The OT Magazine – Nov / Dec 2020 by 2A Publishing

THE

MAGAZINE Issue 37 | Nov/Dec 20 | Improving Independence

Snowsports Explore the wideranging benefits of adaptive snowsports for your younger patients

COLU M N S

PRO DUC T S

CPD

EVENTS

MENTAL HEALTH

We’ll be there With the uncertainty of the current COVID-19 situation, there’s one thing you can be certain of. The Osprey Group have been here throughout the pandemic and we’re still here for all your showering & bathing needs. Call 425623 to book in with your local Product Specialist or view the full product range online at:

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About us

The Team

Editor: Rosalind Tulloch Staff Writer: Katie Campbell Designer: Fionnlagh Ballantine Production: Donna Deakin Sales: Danny McGonigle Contributors: Kate Sheehan, Emily Stuart, Esther Dark, Sarah Crawley, Georgia Vine, Melissa Purkis

This month’s issue...

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 2020 © 2A Publishing Limited. All Rights Reserved. ISSN-2056-7146

s anyone else wondering how we have suddenly found ourselves in November? This tumultuous year has gone by surprisingly fast, and while we are all collectively looking forward to putting the year of 2020 behind us, it is uncertain what 2021 will have in store for us.

One thing is for sure, the occupational therapy profession, in its ever-evolving spirit, will continue to diversify and create new pathways and methods to work with clients in the most person-centred way possible. This year has brought many challenges and changes to the way OTs work, let’s hope we can all take something positive from this experience, whether it be learning a new skill, reassessing your practice, or using your creativity to overcome obstacles to interventions. November would normally be the time we are gearing up for The OT Show, an exciting time where we would get to meet our lovely readers and spend two days exploring the exhibition. This year we luckily don’t have to pack, travel or organise deliveries of thousands of magazines, because we will all be attending in a virtual capacity. The OT Show and Care Show have teamed up to present the Virtual Care Festival. Taking place on 25-26 November, you will be able to virtually attend the exhibition from the comfort and safety of your own home or office and talk to the exhibitors, attend talks in the theatres, network with peers, and it won’t cost you a penny! Have you ever thought of snowsports as a form of therapy for your younger clients? Take a look at the benefits on page 55. We get the lowdown on how to set up your own podcast and Esther Dark explores the importance of cultural competence as an OT. Plus, our regular column from Kate Sheehan, innovative products, news, and OT contributions. We hope you enjoy the latest issue. Until next year, stay safe. The OT Magazine, Editor

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

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What’s inside 30

07 What’s New

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

13 Kate Sheehan Columnist Kate Sheehan highlights the importance of keeping good records

15 Cultural

Competence

OT Esther Dark explores how important cultural understanding is for clients

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

22 Ableism and OT Susan Griffiths explores ableist practice within the OT profession

25 Day in the Life A day in the life of Sarah Crawley, a children’s OT working in social care

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Learn more about a new book taking a therapeutic approach to cooking

28 Managing

Malnutrition

Dietician Emily Stuart explores how OTs can manage malnutrition

30 From Service User

to Professional

Georgia Vine describes her journey from a service user to a professional OT

32 Virtual Care Festival 49 Changing Times for This year’s OT Show is going digital

35 Product Focus More of the latest must-have products

39 An OT’s Focus

Product

Focus 35

OT student Farrah Money explores the inspiration behind her new podcast

42 Podcasting for

Beginners

Want to start your own podcast but don’t know how? We’ve got all the info

Changing Places

Building regulation changes means there will soon be more Changing Places in the UK

53 Paediatrics Section The latest products, the challenge of snowsports, and more in our paediatrics section

63 Media Matters OTs rarely show up in our media, and when they do, they’re often depicted poorly

45 OT Overseas Melissa Purkis shares her experiences of volunteering as an OT abroad -magazine.co.uk

Identify physical and behavioural needs in children and young people Getting the right care from an early age is important for a child’s development. The PEDI–CAT is a new computer–adaptive caregiver report that helps you measure a child’s abilities in four domains: Daily Activities, Mobility, Social/Cognitive, and Responsibility, from birth to 20 years old. New ASD Module! This new Autism Spectrum Disorder (ASD) Module provides additional directions to help respondents select an appropriate rating, given the unique characteristics of children with autism. Telepractice with the PEDI–CAT Understandably, you may not be able to deliver in–person sessions right now. To support your Telepractice needs, the PEDI–CAT is now only available digitally on Q–global®, our web–based scoring and reporting system.

Find out more at pearsonclinical.co.uk/PEDI–CAT

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

What’s new? APPLICATIONS OPEN FOR

RCOT RESEARCH FOUNDATION GRANTS Applications are now open for the 2021 round of RCOT’s Research Foundation grants. Designed to support occupational therapists in funding research at any stage of their career, the only stipulation to receiving funding is that they must be in line with the ten priorities announced by RCOT earlier in 2020. Five different grants will be available to RCOT members, with values ranging from £10,000 to £100,000. Research Priority Grants will see one sole grant of £100,000 provided to an occupational therapy project in the UK which increases the research capacity of the profession by providing developmental opportunities for other occupational therapists within the project. Research Career Development Grants give two grants of £10,000 each, offering

support towards doctoral or early post-doctoral research that is in line with RCOT’s ten priorities. Systematic Review Grants will provide two grants of £10,000 each, supporting efforts to extend the assimilation and development of the evidence base underpinning occupational therapy. One will be awarded for a systemic review that answers the question: “What is the evidence that community rehabilitation delivered by occupational therapists is effective, making a difference and having an impact on everyday lives?” The second grant will be issued to a systemic review based on one of RCOT’s ten priorities. To find out more, email Angie Thompson at angie.thompson@ rcot.co.uk.

OT WEEK 2020 Occupational therapists around the world celebrated OT Week on 2-8 November, centred around the theme of securing the future of the workforce and increasing diversity within the profession. In the wake of the George Floyd protests, and amid the still-relevant Black Lives Matter movement, this theme was more important and relevant than ever. OTs were hoping to raise the profile of the profession while attracting an influx of young, diverse people who are interested in occupational therapy. To coincide with OT Week, RCOT launched their new careers website.

To drive new, young professionals to the site, you can help by tweeting about why you love being an occupational therapist using the hashtag #ChooseOT. The OT Magazine will be supporting the campaign on our social media, so please join in and share why you love your profession!

OTs were hoping to raise the profile of the profession while attracting an influx of young, diverse people who are interested in occupational therapy”

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IRISH CHILDREN IN OT ASSESSMENT LIMBO Around 21,000 children across Ireland are currently waiting for occupational therapy assessments, with Irish healthcare professionals being redeployed into other aspects of the health service to fight COVID-19. Per the Irish Examiner, 21,286

children are currently awaiting assessment, with just under half of those children having spent more than a year waiting on their appointment. Two of the country’s Local Health Offices, Limerick and Sligo and Leitrim, informed the paper that they were not in a position to

Julia Scott Steps Down from RCOT RCOT chief executive Julia Scott announced that she is leaving the organisation at the beginning of next year after 15 years in the role. Speaking on her time with RCOT, Scott said: “I feel that now is the right time to start a new chapter in my life, safe in the knowledge that RCOT has never been in a better position.

so that more people understand its value, while also supporting our members to provide the best possible occupational therapy services to the people who most need them. I would like to thank our members for their support over the years and for the difference they make to people’s lives every single day.

“I will always be incredibly proud of our profession. It has been a privilege to have played a part in raising the profile of occupational therapy

“After 38 years in the profession, nearly fifteen of those as Chief Executive and prior to that three years on Council, it’s time for a

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provide information relating to the Examiner’s request. It is believed that this is due both to OTs being moved to COVID-19 related services, such as swabbing centres, and the low number of OTs recruited by the executive in the previous year.

new challenge. I’m looking forward to exploring opportunities with national and local charities and in the membership association field. “I am very grateful for the support I’ve received over the years from RCOT’s Council, leadership team, staff and members. During my final few months as Chief Executive, I will continue to put the needs of our members at the heart of everything we do, while supporting the recruitment of my successor and preparing a robust transition plan.” RCOT’s chair of council commended Scott’s hard work and contribution to the field, and confirmed that the search will begin for her replacement as soon as possible.

A study carried out by researchers at the University of Pittsburgh’s School of Health and Rehabilitation Sciences has found that patients who receive treatment and support from physiotherapists and occupational therapists are at a decreased risk of hospital readmission or death. The study examined over 30,000 patients who had been discharged from hospital after pneumonia or influenza-related conditions, all of whom were over 18. Researchers told Futurity that they hoped this would provide a framework for hospitals in the United States to become more confident in how they allocate therapy resources to ensure the patient reaches their maximum potential in recovery.

OT DECREASES PNEUMONIA READMISSIONS, STUDY FINDS

Janet Freburger, a researcher on the study, told the news site: “In some ways, we weren’t surprised. Therapists understand the value and importance of mobility and appropriate discharge planning, so patients don’t have adverse outcomes that could lead to readmission. It was good to see the data support this.”

Housing Options Scotland Welcomed OT Students Scottish charity Housing Options Scotland welcomed three occupational therapy students from Queen Margret University as part of their final placement, marking the first time that the charity has ever worked with occupational therapists. The three students, Karen, Hannah and Amie, spent two months working with the charity, offering an occupational therapy-based approach to clients in need of resources or assistance. The Edinburgh-based charity has helped disabled people, older people and members of the armed forces find suitable accommodation since 1997. Before the students left for their placement in September, Shona Henderson, a lecturer at Queen

Margret University said: “This placement focuses on home, health and housing which is an area of interest to occupational therapists - it’s great that our students are able to gain insight into this area by working in the sector. The students are understanding more about the meanings attached to space, place and home, and how these align with Scottish national health and wellbeing outcomes. “The pandemic has really forced us to think creatively about how our students can complete their placement work and this partnership with Housing Options Scotland is a great example of how we’ve adapted and overcome that challenge.”

The pandemic has really forced us to think creatively about how our students can complete their placement work”

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PRINCESS ANNE WELCOMES UCLAN OT STUDENTS Patron of the Royal College of Occupational Therapists Princess Anne celebrated the achievements of University of Central Lancashire students last month and officially opened the new OT Practice Skills area. The Princess Royal officially unveiled a plaque to mark her visit to the Faculty of Allied Health and Wellbeing and met with undergraduate and postgraduate occupational therapy students. Speaking to students during her

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visit, Princess Anne said: “A big thank you to the University here for their support of occupational therapy. The Royal College is delighted that you have taken it on to this level and are evolving it so rapidly.” Samuel Esiategiwa, one of the first graduates from the university’s MSc (Hons) Occupational Therapy course who met the Princess during her tour, said: “You could tell that Her Royal Highness really cared about the development of occupational therapy. She was very

knowledgeable and personable in equal measure.” Dr Anne Milston, deputy head of the School of Community Health and Midwifery, who also led the Princess’ tour, said: “The Princess Royal is a leading advocate for our profession and we hope her visit will highlight the vital work our first cohort of talented graduates will be doing in the future to support people of all ages, whose health may prevent them from getting on with their everyday lives.”

