ISSUE 14 JAN/FEB 2017
IMPROVING INDEPENDENCE
States to Stornoway Swapping city lights for the Northern Lights
Flour Power Whipping up a creative therapy
Mindfulness Free your mind
Stub it out Practising what you preach
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Welcome LISA MITCHELL
Hello About this issue... H
appy new year to you all and I hope everyone had a fantastic Christmas break. I am delighted to bring you the first 2 17 issue of The T aga ine. s I try to fill the elegantly-kept stilettos of our beloved editor, Ros, I’m sure you will all join me in wishing her the very best with her new arrival and look forward to her return later in the year.
As always, we love to hear from all our readers...
A new year brings with it new resolutions. Whether that be eating healthier, taking up a new hobby or getting into a new fitness regime, everyone has a different view for their own self-improvement, either personally or professionally. ne new year s resolution that proves popular is finally stubbing out those enson edges for the very last time. ne T, ina ara, took full advantage of the toptober challenge in ctober 2 1 in an attempt to motivate her clients into doing the same and becoming smoke-free. ead how she faired on page 4 . We also continue our mental health series by exploring the wide and varied area of an iety. There are over three million people in the living with an an iety disorder and we speak to therapists up and down the country about their role within this sector on page 27. lso in this issue, we learn from merican T ana, about what paediatric T is like in her adopted home of tornoway in the cottish estern Isles, the highlights of The T how 2 1 and the therapeutic benefits of cats the animal, not the musical…) As always, we love to hear from all our readers. If you have any comments, queries or anything of interest to the T community we would love to know. lease feel free to email me at lisa@2apublishing.co.uk. e are also e cited to bring you The T aga ine 2 17 all lanner in this issue. It is peppered with all the very best events for Ts throughout the year and I have confidence it will be a handsome feature on every ward, clinic, office and home wall you choose to display it. It is without further ado that I wish you all every success in 2 17 and hope you enjoy the magazine as much as we enjoyed bringing it to you.
Member of PPA Scotland
Disclaimer The OT Magazine is published by 2A Publishing Limited. The views expressed in the OT Magazine are not necessarily the views of the editor or the publisher. Reproduction in part or in whole is strictly prohibited without the explicit written consent of the publisher. Copyright 2017 © 2A Publishing Limited. All Rights Reserved. ISSN-2056-7146
The OT Magazine, Acting Editor
The Team
Contact Details
Editor: Lisa Mitchell Staff Writer: Niki Tennant Staff Writer: Colette Carr Designer: Stephen Flanagan Marketing: Sophie Scott Sales: Robin Wilson Contributors: Kate Sheehan, Dawn Blenkin, Adam Ferry, John Chacksfield, Dina Vara, Jo Webb, Darren O’hare, Veronica Broomes, Erin Buchanan
2A Publishing Ltd, Caledonia House, Evanton Drive, Thornliebank Industrial Estate, Glasgow, G46 8JT
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@ot_magazine3 The OT Magazine www. -magazine.co.uk
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27
32 17 7 What’s New?
25 A day in the life of…
37 Product focus
15 OTs who influence
27 Mental health
40 Do you
We explore what’s happening in the healthcare sector Kate Sheehan acknowledges and thanks OTs who have inspired her
17 Flour power
Discovering a recipe for good mental health as we look at the pros and cons of baking therapy
20 Product focus
A selection of innovative products
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Each issue we speak to a different OT about their job The fourth instalment of our mental health series focuses on anxiety
30 Mindfulness
Learning how to mindfully enhance your occupational performance
34 The Occupational Therapy Show
eflecting on another successful OT Show
More innovative products to aid independent living
#KnowRaynauds?
Discovering more about Scleroderma and Raynaud’s in its UK awareness month
45 Stub it out
OT Dina Vara explains the importance of practising what you preach as she quits smoking
49 Children’s section Keeping up to date with paediatric OT
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45
What’s
INSIDE
59
55 51 Sensory Smart Child
e look at one T who took sensory matters into her own hands
55 Children’s products
The best children s products on the market
59 States to Stornoway
aediatric T ana ose uchheim e plains the differences between city life and island life
63 Thinking of becoming independent?
e compile a pros and cons list to help you decide
65 Pet and patient
The benefits of cats in pet therapy
68 Forensic OT
Ts role in offenders with learning disabilities
71 Student advice
awn lenkin speaks about dealing with returning to uni and post hristmas blues
73 Sewing in Sri Lanka
T arren hare shares his e perience of working with ri ankan olunteers
76 Top tips for profitable OT practices
etting prices and negotiating contracts aimed at Ts in private practice
80 Find events for you
pcoming events in 2 17
71 www.
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What’s new? We explore what’s happening in the healthcare sector, from new products and services to inspirational stories.
OTs benefit from Abacus Healthcare Bath funding guidance at OT Show Abacus Healthcare, a leading choice for healthcare professionals seeking power assisted baths for clients, has successfully showcased its ‘#BathingIsBetter’ campaign to high numbers of occupational therapists attending the OT Show. The ‘#BathingIsBetter’ guidance programme from Abacus provides OTs with wide ranging and essential information to help achieve funding for an assisted bath through a Disabled Facilities Grant (DFG). When a disabled client requires specialist assistance with washing, many local authorities choose to fund adapted showering or wet room facilities instead of a bath with a transfer seat or hi-lo functionality. This can be based on the preconception that accessible showering provision is more cost effective, however in many circumstances this is not the case and not appropriate for the client. If families or carers feel that a bath is essential for a disabled child or adult, then the #BathingIsBetter free advice guides, videos and social media help justify a successful DFG application. To summarise the human rights and health related benefits associated with bathing, ate Sheehan OT, presented a seminar at the OT Show during day one of the event. ates informative and engaging presentation entitled: “#BathingIsBetter - assisted bathing…choice and support’ highlighted several key factors that demonstrate why a power assisted bath is both necessary and appropriate for many clients. ate demonstrated why bathing is an occupation, the legislation that supports bath provision and the clinical reasoning OTs can adopt when recommending a bathing solution. There was a Q&A session after the presentation and the seminar content is now available on the Abacus Healthcare website.
ate said Throughout my client-facing work I regularly meet families and disabled children who would choose to bathe, however many are only offered a wet room or shower conversion through a DFG. Meeting budgets is indeed a challenge these days and all professionals have to consider what is necessary and appropriate. However there is legislation that clearly supports the case for bath provision. It was a pleasure to present a seminar at The OT Show as I believe this campaign is so important. I do hope my peers attending the presentation now feel the same.” www.abacushealthcare.co.uk/disability-bathing/ assisted-bathing-vs-showering www.facebook.com/AbacusHealthcareUK www.twitter.com/abacusbaths
Repose Competition Winner Many visitors to the Repose stands at either Trade Days or The OT Show will have picked up a elfie id or Posing Polly pen. As you will have seen on social media, the company has been running a competition to see who could either Facebook or tweet a picture of Sid or Polly in the most unusual location. Following careful consideration, Repose is delighted to say that the winner is erry eswick who took Sid and Polly all the way to Queensland, Australia and arrived just in time to help decorate the Christmas tree. erry has won a night away. The runner up was o onsor, a Repose retailer who took Sid and Polly on a short break to Amsterdam as well as visiting her mother who was pictured with her pens while sitting in her Repose chair. Jo wins a Hotel Chocolat hamper. For more information on the range of bespoke adjustable furniture and training available from Repose or to find your nearest retailer call 0844 7766001, email info@reposefurniture.co.uk or visit www.reposefurniture.co.uk
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What’s
NEW? Charity shows how gardening can be used to help people living with dementia National charity Thrive is helping hundreds of people living with dementia to safely use gardens and the outdoor environment to improve their health and wellbeing. Thrive is providing e pert advice and guidance to garden designers who will transform the outdoor space at dementia care settings in the UK. By carefully designing the gardens, residents will be encouraged to use the outdoor spaces more often to improve their health and wellbeing. Thrive is also training the staff working in those settings in how to make best use of the new outdoor space ensuring that people with dementia benefit from stimulating garden tasks and meaningful activity. The work forms part of a project led by the charity Learning through Landscapes which received 1. million of funding from The Big Lottery. Age UK are providing e pert professional guidance and there is a formal selection process to identify dementia care settings whose gardens will be transformed by the charity Groundwork which will carry out all the hard landscaping and planting. The University of Kent will evaluate the project. The team at Thrive have applied the research and knowledge gained from years of working with people who have dementia and have created a series of films and online resources for staff in care settings showing how and why gardening can help people living with dementia. This has all been put together in the first ever web-based learning resource for garden designers on how to create a garden suitable for people with dementia. Thrive has designed a new website dementia arden or u which anyone can access and find out more about dementia-friendly gardens.
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Theraposture delivers at The OT Show s disco er ho the on otofle ed and ni ue ascot cot rom theraposture de i er si ni cant sa in s At The Occupational Therapy Show, Theraposture, a proven choice for quality assistive beds, chairs and care cots, has successfully demonstrated why its market leading otofle rotational bed and adjustable Mascot cot ranges deliver significant cost savings. Theraposture is regarded as the leading specialist in the provision of assistive Cot Beds and Rotating Bed Systems. Its Trusted Assessors work closely with OTs to ensure the individual needs of disabled clients are always met through appropriate equipment provision, backed up by a 14-day Suitability Guarantee. Bespoke Theraposture products are the most diverse on the market and provide the greatest choice for OTs and their clients. This fle ibility allows a greater range of needs to be catered for so that comfort, safety and personal preference is ma imi ed. ignificant cost savings and outstanding product value are also achieved by selecting a Theraposture product as Ts benefit from preferential professional prices. In the case of the otofle , this fully powered rotational bed helps users get in and out of bed without the need for carer assistance. The otofle empowers users, often with neurological conditions, so they can access a bed independently and therefore negates e pensive carer costs. In the situation where two carers are reduced to none, the otofle can typically pay for itself within 14 weeks – saving around £27,000 in care costs per annum following purchase. It encompasses precision German engineering and its proven ergonomics have been enhanced over a period of 20 years. It continues to be the original, market leading and best design that minimizes risk and ma imi es safety and confidence for disabled users. For care of disabled children, the Mascot Mk2 cot provides monetary saving through its fully modular design. The Mascot is the only cot available in the UK that offers a completely fle ible concept that can be adapted as a child’s needs change. It can be specified, with or retrospectively changed to, 4 or 8 door access on both sides and can be fitted with internal dividers so the sleeping space is always appropriate for the age and size of the user. There is a range of door heights from 60-120cm and it incorporates smooth and quiet height adjustment so parents can avoid the risk of back injury from e cessive bending. The sleeping platform can also include profiling and a vast range
of specialist mattresses and padding are available. As a design for life the Mascot ensures additional cots do not need to be purchased so pressure on public and private budgets can be eased.
Liam Braddell, Theraposture Sales Director comments: “Our stand this year featured three models from our benchmark setting otofle range the ow ccess otofle 17 , otofle 2 and the ariatric otofle kg . These solutions have evolved from our original rotational bed concept and continue to demonstrate the best in ergonomic, safety and stability. The design of the otofle has been heavily influenced by user groups such as MS, Parkinson’s and MMD, which is why, for e ample, the otofle helps users stand by vertically rising so that those with inconsistent weight bearing ability are not tipped forward like a riser chair. The otofle has proven performance and truly delivers independence at home with the opportunity to avoid the high cost of carers or residential care. Equally the Mascot modular cot bed will provide cost saving through its futureproof and fle ible design. iam continues e have seen other e amples of rotating beds flood the marketplace in recent times and we remain confident and proud that the otofle stands out as the considered user focused choice, thanks to its 18 years of continual development, specific user focused design and precision erman engineering. e believe these quality, hand-crafted products provide e ceptional long term value and when combined with our ethical and caring service, we believe Theraposture is the only choice for client and T peace of mind.
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What’s
NEW? NHS to give amputees advanced prosthetic technology Ottobock UK has welcomed the Government’s decision to approve the funding for the long awaited, Clinical Commissioning Policy, Microprocessor Controlled Prosthetic Knees. The policy allows hundreds of amputees living in England with above-knee limb loss access, via the NHS, to a life changing Microprocessor Controlled Prosthetic Knee (MPK). The policy regulates the NHS provision of a specific category of prosthetic knee components, the MPK. It means hundreds of amputees living in England with above-knee limb loss and those with hip disarticulation will now have access via the NHS to a life changing MPK, including one of the safest and most popular MPKs on the market, Ottobock’s C-Leg. By making MPKs more widely available on the NHS it is envisaged that quality of limb loss rehabilitation will be improved at a national level. The policy was submitted to NHS England back in 2013 to guarantee centralised funding for the treatment of above-knee limb loss. Since the submission, various organisations have campaigned for the approval of the policy and together with the Clinical Reference Group on Disability Equipment – creators of the policy – have managed to secure the centralised funding for this much needed and life changing policy. The implementation of this policy means that prosthetic MPKs will now be funded through Specialised Commissioning by NHS England and will soon be available through Rehabilitation Service Centres. “This policy has been in the making for a long time. We campaigned tirelessly for over two years to ensure the approval from NHS England of this vital, necessary and important component to improving rehabilitation and
quality of life for those with above-knee limb loss,” states Phil Yates, Managing Director at Ottobock. “We believe this is a positive step forward, which recognises that the advances in prosthetic technology can make a real difference to the lifestyle and health of amputees. MPKs allow amputees access to activities that may not have been previously achievable and in some cases enabling them to go back to work.” MPKs are designed to help amputees walk with a much more stable and efficient gait whilst reducing the chance of stumbles and falls. For instance, Ottobock’s C-Leg 4 has a complex sensor system that captures data in real time and recognises which phase of walking the user is in. It adapts to the users natural gait pattern, even at various speeds, whether on level ground, going down stairs step-over-step or on slopes. The user will be able to navigate difficult surfaces such as forest floor, sand and gravel. It also has a stumble recovery function that makes it extremely reliable. “Being able to stop and stand still without thinking, change your speed of walking, or take a step backwards should not be a luxury,” explains Rachel Neilson, Ottobock UK Academy, “and an MPK such as the C-Leg 4 provides all of those safely and predictably so that the amputee can just get on with what they want to do.” Kiera Roche, founder of LimbPower, comments, “This is a huge win for those living with above-knee limb loss. The application of this policy will be life changing for hundreds of people; I have met so many who have been trapped by the limited capabilities of their current prosthesis. Giving them the possibility to be able to go out without the fear of falling and hurting themselves is priceless. This is why I have backed
this policy from the start and I am just over the moon to see it come into force.” omeone who knows the benefits of an MPK is Gillian McBain. She was a competitive swimmer for the first 1 years after having her leg amputated, back then she was only concerned about getting from her car to where she wanted to go and back again. Gillian explains, “As long as my prosthesis got me from the house to the car and the car to the pool or gym that was all I asked of it”. She was then offered the chance to wear a C-Leg. This was the start of her life returning to something along the lines of what she used to know and allowed her to do the things she loved doing before her amputation. To see how the C-Leg 4 has enriched Gillian McBain’s life watch this video where she tells her story: www.youtu.be/0BbMXq-JZJM Ottobock’s C-Leg is the most frequently evaluated and most comprehensively documented microprocessor knee joint in technical and scientific studies worldwide. It took five years of development from prototype stage to initial launch and since then over , users have been fitted worldwide making it the most popular MPK to date.
