brotherwood The European Wheelchair Accessible Weekend Neuro Convention Haynes International Motor Museum, Somerset Learn what Brotherwood have on offer and take the unique opportunity to get ‘handson’ with their wheelchair passenger car range. The experienced team will present free, in-depth personal needs assessments. brotherwood.com

ExCel London Europe’s only trade show dedicated to brain and spine experts, dedicated to providing unparalleled expert insight into the latest technology and trends that are advancing the neuro-surgical, diagnostic, rehabilitation and brain stimulation fields at an incredible speed. For tickets and more information please visit the website neuroconvention.com

11-13 June 17 May & 5 July

Kidz to Adultz South: Farnborough International Conference & Exhibition Centre Wales & West: Thornbury Leisure Centre, Bristol A one stop shop, with over 100 exhibitors, for the most up-to-date advice on mobility, funding, seating, beds, communication, sensory, transition, education, and more. Boost your CPD by attending the free accredited seminars. kidzexhibitions.co.uk.

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RCOT Conference Belfast Waterfront The Annual Conference and Exhibition is back for 2018 with Specialist Sections: Children, Young People & Families and People with Learning Disabilities, with a packed agenda of talks, discussions, occupation stations, networking, demonstrations and more. For tickets and more information please visit the website rcotannualconference.org.uk

-magazine.co.uk

01/05/2018 13:10

Every issue we bring you the latest events taking place in the OT Calendar.

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

13 June & 11 July

OTAC Cambridge: Hallmark Hotel Llanelli: Stradey Park Hotel Led by Promoting Independence, the conference focuses on bringing suppliers and OTs together in one place. The free events provide advice, support and resources to over 4000 OTs, plus networking opportunities. otac.org.uk/events

12 July, 16 August & 18 September 27-28 June

Health+Care Show ExCel London Health+Care is constantly evolving to meet the everchanging needs of health, care and digital healthcare professionals. Health+Care welcomes the NHS, local government, care homes and the voluntary sector to share learning around implementing change. healthpluscare.co.uk

RISE 4 Disability East Midlands: East of England Showground / North: New Dock Hall-Royal Armouries / South East: Kent Event Centre RISE events combine more than 100 exhibitors showcasing a wide range of innovative disability products, services, activities and advice with the RISE Ability Theatre delivering key topics from leading speakers. rise4disability.com

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For exhibiting opportunities please contact Nick.Woore@prysmgroup.co.uk or call 0117 929 6083

THE NATIONAL CARE FORUM

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Training & Recruitment

JACQ U E L I NE W E B B

Care Expert Reports Jacqueline Webb explain what is commented on in a Care Expert report.

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changes to a building but will be expected to comment on the adaptations required i.e. level-access wet room or ground floor extension.

e get asked a lot about the contents of our Expert reports. Most of our Experts are occupational therapists and they comment on the functional abilities of their clients in acute or community care, independent practice or case management. Expert Witnesses do the same, they complete a functional assessment and write a report on their findings. It is clear then that most occupational therapists will have the core skills required to act as an Expert Witness.

However, the key difference comes in the detail, so we felt this was a good opportunity to highlight what our Experts actually comment on in a Care Expert Witness report.

have to use these skills to justify the likely required level of support. This may be simple personal care facilitated by an agency or a more complex 24/7 care package with directly employed care teams. Care tends to be the largest section in our reports, because of the overall complexity and values involved.

Equipment

Miscellaneous

Assessment

Our Experts have great freedom to recommend the equipment that is right for the claimant, rather than facing the restrictions often seen in statutory services. Experts can use their knowledge of the latest technological developments to return the claimant to the level of functional independence enjoyed prior to their injury.

Many occupational therapists with a statutory services background will never have had the opportunity to make such broad recommendations before. A truly holistic approach! The miscellaneous section could include leisure and social activities, domestic support, holidays, additional heating costs, further therapies or specialist footwear or clothing.

Our Experts initially conduct a one-off face-to-face assessment usually in the claimant’s own home. This is focused on function and mobility, much the same as in statutory services or independent practice. Our Experts use their findings to comment on all activities of daily living and consider the past, present and future needs for the claimant.

Care Our Experts have experience in organising personal care often gained in community care and/or case management. They

Our Experts have experience in organising personal care often gained in community care and/or case management.

Housing Our Experts are asked to comment on whether a property is suitable, suitable with adaptation or unsuitable for the claimant’s needs. Our Experts will not be expected to comment on the structural

Transport It is unusual for clinicians to be familiar with a wide range of vehicles and adaptations but it is an essential part of the holistic package our Experts recommend. This highlights the freedom you have to make recommendations without restrictions. We have relationships with all the major providers and offer training and workshops to enhance your knowledge.

If you would like to know more about our work or our reports then please visit jwebb.co.uk/webinar for our next ‘What is a Care Expert?’ webinar. This will further explain, with practical examples, the report produced by a Care Expert.

-magazine.co.uk

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01/05/2018 16:17

Training & Recruitment Maximise Your

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• Are you an Occupational Therapist, Nurse, Physiotherapist or Speech and Language Therapist working in statutory care, independent practice or case management?

Courses held in London & Scotland - open to all.

Courses include: Ramps, Access Lifts, Reading Plans, Bathroom Adaptations, Accessible Kitchens, Adapting for Children with Challenging Behaviour and more!

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• Would you appreciate the opportunity to use your established skills in an exciting and challenging industry whilst maintaining your current clinical role?

• Do you appreciate continuous, collaborative development?

• Are you frustrated in your current position and wish you could achieve more?

To find out about the potential earnings and apply visit www.jwebb.co.uk/apply

Britain’s No.1 Rehab Cost Consultancy

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01/05/2018 16:54

EDGE services

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01/05/2018 05/02/2018 14:02 17:41

Heading here

Your Voice Counts We want your help to shape The OT Magazine. We are constantly striving to ensure we get the content right to provide you with an enjoyable and informative magazine.

We would really appreciate if you could take the time to share your thoughts and ideas with us.

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Please post your form back to The OT Magazine, Caledonia House, Evanton Drive, Thornliebank Ind Est, Glasgow, G46 8JT

-magazine.co.uk

01/05/2018 13:11

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01/05/2018 14:03

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