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RECORD KEEPING

he Health and Care Professions Council (HCPC) requires you to “keep full, clear, and accurate records for everyone you care for, treat, or provide other services to”, and that “you must complete all records promptly and as soon as possible after providing care, treatment or other services”. What constitutes a ‘care record’? According to the Data Protection Act 1998, it refers to a care record as any record which: a consists of information relating to the physical or mental health or condition of an individual, and b has been made by or on behalf of a healthcare professional in connection with the care of that individual. They are critical for many reasons, including continuity of care for an individual patient/client, and therefore must be clear concise and evidence-based, supporting fellow colleagues to understand the interventions and allow them to carry on day-to-day care, to meet your employers standards of practice, to meet legal duties and to enable audits and learn from good and poor documentation, to name but a few. Importantly, it is a tool we can use to indicate our core professional requirement of putting the client at the centre of everything we do, to show we are giving our clients

choice and control over how services are provided to them, recording where this has not been achievable and how this could be changed in the future. Do we take them seriously? The HCPC can and does take action against occupational therapists who fall below their standards of conduct, and it is one of the top reasons for HCPC registrants being struck off. Yet do we take it seriously and why is it so vital that we keep clinical notes? Having reviewed a number of clinical notes recently, from both the NHS and local authority, I would have to say my overwhelming experience is that we do not take it seriously, and as a profession we need to do better. One of the key issues is no record of asking consent for therapy input. This could be for a one time intervention, for example, an on ward washing and dressing assessment or cooking session. It could be a period of time to conclude all the actions agreed with the client, for example, the assessment, provision and training of a hoist or a six-week wellbeing course. Whatever it is, record it clearly in the notes. Ongoing notes should not be an afterthought; they should not be scribbles at the end of the day in poor handwriting, but well thought out, clear notes that provide essential information for all of our colleagues, completed in a timely manner. We

must add admin time into our day to complete our clinical notes. If on a visit, keep your contemporaneous notes and scan them if necessary, to keep on client’s files, as a timely record of your observations and recommendations. Also remember that your records can be used as part of a court case, so make sure they are full, accurate, clear, concise, legible and understandable. Only ever use recognised abbreviation agreed by your company, Trust or local authority, or - better yet - still none at all. Therefore, I challenge you to do three things; 1 Ask a colleague to review your notes and do a critical evaluation 2 Complete a reflection on your note keeping, highlighting what has worked, what hasn’t and how you can improve 3 Ask for professional support from our governance team on how to audit your clinical notes against company, Trust, or local authority procedure. The outcome will make you much better at writing clinical notes, making handover to colleagues easier, which will ultimately provide a better quality of service to your patient/clients. Please do also take time to read the HCPC standards of conduct, performance and ethics, and the RCOT’s record keeping document, both of which can be recorded as continued professional development.

Ongoing notes should not be an afterthought, they should not be scribbles at the end of the day in poor handwriting

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CULTURAL COMPETENCE OT Esther Dark explores the need for true cultural understanding with every client

iven that a core tenet for this year’s UK Occupational Therapy Week is ‘increasing diversity’ and it is set against the backdrop of this year’s Black Lives Matter movement, it is imperative now more than ever for occupational therapists to grasp the diversity of the world in which we operate. Individuals are unique occupational beings. Blanket approaches to treatment and assumptions of individuals or areas of practice does not, and will not, fit the paradigm of occupational therapy practice. Cultural competence is a framework which upholds equity within healthcare systems and ensures therapists facilitate culturally relevant interventions which are truly meaningful for those they interact with and are not formed from the therapists’ own cultural worldview. Occupational therapy practice should pivot on an iterative and cyclical relationship between the therapist and the client. Therefore, it is obvious communication is key to effective treatment outcomes; as how can it be possible for a therapist to understand the psychological, physical and environmental spheres of their clients if they do not have a line of clear communication? Therapists then must first make it their priority to endeavour to understand and enter the cultural world of their clients in order to be truly effectual. This means truly listening and seeking to understand the world of another. Agner (2020) recently suggested the profession should now take an extra leap and turn our emphasis from simply abiding by a framework of cultural competence, to a practice of cultural humility, that is adopting a life-long, humble approach to seeking the cultural needs of those they work with in order to address the power dynamics in the therapeutic relationship. Culture is often restricted and seen through the narrow lens of race and language; yet it is much more than this, it spans the multi-faceted spheres of an individual’s identity, their gender, class, abilities and occupation, to name but a few. If we merely view culture as race or language, we will naively miss the depth of an individual’s being and fall into stereotyping and assumptions. I currently work within mental health services for older adults where it is well-researched and known, that person-centred care, which focuses on an individual’s specific needs leads to successful health outcomes. For so many

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of the patients I work with, meaningful engagement becomes incredibly significant as their mental health declines. Meaningful engagement is closely associated with understanding the diversity of an individual and enabling them to be immersed in their social and cultural contexts. All too often though, the care settings I encounter, such as day centres and residential homes, offer activities such as bingo or tea dances, typically British activities, which leave me wondering if these activities are applicable to all? Shouldn’t we be re-thinking and collaborating with the clients we work with to create truly meaningful opportunities for engagement? Furthermore, when we partner with our clients, do we fall into neutral patterns of offering or suggesting activities created from our own worldview or the systems within which we work, without truly knowing the clients we work with or their cultural backdrop? Whereas, cultural competence seeks a dialogical approach, which recognises and responds to the individual, their context and their family; it is open and ready to change, it puts up its hands when things go wrong, and allows the client to lead their intervention and recovery. I have been challenged this year to make a few adjustments to my own professional practice:

...the care settings I encounter, such as day centres and residential homes, offer activities such as bingo or tea dances, typically British activities, which leave me wondering if these activities are applicable to all?

1 Not to make hasty assumptions about the clients I work with because of their age, diagnosis, skin colour or any other factor for that matter, but ask critical, truly open-ended questions both to the clients I work with and myself. It is vital that we learn to reflect and use supervision as a space to voice our prejudices and judgements in order to provide client-centred care. Cultural competence is recognising our own heuristics and discriminations. 2 It is also important to understand that cultural competence is not a tick box exercise; it is a life-long journey of learning. There are so many cultures within our world which are impossible to fully understand, therefore we need to view becoming culturally aware as a journey, not a destination. Co-production and collaboration is key for learning and moving forward. 3 We need to be okay with the fact that we will most probably offend or insult someone at some point or will be offended ourselves. This is an uncomfortable one to come to terms with as therapists, as we want to say the right thing and be respectful to those we have the privilege of working with, but it is impossible to do so; this is because we don’t know what we don’t know. When I work with my patients, I wasn’t born into their culture, their family, or have experienced what they have experienced, I need to listen, to learn, and humble myself. 4 Our words are not enough. RCOT’s BAME Big Conversation highlighted this year that as a professional body we need to do more to promote equality, diversity and inclusion in order to provoke meaningful changes. Therefore, how can we effect change and action in the places we work and our own attitudes to address diversity and equality? 16

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FOLLOW You can follow Esther on Twitter @EstherDark3

A BIG THANK YOU! from

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

FLOW X CURVED STAIRLIFT

A seamless blend of innovation and functionality, the Flow X curved stairlift from Access BDD is packed with next-generation features. A unique automatic folding seat and automatic folding footrest, advanced swivel and levelling technology, and an innovative armrest design concept that allows for easy side transfer. All combined in a calm contemporary design that gives maximum space and comfort for the client whilst taking up the minimal amount of space in the home. accessbdd.com/flowx | 01642 853 650Â Â 2

SOCKS WITH LOOPS

For any patient who has limited hand or finger function putting on socks can be difficult. These socks have ribbon loops sewn on either side of the top of each sock, allowing the wearer to simply slide a finger through each loop and pull the socks on with minimal fuss. They come in a standard black colour and are available in thin or thick materials. activehands.com | 01564 702255

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MT EVO

Mountain Trike’s MT Evo is adapted for riders with limited hand function. It has the same excellent all-terrain performance as the original Mountain Trike, but with even simpler controls. It is ideal for everyday outdoor use and will allow your clients to tackle woodland trails, rocky paths or get through snow and mud – all while keeping their hands clean and dry due to the clever lever function. mountaintrike.com | 01270 842 616 4

EDZ MERINO WOOL TOUCH SCREEN GLOVES

These merino wool gloves are made from beautifully soft wool to keep hands nice and cosy. The wonderful thing about them is that they are thin enough to text on a smartphone while wearing them, and they also have rubber dots on the palms and fingers for grip, ensuring any smartphone is safe in a person’s grip. edzlayering.com 5

SOUND OF SLEEP

Many people have been struggling with sleep during the pandemic. The constant changes to daily lives and routines have been taking their toll on many minds, ruining sleep patterns and causing exhaustion. The Sound+Sleep machine delivers a choice of soothing, naturally recorded sounds that promises no repetition on every cycle. Whether it is sounds of the city or cascading waterfalls, this machine will help you or your client drift off. soundofsleep.co.uk | 0871 288 4279

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RECHARGEABLE HEAT POD

Hot water bottles are a great source of warmth during the winter months, but they involve pouring boiling hot water into a tiny hole to just the right level. This can be a high-risk function for older people or those living with impairments. Avoiding the need to handle boiling water by using this rechargeable heat pod negates any risk and keeps your patients warm and comforted safely.

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COMPACT FLIP UMBRELLA

Getting prepared for the rainy weather that inevitably accompanies the winter months is essential. This clever little umbrella opens and closes at the touch of button, great for those with limited hand dexterity, and it also closes in reverse. This may sound strange but by closing in on itself it prevents the user from getting soaked when putting it down. The Brolly Store - ÂŁ29.99 8

MINDFULNESS COLOURING BOOK

There is no better way to help your patients stave off boredom and keep their minds active and calm, than with an intricate colouring book. Adult colouring is a very popular pastime and has been increasingly used throughout recent months to help with anxiety. The therapeutic nature of colouring is helping people of all ages and abilities make it through these difficult times. amazon.co.uk

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Ableist Attitudes

Susan Griffiths is the ASD occupational therapy lead in Children’s Therapy Services at Poole Hospital NHS Foundation Trust. Susan is Deaf, and recently she hosted an OTalk session to highlight and address the presence of ableist practices in the occupational therapy profession.

s occupational therapists we pride ourselves on being a person-centred profession where we ask ‘what matters to you?’ rather than ‘what’s wrong with you?’. The aim of occupational therapy is to enable people to participate in the occupations they want to do personally, as well as the things they need or are expected to do socially and culturally. But do we really do this? One of the biggest barriers to person-centred care is ableism, yet this is rarely talked about within our profession. A recent poll that took place during an OTalk that I hosted on Twitter showed that 33% of the occupational therapists that took part in this poll have never heard the term ‘ableism’. For those who have not heard of ableism, it is the discrimination and social prejudice against people living with disabilities or those who are perceived to be living with disabilities. It is a system that values people based on their bodies and minds and what society deems to be ‘normal’. Here are some examples of ableism that I have personally experienced as a Deaf person: Ableism is when people say that I don’t act disabled and expect me to take that as a compliment. “But you speak so well.” Ableism is when you make assumptions about what I can or can’t hear without asking me. “Oh you wouldn’t have been able to understand him.” Ableism is when you make assumptions about what I can and can’t do based on my disability. “How come you can drive a car when you can’t hear?” Ableism is when you force unsolicited help upon me because, to you, it seemed like I needed it. “She is Deaf, so you need to speak loudly” Ableism is when you view me as either an object of pity or inspiration. “You are Deaf… I am so sorry.” “You are an occupational therapist? That is an amazing achievement for a Deaf person” 22

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In short, we live in an ableist society where non-disabled people are valued over disabled people. Here are some disability facts: 1 Disabled people are more than twice as likely to be unemployed as non-disabled people (Labour Force Survey April to June 2020). 2 Life costs £583 more a month if you are disabled (Scope - The Disability price tag, 2019). 3 One in three disabled people feel there is a lot of disability prejudice compared to one in five nondisabled people (Disability Perception Gap 2018, SCOPE). 4 One in three people see disabled people as being less productive than non-disabled people (Disability Perception Gap 2018, SCOPE).