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What’s
NEW?
Cosyfeet Launches £1000 OT Award A £1000 award open to OTs and OT students has been launched by Cosyfeet, the UK’s specialist manufacturer of extra roomy footwear. The Cosyfeet Occupational Therapy ward is open to any ualified OT or OT student planning to undertake voluntary work, a work placement or research, either in the UK or abroad. The winner’s application should demonstrate that their chosen project will develop their professional knowledge and skills while benefitting others.
have plans to undertake research within the field of occupational therapy, you are eligible to apply.
With 2017 its inaugural year, The Cosyfeet Occupational Therapy Award will be made annually to one successful applicant. Any T student or practising T is ualified to enter. Whether you are planning to volunteer in the UK or abroad, you are a student undertaking a work placement as part of your professional studies, or if you
Cosyfeet specialise in making extra roomy footwear, socks and hosiery, designed to fit people with extra wide or swollen feet. As a company they care passionately about falls prevention, and ensure that their range includes a selection of styles that provide excellent support to the foot and a secure, adjustable fit. Their goal is to
The £1000 award will be granted to an applicant who can show that their planned project will be of benefit to them in a continuing professional development capacity, and will also be of benefit to others. The funding is designed to assist with costs associated with the applicant’s selected project, which could include expenses for equipment, travel or living.
help keep people independently mobile for as long as possible by providing good footwear to fit swollen and misshapen feet in comfort. “As a company we care about our customers and share many of the same values as the OTs who treat them,” says Cosyfeet managing director Andrew Peirce. “We see great synergy in launching this award, to support OTs in their professional development.” If you would like to apply for the Cosyfeet Occupational Therapy Award, visit www.cosyfeet.com/otaward for further information and to enter online before the closing date of April 21st 2017. The winner will be requested to submit a report and photographs of their experience, and to be included in Cosyfeet publicity relating to the award.
Impey offer helping hand for OTs keen to learn about showering adaptations Showering adaptation and wetroom specialist Impey has released an informative guide, designed to help OTs understand the process of converting a bathroom for elderly or disabled users. The guide is designed to lay out all the possible options for installation of a level access wetroom or showering area – supporting OTs in decision making processes and making specification easier. Released at the recent OT Show at the NEC, the Little Book of Showering Adaptations covers the stages of planning and fitting a wetroom conversion. hapters include: Creating an Accessible Wetroom; Creating an Accessible Shower Area with
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a Shower Tray; Drainage Options; Understanding Slip Resistance; Shower Selection – Electric or Mixer; Choosing Shower Doors or Screens and Finishing Touches. The Little Book of Showering Adaptations is available, free of charge while stocks last, to OTs across the UK. As well as being used to help with the specification of showering facilities, the book – which is a handy pocket size – is a perfect aid to reassure users who are keen to understand the process of a prospective bathroom adaptation. If you’re an OT who would like to request
your free copy of the Little Book of Showering Adaptations, email your name and full postal address to Kieran Mooney via email: kieran.mooney@impeyshowers.com Information about Impey products and services can be found at: www.impeyshowers.com
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The NEW Healthy Balance range. Delicious dishes fortified with vitamin D* and calcium*.
Fortified with
vitamin D & calcium
207 - Beef Hotpot
The new Healthy Balance range helps your patients towards meeting the new SACN vitamin D recommendations of 10µg†, in a way they can enjoy. We’ve fortified each of the 14 tasty mains and 7 delicious desserts to be high in calcium and vitamin D. Just one meal and dessert serves up at least 70% of the suggested new guideline. Arrange a free tasting today and discover the Healthy Balance range, a food first approach to vitamin D supplementation.
To order a FREE brochure or to arrange a tasting call
0800 524 4207 wiltshirefarmfoods.com
* Calcium is needed for maintenance of normal bones and vitamin D contributes to the maintenance of normal bones. † Based on SACN guidelines July 2016 “Some groups of people with very little or no sunshine exposure will not obtain enough vitamin D from sunlight. People from these groups should take a daily supplement containing 10µg vitamin D throughout the year.” https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf
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NEW?
Simple Stuff Works helps children in Bangalore Simple Stuff Works recently donated equipment to The Unit of Hope in Bangalore. The Unit of Hope was set up in 2004 to provide comprehensive, multidisciplinary care for children with special needs, providing subsidised care for those who cannot afford it or do not have access to it. Julie Hudson, a children’s physiotherapist for South West Yorkshire partnership NHS Trust recently returned from Bangalore where she was working with The Unit of ope and saw the benefits of the donated equipment for herself as she explained. “The donation of postural management equipment was really appreciated by The Unit of Hope. It enabled us to demonstrate and teach postural management to professionals, carers and families of children with complex needs. Although we are aware that such equipment cannot be sourced in the region that we were working in, it provided parents and staff with valuable information about what is required to help to support the children. One thing we really learnt from our visit
is how resourceful everyone was and how they would go away and adapt or produce similar items from more readily available materials”. “I am delighted to see what a difference our donation has made to the children, parents and staff at The Unit of Hope. Here at Simple Stuff Works we pride ourselves on supporting charitable organisations when possible and hearing such positive feedback from Julie and seeing the pictures of the children using our equipment is brilliant” commented CEO Sarah Clayton. Simple Stuff Works is an award-winning organisation. The therapeutic positioning system won the British Healthcare Trade Association Independent Living Design Award in 2011 for its simplicity and ease of use. In the last 12 months Simple Stuff Works has gone on to win the British Healthcare Trades Association Best Established Product Award in 2015, the Tamworth Business Awards 2015 for Manufacturer of the Year and was a finalist in the taffordshire hambers and Commerce Business Awards 2016 in the
International Trade category, a huge honour as the final winner was the Staffordshire ceramics giant Portmerion. For more information on the full range of therapeutic positioning solutions and training available from Simple Stuff Works call 01827 307 870, email admin@simplestuffworks.co.uk or visit www.simplestuffworks.co.uk
Repose Furniture launches the Harlem Porter Chair The Harlem Porter chair which was launched by Repose Furniture at The OT Show has been designed to offer a versatile solution for patients with Huntington’s. Kate Sheehan, one of the UK’s leading independent occupational therapists oversaw trials of the Harlem Porter chair at Rapkyns Care Home with Mike Wooldridge. The Harlem Porter is a highly-engineered chair designed with safety and comfort in mind and robust enough to absorb uncontrolled movements. Available in three sizes, small, medium and large the Harlem Porter has a maximum user weight of twenty stone. Standard features include: • Independent Back Rest recline with range of angles, • Seat Angle Adjustment to reduce the risk of a patient falling out due to severe involuntary movements. • Padded seat for additional safety and comfort with a specifically chosen cushion material that reduces friction and shear caused during excessive
movement. • A choice of six interchangeable back styles facilitating different pressure management and posture solutions to meet the demands of long term and changing needs. • Four different seat cushion options to accommodate different comfort and pressure management solutions. • High arms designed to provide a feeling of safety and security • Sliding and padded footplate for ease of patient movement with central castor for additional safety • Leg block support for additional comfort and support options. • rings as standard for fitting of a padded seat belt • Four heavy duty lockable castors
training programme with Kate Sheehan which will be launched in early 2017. If you require further details email keith@ reposefurniture.co.uk
• A range of specialist health fabrics to choose from As part of its ongoing commitment to offering Occupational Therapists the best possible seating solutions for their clients, Repose has developed a CPD
For more information on the range of bespoke adjustable furniture and training available from epose or to find your nearest retailer call 0844 7766001, email info@reposefurniture.co.uk or visit www.reposefurniture.co.uk
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INTEREST FREE HIRE/BUY PLAN AVAILABLE
Call now for a FREE demonstration.
NEW
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Columnist KATE SHEEHAN
This Month... Kate Sheehan
Kate is director of The OT Service. The company provides high quality advice, consultancy and training to manufacturers, retailers and service providers. It also provides occupational therapy clinical services in housing and equipment to case managers, solicitors and private individuals via their handpicked network of occupational therapists. For more information email kate@theotservice.co.uk
OTs who influence
New year resolutions are always foremost in our minds in January and I am sure this year is no exception. However as an occupational therapist it is important to reect on the past and 2016 caused me to do this more than usual.
O
ur profession lost two incredible OTs last year and they were huge influencers in my career. Kay Draper was the reason I moved fully into private practice, her knowledge, skills and positive way of supporting you to develop your own abilities was second to none. he influenced many a new independent practitioner and also trail blazed the profession within the insurance sector. She was one of the first OTs to work with the NFU to support people who had had catastrophic injuries back to work and her impact on their lives was enormous. On a more personal note she was the kindest and funniest person I knew with hidden talents such as being part of the GB glider team in her younger days and having an unrivaled gift of getting from A to B in the fastest way possible (not always legally). She will be greatly missed by all who knew her. The second person was Yvonne Ellis, an amazing housing OT who worked the latter part of her professional life at Maidenhead and District Housing Association, influencing the design of sheltered, supported and general needs housing and highlighted the need for accessible housing for all.
She was also kind-hearted and always willing to give back to anyone who asked for help. Yvonne taught me that with the appropriate knowledge, the skill of effective communication and the ability to listen you could g e t yo u r p o i n t a c r o s s w i t h o u t alienating anyone. Why am I mentioning these people? Well, a very wise OT (Rachel Wilson) said to me recently, we should celebrate those who influenced our practice, not necessarily through awards or certificates of achievement but by thanking them personally a t eve r y o p p o r t u n i t y we have. My challenge to all OTs (and anyone else who reads my articles), is to thank those around you for the help, support and guidance they give you, explain to them how much it means to you and the fact that their involvement in your professional life has had a impact and influenced your way forward. Don’t leave it to a memorial, say it now. So can I take this opportunity to wish everyone a wonderful 2017 and thank you all for reading my ramblings and for providing me with feedback. You make my day when you say you enjoy it. n www.
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INTEREST FREE HIRE/BUY PLAN AVAILABLE
Call now for a FREE demonstration.
NEW
I N N OVAT I O N
01559 384097
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Flour
POWER
Flour power
B
aking has been ingrained in our societies for as long as we can remember. From simply needing to provide bread for the table thousands of years ago to now being a huge leisurely activity that even features on one of the biggest TV shows in the country, baking isn t just confined to kids, bread-makers and grannies now. But there’s more to it than just making delicious fairy cakes and breads to pass time or not go hungry, as with the right mix of ingredients and a dash of commitment, grabbing the apron and rolling pin could help your mental health.
THE PSYCHOLOGY There are many everyday benefits of baking. The therapeutic and leisurely pastime is a known comforter and is widely regarded as a reliable means of stress and anxiety relief, an outlet for creativity and is a purposeful task. But for those with mental health issues, there’s more to it than simply
just a stress minimising activity. The 2004 British Study of Occupational Therapy reported that there are several positives to employing baking therapy. It outlined that it was particularly beneficial to people with mental health disorders from schizophrenia to severe depression. They noted “improved concentration, increased coordination and built confidence, leading to an increased feeling of self-esteem,” in those that had undertaken baking as a means of therapy, and stated it provided “purpose and meaning, as well as a real and tangible way of filling time . The psychology goes deeper though. At a simple level, it encourages nourishment and stresses the importance of eating and nutrition (maybe more relevant to less sugary bakes), and it promotes a pathway back into the community. While baking can be carried out alone, a social group environment can help ease feelings of isolation, alienation
or disconnect that are associated with certain mental illnesses. It also offers achievement and success after completing a bake, and the act of sharing and giving is another natural mood booster. It also moves attention away from emotional distress and rumination onto the engaging occupation that demands the participant to be actively present in the moment and to not overthink. As it requires close focus to the hands-on task, a client must concentrate on what they are doing, and physically create something with their own hands. owever, it is argued that it is difficult to measure the true impact of baking therapy in practice, and it is therefore recommended that it be undertaken in a mix of treatments. Baking itself, while helping manage symptoms, does not deal with the sources at heart, however, most of mental illness work is concerned with day-to-day management and self-monitoring of emotions and symptoms.