Ableism is when you force unsolicited help upon me because, to you, it seemed like I needed it

Yet, does ableism exist within the occupational therapy profession, and if so what does this look like? A recent OTalk poll that asked the question ‘Does ableism exist in your OT practice?” showed that 56% of the occupational therapists that took part in this poll said ableism does exist in their OT practice and 29% reported that they were not sure. This is what they shared: “Individuals with disabilities are often thought to be less able to complete tasks independently, yet this is rarely based upon their function. It is based on assumptions and pre-conceived ideas”. “The belief that independence is the goal or that a task has to be done a certain way”. “Extremely high costs for equipment purely due to the disabled tag”. “Often a blanket approach is used when one strategy has been helpful for one disabled person so an assumption is made that it will be helpful for all disabled people” “Not having the equipment available that helps a person live their best life such as lightweight wheelchairs” “Assuming children with disabilities are either verbal or non-verbal and if they are non-verbal, assuming they can’t communicate” “The belief that we know more about someone’s disability than the person with the disability” “Disabled OT students going on placements where there are no wheelchair accessible facilities for staff, only patients” “Ableism is embedded in our use of OT language i.e. “wheelchair bound’; “patient suffers with…”; it is behavioural” “The idea that there is a normal person or way to participate in occupations… what is normal? Who in society defines what is normal?” “We use a medical model that focuses on what is wrong with the person and trying to fix this rather than what the person needs”

middle class occupational therapists which perpetuates ableism. We need to increase diversity within our profession at all levels. We need to include our own health conditions as part of our professional identity as OTs, without losing focus being on the person we are supporting. We need to support our disabled OT students on placements and not use their disability as a barrier to them accessing placements. Universities need to incorporate critical disability studies into the OT curriculum and teach OT students how to identify and understand how ableist ideals have become part of our practice. We need to be critically thinking about the assessments and interventions we use. Most standardised OT assessments unilaterally frame questions around disability in a problem-focused way or box things into participation categories woven with ableist assumptions. We need to make our workplace as accommodating as possible, not just for our clients but also for our disabled colleagues. Don’t just focus on the obvious, such as accessible bathrooms and accessible parking, but also focus on things like braille leaflets, using alternative forms of communication, for example, sign language, texting or emailing instead of calling, providing quiet hour or a quiet room for those who find busy/noisy environments difficult, and offering appointments in different formats according to your client’s preferences, whether that be video calls, telephone calls, or face-toface. In short, we need to advocate, practice and champion co-design and meaningful collaboration with disabled people in everything we do, from service design, quality improvement, research, technology and equipment development, pre and post registration education, and policy. I will leave you with this last thought: “Do the best you can until you know better. Then when you know better, do better” Maya Angelou You can follow Susan on Twitter @SusanGriffiths5

“OT assessments and interventions based on occupations that are defined from a Western viewpoint. The biggest example is being independent” “Thinking occupation is task focused and what society sees as productive to the exclusion of simply ‘being’ or mindfulness” In answer to the question ‘Is ableism perpetuated within occupational therapy?’, the uncomfortable truth is yes, we may be unknowingly and knowingly perpetuating ableism within our practice. So how can we challenge ableism in our practice? The first step is to create awareness by recognising what is already happening and then we can take action. Everyone’s experience of disability is different and complex. We need to look through the many lenses of the disabled people rather than rely on our own assumptions and pre-conceived ideas. Our profession mainly consists of white, non-disabled,

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n i y a d A . the life of.

ley w a r C h a r Sa nal occupatio

dren’s ley is a chil w ra C he began h ra Sa cial care. S so in g in 5 ork are in 200 therapist w in social c st o p l a n 6 00 and a rotatio e post in 2 m ti ll fu a g 7. urin ren in 200 before sec with child rk o w to moving

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

Sarah Crawley

What is your current role?

Describe a typical day

I am a children’s occupational therapist in social care. I assess children with disabilities in their homes. I carry a complex caseload with a combination of children with physical disabilities and children on the autistic spectrum. I provide practical advice as well as equipment and adaptations to support each child and their parents/carers to enable them to be independent, as well as maintain their safety at home. Adaptations to their home could be from lower level adapts such as a stairlift or a level access shower, to the provision of an extension. To provide the more complex adaptations, I need to be able to clinically justify my recommendation, so I liaise with health, education and other social care professionals to evidence the need of what I am recommending. As children’s long-term needs can be variable, due to their anticipated growth and evolving conditions, I use the evidence gained from other professionals to assist with my decision making as to what their needs could be in their future.

We don’t really have a typical day, and whatever plans we may have had don’t always come to fruition. We could be carrying out assessments, either on our own, with reps, adaptations officers, other health professionals – they tend to go ahead as planned. The rest of the day would be writing up case notes, responding to emails, completing a variety of reports for housing or panels (equipment or adaptations). We could take a phone call that needs to be signposted, or deal with an emergency, this could be an issue with some of the works that are progressing, equipment failure, or an injury to a parent.

Their current environment may not be suitable for adaptations, so the whole family may need to be rehoused to a more suitable property. This often means that their next home may also need adapting including further extensions. I, again, support the parents through this whole process, ensuring that their next property will meet their long-term needs.

Each month ..

We are all working from home at the moment, so have a few online meetings each week; this is to maintain our sanity as we are now working even more in isolation from each other. All calls are carried out via video, as I believe it is vital to be able to see a face when having a conversation, and it almost mirrors working together in the office. In the beginning, when we were in lockdown, we carried out a lot of phone and video assessments, we have gradually begun going back out into families homes, fully PPE’d up. Personally, I have found having face to face contact is a much better way of working, and much prefer being back into family’s homes, especially when it is a new family, I pick up on more

information when in their home than over the phone or video call and this helps build a better working relationship. That said, I have also worked well with all the families and provided equipment/ adaptations without physically meeting them.

What’s the hardest part of your job? Managing expectations of families, but also being their advocate when we feel let down if we have asked for something specific. I appreciate that we have budgets, and they are getting smaller, but sometimes certain recommendations should be provided, as I feel they can have a significant impact on the whole family, which could create a longterm saving for the council.

What’s the best part of your job? Definitely the families that I work with. I feel honoured to be working with lots of fabulous families and I feel that I have provided a good service for all. Enabling families to care for all their children, reducing risks and achieving a positive outcome is a rewarding feeling. It is not just the child we assess, we carry out a holistic assessment as their disability can have a direct impact on their siblings. I also work within a fabulous team, we are a small team and work closely with each other offering support and morale.

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RICE DISHES ARE BACK ON THE MENU FOR THOSE WITH DYSPHAGIA The UK’s leading provider of frozen ready meals, Wiltshire Farm Foods, has announced the introduction of three new dishes to its award-winning Purée Petite Softer Foods range, all of which incorporate a new and highly innovative rice component to its selection of Level 4 meals. Due to its grainy nature and high starch content, rice is notoriously challenging to fully purée and home-blending does not always achieve a smooth or adequate consistency. Wiltshire Farm Foods provides a safe and delicious solution, due to its expert cooking and preparation methods, which have enabled the company to achieve a puréed texture.

This addition of shaped rice to Wiltshire Farm Foods’ texture modified range is a ground-breaking concept and will be welcomed by those with swallowing difficulties. This condition is also known as dysphagia and has a huge impact on how those living with it consume certain foods; many are simply unable to eat rice in its solid form. With rice now accompanying each of the new dishes, the carefully developed new meals include: Beef Chilli featuring a warming puréed beef chilli with kidney beans, served with rice and peas; Sweet and Sour Chicken, which comprises puréed chicken, pineapple and peppers in a sweet and sour sauce along with rice and peas, and Chicken Tikka Masala. This delicious, puréed chicken has been infused with a medium spiced coconut and tomato sauce and is served with rice and creamed spinach.

it has been estimated, by The Royal College of Speech and Language Therapists, that up to 40% of people who have experienced a stroke develop swallowing difficulties. “All of the dishes are more convenient than home blending as no preparation is required. Simply cook the meals in the microwave or oven straight from the freezer.” Emily Stuart, Registered Dietitian for Wiltshire Farm Foods There are numerous challenges in creating safe, compliant meals via home blending with the process being both time consuming for carers and potentially hazardous for patients if the correct texture is not achieved. The nutritional content can also be significantly reduced when water is added to liquify the food. Wiltshire Farm Foods eliminates any need for home blending with its texture modified meals.

The Queen’s award-winning Purée Petite range has been specifically created for those with dysphagia. Dishes with this texture are puréed and smooth with a consistent texture, each one developed in line with the IDDSI (International Dysphagia Diet Standardisation Initiative) Level 4 requirements. With over 500 calories and at least 16g of protein in every 275g portion size, the Purée Petite range makes mealtimes more manageable for those with swallowing difficulties, which can account for severe malnutrition if not managed correctly. ORDER YOUR TASTING BOX

An alarming 1 in 17 people will experience some form of dysphagia in their lifetime, according to the World Gastroenterology Organisation. To articulate this further,

For a limited time only, Wiltshire Farm Foods is delivering tasting boxes for you to cook up and enjoy yourself.

Inside you will find a selection of frozen ready meals including our award-winning Softer Foods range, our guide for Healthcare Professionals, vouchers for your patients, pens, mugs and more! To order yours, visit: wff.link/TastingBox

Cookfulness A therapeutic approach to cooking for people living with chronic illness and pain

an Taverner has created a unique cookbook aimed at helping people living with chronic health conditions get back into the kitchen.