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Flour
POWER
Better Health Bakery London artisan bakery, Better Health Bakery, has recognised the power of flour. The Haggerston-based project is part of the Centre for Better Health, a community mental health charity that has served East London for more than 50 years and has supported those recovering from mental illness for the past four years. Serving sourdough breads, sandwiches, pastries and sourdough pizzas all made from natural ingredients, the bakery has whipped up a great recipe for success. Commercial Lead for the bakery, Sarah Lo said: “The charity was looking to support individuals who had been distanced from the employment market through mental ill health. “Looking around the area where we were in East London and thinking through various businesses we decided upon a bakery (Better Health Bakery). Baking was a craft and a skill that was interesting, easily accessible
and satisfying. “It also had the potential to be commercially viable which was important and provided genuine routes to employment.” The charity supports people who are recovering from mental health issues by taking them on in three-month trainee placements that combine the therapeutic elements of baking with emotional support and re-engagement with the community. “The main purpose of the trainee placement is to develop the ‘soft skills’ such as motivation, routine, turning up on time, being in a work environment, socialising and developing self-esteem - all the things that might have been lost through ill health that need to be regained before an individual might be able to return to employment. Baking and bread is the interesting and therapeutic mechanism to facilitate that,” explained Sarah. “Everyone is unique and brings with
them their own personality and skills, and everyone also has a different pace of learning. Therefore, we really try and meet those needs with the amount of info and learning that we aim for with each trainee. As a rough idea, in the bakery there are opportunities for socialising, dough shaping, patisserie, front of house, market stall and even early morning bakes!” In the project, there is no designated occupational therapist, instead OTs work with the bakery by referring trainees to them or volunteering in the kitchen. “A major element of the project is the ‘normalisation’ of the experience. “We do not work with a diagnosis. Anyone in the bakery is a part of the team helping to get the bread made and sold. We have found this is to be a valuable part of an individual’s placement.” www.betterhealthbakery.org.uk
Joe’s story Before the bakery, I was at a bit of a dead end,” Joe began. “I didn’t know what I wanted to do, I didn’t know how to get a job. n my first day at the bakery I was so nervous and scared to share history about my mental illness. However, being part of the project was very supportive. “My experience of working in the bakery team has been really positive. It was hard to get into the routine at first but it gave me stability and a routine. As I approached the middle of the placement I started to become more confident and open with people, which was a key part of my recovery. 18
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hen you finish your placement they’ll help support you into something else. I may have felt a bit lost if I had just left without options. They referred me to the Waterhouse Restaurant to start a catering apprenticeship and I took the opportunity with both hands and never looked back. This was due to the bakery giving me that confidence to get out there and not be scared. The placement has helped me realise my potential and I’ve now lost the fear factor. I feel more confident in the job market now. “There needs to be more resources like this to help people”.
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21 YEARS OF HAND-BUILT QUALITY • UK manufacturer, established in 1996 • Curve and Horizon Straight stairlifts • Innovative adjustable ERGO chair • Award-winning reconditioned scheme • Space seat for narrow staircases • Fastest lead times in the industry for • a hand-built, custom-fit, curved rail • Outstanding customer service and aftercare
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Product
FOCUS
Do you have an innovative product you think we should feature? If so, get in touch! Contact us at lisa@2apublishing.co.uk
The Kettle Tipper › There are many associated risks with the seemingly simple task of boiling a kettle and using it. Kettles with boiled water are often heavy and present the risk of dropping and injuring or spilling and burning. For those with gross motor function skills and proprioceptive dysfunction this kettle tipper may resolve some of these hazards. This kettle tipper holds the kettle and its raised pivot point prevents spills and accidents by springing automatically back to its upright position when released by the user, and has a strap to ensure the kettle is kept securely in place. The simple wire frame means mugs can be placed close to the kettle to again reduce the risk of spills and eliminate the need to lift the mug to the kettle. The frame stands at 160x40x180mm and is suitable for use with the majority of kettles.
Prices from
£13.44
Mobility Smart 0345 868 8612 or 01995 638086 www.mobilitysmart.cc
Terry Bath Pillow athe in comfort with the terry cloth bath pillow. The inflatable warm pillow covered with soft terry cloth can be inflated to a comfortable size and sticks to your bath with ease through the four suction cups to stay in place, but remains easily removable. The shell shape of the cushion was designed with comfort in mind, incorporating chambers to provide neck and shoulder support to ease any pressure of sitting in the bath, allowing a user to sit comfortably and relax. The uick deflation and si e means it is easily stored so is ideal for travel. It measures at 14.5 x 21”. Prices from
£10 20
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www.
OT Stores 0845 260 7061 www.otstores.co.uk
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Product
FOCUS
The Hydrant Drinking System Help your clients prevent dehydration, urinary tract infections and constipation by providing them with instant access to water with the Hydrant. Give your client more independence with this bottle that can clip onto almost anything. The bottle is easy for your client to use – they can simply bite the valve and suck fluid through the tube, and the sealed systems means no spills or leaks and the risk of contamination is eliminated. It holds 1l and fluid monitoring is available 24/7, and it also works as a siphon if hung above head height, helping those with limited sucking ability as the fluid gently flows when the valve is activated.
Mobility Smart 0345 868 8612 or 01995 638086 www.mobilitysmart.cc
Prices from
Object Locator Key Finder ›
£19.99
Misplacing items is part of everyday life, but if your client is living with dementia or Alzheimer’s the situation can be all the more frustrating and distressing. This remote-controlled object locator key finder can help eliminate this frustration and confusion by attaching bleepers with keyrings or velcro rings to items like handbags, keys and wallets etc. With an activation range of up to 50 metres and battery life from two to four months depending on use, the loud bleeping noise can help find the lost item. The finder is also ideal for those living with sight loss or with other visual impairments.
Unforgettable 020 33 22 90 70 www.unforgettable.org
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20/12/2016 14:45
Rota-Pro
Adam Ferry
UK Therapy Services
Adam Ferry is an occupational therapist in both the statutory and independent sectors. He is also co-founder of UK Therapy Services. With combined experience of over 30 years, UK Therapy Services specialises in providing high quality occupational therapy assessment, rehabilitation and consultancy packages for the private, statutory and business sectors. In this regular feature, Adam explores and reviews products he experiences in practice, giving insight and reflection to those who may benefit. You can contact Adam on adam.ferry@uktherapyservices.co.uk or visit www.uktherapyservices.co.uk for more information.
The Rota-pro, sold by Nexus DMS, is one of the current market options for supporting otherwise ambulant and weight-bearing clients who struggle to get in and out of bed independently.
support both bed mobility and sit to stand transfer without need for further adjustment. The only feature that the bed does not offer is a riser element from position of sitting once turned.
When I tried this bed at The OT Show in Nov 2016 I asked the question: “What makes it different to the rest?,” essentially trying to determine why I would recommend this product over some of its competitors.
What made it stand out for me however was the price.
The general principles of the bed are very similar to others; the structure of the bed allows the mattress to rotate 90º and goes from fully sitting to fully supine with simple hand held controls. There are a variety of models which give fle ibility over weight limit and client size. The bed does exactly what you would expect it to do and does it very comfortably. The rail options provide good fle ibility to
At around £4000 cheaper than some of its competitors not only does the bed do what it needs to, it makes it financially accessible to a far wider client group, whether it be to support efficient use of allocated funds via case management, through private purchase or when requesting in statutory services. Nexus always seem such an approachable and friendly company and offer excellent support to the clinician. I am always impressed. For more information visit www.nexusdms.co.uk
Wealdon Rehab Raz AT Hygiene Chair There are so many shower chair products on the market it is often difficult to determine what is different from one to another. However, this is a product that stands out for me. Despite looking rather clinical, which is something I’m not sure how you avoid for a product of this type anyway, the shower chair is incredibly comfortable. The design is modular, meaning that each element can be replaced as the user’s needs change to support both occupational engagement and comfort. It also means that all single components can be adjusted to suit posture and pressure care needs. The seat depth is fully adjustable and the hydraulically adjustable chassis achieves up to 45° tilt.
clearance for automatic toilets. What I was particularly impressed by was the thought that had gone into the design to support the carer. The product feels light but sturdy and tilts easily with the design supporting good posture with minimal effort. The demonstration I received at The OT Show was excellent and I will undoubtedly be using this product in the future. For more details visit www.wealdenrehab.com
The AdjustaBack offers tensionadjustment in the backrest to provide postural support to spinal curvatures and can offer a degree of lateral support. The AT is also available with a wide chassis base which provides greater
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Your Guide to
Wheeled Shower Commodes Our range of height adjustable shower commode chairs have been designed to cater to a number of complex user requirements.
Deluxe Shower Commode Chairs Versatile Design These deluxe shower commode chairs feature a lightweight, silver painted aluminium frame, which provides a rust-free, high strength product. Available as either attendant propelled or self-propelled. Attendant Propelled
Self-Propelled
Overall height
990mm (40˝)
990mm (40˝)
Overall width
690mm (27˝)
555mm (21¾˝)
Seat width
457mm (18˝)
457mm (18˝)
Seat height (fixed)
540mm (21¼˝)
540mm (21¼˝) Seat height (adjustable) 495 – 570mm (19½ - 22 ½˝) 495 – 570mm (19½ - 22 ½˝)
125 191/2 kg
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Deluxe Heavy Duty Shower Commode Chair Built for Strength With an increased seat width and a corresponding increase in the maximum user weight, this heavy duty chair is sturdy yet easy to manoeuvre and is available in two user weights. Attendant Propelled
Self-Propelled
Overall height
990mm (40˝)
990mm (40˝)
Seat width (150kg)
510mm (20˝)
510mm (20˝)
Seat width (200kg)
560mm (22˝)
560mm (22˝)
Seat height
495 – 570mm (19½ - 22½˝)
495 – 570mm (19½ - 22½˝)
150 231/2 kg
st
Deluxe Tilt in Space Shower Commode Chair Created for maximum comfort This chair has all of the exceptional features of the height adjustable commodes, but caters to users with more complex support requirements, with tilt functionality. Reclines from -5 up to 30 degrees and includes a padded neck support. available in two user weights. Overall height
1170mm (46˝)
Overall width
560mm (22˝)
Seat height
530 – 605mm (20¾ - 23¾˝)
Seat width
457mm (18˝)
130 201/4 kg
st
For further details contact Paul Smith, National Account Manager for Community Equipment on: Tel:
07970 512 986 Email: paul.d.smith@pattersonmedical.com
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Day in the
LIFE
A day in the life of...
Farzana Karim What is your current job role?
About Farzana
Farzana graduated from the University of Derby in 2011 and started working as a locum OT. She progressed from a junior therapist to a senior therapist within five years of practice and currently works in Rapid Access Services.
Correction: Unfortunately, due to a printing error last issue, Farzana’s column was incomplete. Here it is now in full. Apologies for any disappointment or confusion this may have caused.
I am currently working as a Band 7 Rapid Access Services Occupational Therapist for Central and North West London NHS Foundation Trust in the quirky and unique London Borough of Camden. As part of my role I work across three teams; Rapid Response, Rapid Early Discharge Service (REDS) and Post-Acute Care Enablement (PACE) team, these are all based in the community.
Describe a typical day… My day starts with the REDS therapy handover and a simultaneous PACE handover by the nurses at 9am. Once complete, the nurses plough on with the Rapid Response handover. Better be in shape, as nothing less than a quick jog to the other side of the desk will ensure no crucial information is lost. So that’s three teams, three handovers and it’s not even 10am – time to allocate visits. The visits are prioritised and allocated to the appropriate therapist i.e. physiotherapist, OT or therapy assistant. Rapid Response and PACE patients are allocated to both a therapist and nurse as the two services are nursing and therapy led. Following handover an acuity score must be generated. This calculates our capacity based on the number of staff and number of visits required - sounds scary but a simple traffic light system sorts us out eg. if we are RED we have reached our capacity (a lot of the time we are amber). I then book visits using an electrical diary, read through the notes, liaise with the wider multi-disciplinary team and collect any equipment for my allocated patients. Then, it's time to head out and tackle the dreaded London Underground, buses and traffic. All patients are visited in the community, within their home environment . A typical day may involve visiting patients from all three teams, completing initial assessments, acute medical assessments, risk assessments, cognitive assessments, equipment checks, medication reviews, assessing for and arranging care packages. Although the assessments are similar, each team requires a different approach which can be challenging. Being flexible
is paramount as you constantly have to think on your feet and resolve issues instantaneously. Once my visits are complete, I head back to the office, type up notes, care plans, liaise with GPs/nurses and social services to ensure patients are safe in their home environment. This may involve ordering hospital beds/hoists/ commodes to be delivered within four hours of assessment. Any equipment ordered within four hours will be reviewed on the same day to ensure safe use and minimise risk. Then I’m on call (that’s how I’d describe it). We receive over-the-phone referrals for patients who need to be seen urgently to prevent hospital admission. Patients may be referred from the London Ambulance Service, GPs, social services, A&E and self-referrals. The call is received and accepted and off I go again, depending on the presenting complaint either alone or with a nursing colleague. I then return to the office to document my visit and complete any urgent interventions. Patient white boards are updated with accurate and up-to-date information. It is 9pm and it’s time to head home after a dynamic and productive day.
What is the best part of your job? The best part of my job is assessing patients in their own home environment and keeping them there. I enjoy the diversity of patients that Camden has to offer and spending those extra 5-10 minutes sitting and reminiscing about past experiences, previous jobs, friends, partners and pets. Patients enjoy telling their stories and I enjoy listening to their life experiences. I have met one of the first Concorde test pilots, Baronesses, Ladies and Lords, journalists who have written for eminent newspapers and patients who had been employed in the same role for over 40 years. Observing patients in their own home environment gives you real insight into how elderly patients cope. They each have their own strategies for coping and seeing this first hand gives you the foundation for holistic intervention.
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The
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20/12/2016 15:53
Mental
HEALTH
Mental Health
ANXIETY By Erin Buchanan
G
eneralised anxiety disorder is a long-term condition that causes you to feel anxious on a daily basis about a range of situations rather than just one specific event. The government statistics find 4.4 of adults 1 - 4 to be affected by generalised an iety disorder and .4 of those have e perienced comorbidity with another psychiatric condition government, 2 . The main feature for diagnosis is e cessive worry about a number of different events associated with heightened tension I guidelines, 2 11 and it can result in both psychological symptoms such as restlessness and having difficulties concentrating as well as physical symptoms – dizziness and heart palpitations hoices, 2 1 . oth physical and psychological symptoms can have an impact on the person s occupations. ď ľ
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Mental
HEALTH
When a client with generalised anxiety is referred to the occupational therapy team they will be offered an initial appointment. In this appointment the occupational therapist will explain their role and assess the client to gain an understanding of how the condition is impacting on their life and the person’s thoughts and feelings around their condition. This is done through conversation using an initial interview form and/or standardised assessmentcommonly the Occupational Circumstances Assessment Interview and Rating Scale (OCAIRS) - to gather and evaluate information. Further MOHO (Model of Human Occupation) assessments like the Occupational Self Assessment (OSA) are also commonly used to gain a client’s perspective of their illness. The occupational therapist will gain an understanding of how anxiety is affecting the person and their occupations (all activities of daily living in the areas of self-care, productivity and leisure) and the environments in which the client functions in. The occupational therapist will work collaboratively with the client to set individualised goals following the NICE guidelines for person-centred care (2011). The goals are written in a SMART format to make them as clear as possible; this is pecific, easurable, chievable, Realistic and Timely. A plan will be made in collaboration with the client as to how the client will achieve the goals and the Occupational Therapist will approach this using various techniques explained below.