In his mid-thirties, Ian began to experience chronic pain, anxiety and depression, and was subsequently diagnosed with chronic fibromyalgia and arthritis. He attended an exclusive programme at the NHS National Centre for Pain in Bath, and this programme gave him hope and drive to find a way to live with his condition. This course is also the reason Ian began cooking again and it ignited a passion in him to get back into the kitchen to cook for his family. Seeing his family enjoying the food he made, cooking with his children and being creative in the kitchen gave him back his family and gave him a renewed purpose in his life. Ian has taken this drive and passion and channeled it into creating a book that will help and encourage individuals living with chronic conditions start cooking. He comments: “Chronic pain and mental health sufferers can see wanting to cook as the biggest hurdle. Not being able to, or wanting it is the biggest hurdle. I wanted to create a new kind of cookery book which is optimised for symptoms such as fatigue and brain fog to make the barriers to benefiting from the therapy of cooking as few and as easy to navigate as possible.”

COOKFULNESS The book itself has a unique content layout to help make the prospect of cooking less daunting and more enjoyable as an experience. It is different to your usual cookbooks and there are no images of final dishes, removing the pressure some people may feel on how the dish is supposed to turn out. Ian is ceoliac, so all the recipes are aligned to this diet, meaning no wheat or gluten, but you can add in gluten or wheat products where appropriate if you wish to do so. The recipes are designed for the whole family to enjoy and are thoughtfully created to be as simple as possible, ensuring anyone can cook good, nutritional, home-cooked meals. The book includes great tips for helping people to conserve energy when needed. Ian recommends keeping chopped frozen vegetables in the freezer for the days when you are low on energy or experiencing pain in your hands. He has also created the ‘Give Yourself Time’ section for each recipe, for when you are experiencing a ‘bad day’, this allows you to still cook at your own pace. Each recipe also has a list of all the utensils you will need to make the dish so you can get everything out before you start, and there is a difficulty rating and hints and tips for each dish too. The key important elements are highlighted throughout each recipe to keep you on track even on days where brain fog seems insurmountable. This book has just been released and is available on Amazon and to order from all good book stores. If you have any patients living with chronic illness who are looking for support in getting back into the kitchen this book would be a great recommendation, and part of the proceeds will be going to the NHS Bath Centre for Pain Services.

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MANAGING MALNUTRITION Dietitian Emily Stuart explores how OTs can help to prevent, detect, and manage malnutrition in the UK

efore occupational therapists can support with managing malnutrition among their patients, they must first know the warning signs to look out for, and how to identify someone at risk. Weight loss is an obvious, objective sign to look out for or to discuss with patients. There are also other signs of malnutrition that can reveal themselves physically, socially, or psychologically. These include dry, thin, or brittle hair; cracked, dry nails; xerosis (dry skin), or loose or poorly fitting dentures. You may also notice that your patientâ&#x20AC;&#x2122;s clothes or jewellery are loose or poorly fitting. This can be an indication that they have lost weight over time but may not be acutely aware and is often more of a subtle sign than significant weight loss. See box 1 for other signs of the presence or risk of malnutrition. As part of your assessment with your patients it is important to consider if a poor nutritional status may be linked with signs and symptoms they may be showing, and consider how you can build in some investigative questions into your time with them, or consult a dietitian if you are not sure.

Occupational therapists are well placed to help detect malnutrition among their patients. There are validated screening tools that exist and can be completed with just a few details from the patient. The Malnutrition Universal Screening Tool (MUST) is the most frequently used of these screening tools, and full guidance is available on the BAPEN website www.bapen.org.uk/screening-and-must/must/ introducing-must, with adaptations available for use during the pandemic. Self-screening can be encouraged during remote consultations and can support occupational therapists to deliver a patientcentred care approach. As allied health professionals working both in acute care and in the community, one of the many shared objectives is, where possible, to help patients maintain their independence. By having a heightened awareness of how malnutrition can present and how it can affect your patients, occupational therapists can strengthen their practice in this area.

BOX 1: WARNING SIGNS OF A RISK OF MALNUTRITION AMONG ADULTS (BDA, 2019; MALNUTRITION TASK FORCE, 2017; NHS, 2020) 1 Reduced appetite 2 Lack of interest in food 3 Marked tiredness and lethargy 4 Loss of muscle strength 5 Prolonged healing of wounds 6 Prolonged recovery time following illness 7 Low mood and/or depression 8 Poor concentration 9 Frequently feeling cold 10 Dysphagia (problems swallowing) 11 Oral problems, such as with dentition 12 A recent diagnosis or period of poor health 13 Physical limitations with shopping or cooking (and inadequate support)

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MANAGING STRATEGIES AND HOW OTS CAN HELP Providing effective and good nutritional care for patients is rarely one person’s responsibility. Whilst dietitians are the healthcare professionals (HCP) responsible for influencing policy in this area and treating the more complex cases of malnutrition, there are many shared roles. For example, the previously mentioned MUST can be completed by any HCP and the prescribing of oral nutritional supplements (ONS) is also frequently done by GPs or prescribing nurses. Despite dietitians focusing largely on a ‘food first’ approach to treating malnutrition, ONS are also frequently required as part of the treatment. A food first approach is one you may be familiar with. For many people affected by malnutrition, simple changes to their diet such as fortifying their food with ingredients such as butter, milk, cream, cheese, or

BOX 2: NUTRIENTRICH FOODS AND DRINKS FOR PEOPLE AT RISK OF MALNUTRITION 1 Whole milk, which can also be fortified with milk powder 2 Hot drinks such as Ovaltine, hot chocolate, and milky coffee, made with whole milk where possible 3 Whole yoghurt, which can be enjoyed with honey, fruit, nuts, or granola 4 Cheese and crackers 5 Sauces such as mayonnaise which can be added to salads and sandwiches 6 Peanut butter, mixed nuts, and dried fruit 7 Smoothies based on dairy or fruit, that can be fortified with yoghurt, ice cream or honey 8 Desserts, ideally based on whole milk 9 Cereal or nut bars

peanut butter can have a substantial impact on their energy and protein intake. Crucially, as these foods are higher calorie, they have less impact on the overall volume of food than some ingredients. This is very important for people who are experiencing a poor appetite. For patients for whom the physical ability to prepare and cook meals is a barrier to eating well, occupational therapists can support by recommending ways around this. There are meal delivery services that can provide a solution by delivering frozen meals with carefully considered nutritional content, such as those that are energy dense (often used to refer to meals that contain 500 or more Kcal per meal). Taking away the need to cook regular, nourishing meals can release some burden from patients, family, or carers, and when planned carefully, using a meal delivery service can provide assurance on the quantity and quality of nutritional intake. Some patients may respond better to a ‘little and often’ approach to food when it comes to treating malnutrition. Occupational therapists can support with this, by exploring this option with their patients and ensuring that if they are swapping to ‘little and often’, that the foods and drinks they are consuming are nutrient-rich. See box 2 for some ideas for foods and drinks that fit well into a ‘little and often’ approach to managing malnutrition.

If you are concerned about the nutritional status of any of your patients, an appropriate first step would be to consider completing a screening tool. If that is not possible, questions can be asked to them to help form an impression based on subjective criteria, and the BAPEN self-screening tool is useful here. In the interest of multi-disciplinary team working, be sure to consult with dietetic colleagues if you think more specialist support is needed. Together, we can help to raise awareness, reduce the burden on patients and the healthcare system, and educate patients about how poor nutrition is not an inevitable part of being unwell. About the Author Emily Stuart is an HCPC registered dietitian for apetito and Wiltshire Farm Foods; healthcare expert; member of the BDA, with several years clinical experience in a variety of settings including acute and primary care dietetics. For practical advice on solutions for managing swallowing difficulties and malnutrition, please visit specialistnutrition.com/swallowing-difficulties.

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Service User to PROFESSIONAL From

Meet Georgia Vine, a third year OT student using her disability as an important tool on her journey to becoming an OT

’m Georgia, a final year BSc occupational therapy student at Sheffield Hallam University. In this article I’m going to discuss how my occupational therapy journey is a little different than most.

...my parents used to buy toys purposely to improve my fine and gross motor skills

I’ve had OT input from being born up until the age of 16 due to having spastic cerebral palsy which affects all four limbs and my speech (this being the short description of course). When I was younger, I really struggled with my fine motor skills I remember doing the nine peg-hole test a lot. My parents have always supported me, and my therapy sessions never ended when the therapist left as my parents made sure that they incorporated it in everything I did. My house was full of toys, but little did I know that my parents used to buy toys purposely to improve my fine and gross motor skills.

... I’ve had some funky access methods in my time, from roller balls to joysticks

I thought it was just a coincidence when I played with a toy during therapy and then I’d magically get a new toy a few days later! I played many games just like any other child but obviously, there is a reason why my parents bought building blocks and challenged me to build the tallest tower or used to get me chunky pens. We knew from around the age of seven that my handwriting was not going to improve drastically, therefore I started doing all my written work on computers. Let me tell you, I’ve had some funky access methods in my time, from roller balls to joysticks. However, when I started working on a computer, I used to feel isolated as often I’d be sat on the computer in the corner all on my own, and these lessons were always the hardest. My teachers started to notice that it was affecting my learning. One day I walked in to find my computer decorated with bright colours, my stand for my keyboard had been totally revamped. This meant a lot to me I will never forget walking into my classroom that day!

My occupational therapy input during my childhood plays a massive role in my life 30

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One day I walked in to find my computer decorated with bright colours

When I moved to working on a laptop where I could work at a desk with all my peers this did wonders for my self-esteem. I still took up most of the table with my clunky equipment, but I didn’t care because I could sit with my friends. I only really started using just my laptop with no funky keyboards or mouses around age 15 and this was only because, as the workload grew, I found that I didn’t have enough room for all my work and adaptations on my desk.

I can use my disability as a strength and as a tool and this is what I have been doing in my recent work

Although my computer luggage may have become lighter over the years, I still use a lot of equipment around the house daily to enable my independence. For example, I have a bath board, a shower seat, a plate guard, Dycem, and other pieces of equipment that I use daily. I have become a lot more independent over the years but just because I don’t have input from services now, doesn’t mean that I don’t need help in completing activities of daily living. I mean mealtimes would be a mess without my Dycem and plate guard - and that’s with my food being pre-cut! My occupational therapy input during my childhood plays a massive role in my life and I think that’s why my goal is to become a paediatric OT. This is because I can use my disability as a strength and as a tool and this is what I have been doing in my recent work. In 2019 I set up my own blog named Not So Terrible Palsy and more recently I have been using my blog as part of my studies as I completed a virtual occupational therapy placement. My virtual placement was all about the benefits of online communities for disabled people as I myself have gained more confidence due to the online communities I’m involved in. My work on placement was just the start as I continue to make the power of online communities more understood in the professional world. So, this again is an example of the significant role my disability plays in my life. As without my cerebral palsy I probably would not have even chosen to study occupational therapy and I certainly wouldn’t be raising awareness of online communities in the OT world. I feel fortunate that I can do this, and I will continue to use my personal experiences of disability as a tool throughout my career.

FOLLOW Twitter: @GeorgiaVineOT Blog: notsoterriblepalsy.com Email: georgia@notsoterriblepalsy.com

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Virtual Care Festival The OT Show and Care Show have teamed up this year to bring you the Virtual Care Festival

he OT Show and Care Show will be running the UK’s first Virtual Care Festival on 25 – 26 November 2020. The festival will be a great opportunity to gain CPD through lectures and seminars presented by our world-renowned industry speakers, network with colleagues, and meet your favourite suppliers. In a time where face-to-face learning for health and care professionals is restricted, there still needs to be a space where professionals can network, learn and explore the latest innovations in the industry. The Virtual Care Festival is a place where OT professionals can do this with ease. Today, audiences expect more. Not death by PowerPoint or disruptive phone calls, but a tangible online experience that is human, interactive, and engaging. The Virtual Care Festival 2020 will run on 25-26 November. The event will be the largest digital gathering of occupational therapists and decision-makers working in social and private care, both domiciliary and residential, in the UK. At the beginning of August, The OT Show conducted a survey to over 22,000 OT professionals to find out what could be done to help with their continued learning and development in the absence of face-to-face events. Out of those 22,000, a stunning 84% said they were actively seeking some form of online engagement to fill the gap. To fulfil the needs of our OT community, we have designed the Virtual Care Festival. Although the live event can’t go ahead this year, we wanted to organise an event that was safe for our community of occupational therapy professionals. We understand that a great deal of our visitors work hard to support and improve the lives of vulnerable people, therefore, we felt it irresponsible to try and run a live event in 2020.

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HOW WILL IT LOOK?

The Virtual Care Festival will run like an actual event but from the comfort, safety and convenience of your own home or office. Although physical events are not running this year, we wanted to provide an experience just as exciting and insightful. Just like a conference centre, you’ll be able to move around and talk to your colleagues like you would at any face-to-face event. This virtual space is split up into four areas for easy navigation.

THE ENTRANCE LOBBY This is where the journey starts with easy navigation to all the theatres, exhibition hall, and a help desk for advice.

EXHIBITION HALL

Where you can explore the latest brands, technologies, and engage with the exhibitors. This virtual space allows you to have face-to-face conversations with the best companies in the industry. Visitors can explore over 50 interactive leading suppliers showcasing different products and services for all organisation requirements, including: Arjo, CareLineLive, CoolCare, Opera Care, Recruitive, Sunmed, Vileda Professional, My Learning Cloud Limited, Essex County Council, AKW, Closomat, Hillrom, Accora Limited, OSKA, and Medequip.

SPEAKERS

To provide an event that will benefit the education and learning of our community we have talks from some of the top names in the industry, some of which have provided excellent presentations at our live events in the past. Among these are Dr. Michael Iwama, Dean at MGH Institute of Health Professions, Rt Hon Sir Norman Lamb, Former MP, Chair of the South London and Maudsley NHS Foundation Trust and Chair of the Children’s and Young People’s Mental Health Coalition, Michael Mandelstam, Legal training in social and health care at Michael Mandelstam Ltd, Debbie Ivanova, Deputy Chief Inspector (DCI) of Adult Social Care at CQC, Nadra Ahmed OBE, Chairman of NCA and Barbara Keeley, MP, Shadow Cabinet Minister for Mental Health and Social Care. The Virtual Care Festival will take place on Wednesday 25th and Thursday 26th November 2020 between 09:00 – 17:00. Information on joining the event will be made available upon registering via email. To register your interest visit: www.theotshow.com/ ot-magazine For any other enquiries, please contact the team on 0207 348 5276 or email Joseph Church on j.church@ closerstillmedia.com.

The platform also allows you to arrange meetings with exhibitors via chat windows and video conferencing tools. As they are the leaders in their field and have been particularly vital to the industry during the pandemic, there will be plenty to engage with over the course of the two days.

NETWORKING LOUNGE Networking opportunities with peers and a chance to discover valuable new acquaintances. A place to meet attendees, speakers, and other exhibitors.

THE THEATRES

Where the learning takes place. Five theatres with world-renowned speakers to gain over 60 hours of CPD engagement.

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Help clients ‘access all areas’ quickly without disruption Addressing the impact of reduced mobility on a client and their family can be disruptive to all involved, and on multiple areas of their home- but it need not be. We look at a fasttrack solution, that may well already be in your equipment store!

e’re all aware of the current drive to enable safe discharge of patients from hospital to home. That is in addition to the typical pressure of assessing clients as existing issues change, requiring different solutions to enable them to remain in their own home. Moving around at home is the biggest problem: almost 7 million people - 48% of the British disabled population - say mobility is their biggest issue, making it the biggest single limitation. (1) For the client, adapting to a life-limiting condition is hard enough, whether short or long term, without the emotional trauma of having their bed in the lounge, and what if they do not have a downstairs WC?

NO BUILDING WORK More often than not, the ‘go to’ solution is to assess for major works, an adaptation including the provision of a through-floor lift or stairlift. That inevitably takes time, whilst the appropriate funding stream is authorised and the works approved.

to move furniture from one room to another. Familiar life can continue for the whole household. Even the slightest able-bodied person can easily use it to move even a morbidly obese passenger (up to 135kg). Fully-adjustable speed controls means the operator can set the Sella to whatever speed is comfortable for them, and automatic braking holds on each step for optimum safety and security. The AAT Sella reduces, or even eliminates, the need to transfer on and off: many people use it as their primary means of transport in place of a wheelchair. An optional universal back with integrated safety harness ensures any passenger is comfortable and secure, even if prone to spasms or seizures. The rechargeable battery pack is capable of 300 steps from one charge.

If the mobility limitation is comparatively short term, a matter of weeks or months, then what?

BEST VALUE

An AAT Sella powered stairclimber is not just a quick fix, but can actually deliver better PROMs and best value in use of financial and other resources.

AAT’s nationwide team means an OT can quickly action an assessment (virtually, remotely or actually). Most local authorities already have at least one AAT stairclimber in stores, so the solution can be delivered quickly and often at almost no cost. AAT offers a hire facility, for as short a time as a week, to further accelerate the delivery of safe home living. AAT fully trains all operators to ensure they are comfortable using the equipment.

The AAT Sella has a small turning circle, meaning it can accommodate narrow fights and tight turns. When not in use, it simply folds away.

SINGLE-HANDED CARE A battery-powered Class 1 Medical Device, the Sella is operated by one person, providing safe and smooth movement of the passenger between levels, with minimal effort: https://youtu.be/zoA2uhyFGmQ. It means a mode of transferring the client up and down stairs is quickly and cost-effectively delivered, without any disruption to the fabric of the home, nor any need

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Familiar life and routines can continue almost uninterrupted, safely, within a matter of days. Find out more, or arrange a free home assessment for a client here: www.aatgb.com/s-max-sella. (1) https://assets.publishing.service.gov.uk/government/uploads/ system/uploads/attachment_data/file/874507/family-resourcessurvey-2018-19.pdf

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

BUDDI

Available in a number of colourways, Buddi is a smart and discreet way to provide peace of mind to the families of vulnerable people this winter. Usable with or without a smartphone, it alerts friends or family that their loved one may have taken a tumble and should be checked up on. Ideal for when the bad weather sets in. buddi.co.uk | 0800 978 8800 2

UNIQLO HEATTECH EXTRA WARM SCOOP NECK

UNIQLOâ&#x20AC;&#x2122;s Heattech line offers stylish and subtle thermal clothing that can be utilised for any occasion. This scoop neck is part of the Extra Warm range, and features a fitted cut to prevent any bulkiness, allowing the wearer to layer as needed, while providing 1.5x more heat retention than their standard range. uniqlo.com/uk

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EXCEL G-EXPLORER SELFPROPEL WHEELCHAIR

Whether your client wants to get back into the great outdoors, or needs a chair that can support them through the challenges of constantly changing winter weather, the Excel G-Explorer can overcome just about any terrain. It features pneumatic mountain bike tires, a textured paint finish, and is lightweight. glebehealthcare.co.uk | 08000 23 23 35 4

SEROLA SACROILIAC BELT

Ideal for clients with high-risk occupations who experience changes in loading, this belt helps prevent acute back pain from developing into chronic pain. It is useful for a number of conditions which affect the lower back, including sciatica and sacroiliac joint dysfunction. Soft and breathable, it can be used 24/7. healthandcare.co.uk | 020 7720 2266 5

CARE CO SAD LAMP

LED lamps are an excellent way to help lessen the symptoms of seasonal affective disorder, which some people can find extremely inhibiting. The 45W lamp inside this light outputs at 10,000 lux, and is UV-free. Mains operated, the light can assist in the production of both melatonin and serotonin. careco.co.uk | 0333 015 5000

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FLEXYFOOT FERRULE

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OT’S FOCUS AN

Farrah Money is a third year occupational therapy student who has started her very own podcast to discuss and explore all things OT. Here, she tells us all about the inspiration behind her venture

What drew you to occupational therapy?

Where did you get the inspiration to start a podcast?

I was drawn to occupational therapy for a few reasons. The ability to really work in collaboration with people is a huge draw for me because the partnership working is unique. Also, the profession has such a vast range of practice areas meaning you could never get bored within your career.

I listen to a few OT podcasts but one I have been listening to for a while now is Spill the OT. Although the host Robyn is based in the United States, I really appreciated her honesty about the profession and her openness to the reality of being an OT. So that is definitely part of the inspiration behind the podcast. The other was the fact that as great as all the OT podcasts are, there were so few based in the UK. The fact that the UK is so unique because it has the NHS, meant that much of the finer details about practice within podcasts would become lost as different countries work under different conditions. So, I thought why not? I love to learn and enjoy talking so it seemed perfect.

Has the course been everything you expected so far? To be fair I wasn’t sure what to expect! I have studied previously so I wasn’t too sure how the academic element would compare, but so far so good. The placements have been tricky as there just aren’t enough to go around but I don’t see this as the university’s fault. Its strange to think by July (fingers crossed) I will be qualified, so something must be going right!

...as great as all the OT podcasts are, there were so few based in the UK

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You have covered some really interesting topics; do you have a favourite episode? Each episode for me is a real treasure so I couldn’t really single one episode out as a favourite. What’s nice is each time I get a different experience and learn so many new things, each guest brings their own essence which I really like. I have some super guests lined up for the end part of the year so I am hoping people will continue to enjoy the range of content.