Activity analysis and grading activities The occupational therapist will use activity analysis and a graded approach to activities which cause the client anxiety. This allows the occupational therapist to observe the client in activity, support them to carry out the activity and to make the activity more or less challenging depending on the need. The occupational therapist breaks down identified an iety provoking activities and will agree with the client one part of the activity they feel they could 28
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try. The occupational therapist will support the client with this activity and make it more or less challenging for the next session based on the outcome of the session and how the client is feeling. Sessions will be done regularly with encouragement for the client to practise by themselves or with someone else out with treatment time. An example of a graded activity is a client using the bus. They may have stopped doing this as they become very anxious in this situation. In context, this can be a particular problem in Moray as it is a very rural area. Without transport the person won’t be able to access occupations such as going to work, visiting family or attending the leisure centre. The occupational therapist will break down using the bus and suggest that the first session maybe only walking to the bus stop and checking what time would be suitable to get the bus. The next session they may try to stay on the bus for one or two stops, slowly building this up till the client is able to visit their desired location and use the bus to get where they want and need to go. Another element of grading is for the client to get the bus without support. The occupational therapist could then get on at a later stop or meet the client off the bus with the aim of the client eventually being fully independent in this area.
Psycho-education The client may not have a good understanding of their condition, where changes need to be made or occupational therapy treatment received. In these situations psycho-education is an appropriate intervention. Psycho-education is providing information to clients in a way they understand to promote awareness and pro-activity around their condition. Occupational therapists would explain their role in increasing the person’s independence and ability to engage in occupations while living with their condition. There is a lack of literature relating to occupational therapists’ role in psychoeducation. However, a key part of this is the client understanding their limitations and setting goals which is part of the occupational therapy
process. A case study where occupational therapists led psycho-education in an acute mental health setting found that the occupational therapists were best placed to explain the meaning behind activity in relation to the person’s condition (Eaton, 2002). Psycho-education is therefore relevant to occupational therapy treatment with clients who have a diagnosis of Generalised Anxiety. In this community mental health setting this technique is used to provide comprehensive treatment sessions that impart information and apply learning through practical goal setting.
Anxiety management Once the client understands their condition and how they can work with the occupational therapist they can then begin to learn how they can manage their anxiety and put learned techniques into practice. This can include breathing techniques, muscle relaxation, challenging thinking, and managing physical symptoms of anxiety. The client will identify where they feel anxious and which techniques they can use in this situation to manage these symptoms. They will then practice using these techniques in the situation either by themselves or with the occupational therapist and see how effective these techniques are in situation. n
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Mental
HEALTH
CASE STUDY: Sarah
S
arah*(name made anonymous for the purpose of this case study) is a young lady with generalised anxiety disorder. She has become increasingly anxious about going out the house and is thinking about quitting college. Sarah enjoys singing and playing the piano however her anxieties about performing are holding her back. She studies music at college and being able to perform in front of the class is one part of this which she struggles with. Sarah also has difficulties asking uestions in class and sharing her feelings with others, especially her family. She lives rurally and has to get the bus to college; this is another activity and environment where she feels anxious. The occupational therapist visited Sarah and gathered this information through an initial assessment. From this, the occupational therapist has a discussion with Sarah about her condition and how it is impacting on her. The occupational therapy role was explained and from this they were able to collaboratively set goals. Sarah set herself goalsto complete her college course, be able to assert boundaries with others, to be able to ask questions in class and to share her feelings with her family. In order to achieve these goals the occupational therapist would focus on anxiety management, challenging negative thinking and assertiveness. The occupational therapist also taught Sarah breathing and muscle relaxation techniques. Sarah was able to use these techniques on the bus, at college and at home or at any time when she was feeling anxious. Sarah found these particularly useful at home when she felt stressed and in college before she performed in front of the class. Sarah had been
having thoughts about quitting college; the occupational therapist discussed how she could challenge these negative thoughts through writing down thoughts, problem solving and seeking alternative perspectives to assist coming to rational decisions. Sarah was able to see that college made her happy and that she would be unhappy if she were to leave. Sarah was also able to see the situations in college that were making her want to quit wouldn’t be there forever. Sarah is very passive both verbally and non-verbally, occupational therapy discussed what assertiveness is and techniques Sarah could use to assert herself in college and at home. Occupational therapy broke down what feelings she would like to share and practiced her saying these through role play, making her more confident to say them. arah now feels that with more practice she will be able to share feelings with her family and other students in her class using this technique. Now Sarah is able to get the bus to college using the anxiety management techniques. If she feels like quitting she breaks down the thought, doing this in her head rather than writing this down and challenges the thought by reminding herself that she is motivated to go and enjoys college once she is there. Sarah has begun to ask questions in class which will contribute to her learning and passing the course. She feels that with more practice in being assertive she will begin to share her feelings with her family. Sarah is aiming to move away from home for study further away next year in a busier city environment. She has made good progress towards achieving this and with more practice with assertiveness Sarah will be able to participate fully in a larger class.
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20/12/2016 14:59
Free your
MIND
Enhancing Occupational Performance
Picture the last time you were relaxed, perhaps on holiday or after work, when you were able to sit down and things just flowed. This may have been a long time ago. For many the last time they had a real stress-free day was on holiday or as a child. s a child, we lived in the moment. We tended to take things one at a time and deal with them there and then. As we grew up, we found an increasing chatter of thoughts were whirling around our minds. Most of us find it hard to stop thinking, even for a moment. Our thoughts then drive our emotions, which arise as a consequence of them and then also perhaps trigger our stress-response. This chain reaction can lead to longterm stress and even illness if we do not deal with it. The good news is that there is a relatively easy way 30
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ohn hac s e d has een an occupationa therapist since 1 and has used mind u ness in his practice in oth communit menta hea th and ith the mi itar e is a researcher and ecturer at anter ur hrist hurch ni ersit and pro ides trainin on mind u ness and other topics ia round ruth onsu tin ere he ta s a out mind u ness and its p ace in occupationa therap
to counteract this process and this is where mindfulness comes in.
the present moment.” (Kabat-Zinn, 1990)
Mindfulness is a term that has come into common parlance since its popularisation by psychologists and other health professionals, following some seminal research by Buddhist psychologist, Jonathan Kabat-Zinn. e was one of the first people to use research to demonstrate very clearly that the practice of what he calls mindfulness leads to a reduction in stress or a state of relaxation. abat- inn has appeared in videos on ouTube and a uick search on the internet will reveal many links to his work.
Although Kabat-Zinn made mindfulness acceptable and it has now been sucked under the ever-widening umbrella of cognitive behavioural therapy, he did not invent it.
abat- inn s definition of mindfulness is as follows The intentional, accepting and non-judgmental focus of one’s attention on the emotions, thoughts and sensations occurring in
indfulness is thought to have several points of origin, including Ancient Greece, Ancient Egypt, Ancient India and centuries-old Buddhist teachings. Buddhist monks see mindfulness as central to their practice and offer free classes on how to do it in many of their centres. They believe it frees the mind and helps towards enlightenment. Tibetan ama scholars describe the mechanism. Theravadan uddhist leaders, like jahn hah, have written books on it. One in particular is called ‘Mindfulness- the path to deathlessness’.
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Free your
MIND
Mindfulness, however, should not be confused with religious beliefs. It is more than simply a religious practice. It seems to reveal a universal ability of the human mind to observe and detach from crowded thought patterns, leading to a sense of relaxation, peace and mental freedom. The American Mental Health Association states: “Meditation programmes, in particular mindfulness programmes, reduce multiple negative dimensions of psychological stress”. This level of support from major mental health bodies has enabled mindfulness to become part of mainstream therapy and there is a great deal of research evidence to support the idea that it reduces stress levels in many different ways. In the United Kingdom, mindfulnessbased cognitive behavioural therapy
(MBCBT) has been recognised by the National Institute for Clinical Excellence (NICE) as a recognised intervention, for example in the NICE Guidelines for Depression. It has to be emphasised that this is a very specific use of T in a specific circumstance and probably because there is not enough research for other conditions where mindfulness might be helpful. In the American military, psychological research has been carried out. A psychologist named Amishi Jha travelled to Hawaii to train US Marines to use the same technique for shorter sessions to achieve a much different purpose: mental resilience in a war zone. “We found that getting as little as 12 minutes of meditation practice a day helped the Marines to keep
their attention and working memory — that is, the added ability to pay attention over time — stable,” said Jha, director of the University of Miami’s Contemplative Neuroscience, Mindfulness Research and Practice Initiative. “If they practised less than 12 minutes or not at all, they degraded in their functioning.” So people are beginning to research and gather evidence for the effectiveness of mindfulness to a greater extent. In terms of practice, since around 2010 the literature indicates that increasing numbers of occupational therapists have started to use mindfulness on a formal basis, as an adjunct to what they do (see an article by Canadian occupational therapist Nina Elliott, 2015, for a brief overview of the literature). www.
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In time we can broaden our mindful practice to include the world around us.
So what is Mindfulness? At the core of mindfulness is the ability to observe our thoughts and not become involved in them. This may seem difficult at first. ou may be thinking I think all the time, how can I not become involved es, this would seem to be the case at first consideration. Actually there is another way. The first challenge of mindfulness is finding time to learn how to practice it. In the early stages it is important to make separate time each day to practise the techniques. Find a room where you will not be interrupted, turn off any phones or alarms. Sit still.
Key areas are in mental health and also pain management. An article in The OT Magazine which I wrote in 2014, focused on this. Mindfulness is not exclusive to any one discipline and others also make use of it. However for occupational therapists, in the author’s experience, mindfulness is a key enabling factor. It enables somebody to improve their occupational performance, a bit like the use of ice within physical healthcare settings to enhance muscle movement. What we tend to notice is threefold: First, thoughts and other mental phenomena have a beginning and an end. This varies in time and thoughts can recur, but they do start and end. Second, there is a gap between each thought or feeling and the next. We can widen the gap. Doing this can bring a peaceful feeling. Third, we have a choice about whether to engage in thoughts and mental phenomena or not. We can simply watch them and remain non-attached to them. We can also allow ourselves to follow them and become emotional or reactive. In time we can broaden our mindful practice to include the world around us. So noises outside, interruptions, even physical touch by another person or objects being thrown at us, can be viewed separately and we can detach from the experience. Over time, we begin to establish a real sense of inner peace, simply because we have calmed our thoughts. We no longer engage in phenomena, 32
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therefore there is no resultant emotion or stress response. As the saying goes, it all becomes ‘very Zen’! How is this useful in occupational therapy? Mindfulness has been used by occupational therapists to enhance individual coping skills and also in groups. It can support pain management programmes. It can help someone with depression to detach from thoughts that may be leading to low mood. It can also potentially help a person experiencing hallucinations to remain detached from these and bring their effects under control. It has been used in the field of addictions to reduce cravings and control thoughts that lead to further substance misuse. For occupational therapists, teaching mindfulness can help a client to carry out daily occupations which they find difficult. It can be taught individually or in a group. We recommend that anyone teaching mindfulness first learns it thoroughly and experiences its effects. One way to gain a head start is to visit a Buddhist centre. Information about these can be found at www.thebuddhistsociety.org.” n
Contact John via curious@ groundtruth-consulting.com if you are interested in him coming to train your service in mindfulness-based occupational therapy.
Step 1
Proponents of mindfulness use various types of focus to help people to remain in the present moment, such as mindfully eating a raisin or mindfully cleaning their teeth. Whatever your focus is, the ability to stop doing it automatically, but instead to remain aware of the task as you are doing it, is a very helpful way to start. An occupational therapist called Sarah whom I worked with sometimes suggested to her patients the option of “mindfully eating your dinner”. What she meant was being aware of every mouthful, every movement as you do it. Feel how you lift the fork to your mouth, the heat of the food on your tongue, the taste of it and how it feels as you swallow it.
Step 2
The next step is to observe the thoughts in a similar way. I used to suggest to my patients: “Just watch your thoughts, like watching television, and let them arise and fade away. Do not chase them or get involved. Just watch them, without judgement, as if you are an outsider, observing your mind.” Others use metaphors like imagining your thoughts are like clouds passing in the sky, or bubbles rising up through water and floating past. It is important to relax while doing this, and if it becomes difficult, simply stop and when ready, gently lead your mind back to the process of observing the thoughts. With practice, this becomes easier. It does require quite a lot of practice, and it does require at least 12 minutes per day to begin to feel some benefit, according to some research.
-magazine.co.uk
19/12/2016 16:35
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The OT
SHOW
The Occupational Therapy Show does it again The Occupational Therapy Show has excelled once again this year, exceeding even the highest of expectations.