It’s a great way to network with other OTs and OT students on a global level as they reach out via social media How did you go about starting it? I watched a tonne of YouTube clips from how to set up the best sound quality through to setting up intros and outros. Then I started to really listen on another level to the podcasts I enjoyed, taking in ideas of how they structured their interviews with guests. I knew I didn’t want it to be too rigid in format and I liked the idea of it being more natural. I got in touch with the only other UK-based OT podcaster I knew of at the time - Kwaku from the OT and Chill podcast and he gave me some great advice to follow, and the rest is now history! Do you get nervous hosting your own podcast? Sometimes I do, it depends on the moment. I always get online early to take a few deep breaths and compose myself. A cup of tea helps to steady any nerves and I just make sure I am super prepared beforehand. I have to admit I am a bit of a serial microphone checker! What do you get out of it and what do you hope others take from it? I honestly have learnt so much already. It’s a great way to network with other OTs and OT students on a global level as they reach out via social media. This has been super interesting as you get to have conversations with other likeminded people about how OT works in their part of the world. So that has been a real privilege and positive for me. What I hope for others is that they enjoy listening and maybe they learn something they didn’t know or clarify something they maybe weren’t so sure on. I try to get a good range of content to keep things interesting and would always welcome any suggestions or offers to be on the show. Its also hopefully a little bit of inspiration for others to start up a podcast if they want to, let’s make this UK-based OT podcasting world a little bigger. 40

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Is it something you hope to continue once you are qualified? Absolutely! I’m really excited to chart my career once I qualify, via the podcast. I will do a few solo episodes detailing various elements of my setting and offer more ‘in context’ episodes informing guests and followers on what I’m up to, where I’m heading and what I experience as a newly qualified OT. I may even be lucky enough to find a couple of permanent co-hosts within my future team and make a little MDT trio podcast! Is it difficult to balance your workload and host this podcast? Its all about the balance. I aim to release an episode every two weeks so that’s quite a lot of work on top of family, life, and university you don’t realise how much time it all takes until you start, but I enjoy doing it so I don’t mind. Do you have any advice for OT students looking to expand their horizons and positively promote the OT profession through creative mediums? I would say if you have something in your mind explore it a little to begin with and don’t be put off thinking its unachievable for you or you can’t do it. Reach out to others in the field who you feel may be able to help or offer advice, most people are approachable and happy to support fellow OTs and students so I say go for it! How do OTs tune in to your podcast? My podcast is created via Anchor so you can listen there at: https://anchor.fm/farrah-money or if you search ‘OTWhat’s your focus?’ on either google podcasts, Spotify, Apple podcasts, Breaker or Radio Public I should come up. You can also follow me and the podcast on Instagram at @ot_whatsyourfocus.

The Motability Scheme enables disabled people to lease a new car, scooter or powered wheelchair without the worry of owning and running one. Parents and carers can drive on behalf of the customer. The vehicle should be used by, or for the benefit of, the disabled person.

Making life easier for disabled people

Who can join the Motability Scheme? Your patient may be eligible to join the Scheme if they receive one of the following: • Higher Rate Mobility Component of Disability Living Allowance (DLA). • Enhanced Rate of the Mobility Component of Personal Independence Payment (PIP). • War Pensioners’ Mobility Supplement (WPMS). • Armed Forces Independence Payment (AFIP).

What’s included on the Motability Scheme? Insurance Breakdown assistance Servicing and repairs Tyres and battery replacement

To find out more about the Motability Scheme visit motability.co.uk or call 0800 093 1000 (quote OT Magazine)

“Learning to drive and having my own car has helped tremendously. I have gained a new independence and the freedom to move around easier.” Allison

How Motability, the Charity can help Motability is a national charity which oversees the Motability Scheme. Motability may be able to provide charitable grants towards vehicle Advance Payments, adaptations or driving lessons to support disabled people who would otherwise be unable to afford them.

Do you have patients that could be eligible to join the Motability Scheme? Visit our website to order your free information pack

motability.org.uk/advisors or call 0800 500 3186 Motability is a Registered Charity in England and Wales (No.299745) and is authorised and regulated by the Financial Conduct Authority (Reference No. 736309). The Motability Scheme is operated by Motability Operations Limited under contract to Motability. Motability Operations Limited is authorised and regulated by the Financial Conduct Authority (Reference No.735390).

PODCASTING FOR BEGINNERS You’ve listened to your fair share of podcasts, you’re knowledgeable about a topic, and you have a group of like-minded friends who you vibe with. What’s stopping you from starting your own occupational therapy podcast? If you’re worried about the technology involved, the logistics, or where to put it, never fear - we have the answers you seek.

LAY IT ALL OUT If you’ve ever seriously considered making a podcast, you need to make sure of a few things: you have a good, sustainable idea, and you have people who you vibe with to join you. A podcast is difficult alone; it’s a recorded conversation. Do you have someone who you can converse naturally with to join you, or a solid stream of guests? Do you have time to record it in your busy schedule? Do you have enough topics to sustain you for more than two drawn out episodes? If your answer to all of these questions is “yes,” you have a winner on your hands.

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SETTING UP You have looked yourself deep in the eye and said, “yes, I am the podcaster of tomorrow.” That is good. You’ve made the commitment to get on board the podcast train, because everyone else has one, so why can’t you? It’s both deceptively easy and needlessly complex to get started with your podcast. Audio quality is important to a podcast, because…well, it’s recorded audio. It’s important that you can be heard with ease, and the clearer your audio is, the easier it is to edit. Of course, you can record your podcast with your phone’s microphone, but bear in mind that it is much easier to hear (and to edit) crisp, clear audio, and a more professional quality of set-up helps you appear more professional overall. A good microphone will take you a long way, but remember to buy one that has either a bidirectional or omnidirectional polar pattern if there’s going to be more than one of you recording in person to make sure you pick up all the right sound. Also, if you can, pick up a pop filter. This nifty little piece of fabric sits just in front of your mic and softens the natural “pop” noise that accompanies “p” and “b” sounds. If you’re looking for a microphone, here are some well-loved ones used by podcasters and streamers:

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MAKING FRIENDS With the pandemic still ongoing, having friends around to make a podcast might be difficult, unless you live with said friends. That’s where programmes like Discord, Skype, Zoom and Facebook Messenger come in. These apps allow you to hold conversations online (using your jazzy new microphone), and ensure you’re not spending 30 minutes talking to yourself. It’s always a good idea to record your own audio and get all other parties involved to record theirs separately, too, just in case internet connections drop or things go haywire.

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Once you have the thing you’ll be talking into, you’ll need something to record it, otherwise it’s all been for nothing. Many of the programmes that you can record into also allow you to use them as editing software, which can really speed up the process of making your podcast happen. By and far the most popular choice for this is Audacity, a piece of free software that you operate simply by plugging in your mic and hitting record. It’s so simple to use, and it’s available on Mac, PC and Linux, so you don’t have much excuse for not using it! When it comes to editing the podcast, you might have to branch out. Many people use Adobe Audition to edit as it’s powerful, responsive, and can do many things free editors can’t - the downside being, it’s a bit pricey. Free alternatives, like Oceanaudio and Acoustica will still allow you to put together a really sharp podcast, however, and allow you to edit out mistakes, dead air, downtime, and just generally bad conversation that will inevitably happen!

FIND A HOST You’ve recorded and edited your podcast, now where are you going to put it? You can’t just fling it on Spotify and call it a day, unfortunately; there are rules. If you’re looking to commit to podcasting, you could pay for a service like Podbean, Soundcloud, or Libsyn - all of which do offer free accounts or trials for you to have a shot of first. That being said, there’s nothing to stop you putting your podcast on YouTube, where it’s easily accessible by everyone. There is one drawback to this: it will mean you’ll need to learn how to make very basic videos. Never fear: your laptop or computer probably has iMovie or Movie Maker on it. All you need to do is pop your audio in the program, load in an image as a kind of “placeholder,” and hey presto, your podcast is ready for YouTube.

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F OR MOR E I N F OR M AT ION

OT Overseas Melissa Purkis shares her experience of volunteering as an OT for a school in India

n the 31 July 2019 I landed in Chennai, India to be an OT in a school for children with disabilities. I had given myself one week in the busy city of Chennai to aclimatise. In retrospect the words aclimatise and India don’t really go hand in hand. India, I learnt very quickly is a ‘go with the flow’ kind of place where anything can happen. After a long 12-hour train journey, I met the owner and founder of the school (Murugan) who, with his driver, had made a sign with my name on it and found me at the busy train station. We stopped on the way for paneer curry pizza, and three hours later I arrived in the dark at my new home for the next few months. I would be living in a room above Murugan’s family home in the middle of the countryside in the district of Theni, Tamil Nadu. The next day I discussed with Murugan that I would like to observe the children and their teachers in their classes for a week, which he agreed to. However, two days into this he brought over 110 children (one at a time) into his office. With him sat one side of the desk, a child sat next to me and their teachers, parents, carers standing up in a very small, but thank goodness air-conditioned room! They would proceed to list all their issues, whilst the child sat there not being involved, or more often than not, running away! Murugan would translate as much as he could, then I would give advice based on what little I could observe. I ended up bringing fine motor activities into the space so at least the children were kept busy and I could observe more of their skills at the same time. It was overwhelming to say the least. A lot of children were inappropriate for OT input. On reflection setting up a simple referral system would have been really useful, and

would have saved a lot of time. I gave a lot of advice on seating and posture; this however was challenging to rectify as the classrooms only had long steel benches which resulted in lots of poor posture and in turn reduced attention levels. Facilitating eating skills was another obstacle as children (and adults) sat cross legged on the floor to eat their food with their hands. For children with limited core strength and fine motor coordination this proved a very difficult part of their day.

INTERVENTIONS

I attempted to group children into those needing further classroom observations, 1-1 OT sessions and set up a core stability group which was facilitated by my OT assistant and translator Moutopandi. I also organised an upper body strengthening group and we worked on painting a tree mural on one of the blank walls at the school. This proved very successful, with all the children wanting to get involved. The upper body strengthening intervention involved a fine motor skills warm up of ripping paper, screwing it up and dipping it into paint to print onto the walls. The children also helped to carry paint pots and benches to the space as a calming, grounding activity. I also drew dotted lines of the tree branches and got the children to join the dots. I worked closely with the children’s parents who often came in to help their children access their daily school activities. I gave advice on grading and backwards chaining for dressing, and answered various questions. One question I got asked about a lot was sleep, I came to realise swiftly that due to all the family sleeping in one room the standard UK advice on sleep was not relevant.

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RECOMMENDATIONS I would urge you to live in the country and try to understand the culture first. I jumped straight in without any underlying foundation. This did not help the children and staff I was working with, or myself. Ask yourself, is it sustainable? Who are you actually benefiting? For example, I focused on training the teachers and empowering the parents, rather than doing 1-1 sessions with the children. Are you giving them tools they can use themselves? Can a local person do it, and be paid for it? Make it fun and have fun. Whatever you do, they will benefit more if it is enjoyable. Something as simple as hide and seek produced instantaneous smiles, and worked on occupational skills such as eye contact and tracking. In India, and perhaps many developing countries, women are considered a ‘lesser class’ this ignited the feminist in me (thank you mum)! I was continually fighting to make my point of view heard as a younger woman.

TRAINING SESSIONS

I gave an interactive training session to the teachers which was very well received. I focused on the pyramid of learning. I gave practical easy activities that teachers and children could do to regulate themselves. I also gave everyone pictorial handouts for reference. On reflection I should have done more of these training sessions as it empowered the staff and they were able to come up with their own ideas.

CHALLENGES There were many challenges to my volunteering experience, one of the biggest being the difference in culture and them seeing me as a ‘fixer of the children’. There had been a German physiotherapist and OT that had come previously, who also had a very different approach to mine. The language barrier was a massive one, my manager did speak some English, however it was limited, which impacted on my advice. Feeling isolated due to the language barrier, cultural differences and not having anyone else in person to talk through my experiences with was difficult at times.

ACHIEVEMENTS 1 Making use of informal supervision with OT friends back at home. Writing a blog and reflecting on my experiences for friends and family 2 Realising that a very small change can make a big difference 3 Being able to use my experiences in India to impact my OT practice in the UK 4 Forming good working relationships with Indian colleagues even with the language barrier 46

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Learn the language, or at least the basics, even if you are just travelling in a country. This was vital, and I was lucky enough to have a basic understanding and an OT assistant that could translate what I wanted to convey.

USEFUL LINKS DOCUMENTARIES ‘THE VOLUNTOURIST’: IS VOLUNTOURISM DOING MORE HARM THAN GOOD? A 30-minute documentary pointing out the challenges of volunteering.

ORGANISATIONS MAITS Organisation offering resources, education on disabilities, and grants. Also has great links with professionals overseas to train and empower local communities. maits.org.uk OT FRONTIERS UK-based organisation which supports and informs OTs who are thinking about working in low income countries. Also has a great free PDF resource booklet called ‘Working in less resourced settings’. otfrontiers.co.uk WORKAWAY Organisation offering cultural exchange opportunities around the world, usually volunteer time is in exchange for food and accommodation. workaway.info

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Shortly after getting engaged 10 years ago, Jacqui Green from Hampshire was diagnosed with MS. Unlike some people living with MS, Jacqui’s condition deteriorated quite quickly due to a number of relapses and she soon found herself requiring the use of a scooter. The only problem was every scooter Jacqui tried was fine on paths and concrete but as soon as she ventured off road she would get stuck despite being told the scooter would be OK. This meant her husband David had all the fun of going for long walks with their dog, Duke while Jacqui was left watching from a distance. All this changed when Jacqui discovered All Terrain Wheelchairs. “When I saw the videos online I knew I had found the answer and immediately got in touch with All Terrain Wheelchairs who arranged to visit us with a demonstration model. As soon as I sat in the Extreme X8 and realised what it could do I said to David ‘this is the one for me’ and it was the best thing I ever did, it is just awesome!” Jacqui continued: “I use my X8 every day and it is incredibly comfortable which was another factor when deciding to get one. But the main thing was the fact it does what is says – it goes over all terrain. I am a firm believer that just because I have a disability, there is no reason why I should not be able to enjoy the outdoors as much as I did prior to my diagnosis”.

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Changing Times for Changing Places Recently, there have been changes to the legislation which covers building regulations with regards to accessibility, which will see a huge increase in the number of Changing Places in the UK. Mark Sadler, UK sales manager at Ropox, explained some of the changes, and his views on them.

What difference will these changes make? While they could result in an increase in enquiries to companies such as Ropox, to be honest, these latest changes will have little effect for anything up to three or four years, especially for service users. But five years from now, I believe people will look back at the current situation with regards to changing facilities and realise how inadequate they were. The reason for such a delay in seeing the benefits is that the new rules will only apply to new build planning applications which

are submitted after 1 January 2021, and we all know how long an initial submission can take in coming to fruition, especially for something as substantial as a shopping or leisure centre, motorway services, or theatres. The big difference is that, at the moment, incorporating a Changing Places facility is optional and seen as best practice, but from 1 January next year it will be compulsory in all new building applications of certain types which are submitted after that date.

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What else do you think could be done to further improve Changing Places? I think they could be better signposted, both within buildings and also to the wider public. This could include venues highlighting them on their website, promoting them through social media, and clear signposting from the building’s entrance. Staff awareness could also be improved. It would make such a difference if all staff at least knew what the Changing Places facility is, where it is situated, and how visitors access it. Training is also vital. While many visitors will be familiar with the equipment found in a Changing Places facility, this will not always be the case. Therefore, I would advise that several members of staff at the venue receive training once the installation is complete to ensure there is someone either available or contactable to advise should a user require assistance. People need to be as aware of them as they are of baby changing facilities. The last thing we want is organisations investing the money to include them in their buildings, only for it to sit there unused.

People need to be as aware of them as they are of baby changing facilities

Many Changing Places facilities will be installed in existing buildings. What challenges does this represent? One of the biggest challenges is when the venue is a listed building, as you cannot just start knocking down walls. Sometimes, it is necessary to place the facility in an adjoining building or a portable unit. Unfortunately, on some occasions, it is just not possible to carry out an installation. Space is often an issue with existing buildings, along with finding a suitable location that is accessible for all potential users. Over 250,000 people in the UK require Changing Places toilets to enable them to get out and about. The Changing Places Consortium is a group of organisations working to support the rights of people living with disabilities: established in 2006, they campaign for Changing Places to be installed in all large public spaces so people can access their community. One such family is the Baker family from Oxfordshire, who have been using Changing Places for the last 13 years as their son Elliott has kernicterus, a condition which has symptoms similar to athetoid cerebral palsy. Elliott’s mother Caroline explains how they have helped the family: “From a parent’s perspective this new legislation is fantastic news, and I wish it had been put in place years ago. Changing Places facilities have certainly changed since Elliott was born, but only really over the last few years and during this time, we have spent many hours changing Elliott in the boot of our car as there either wasn’t space or the disabled toilet was just too dirty. Changing Places facilities make a huge difference and definitely influence our choice of location when we are planning a holiday or family days out. “Shopping centres are generally not great as you often have to share with the baby changing areas, which is not ideal and tend to be busy and dirty, so when you do find a Changing Places facility, it makes such a huge difference. Awareness has increased to a degree but more needs to be done so children, teenagers and adults are no longer having to get changed on toilet floors, which is unacceptable in 2020.” Ropox is one of the UK’s leading manufacturers and suppliers of accessible bathrooms and kitchens in both domestic and care environments. They can arrange the design and full installation of Changing Places units across the UK and Ireland. For more information on the full range of products available from Ropox, or to book an assessment, call 07831 401118, email pd@ropox. com or visit ropox.com. You can contact Mark on ms@ropox.com or 07444 577609.

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Paediatrics All the latest from the world of paediatrics

SECTION inter is well and truly with us. The nights are drawing in so much faster, and with the darkness comes the cold. While some of us crave the feeling of basking in the summer sunshine, with our toes in golden sand, others enjoy the colder things in life. With the cold weather comes snow and ice, and with that comes snowboarding and skiing.

We take a look at how snowsports can provide both OTs and their clients with an enjoyable challenge in terms of both the activity and the adaptive equipment that is required

to take part - turn to page 55 to read more. On page 58, we explore the revolution started by Quest when they introduced their Kaye Posture Control Walker to Europe in the early 90s. The walker flipped conventions on their head, becoming a game changer when it came to rollators.

As ever, if there is anything you would like to see covered in our paediatrics section, please donâ&#x20AC;&#x2122;t hesitate to get in touch. You can contact us by emailing ros@2apublishing.co.uk.

Read on to find out more...

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BIG CHILL Snowsports are both an excellent way to ensure patients and clients are engaging with their community, and an excellent challenge for OTs to provide adaptive equipment.

hen we think of exercise, we don’t often think of snowsports. Unless you’re situated not two metres from beautiful, fresh powder in a cosy warm chalet, it’s not something the majority of people ever really think about. With snowsports, there’s a barrier to entry: you need equipment, which can be expensive, and snow, which can be hard to find in the urban centres of Britain. Snowsports are for the passionate among us: people who love the bracing chill that strikes your exposed face as you roar down a mountainside, and those who would love to try skateboarding but prefer both the feeling of being strapped to the board and having something soft to land on. In the UK, there are a wealth of venues to try snowsports in, from artificial slopes to the very real thing, and there are even five indoor slopes across the country that offer the chance to ski or snowboard on real snow all year round! Snowsports could provide an opportunity for people, especially children and young people, to learn an exciting skill, while also working towards occupational therapy-related goals. It can also provide a solid learning experience for OTs who would like to explore the world of adaptions relating to snowsports. In 2010, a paper published in the International Journal of Rehabilitation Research noted that snowsports possess real therapeutic potential for people living with disabilities, noting that people who took part in the sport were at no greater risk of injuring themselves, which positively influenced self-esteem, physical self-

worth, standing balance, and gross motor function. Similarly, a 2019 study by Mavritsakis et al concluded that adaptive snowsports offered people living with disabilities a meaningful opportunity to develop a sense of community, and was a useful form of rehabilitation. Further, a 1996 study from the American Journal of Occupational Therapy by Pasek et al saw 14 teenagers who live with limb differences take a six-day skiing trip, the goal of which was to determine whether their success in learning to ski, and mastery of aspects of the sport, would have a positive effect on their selfesteem. The study concluded that there was a definite link between mastering the skills required to ski and a boost in self-esteem, proving the presence of short-term positive effects and leaving space for the long-term effects to be studied similarly.

The study concluded that there was a definite link between mastering the skills required to ski and a boost in self-esteem

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In 2015, a group of five University of New Hampshire occupational therapy students took a fieldwork placement in the local White Mountains, where they combined their working knowledge of occupational therapy with ski and snowboard instruction, teaching a group of people living with disabilities to ski. The 12week course was the very first of its kind anywhere in the world, according to New England Disabled Sports, who organised the internship. In a press release from the university, associate professor of occupational therapy Barbara Prudhomme White explained that OTs consider all aspects of daily living - from seemingly small things, to big activities like snowsports. For some people, snowsports may take the form of an act of self-care, an exercise in engaging with their community, or a way to live life to the fullest, all of which are vitally important to the activities of an OT. Kailee Collins, one of the student OTs who participated, said: “This is out of the box, not quite as clinical as I would get in a hospital or a school, but we’re still evaluating, treating, using so many different pieces of adaptive equipment. It’s drawing all my clinical experience and all my school experience into one.”

The 12-week course was the very first of its kind anywhere in the world

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...monoskis and biskis are ideal for people who live with spinal cord injuries, double amputees, and brain injury Adaptive equipment for skiing and snowboarding is surprisingly diverse, taking into consideration everything from people who live with limb differences, to those who live with a visual impairment. Three- and four-track skis help people who live with cerebral palsy, spina bifida, MND and MS; monoskis and biskis are ideal for people who live with spinal cord injuries, double amputees, and brain injury. Snowsports are an excellent way to boost morale, but can also be a terrific way to ensure that patients are engaging with and participating in their communities. Incorporating snowsports into the leisure occupations of patients who may have previously done so but may now require adaptations to do so, and can be used as an aspect of both goal setting and the therapeutic process.