T
he careful balance of lectures, hands-on workshops and stand demonstrations held over two days tailored for the whole occupational therapy team ensured that no one missed out. The hours of accredited CPD available made it a highly valuable excursion, as well as giving delegates the opportunity to network and catch up with friends and peers. Once again, the event did not disappoint when it came to the calibre of speakers. National and international authorities, with highly respected credentials, took to the stage to share new insights, give practical tips and answer questions from delegates. Through their extensive clinical research, collaboration with leading manufacturers and years of hands-on experience, the lectures were enticing, invigorating and informative. Among those headlining in The Occupational Therapy Show education 34
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programme were Professor Carolyn Unsworth, Chris Connell (NICE Field Team , ohn hacksfield, ennifer reek, Ritchard Ledgerd, Michael Mandelstam and Jen Gash, each drawing huge crowds of delegates keen to learn from some of the best in the OT world. Particular highlights included Jennifer Creek’s engaging lecture on effective occupational therapy on the margins. Her enthusiasm and expert knowledge enthralled the packed audience, as they were eager to hear from her on her most recent research and studies. The Poster Zone was also a resounding success and a great addition to this year’s show and was the talk of the Network Drinks that took place after the first day of the successful exhibition that this year supported Alzheimer’s Society and Dementia Friends alongside AKW. The Occupational Therapy Show’s success is often attributed to the fact that all Ts can benefit. The education session covered areas such as mental
health, children and families, physical, research in practice and innovation. To add to this, there was also the opportunities for OTs to learn more about the products and services available to them and their clients through on-stand education provided by the trade floor suppliers. Kathryn Dixon, Consultant Occupational Therapist at Nable Services said: “This is the main show for OT’s to come to in the year! There is such a wide range of exhibitors, so much information and the seminars are amazing. Everyone has to be responsible for their own continued professional development and this is an ideal opportunity to come and get trained up in lots of different areas. I came last year and I am definitely coming again.” New for this year and adding to the education programme was the Posture and Wheelchair Essentials Programme, brought to the show by the Posture and Mobility Group (PMG) and
-magazine.co.uk
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OT Winners
Outstanding OTA/ OTII: eraldine inks, Occupational Therapy Technician
Outstanding Senior OT: ane iller, ounty Manager Occupational Therapy & Reablement
National Wheelchair Managers Forum (NWMF). Each session was packed and extremely well received. n the e hibition floor, a breadth of more than 300 OT relevant manufacturers and suppliers allowed face-to-face interactions and information on the launch of the very latest innovations. The trade did not disappoint delegates by offering exclusive promotional deals and sample giveaways, while also providing information and on-stand learning to help delegates fully utilise their e uipment, materials and innovations. elen urdy, occupational therapist at HPD Occupational Therapy Ltd said: “I work with complex service users and we have access to funding to get specialist equipment. Mainly for us we are here to look at all the different types of equipment that’s out there and broaden our horizons and there really is a lot here!”
s for the social programme, those in attendance on the Thursday may have enjoyed a special treat from the organisers – in the Networking Lounge a free tea and cake afternoon was held. The Occupational Therapy Show wards also took place on ednesday, presented by Jen Gash and her trusty panel. Congratulations to all the finalists and indeed all the very deserving winners! You will be able to read more about them and their work in the upcoming issues of The OT Magazine. ith all this and much more on offer, The Occupational Therapy Show met all expectations for yet another year. ith first-class education, networking and products available, alongside plenty of opportunities to have fun, delegates were certainly able to make the most of their two days! ave the dates for ne t year, Wednesday 22nd and Thursday 23rd ovember 2 17, , irmingham.
Outstanding OT Innovation: Janet Taylor, enior aediatric Occupational Therapist
Outstanding OT: Sarah odge, ac illan Occupational Therapist
www.
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-magazine.co.uk
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Know
RAYNAUD’S
Do you #KnowRaynaud’s? With Raynaud’s Awareness Month occurring in February, we collaborated with Scleroderma & Raynaud’s UK (SRUK) and spoke to Chief Executive, Sue Farrington, about developments in Raynaud’s and what they are doing to raise awareness of the condition.
T
his winter the UK is set to have the heaviest snowfall for many years, bringing misery and suffering for millions of people with Scleroderma and Raynaud’s. Many of us take it for granted that chilly hands will disappear once spring arrives, but that’s not the case for many people with Raynaud’s. A trip down the freezer aisle of the supermarket or simply sitting in an air conditioned office anytime of the year, can trigger a painful attack for up to 1 in 6 people in the UK living with a little known condition called Raynaud’s. Raynaud’s is a condition that affects the blood supply in the body’s e tremities usually the fingers and toes - and many people living with the condition will regularly experience colour changes to the affected area, pain and discomfort. Sue Farrington explains, “Up to 10 million people in the UK are affected by Raynaud’s yet many living with the condition are not aware they have Raynaud’s or that support and 40
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treatment is available. “Research we have undertaken over the last year reveals that only 4% are able to identify the symptoms of Raynaud’s. SRUK is tackling this lack of understanding by getting everyone to #KnowRaynauds during February”. SRUK has launched a simple online test, accessible via their website to help identify if you may have Raynaud’s. At the end of the test participants will be told if they could have Raynaud’s and the next steps to take, which could include top tips on keeping warm or downloadable information to take to their GP. For many with Raynaud’s it will be a mild inconvenience but for 1 in 10 people affected by Raynaud’s they will go on to develop an autoimmune condition like scleroderma (which can cause disability and can be lifethreatening), arthritis or lupus, which may need further treatment and close monitoring.
Symptoms can last for a few minutes or several hours. “We are encouraging more people to seek medical help and advice if they regularly experience one or more of the main symptoms which include pain, numbness or tingling in the body’s extremities,” says Sue. “We know that despite a quarter of people saying that they had experienced symptoms, only 10% on average have visited their GP. This needs to change – Raynaud’s can be a minor but
Other parts of the body can be affected by Raynaud’s including the ears, nose, lips, tongue and nipples.
-magazine.co.uk
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Know
Image © Matthew Clevey
RAYNAUD’S
uncomfortable inconvenience, but for those more seriously affected by Raynaud’s or Scleroderma, it’s crucial that they seek medical treatment and support as early as possible. We hope with our online test people can better manage their condition, seek treatment where necessary but above all know that they are not alone. We are here to support and assist people in coping with the painful and sometimes life-changing effects of the condition.” SRUK currently supports over 25,000 people in the UK living with the conditions but this is just the tip of the iceberg.
So, how can occupational therapists help? Liaison with other team members is important. Usually, the patient will have been seen by the rheumatologist, and possibly even a clinical nurse specialist, before reaching the OT. Through liaison, valuable background information can be gathered, assisting in rapport building with, not only with the patient but also with the team.
Occupational therapists who work closely with physiotherapists will be able to offer the best therapy input for the patient.
old toes and fingers Colour changes in the skin in response to cold or stress
Assessment, planning and evaluation Assessment of the whole person in order to establish and plan intervention is of paramount importance to ascertain the individual’s motivations, abilities and needs. The aim is to work in partnership with the individual and his or her family in order to achieve and maintain optimum independence in activities of daily living. When getting milk out of the fridge or peas out of the freezer can cause an attack, it’s important to understand triggers and make sure that the patient is aware of them.
Colour changes in the affected area to white, to blue and then red Numbness, tingling or pain in the fingers and toes Stinging or throbbing pain upon warming or stress relief
The use of a daily living assessment or checklist in conjunction with a validated, standardised, functional evaluation is recommended as it is not only useful in planning goals but also in measuring outcomes. www.
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Know
RAYNAUD’S
Children’s Case Study he he e d hi dren s ospita c inic speci ca for those with Raynaud’s, is always on hand to help. As Raynaud’s has no cure, they help families focus on preventing and managing symptoms with ongoing support.
Occupational Therapy Intervention Based on needs established at assessment and organs involved, Raynaud’s is largely helped using behavioural changes.
Keeping Warm • Wearing gloves and socks and adequate clothing to maintain body temperature • Assistive equipment might include the use of portable hand warmers or battery heated socks • Using gloves when getting items out of the fridge or freezer • If hands and feet get cold, advise warming them up gently • Avoiding stressful situations • Identifying stressors and adopting cognitive behavioural strategies to cope • Use of relaxation and/or biofeedback therapy
Smoking • Advise the patient to give up smoking as this causes vasoconstriction
Occupational Hazards •
ibration hite finger is a Raynaud’s occupational origin, seen in people who use vibrating tools or machinery such as chain saws, pneumatic drills, hammers or polishers as part of their job. Career/ job advice and task analysis may be necessary 42
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Raynaud’s In Children • At school play times, children may need permission to stay in on cold days. However this shouldn’t be an excuse to avoid exercise! • Health and safety precautions should be taken during ‘risky sessions’ for example in the science lab or during cooking sessions – cold or numb hands could get burnt. • Take care when showering or bathing, check the water temperature
SRUK support You can request a poster to put up in your clinic and share information with patients to help raise awareness. There is various support information on our website too for you and your patients so please view our factsheets on keeping warm, Raynaud’s or other conditions linked to Raynaud’s such as scleroderma.
or more information on Raynaud’s, the signs to look out for, how to manage symptoms and signpost to their #KnowRaynaud’s online test, go to www.sruk.co.uk and download a Raynaud’s information pack today. Email: info@sruk.co.uk Tel: 020 7000 1925
We spoke to Sally Milward from Wiltshire, an Associate School Nurse who told us children with Raynaud’s don’t just need to wear additional clothing during outside activities but may need to wear gloves during class sessions. Schools can be very stringent about rules and regulations and how they want pupils to dress, so this is where a school nurse can assist. They can help mediate by outlining the child’s requirements, in collaboration with parents and then negotiate with the school Governors’ special dispensations, thereby ensuring that everyone knows what the allowances are for that particular child. , aged 1 from heffield had some issues with her school and her parents had a couple of meetings with the headmaster to discuss her challenges in the hope of support and care from them. “I get very cold, even in summer. I would want to wear gloves all the time if I could but I’m not allowed. I hate gym because I know it’s going to be freezing and I’m not allowed to wear any extra clothes”. Sadie, CJ’s mum told us “CJ’s condition is serious enough that we had to go in for a review with the headmaster. They thought she was playing up and wanting to bend the rules for reasons like ‘fashion’ or to be ‘trendy’ but what they didn’t realise is that CJ wants to fit in, she doesn t want to be different, so hasn’t spoken up before now. Her condition is now so severe it cannot be ignored, we are worried about long term effects on her health and are glad we’ve been able to work with the school teachers on the advice and guidance of the multidisciplinary team at heffield, to work on best measures for both”.
-magazine.co.uk
20/12/2016 09:13
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Minimal carer effort is required to tilt the user backwards or forwards in a smooth motion to the desired position for washing and showering. The unique shape of the Cosmos provides a good position for successful bowel movements. Cushions are available in different sizes and can be changed as the user grows.
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Stub
IT OUT
Dina Vara
Occupational therapist, North-west London
Dina Vara, a 26-year-old occupational therapist from North West London, started 2016 as a smoker, as did many of her clients. She knew that telling them to simply ‘give up’ was easier said than done, and somewhat hypocritical. She decided to do something about that. October 2016 saw her take up the ‘Stoptober challenge’, vlogging all the while. Here, she talks about her journey to becoming a nonsmoker to benefit her clients and herself.
Stub it out I am often called a people person because I like to talk and enjoy helping others. I studied Health and Social Care at college and had a placement in a residential care home where I saw first-hand how boring it was for the patients; there was no engagement in any activities or meaningful occupation so I started to do activities and engage them more. Without knowing it I was practising OT. Since that placement I knew occupational therapy was the job for me. In my current role I work in a mental health rehabilitation service and I have been working in this setting for a year now. I have always been drawn to mental health work due to the creative and challenging nature of the work. My patients’ diagnosis include personality disorders and psychotic conditions. My experience to date is that OT is still being neglected due to a fundamental lack of understanding of what we do and how we do it. I promote OT almost on a daily basis and I use my creativity to build new and interesting interventions for my patients to engage in. Our Trust becoming smoking free was an idea I initially struggled with. I even
questioned if it was allowed to happen and you don’t need me to tell you how my patients took it when it was relayed back to them. Leading up to the date of my service becoming smoke free we held groups and smoke free sessions to prepare them for the change and make the transition as comfortable as possible. We used the month of October, Stoptober, to really drive this. I remember I was in the smoke free group and it had just finished, I reached over for my coffee, cigarettes and lighter, and that’s when I started to think about this smoke-free movement slightly differently. We often try to understand and have a sense of empathy towards our patients but this only takes us so far. I realised that as a smoker I could go the extra mile because I had the ‘need’ to smoke too. I often got patients saying “what do you know? You go home at the end of the day and I’m stuck in this place”, or that it was “us against them”, so this was my way to demonstrate differently and challenge these statements. When I said that I was going to participate in the Stoptober challenge, most of my patients laughed at me.
www.
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IT OUT
When I said that I was going to participate in the Stoptober challenge, most of my patients laughed at me. As the weeks went on and they could tell that I was taking the challenge seriously, raising money, vlogging my journey for the portal and taking tasks (bake a cake) from the patients for the month, their interest sparked. My patients began to ask me questions, “Why I am doing this?” My reply was simple – to see what it is like to stop something you don’t want to. I think that was a key turning point in the journey as my patients started to take note, monitor my progress, asked me how I was feeling and how I coped over the weekend. Some even offered to buy me chocolate and some were so shocked that I went cold-turkey with no NRTs that they started talking about the range of products available. I took on my patients’ own coping methods. For example, one patient said that when she was feeling down she wore her onesie and had hot chocolate, so I did the same. Patients were also able to see that it was not easy and I struggled - I was close at one point to failing but I managed to complete it. I received a lot of support from my team and they joined me in making a vlog too. Everyone engaging in the challenge positively impacted the month.
I had to go and walk it off. I also noted that I needed something in my hands to play with, like a pen. This soon changed into apples and carrots towards the end of Stoptober as my appetite increased. My going smoke-free and undergoing this change led to the patients actually listening and instead of the smoke free change being ‘you against us’ it became ‘we’. This resulted in more open discussions with staff and services. Additionally, the idea that occupational therapists are creative was clearly demonstrated during all my tasks. It highlighted to me that we should consider that to our patients we ourselves are almost role models. ‘If you can do it, I can do it too’ - this was what I began to see towards the end of my challenge. It also challenged the theory of interventions. An intervention does not need to be in a 1:1 or group setting for it to support the overall recovery journey. Often disconnected patients commonly feel that they are unable to
relate to others, leading them to feel alone or have a sense of hopelessness. Although we do need to maintain our professionalism, we can still highlight that just like in the Stoptober challenge, everyone has struggles but they can be overcome with the right support. Since Stoptober I have tried to carry on the challenge and I have cut down significantly. I hope to stop in the near future. I am proud of myself for completing the challenge. I feel it has informed my practice and made me connect with my patients in a way that I don’t think would have been possible without doing this challenge. I can now say to my patients that we really are working together and truly trying to understand the effect on their life psychologically, physically and socially. I would 100% do another challenge like this again, in fact I am already looking into my next project! n
Stoptober affected me more socially than I had anticipated. I had to change my morning routine as this was the hardest time for me. I also had to assess my social events and friends as to stay away from the ones that smoke so I wasn’t tempted. At work, I had cravings to smoke which meant
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-magazine.co.uk
19/12/2016 16:37
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Paediatrics SECTION P
aediatrtic occupational therapy is amongst one of the most sought after areas of OT there is. Many OTs nd their ca in in this sector Helping children and young people is both a challenging and u in career path
Paediatric care is always readily available in most hospitals and clinics in every major city and town in the country. But what if you live in a community where such healthcare is miles away and the nearest hospital or care facility is on an entirely different island? This is the case for most of the population on the Scottish Western Isles. Lana Buchheim has settled down in Stornoway, Isle of Lewis, a far cry from her home city of Baltimore, USA. Between them, she and her colleague Careen deliver vital occupational therapy to the children and young people who are spread out all over the 15 inhabited islands in the Outer Hebrides. We also feature the independent work of the Sensory Smart Child clinic. The centre, run by Karen Garner (nÊe Holcombe), offers private occupational therapy to children who need it most in South-east England. As always, we showcase all the best children’s products on the marketplace. If you have any stories or products you think deserve a mention from the paediatric sector, we would love to hear from you. Please email lisa@2apublishing.co.uk.
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Paediatrics SECTION
Sensory Smart Children Karen Garner (nĂŠe Holcombe) speaks to The OT Magazine about The ensor mart hi d the eadin pri ate paediatric occupationa therap ser ice in outh east n and aren the o ner and mana in director o the urre ased practice has o er 12 ears o e perience ehind her and is passionate a out usin it to he p e er chi d she can Where did the idea for The Sensory Smart Child come from? I ualified as an occupational therapist in 2 1 and went to work in the in a rotational based post. I specifically wanted this job at a large Trust in urrey as their rotation included a paediatric post. I waited two years to move into paediatrics and have never looked back. I was happy in the but as I began to understand more and more about child development and the difficulties that so many children faced on a daily basis, I became more and more frustrated that I was not in a position to work with them to overcome their difficulties. ack of resources and service demands sadly meant children sat on waiting lists for several years, unable to receive the support they needed. hen they did reach the top, we were so underresourced we could only offer advice and group work. lthough this was great, I could not help feeling I wanted to offer more.
How did it start? I took the plunge in 2 4. I left the security of my job and began to look into how I could further develop my skills in order to better meet the needs of children who were struggling. I self-funded a postgraduate course and became trained in ensory Integration Therapy.
When was it established? In 2 , I officially started The ensory mart hild td. I created a small website but most of my initial referrals were generated through word of mouth.
o
as it rst recei ed
I rented a church hall and set up an occupational therapy treatment space which allowed me to work hands on with children. I was then able not only to assess and identify a child s needs and difficulties but also had a facility to work directly with children, their families and schools to support them in overcoming their sensory, motor or academic challenges. ď ľ
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Paediatrics SECTION
We are constantly expanding and currently have a number of job openings for trained and dedicated occupational therapists to join our incredible team. My services were well received; I am still in touch with some of my very first families who keep me updated on the progress the children are making. ne has a sports scholarship and I recently heard that one of the children I worked with is pursuing a career as a lawyer. I finally felt I was fulfilling my professional dream and actually making a difference.
the family and child wish to achieve.
How has it grown since then?
e work with children aged -1 . Children may or may not have any formal diagnosis. ecause we look at the functional challenges they face, often the diagnosis is secondary to the treatment planning and therapy provision. ots of our children are in mainstream schools and do not have a diagnosis. owever many have autistic spectrum disorder, dyspra ia, , learning difficulties or even physical difficulties.
ince 2 when I worked alone in a church hall, I now have a team of 17 therapists and three admin staff working out of our specialist practice in alton on Thames, urrey. e have e panded to offer specialist services through the opening of our (Sequential - Oral - Sensory) multidisciplinary feeding clinic in 2 12, to receiving astute renowned training to all staff in Sensory Attachment Intervention in order to offer services to children with difficulties related to attachment and developmental trauma history.
What kind of work do you do? We are all trained in Ayres Sensory Integration however, our treatment is not limited by this approach. e receive referrals from paediatricians, parents, education authorities and schools and assess each child’s needs on an individual basis. e use standardised assessment measures to gain functional base lines and plan treatment according to specific goals
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e see the most improvement when a child comes in for intensive 1:1 therapy however we offer weekly therapy sessions, group sessions and treatment in school if we identify a need.
What kind of children do you work with?
What kind of OT practices do you use? All our assessments and subsequent treatments are individually tailored to meet the needs of each child. e offer yres ensory Integration Therapy, feeding therapy, ensory ttachment Intervention. ur specialist treatment approaches are supported through use of targeted sensory and perceptual motor skills therapy, handwriting interventions, therapeutic listening and integrated listening to ensure the holistic needs of each child are addressed.
What makes you different? lthough one of the largest paediatric
practices in the , we do not use associates all our staff are employed directly, they are nurtured, appreciated and encouraged whilst being given opportunities to develop and learn. e always keep the child and family central to our treatment; we invest heavily in e uipment, training and resources that are directly relevant to each child we see to ensure every client has access to the best facilities available.
Do you have any plans for expansion? e are constantly e panding and currently have a number of job openings for trained and dedicated occupational therapists to join our incredible team. e are e panding our community services and continuing to build on our relationships with educational authorities who seek our support in the provision of services for children with s and tatements of pecial ducational eeds.
What does the future hold for The Sensory Smart Child? ne day we hope to have our own purpose built establishment where we can target even more specific needs however for now we will continue to invest our time and money in providing the highest uality of care and intervention to all our children. n
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Paediatrics SECTION
Testimonials “My son has been going to The Sensory Smart Child Ltd for over a year and we have seen improvements in all areas of his development. He moves with more confidence and is starting to experiment with his body. Previously he was quite guarded in trying new things as his balance and co-ordination had been very poor; we now have to drag him down from climbing trees! With the help of the well trained therapists he is learning how to self-regulate his alertness which improves his attention and concentration and we are seeing improvements in his academic progress because of this. The therapists have built a good relationship with my son so they know his areas of weakness that need working on. Whilst we still have a long way to go, I feel because of the support at The Sensory Smart Child Ltd, my son will be able to achieve his full potential.” Mrs O “Karen’s work has been crucial in helping us to better understand our son and his difficulties. Her experience in loss, trauma and attachment and the impact of these when struggling with sensory integration issues is invaluable when dealing with an adopted child. We have always found Karen and the team at The Sensory Smart Child Ltd approachable and helpful. Our son looks forward to his sessions with Karen, who we feel is very in-tune with his personality, knowing how to get the best out of him. Over the time that our son has been attending sessions at The Sensory Smart Child Ltd, we have seen a huge change in him and his ability to process and understand his environment. It has been fantastic to see him develop and make achievements that were so very hard for him before. We couldn’t recommend Karen and her team at The Sensory Smart Child enough.” Mr & Mrs R ‘Karen’s assessment has been life changing for Charlie. In his words ‘You see – I have been saying that!’ He now feels believed and supported and is finally unwinding after all these years.’ Mr and Mrs S
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20/12/2016 16:42
Paediatrics SECTION
KIDS Product Focus
A
s part of our Paediatrics Section, we take a look at the products on the market that can help improve the lives of your younger patients.
Scooter Board This funky scooter board is specially designed for use by children who have a learning disability.
Kinderkey Bearhugzzz › The Kinderkey Bearhugzzz is a bespoke bed that can be made to fit any space. It will keep vulnerable adults and children safe, secure and comfortable whilst in bed. Its modular strong steel walls are encased in foam and covered with a waterproof, wipeable, antimicrobial fabric. The fabric is available in a wide range of beautiful patterns and colours suitable for adults and children.
The child can propel themselves along, which helps to develop motor control, space awareness and muscular strength. Two handles enable the user to grip securely, and four high uality castors provide smooth and safe mobility. The top surface of the scooter board is easy to wipe clean and is waterproof.
Essential Aids Tel: 01273 719889 www.essentialaids.com
Prices from
ÂŁ239.99
The Bearhugzzz can be made to any height your room will accommodate and one or more of the sides can be fi ed to e isting walls if wished. inyl or mesh windows can be incorporated into the design and an optional wooden base is also available to enable mobile hoist access. s with all their beds and cots, inderkey International offers a home demonstration of the earhug .
PRICES AVAILABLE ON REQUEST
Kinderkey Tel: 01978 820714 www.kinderkeyinternational.co.uk www.
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Paediatrics SECTION
UV Tactile Disc The UV Tactile Disc is perfect in a dark room. When exposed to a UV light, many of the shapes burst into life giving a visually appealing effect and creating engaging environments. The UV Tactile Disc is engaging and stimulating and helps to improve a range of skills, including fine and gross motor skills. The disc is made from Russian Birch Wood so it is strong and durable. The disc has a number of textures which are soft, hard, smooth, rough, cool, warm and uses a wide range of various materials including metal, plastic, wood, carpet and mirrors. The Tactile isc is 1.2 metres in diameter and fits directly onto the wall for ease of use.
Experia Tel: 0800 612 6077 www.experiainnovations.co.uk
PRICES AVAILABLE ON REQUEST
Prices from
£12 Aroma + VAT Huggabuddies Penguin Super soft and super sensory! The Aroma Huggabuddies Penguin is tactile, visual and aromatic. It’s cute and cuddly and can be warmed in the microwave. Pleasantly heavy, it sits in the small of your arm like a baby. Can be ‘posed’ to imply emotions. Pleasant lavender aroma. For three years and over. Not suitable for those who mouth. Also available in other animals, including the elephant and giraffe.
Rompa www.rompa.com 01246 211777
Body Massage Sensory Bag This body massage sensory bag has wheelies, brushes, vibration and massage objects designed to provide an array of tactile sensations. The sensations pack includes a body brush set, animal massagers, smoothies, a massage hair brush, a bug and tortoise massager and massage car.
Essential Aids Tel: 01273 719889 www.essentialaids.com
Prices from
£151.41 56
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20/12/2016 15:17
Paediatrics SECTION
Seahorse Plus Toileting Shower and Chair
Soft grip child’s plate
The NRS Healthcare Seahorse Plus is the latest product in the award-winning Seahorse Sanichair range. Re-designed following extensive feedback from healthcare professionals, carers and users, many accessories are included as standard including lap strap, detachable splash guard/pommel, foot straps, large capacity potty, arm rests and head rest.
The plate’s removable, soft grips make it easier to hold, and the base grip prevents movement when a child is eating.
Not only can arm rests help an ambulant user to get in and out of the chair, they also provide a safe place for the user to rest their arms.
Prices from
£14.99
This colourful plate allows for easier eating for children who have motor and strength difficulties. The fun cartoon design on its base may help motivate a child to eat.
Available in two cheerful, bright designs, the plate is dishwasher safe when the grips are removed.
NRS Healthcare, 0345 121 8111 www.nrshealthcare.co.uk
The Seahorse Plus has been designed to accommodate the use of a hoist, ensuring that the arm rests are uick to remove. The foot rests can flip up to enable easy access.
NRS Healthcare 0345 121 8111 www.nrshealthcare.co.uk Prices from
£1320
Undo Me Mini Cube › The Undo Me Mini Cube provides safe and educational play for children and adults in a home, school or therapeutic environment. The soft and colourful activity cube is fun to undo and rebuild, benefiting from a range of skills such as coordination, mobility and group interaction. It can also have a calming effect, improving concentration or reducing boredom. Each side of the cube features poppers, zips, laces and safe buckles for fun and varying tasks. The Undo Me Cube is made from a soft and colourful fabric with no attachable parts, enabling safe play and entertainment for people of any age. Size: 20 x 20cm (8 x 8ins)
Prices from
Essential Aids Tel: 01273 719889 www.essentialaids.com
www.
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£33.99 -magazine.co.uk
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20/12/2016 24/10/2016 17:09 12:52
From the States to Stornoway L
ana Rose Buchheim received her Bachelor’s and Master’s degrees at Towson University in Baltimore, Maryland, USA. A far cry from the secluded isles on the other side of the world, where she no nds herse
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Paediatrics SECTION
The differences between the USA and the Western Isles are pretty stark... Lana Rose Buchheim, OT Isle of Lewis
The 27-year-old paediatric occupational therapist has now had to adapt to the quiet life of an islander in Stornoway, Isle of Lewis. Lana was aided by her colleague, 31-year-old Careen Matheson, an Isle of ewis native, when she first landed on the Scottish Western Isles. The two may have had very different cultural backgrounds but their jobs are the same. “The differences between the USA and the Western Isles are pretty stark.” Lana commented. “For one patients are empowered and encouraged to remain in the comfort of their own home if and when possible. I find that the length of the hospital stays, recovery timeline, distribution of equipment and medications and completion of tests and appointments (e.g. x-rays, MRIs, psychological testing) is longer but no one seems particularly bothered by it. ‘Island time’ is a real phenomenon. “People here work hard; but work feels like an aspect of life rather than its rival. In warmer months, I camp during the week and hillwalk after work, especially when I can fle my schedule. That, in and of itself, is a game changer for me. My clients, their families and my co-workers all seem to engage with the outdoors in some capacity, too. There is a strong sense of family and trust among islanders here, which is, in fact, quite similar to the way that families interact with each other in Baltimore different social cirlces are pretty clued into each other’s lives and it’s common to enquire about someone’s ‘people’ (family) are.” 60
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Careen, who studied in Glasgow, always wanted to return home, missing what others might find unusual. Careen said: “I was born and raised on the Isle of Lewis and always knew I wanted to come back. After some travelling after university I was lucky to get a temporary Band 5 post in the community that was then extended for two years. I later moved to Inverness and worked in Raigmore hospital for four years before moving back to Lewis into a paediatric post. Although I wanted to live on Lewis, I think it was very important to go away and gain experience elsewhere before settling back here. “The occupational therapy team (hospital, neuro, community, mental health, hand therapy, rheumatology, paediatrics, the community equipment service and the telecare service) on the Western Isles work very closely together and are managed by the same person. Having worked in other areas, I find this reduces duplication of work and increases consistency for clients. This team approach allows joint working, sharing of knowledge and skills and using each other’s strengths and expertise when necessary. Remote and rural practice, I feel, allows for lots of opportunity to trial innovative ideas and practice.” Lana acknowledged that this takes some getting used to: “Because we have fewer staff members covering the islands, we are expected to wear many different hats and work outside of our comfort zones. In a given day I might be using physical dysfunction
knowledge, a sensory-motor approach to treatment and mental health concepts.” In Lana’s home country, the education process is very different and the culture of healthcare in the USA is another animal entirely. Lana said: “Medical professionals in the US generally spend more time in university and are required to sit for a licensure exam prior to practicing (e.g. in the US, OTs are required to have Master’s degrees—six years of school, physical therapists need clinical doctorates—approx. seven years of school, etc.). “Evidence-based research and standardised assessments are emphasised and high productivity standards were typical of most workplaces in the States (e.g. 4.5 hours of your eight-hour day might be spent directly treating patients). The salary for some AHP staff is as much as one third less than it is in the US. Americans get less annual, sick and maternity/paternity leave and our health care system is largely privatised. I feel as though I worked more and at a much faster pace in the US. Moreover, American clinicians rely more heavily on a medical model to guide their practice; when I worked in paediatric mental health, many of my patients were on medication, despite being as
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Paediatrics SECTION
young as five years of age.” Not only was the procedure of her trade completely different, Lana also had to adapt to the islanders’ way of life and abandon mainland conveniences. She said ouse numbers are rarely in order and you rely on physical, paper maps to navigate home visits (we don’t get 3G/4G on most places on the island) which can be quite tedious at times.” Careen admitted that the Western Isles situational obstacles are hard to avoid. She added The biggest challenge is the complex geographical environment and ensuring an equitable service to a population of 27,400 across the islands. The islands extend for 140 miles from the Isle of Barra to the Isle of Lewis, with 30% of the population in the Stornoway area and the remaining population scattered over 280 townships. Areas can be very sparsely populated so we may need to travel large distances to see one or two clients. Also with such a small population you have to work harder to ensure confidentiality. ost of the children on our caseload are seen at home and in schools.” ana also finds that small populations can spring up some issues. She commented Island life presents clinicians and service users with uni ue confidentiality challenges. Although I have only been here a couple of months, I already feel very connected to the people and aware of
social circles. You run into co-workers, patients and their families on a daily basis in the community. In addition, people on the island are fairly religious, thus all shops are closed on Sundays and generally discouraged from work or play of any kind. This impacts many of our clients’ goals and priorities for treatment.” Careen recognises that this is very difficult to navigate. he said “Working in remote and rural practice, particularly in the Western Isles, you have to be aware that communities are strong and everyone knows each other, this is very much a strength. However as a health care professional you have to work harder to maintain confidentiality at times both in and out of work hours. There is a natural resilience among the local population and communities are very supportive of each other; there is a culture of self-reliance and self-sufficiency and these are highly valued in rural areas. Gaelic is the predominant spoken language amongst older people and it can assist a therapeutic relationship if you acknowledge this. You have to be aware of cultural differences. There is an increasing aging population more marked that anywhere else in Scotland; from 2005 to 2015 the 65-74 age category increased from 10.6% to 13.2%. That means that those over years represent a fifth of the population. There is a continuing trend for young adults to leave the islands for further education or employment purposes, therefore reducing the local skill level and this can pose challenges for recruitment and retention within the NHS and other sectors. Employment is different in remote and rural areas, many are selfemployed, rely on subsistence crofting and fishing, off-shore work or the other main employers the NHS and the local council and many rely on multiple jobs. Access is an issue in rural areas, affecting all aspects of life - access to services, information, transport links, support, employment opportunities, learning and training.”