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DOWN In 1990, Quest started a revolution in walking training for children with cerebral palsy by introducing the Kaye Posture Control Walker to Europe. Otherwise known as the Kaye Walker, this piece of assistive technology enabled children and young adults to achieve a more upright posture whilst learning to walk, making the ‘swing’ phase of gait (walking), easier to achieve. Until this point, conventional rollators were the order of the day. So, what was new about the Kaye Walker back in the 90s? Rob Henshaw, Quest’s managing director shares the history of this life-changing device.

he first thing that struck people was that it was backwards! The frame actually went around the rear of the person using it, with the hand positions at the users’ side. The front was therefore open for access to a desk, or a ball, or a brother, sister or friend. All of a sudden, the barrier had gone, both the physical one and, as it would soon be discovered, the social one as well. If you imagine parallel bars that you would see in a rehab gym, but now on wheels, then you generally get the idea of the Kaye Walker and how it improves posture. Add wheels to the picture and you have something which not only improves posture and walking function, but also includes a dramatic improvement in walking rhythm. In a rollator you push the apparatus away and you catch up and so on but the Kaye Walker moves with you. In the first 10 years, the Kaye Walker was primarily used in rehab gyms for walking training, however, its ease of use led to it being used every day and in all kinds of environments. We started to see more and more photos of the Kaye Walker in use, some showing the walker being used in the sea, on ice rinks and on the athletics track. It was becoming apparent that the walker was not just transforming walking training in physio sessions but it was also transforming lives and creating independence for these children by giving them more time on their feet rather than being in their wheelchair or buggy most of the time. I cringed at many of these photos, such as the children using walkers on the ice, because at the time I was the person responsible at Quest for managing

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found physio routines a chore in the past are now far more engaged, as not only do the new routines benefit their development, they now make them a better footballer or rugby player. The APCP, Association of Paediatric Chartered Physiotherapists have even created a sequence of football related physio routines that bring physio and football together. Little did we know that 30 years ago, when we started our family business that this piece of equipment would be so life changing for so many children in the UK and around the world. We look forward to seeing it transform many more lives in the future not just in terms of physio and rehab but also through a widening array of frame sports and activities.

product safety and medical devices and ice skating was certainly not on our list of ‘intended uses’. At the same time, I smiled and began to see just how revolutionary the Kaye Walker had become.

For more information on the full range of therapy, rehabilitation and adaptive cycling solutions available from Quest, advice on funding or to arrange an assessment please call 01952 463050, email sales@quest88.com or visit quest88.com.

The Kaye Walker has now been in the UK for 30 years and is just about to go through a significant facelift including the release of new colours and accessories. It’s hard to improve on a winning format, for example, the frame geometry and safety of the walker have not been improved on, despite many people trying. There are six sizes and that is important, as each size needs to be proportionate in weight and size for the child using it, as they use this equipment for many hours each day. Over the last five years the Kaye Walker concept has opened up new possibilities for children and young adults through the introduction of the Gameframe which takes advantage of the open front aspect of the frame. It became apparent several years ago, that children were pushing their own boundaries further and further and I began to see children using their Kaye Walker for football, volleyball and tag rugby. I concluded that what was needed was a range of walkers that were specifically designed for sport and which had different characteristics depending on the sport in a similar way to there being different wheelchairs for tennis and basketball for example. So at Quest we came up with the Gameframe. The Gameframe is basically a wider frame, in the case of the football version, the “Kick”. We worked with several clubs and universities to adapt the original Kaye Walker concept, adding width for trapping and kicking the ball and allowing the ball to roll through if missed, to assist with continuity of the game. The frame is stronger to cope with a bit more rough and tumble than the Kaye Walker and it can be finished in your favourite team colours Frame football is fast growing in the UK and in places like Japan, Malaysia, South America and Malta. The FA and IFCPF (International Federation for CP Football) have also ratified the rules taking into consideration the needs and abilities of players with cerebral palsy Another great thing is that children who may have

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

Kids

CHILDREN’S SENSORY BALL POOL

Compact and fun, this LED ball pool is designed to be able to fit into most rooms, even ones with limited space. It features a soft but thick mattress base and LED lighting, which can illuminate the 1500 clear balls included in the set - in five different colours. Made from foam and durable vinyl, it’s easy to clean. costcuttersuk.com | 03333 443370 2

DIMPL

Made from ultra-sturdy ABS plastic, this sensory toy features five brightly coloured bubbles which can be “popped,” offering children a highly portable toy which can assist in the development of concentration and hand-eye coordination. Children will get a lot of fun out of this toy, which takes the principle of popping bubble wrap and adds permanence to it. happypuzzle.co.uk | 020 8953 4484

CHEWBUDDY

With its distinctive stickman shape, the Chewbuddy is ideal for both children and adults looking for oral sensory feedback. Providing a safe alternative to chewing on pencils or fingers, the Chewbuddy can be sterilised by simply placing it in the dishwasher or washing it in hot water and mild soap. sensorydirect.com | 01905 670500

3 60

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SPIKE THE FINE MOTOR HEDGEHOG

Spike the Hedgehog is covered in 12 colourful spines, which can each be pushed into a space on its back. Improves fine motor skills, all while having fun with their colourful little companion. When not in use, the spines can be stored inside Spike for easy cleanup, which makes it easy to transport. createandcraft.com | 0330 3321301 5

CONSTRUCTION PLAY DOUGH KIT

This fantastic kit is produced by an autism- and disability-friendly store, so alterations can be made to the content to suit the needs of the little construction worker who will be playing with it. Available in mini or deluxe versions, the kit is a great way to encourage creativity and communication through sensory play. etsy.com/uk/shop/AQOTASSENSORYTOYS 6

MYSTERY SENSORY BALLS

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Each of these shiny metallic sensory balls reacts differently when played with: some roll straight ahead, some rattle, some twist or shake, but no two are alike in their movement. The mirrored surface produces a visually stimulating fish eye effect, and are made from robust stainless steel. Excellent for developing fine and gross motor skills. tinknstink.co.uk | 01827 767120

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MEDIA MATTERS Occupational therapists are very rarely seen in films or on TV, and when they do appear, depictions are often poor or inaccurate

hen was the last time you saw an occupational therapist on your TV or in a film? Turning to our good friend Google, there aren’t many movies that find themselves graced with the presence of an occupational therapist, but there are a couple - not many, but a couple. American healthcare solution company Centra handily produced the most comprehensive list we’ve encountered on their website, managing to come up with nine titles which have at least a passing contribution from an OT. In 1948’s The Snake Pit, a woman living with schizophrenia receives treatment for her mental health, which includes a visit to an OT. 1964’s Lilith sees Warren Beatty return from the Vietnam War, taking work as an OT at an “insane asylum.” Birdy, released in 1984 has a similar premise, with Matthew Modine playing a Vietnam War veteran whose mental health concerns that were brought on by the war are treated by an OT to little effect. Regarding Henry (1991), Office Space (1999), Adam (2009), Temple Grandin (2010), Another Year (2010) and A Mile In His Shoes (2011) also feature occupational therapists, to varying degrees of importance to the central narrative of the film.

Things are even worse when it comes to OTs on television. Portrayals of OTs are few and far between, and when they are present, little research seems to have been done to ensure it’s an accurate portrayal of the profession. Blogger and OT Kirsty Stanley took the BBC to task in June 2013 for their incredibly inaccurate representation of an occupational therapist on longrunning medical drama Casualty. The OT was in the wrong uniform for a start, and as Kirsty pointed out, the OT’s actions constituted poor practice; they distressed the client, and how they performed their assessment would see inaccurate results in a real-life setting. In 2018, occupational therapists took to Twitter to express their disappointment in a portrayal of their profession in yet another BBC drama, Care. While the show aimed to portray the realities some families face in having to fight for access to appropriate care for their elderly relatives, some OTs thought the way in which their profession was depicted on the show bordered on offensive. OT Di Brown tweeted: “As a qualified OT for 30+ years I am extremely offended by the representation of OT in the first half an hour of this program. I have never witnessed an OT talk so patronisingly to a patient or their relatives.” Children’s OT Ciara O’Neil echoed similar sentiments, saying: “Watching @BBCOne #Care and utterly dismayed at how Occupational Therapists are being portrayed. That poor lady would never [be] taken for an assessment like that considering how she was presenting on the ward. It’s horrible to watch how the health professionals are so cold!” Top: Lilith, 1964 Left: The Snake Pit, 1948

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Image: BBC drama, care

As a qualified OT for 30+ years I am extremely offended by the representation of OT in the first half an hour of this program

The most recent portrayal of an OT on film was met with slightly more mixed reviews. In 2019, Oscar-winning actor Matt Damon portrayed an occupational therapist in Downsizing, a sci-fi drama where people take part in an experimental procedure to shrink them down to a height of five inches which its creator claims will solve overpopulation and global warming. In a twist on previous examples, the fact that main character Paul Safranek (played by Damon) is an OT is integral to driving on aspects of the plot. He explains OT to another character in the movie who isn’t familiar with the profession as: “More like physical therapy...my focus is preventing and treating work-related injuries - carpal tunnel, limb rehab, lower back issues, stuff like that,” a line which will surely make some OTs shudder. The American Occupational Therapy Association said that, while this would indeed be accurate if he specialised in work and industry aspects of occupational therapy, it doesn’t fully convey the scope of the profession, something which they wish had been explored further. Throughout the movie, Paul does dispense some wisdom to friends, clients, and colleagues which resembles OT, but its validity could easily be debated. Occupational therapists are grossly under-recognised in the media, and as even the most casual exploration shows, when they are present, they are often represented in a way that is inaccurate or not fitting of the profession. It might seem unimportant to see OTs in the right uniform on Casualty, but it is indicative of a larger issue: that even where OTs are present, their presence is rarely central to a wider narrative. In that case, occupational therapy falls by the wayside, and its appeal is narrowed to the viewing audience. If occupational therapy is to grow and evolve as a profession, it needs to be allowed to shine in the media, which provides an accessible space for information and entertainment. To portray occupational therapy inaccurately is to do a disservice to the profession as a whole.

Occupational therapists are grossly underrecognised in the media

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Welcoming

Bringing the OT Community Together! The Virtual Care Festival is a two-day online conference and exhibition, taking place on Wednesday 25th & Thursday 26th November, uniting thousands of care providers and occupational therapists together under one virtual roof.

Just some of our spea kers inclu de:

Dr. Michael Iwama

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Legal training in social and health care Michael Mandelstam Ltd

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Debbie Ivanova

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Barbara Keeley MP

Deputy Chief Inspector (DCI) of Adult Social Care CQC

Chairman NCA

Shadow Cabinet Minister for Mental Health and Social Care

The OT Magazine – Nov / Dec 2020

Articles inside

Product Focus

Podcasting for Beginners

Virtual Care Festival

Changing Times for Changing Places

OT Overseas