urban areas would find odd about the Western Isles is just how trusting the islanders are. ana said I still find the sense of safety and trust among islanders to be unique. I recently asked a friend why he keeps his keys in the ignition of his car while he’s away and he responded “How else can people borrow my car?!” I don’t know many people here who lock their doors and with that comes a sort of ‘open door’ policy where your pals just show up to your home whenever! It is actually wonderful, just takes some getting used to.” Of course, moving away from everyone and everything you know would give anyone cause for a bout of homesickness. ana admitted I miss the social, food, and art-related opportunities I have in a big city. I also miss being able to just walk or bike to a friends flat here, some of my friends live in villages 30 minutes away. But, I do love the fact that I spend a great deal of my time here using the land— biking, surfing, hillwalking, running, kayaking, camping, rock climbing, etc. If I am working in one of the schools or in a home, it is quite nice to have your lunch on the beach. Although most places are far away, there are beautiful beaches in nearly every village.” Lana has taken all these challenges in her stride and even plans to implement some of her own ideas into her work. he said ne topic I ve become more passionate about over the years is helping to empower children and young people to use art specifically music and literature) to support them in recovery. That might mean helping parents read and sing to their kids to address particular motor, sensory, and social skills. Or supporting a teenager’s recovery by discussing and studying their music preferences and incorporating that into their treatment goals.” To keep up-to-date with any job opportunities available in the Western Isles, visit www.wihb.scot.nhs.uk/ot-home.
One thing most people who live in www.
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FREE 20/12/2016 17:27
Thinking of becoming independent?
Becoming
INDEPENDENT
One of the biggest queries an occupational therapist has is whether or not to become an independent OT. Is the grass really greener on the other side?
W
hen working within the NHS, an OT can become disenchanted with a lot of the processes and politics that it can involve at times – in any area. However, some OTs who have taken the plunge and opted for independence from the mainstream system wish someone had been there at the start to tell them what this decision entails.
Often, whilst on the cusp of making a big decision, a pros and cons list can help you lay out your thoughts and logically help you to come to the right choice for you. The OT Magazine has done just that. We have compiled a few points to consider before settling on a verdict.
PROS FLEXIBILITY: You can work as many or as few hours as you want. Some independent therapists only work one day a week or just do Saturday mornings alongside full-time NHS work. CONTROL OVER CASELOAD: You have the ability to control how many people you see, or don’t see. If you feel overwhelmed, you can say no to taking on more clients and ensure you aren’t stretched too thinly. CONTROL OVER SYSTEMS: You can choose how things are done; what paperwork to use, how you file, what resources and assessments you use, when you take holidays, what training you undertake, how much therapy you offer, how frequently you see clients, how you keep case notes, etc. RELATIONSHIPS: You get to build really strong relationships with the clients you work with. You have the ability to work with some over several years, build a rapport and get to know them as a person rather than a patient. SPECIALISM: Some therapists are specialists in one particular area and independent practice offers them the opportunity to do this full-time.
CONS NO GUARANTEE OF WORK: Sometimes independent OTs struggle with the steady rate of clients and there can be quiet patches. NOT BEING PAID AN ANNUAL SALARY: Quiet patches are mirrored by the issue of income. A lack of annual salary can often be a worry. EVERYTHING IS DOWN TO YOU: You need to do everything yourself. There is a lot of businesstype things to think about; what happens when someone doesn’t pay? Are you complying with Data Protection? Is your child protection training up to date? What will you do about a pension? What will you do if someone is not happy? Are you getting appropriate supervision? TALKING ABOUT MONEY IS HARD: Invoicing and agreeing a rate with a client can be awkward if you haven’t had any prior experience of this. WORKING ALONE: Being an independent OT can be lonely at times and you may miss being part of a big team, where you are all going through similar issues.
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19/12/2016 16:45
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20/12/2016 17:30
Pet
THERAPY
PET THERAPY: David and Pamela Coombs with Jack Russell Jess, Bella the Border Terrier, White Parson Meg and ‘top cat’ Mr Ginger.
The unbreakable bond between
pet and patient Gentle giant Mr Ginger is a real-life loveable Bagpuss who is warming the hearts and the laps of care home residents, people who have disabilities and hospital patients.
T
he seemingly ordinary twoyear-old domestic ginger tom is achieving some extraordinary results as one of the UK’s 100 visiting Pets As Therapy (PAT) cats. While dog visits to caring environments are relatively commonplace, the independent nature of cats and their tendency to show their owners who’s boss aren’t traits normally synonymous with a good bedside manner. et, the mere presence of fluffy feline Mr Ginger is unlocking memories and opening conversations for dementia patients who had previously lived in a solitary world without interaction. Mr Ginger bears an uncanny resemblance to street cat Bob, whose real-life story of how he turned around the fortunes of his drug addict adoptive owner became a best-seller
and big screen blockbuster. Bob lookalike Mr Ginger is one of four PAT pets owned by animal lovers Pamela and David Coombs. Their accidental introduction to charity PAT came about in 2007 when Pamela took along her Jack Russell, Meg, to visit her elderly mum at Tenlands Care Home in County Durham. Mum Edna had always loved the breed. nd for the first time since a steady decline in her health, the presence of six-month-old Meg sparked a response in Edna. The remarkable connection between pet and patient was witnessed by Tenlands’ housekeeper, who also happened to be a PAT volunteer regional coordinator. “The matron asked if I would mind taking Meg round to see the other residents. The housekeeper was
watching, and she asked me if I’d heard about pet therapy, as she thought Meg would make a good PAT dog,” remembers Pamela. She contacted PAT to request an application pack. To become a PAT dog, Meg had to pass a temperament test and meet certain criteria. She had to: • Be at least nine months old and with her owner for at least six months • Be willing to wear a harness • Love being fussed over and travel contentedly • e fit and well By the time Meg was accepted, Edna had sadly died. But Pamela continued to take Meg to visit residents at Tenlands Care Home. Pamela and David’s other two dogs, Jess and Bella were soon also accepted as visiting PAT pets. www.
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Pet
Image: David Coombs
THERAPY
CASE STUDY PAT animals have been involved in therapy for patients in ward 23 at Queen Elizabeth Hospital in Gateshead for several months. And when he became semi-retired, David decided to explore the possibility of registering one of the couple’s three moggies, Mr Ginger, as a PAT cat. He believed his placid nature and willingness to be stroked and picked up by anyone who approached would make him the perfect PAT pet.
daughter-in-law was there and saw how it brought back some lovely memories for her. As long as Mr Ginger is getting cuddled, that is all he wants.”
He was right. Laid-back Mr Ginger, who regularly joins David and the three dogs on walks, became a PAT cat in July last year.
“As soon as she saw Ginger, that was it,” said Pamela.
“In one of the care homes, there was a lady who had not been communicating at all with staff and other residents. Mr Ginger settled down beside her and rubbed his head on her finger. e even did his normal trick of putting his tail up to show he was happy and relaxed,” explained Pamela, whose beloved ginger tom is bigger than her Jack Russell, Meg. Mr Ginger became a regular visitor at Hadrian House, Blaydon-on-Tyne, where many of the residents and staff are cat lovers. “There is one lady who does not speak a lot. Mr Ginger sat next to her and she started to communicate. We even got a little bit of a chuckle out of her. She kept pointing at him and stroking him. He was clearly encouraging her and getting words out of her about how much she was enjoying his company,” explained Pamela. “At Hadrian House, there are residents who are in the last stages of dementia. One lady took Ginger and gave him a cuddle. She was talking about a cat she’d had and was holding a normal conversation for a short spell. Her 66
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On a recent visit to Queen Elizabeth Hospital in Gateshead, Mr Ginger’s presence sparked another extraordinary response in a patient.
“Staff said they’d never known her to talk as much. She just sat chatting about her own cats and cuddling him while he sat on a blanket on her bed. Hospital staff got lots of new information about how she was feeling, so the experience helped them as well.” Now a volunteer PAT regional coordinator who supports and advises other volunteer owners, Pamela says few people realise that their cat could make a real difference to older people and hospital patients. “When it came to our Ginger, we didn’t think there’d be much interest in a visiting cat in care homes and hospitals, but we were wrong. Having a PAT cat is just as rewarding as a dog,” insists Pamela. “The people he visits love the communication, and the smiles on their faces say it all.” n With 5000 dogs and only 100 cats, PAT is appealing for the registration of more therapy felines. For further information, call 01494 569130, or visit www.petsastherapy.org
During this period, ward manager Michelle Lewins has noticed marked improvement in withdrawn people engaging and conversing with staff, relatives and other patients. “Being in hospital can be stressful for anyone and even more so for the confused patient, and we have witnessed patients visibly relaxing with PAT therapy. “Staff have been able to distract patients and de-escalate challenging behaviours by using PAT therapy as a theme of conversation. Family members and spouses are seeing their loved ones on a social level as they have been in the past. We have seen people actively withdrawing from hallucinations during the time the animals were present and engaging with the animal and conversing with staff.” Michelle and her colleagues have seen stressed family members visibly relaxing when they had the opportunity to stroke the animal, and patients have asked if they can keep the animal permanently with them in their room. Of Pamela and David’s PAT dog Jess, Michelle said: “Jess is accepting and nonjudgemental and provides a huge source of motivation towards our patients. Jess brings ‘humour’ into what can be a stressful and acute environment. “The opportunity to stroke and handle Jess has a powerful and calming or stimulating effect on our patients. She can give one-to-one social interaction, boost self-esteem, self-worth and confidence. ess serves as a social facilitator on our ward and has also had a positive impact on staff morale.”
-magazine.co.uk
19/12/2016 16:46
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Thursday, 25 February 2016 11:07
BAPO ANNUAL 2017
CONFERENCE RICOH ARENA, COVENTRY 17-19 MARCH 2017
• Our Orthotic & Prosthetic programmes promise to give you a taste of what pushing the boundaries in modern day P&O really means! • Our Technical programme will provide delegates with lots of information on what’s new and happening in the P&O industry • Be sure not to miss out on the chance to win our £500 prize – submit a free paper now! • Don’t forget to nominate a Technician who you feel always goes that extra mile for the Algoes Technician of the Year Award • Don’t miss our graduate and student forum - Speakeasy • Join us on friday evening for the NSP Karaoke and our Benefit Ball on Saturday is one not to miss!
PUSHING BOUNDARIES
Don’t miss our keynote speakers Dr Simon Bartold, Richard Whitehead MBE and Nicole Roundy
Register at www.bapo.com
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BRITISH ASSOCIATION OF PROSTHETISTS AND ORTHOTISTS
20/12/2016 17:32
Forensic Occupational Therapy Holly McIntosh and Karen Cormack are forensic occupational therapists, based at Fern Close Supervision Unit (CSU), Elmwood, Royal Cornhill Hospital, Aberdeen. ere the e p ain their or in this niche e d
F
orensic Occupational Therapy is the provision of occupational therapy assessments and interventions for patients who have a history of offending behaviour or the potential risk of offending. They must also have a diagnosed learning disability. In this setting, occupational therapists
D A I LY D I A R Y
are required to facilitate positive occupational behaviour and promote wellbeing which would potentially lead to a reduction in antisocial and offending behaviour. Holly became involved in this clinical field after completing a placement at Elmwood in her second year of university. Finding it rewarding and
looks like for them: Here is what a typical working day e handover from • 0745: Huddle – this is a 15-minut safety issues any of te ward staff to get an upda ent, discussion ronm envi the or ents relating to pati to support of timetables and whether staff need other areas for safety reasons staff information • 0800: Handover to Hawthorn Unit from huddle • 0815: Breakfast group apet (Fizzy) to • 0900: Daily morning walk with Ther occupation ugh thro tyle encourage a healthy lifes ting risk • 0930: Admin (this can include upda ssments, asse assessments/ complete new risk ague/MDT) colle with ing checking e-mails and liais or e • 1030: Morning activity (rehabilitativ assessment-based) • 1230: Notes and lunch /patient activities/ • 1330: CPA meeting or home visit staff training CPA/home visit • 1500: Planning and follow-up from • 1600: Finish
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challenging, she knew it was an area she wanted to work in. In Karen’s case, she had always had a strong interest in learning disabilities. Then a band 7 vacancy arose within the Elmwood Learning Disability Service. This role included covering an Acute Assessment Unit and a Close Supervision Unit (CSU) which accepted
R a OT
As forensic occupation al therapis and Karen ts, Holly focus on a ll occupati involved in o n al activitie ap s activities in erson’s day. In this ro le, these volve: Functiona l assessme nts Home asse ssments Regular risk assessmen ts legal requ irements, fo - consideration of rensic risk Planning a nd facilita ting therap Rehabilita eutic grou tion and co ps mmunity re Liaising w settlemen ith wide M t DT includin OMU, MAP g PA Scottish G overnmen t Teaching st udents Training st aff Service de velopmen t
-magazine.co.uk
20/12/2016 15:24
Forensic
OTs forensic patients. Karen’s interest in forensics then developed through experience and clinical practice, and she went on to become the coordinator and mentor for N2F training for staff of all disciplines. Fern CSU in Aberdeen is an all-male adult inpatient unit. In this locked unit, all inpatients are subject to legal orders. Patients have varying risk factors that are influenced by their individual social dynamics and histories. Holly and Karen explained that some patients are admitted from the community and others are transferred from prisons or hospitals with higher security levels. All patients have a learning disability which affects their cognitive capacity to understand legal boundaries and social norms, legal proceedings or how to always make positive, safe life decisions. The patients they work with often
have high risk factors, but on a dayto-day basis with the appropriate management in place, they present as friendly, humorous, motivated individuals who want to improve their functional capacity, health and wellbeing. “The best part of working in this clinical area is seeing the success of patients progressing through the recovery process and the direct impact occupational therapy has had in aiding this process,” explained Karen. “It is rewarding to witness the high compliance rates and consistent attendance of patients at groups and activities. Patients also display regular appreciation for the OT input they receive which supports job satisfaction.” But what’s the hardest part of working in this area of OT? It can be difficult working with people who have committed offences, especially those of a violent or sexual
nature,” said Holly. “As a professional, you have to remain non-judgemental and ensure every individual receives the same quality of service. As I am relatively new to forensic services, it can be challenging when considering the legal restrictions of the patient and how this impacts on your therapeutic input with the patient.” Families of clients often attend CPA meetings to support service users and to make their thoughts and feelings heard. During this time, occupational therapists will speak with the family and, if appropriate, provide them with an update of any progress being made by the service user. Normally the OT team will also have more contact with family and carers in the lead up to discharge, as often the families will be involved in supporting the patient back into the community.
CASE S TUDY
A forensic patient wa s transferred community to Fern CS activities a U and was initiall nd manage an y confined y potential to onsite activit risks. ies due to A graded tr legal restrictions. eatment p lan was then d eveloped b It was occu y the pational th O T a lo ng with th era main goal e MDT to reintegra py’s (includin te g MAPPA a this patien nd OMU) t back into and the pa tient. The p the commu atient nity; this w is n ow attendin as, however, im g supporte peded by th co d m m unity activ e legal order. ities with a view to pre paring the On receipt m for community of the resettleme appropriate nt. T h e process is authorisati on-going a on, occupation requires re nd al therapy gular revie was the firs ws, risk assess t discipline ments and responsible liaison with the ex for escortin tended MD g this patien T to ensure posi t to attend tive progre their ss is made.
www.
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-magazine.co.uk
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20/12/2016 15:25
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20/12/2016 11:24
Student ADVICE
Homesickness
Dealing with postChristmas blues Thank you for all your emails asking for advice on how to deal with feeling homesick. For those of you who aren’t looking forward to returning to university post-Christmas, we have Dawn Blenkin on hand to talk you through it.
Dawn Blenkin
MA, SFHEA, PGCE LTHE, BSc (Hons) Occupational Therapy Dawn is a senior lecturer at Teesside University. She also holds external roles as a specialist advisor to the CQC and is a visitor who inspects educational programmes on behalf of the HCPC.
It’s natural to feel attached to familiar people and places. Homesickness is often associated with teenagers being away from home for the first time. However, older students, or those who have been away from home before are not necessarily immune. For most students homesickness often disappears naturally as you establish a routine within the first few weeks of returning to university. For some though, this isn’t the case. You or a friend may find yourself still feeling homesick and this can cause anxiety and affect confidence. It’s important to recognise some of the causes of homesickness and find strategies to overcome it. The postChristmas period can be particularly difficult. Often the holiday periods put on hold other problems that we haven’t yet dealt with. If you struggled to settle in during the first part of the academic year and didn’t manage to resolve this, then leaving your families to return to university after Christmas may feel all the more difficult. By the time you are reading this you will have made that first big step and returned to university. You may now just be realising that university life involves a lot of hard work, commitment and determination. The post-holiday anti-climax can bring us down to earth with a very hard bump indeed! For those of you who have been chomping at the bit to get back to university and your friends please share that positivity around. Look out for friends who might be struggling and encourage them to join in university life. T h e r e’s l o t s of things we can do to ease settling back into
university. Try to establish a routine as soon as possible. The fuller your days are, the less time you will have to feel homesick or lonely. The more involved you become in your course and social life the quicker the university environment will become familiar. This will help create a sense of calm and control leading to a healthier happier you. Establish a balance between work and leisure have you covered work, self-care and leisure in class yet? Well it doesn’t just apply to service users! You are NOT expected to work ALL the time but be realistic and keep that balance right. If you don’t put enough time into your university work you risk falling behind. Often the big question is how much contact to keep with home. This really does differ and something only you will really know the answer to. Does frequent contact with home make you feel better? If so, great… if not maybe less contact is the answer. Think carefully about whether or not to go home at weekends. Some students find it helps to ease the transition; others find the constant readjustment makes them feel worse. If you are finding the readjustment difficult, talk to your tutors and peers. Look out for one another and enjoy the journey to becoming an occupational therapist. If you are a student who would like some advice send your questions to theotmagazine@ gmail.com
www.
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-magazine.co.uk
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19/12/2016 16:47
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OTAdverts_Template.indd 26
20/12/2016 17:35
OTs
ABROAD
Sewing in
Sri Lanka S
ri Lanka is usually remembered for its bloody civil war from 1983 to 2009 or the shattering 2004 Boxing Day tsunami, but to Darren O’ hare it is so much more. The 36-year-old occupational therapist discovered the ffantastic antastic opportunity to work with Sri Lankan Volunteers (SLV) whilst studying at university. The occupational therapy placement was exactly what he was looking for and this meant he was a e to u his am ition o o unteerin as an a road is experience not only helped change the lives of the Sri Lankans he aided but it ultimately shaped his own.
y first impression of the country when I left the airport was lovely. It reminded me of home with all the greenery. I lived in a local family s home in orana which is about an hour and a half from the capital, olombo. There were 1 volunteers in the house staying with a ri ankan couple and their three children. here I was staying was very conservative. en and women didn t show affection in public and people with tattoos and piercings were considered untrustworthy or to be drug dealers. I feel I learned more about ri anka because I didn t stay in a central tourist area.
e were involved with special needs projects working with women and children. The projects aimed to help women with a mi of mental and physical disabilities and the projects featuring the elderly aimed to aid elderly women in a care home. fter I settled, I asked the nationals what the ri ankan people wanted us to provide for them. I wanted them to be more independent, so we would focus on activities that suited them. hen I was working with elderly people, I noticed the chairs in the class were wooden and not very comfortable. e learned they like sewing and we made the activity meaningful to
them by sewing cushions. They were so shocked when we said they could keep the cushions they made. I don t know if they were used to the crafts being kept or thrown away but they were so grateful and afterwards they would bring the cushions to class to make their chairs more comfortable. I also learned a valuable lesson the day we were doing the cushions. There was a lady not taking part so I went over and tried to communicate despite the language barrier. I ended up playing dominoes with her for a while. he didn t seem to understand the rules but played along since it was nice to have no need to win or focus like she would with sewing. ď ľ www.
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-magazine.co.uk
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OTs
ABROAD
We learned they like sewing and we made the activity meaningful to them by sewing cushions... I then asked if she really wanted to join the other women in the group and it turned out that she did. Thinking like an OT, I thought it best to let her thread the needle herself but that’s when I realised she had very poor eyesight, so I helped her get started. It became clear then why she was playing dominoes the way she was because she couldn’t see the numbers on the small blocks. I like to think that by taking the time to include her helped her decide to join in with her peers, but it definitely made me more aware. In Sri Lanka, occupational therapy is only really carried out in a hospital setting, while here it’s integrated into the community, forensic mental health etc., although Sri Lanka is now trying to move it into the community. We never really got to see professional OT in Sri Lanka and the projects relied on ourselves using our skills 74
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to implement OT. SLV did organise a day visit to Ragama Hospital, the only teaching hospital in Sri Lanka that specialises in OT. I soon realised that many people who were admitted to the hospital as patients had broken their backs from falling out of trees picking coconuts, a popular occupation in the country. We also visited the wheelchair ward. Many of the patients in this ward were also employed by Ragama Hospital to create new wheelchairs and prosthetics for new patients coming in. I was surprised by the long history of OT in Sri Lanka. I discovered that it has been in practice over there for many years - I thought it was a new profession
in Sri Lanka. I suppose OTs aren’t very good at selling ourselves or the profession anywhere! I found out in the 1950s two OTs from abroad were brought in to teach and implement occupational therapy in the country and the professional association was formed in 1968 so it has been around for a long time. When I set out on my journey I could never imagine just how much I would learn about myself. It started as an experience to understand occupational therapy in a different country and ended with a part of my heart being left in one of the most beautiful and special countries on the planet.” n
-magazine.co.uk
20/12/2016 15:27
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20/12/2016 17:38
Columnist VERONICA BROOMES
Top tips for profitable OT practices ro essiona ua i cations and e perience are essentia to credi i it as occupationa therap practitioners hese a one ho e er do not uarantee pro ta i it o practices
Veronica Broomes Your Small Business Coach and Mentor
eronica, a ualified and e perienced usiness oach and entor, works with freelancers and independent business owners/directors to enhance business growth, set prices, negotiate contract fees and develop business plans. he helps clients avoid costly mistakes in fee negotiations and gain a deeper understanding of the real costs of operating their practices. E: bizcoach4u@gmail.com Follow Veronica on Twitter: @bizcoach4u Facebook: Your SmallBusiness Coach
A
mong key issues therapists in private practice should decide are their ideal clients, location of their practice and desired income. These decisions will determine overhead costs and potential revenue. T analysis is a useful tool in helping this decision-making. This will help you identify strengths in you and your practice and opportunities arising from those strengths. t the same time, any weakness that is a threat T to the functioning of your T practice should be identified at an early stage and action taken to avoid or reduce. ey considerations in setting prices and negotiating contracts include 1. o not offer your services for free. ffer introductory/discounted prices for a specific time or to a known number of patients. ree T sessions can be seen as down valuing your services. 2. alculate all overhead costs, then work out the minimum number of booking hours you need every month in order to cover business e penses. nowing how much it costs to run your business will help you decide minimum costs of therapy sessions as well as level of discounts you can offer. 3. rovide prospective clients with your terms of business which should include time-frame for payment. n invoices, include a clause on the interest applicable for late payment. In instances where client organisations provide claim forms for you to complete, ensure you also submit your invoice to show your terms of payment.
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4. ffer greater value to clients beyond time spent in delivery of relevant therapy sessions. uch higher value can include fle ible hours that are convenient to clients. or e ample, aturdays and early evenings can be best for working parents with children. 5. If negotiating longer term contracts, you need to agree not only length of the contract and type of therapy, e uipment and/or products that will be provided, but also the minimum number of sessions that will be provided each month. ailure to agree a minimum can result in you as the T practitioner having an almost meaningless contract because the client has no obligation to use your services. ou can reduce your cost of client ac uisition by offering rewards for repeat bookings, booking multiplesession packages and having several sources of referrals for new clients. eco m m e n d a t i o n s of o t h e r T professionals with complementary areas of e per tise, insurance companies and solicitors can be trusted sources of a steady stream of new clients. T practitioners have an obligation to themselves and clients to run a profitable enterprise. ailure to do so will result in therapists being caught in the trap of loving their career, but not valued for their e pertise. cceptance of T private practices as businesses is pivotal to profitable practices staffed with e perienced practitioners who deliver e ceptional client value and can negotiate mutually beneficial terms of engagement.
-magazine.co.uk
20/12/2016 15:28
EDGE services Do you need high quality manual handling training to ensure your compliance with UK legislation? People Handling and Risk Assessment – Key Trainer’s Certificate Successful completion of the course will provide delegates with the up-to date skills, knowledge and confidence to train others in safer people handling. • Up-to-date legislation and professional guidance • Information on spinal function and back care • Ergonomics and risk assessment • The opportunity to practise with a full range of up-to-date equipment • The opportunity to practise a full range of up-to-date techniques • ….and much more
Courses conducted across the UK.
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20/12/2016 30/11/2016 11:24 15:05
Recruitment & Training Find out what you are worth?
Join the Barts Staff Bank today
➢ Are you a fully qualified OT, with at least 6 year’s postqualification experience? ➢ Are you looking for a new challenge, flexible hours and generous remuneration package? ➢ Do you have excellent communication and assessment skills? ➢ Can you work creatively to find solutions for your clients?
By joining the bank you put yourself in control of the shifts you work.
Unite Professionals Ltd are a National Case Management Company dedicated to providing a client-centred and flexible service to our clients in all areas of the UK, who have suffered catastrophic and life-changing injuries.
We have immediate opportunities for OT’s in multiple specialisms, in particular we need; • Paediatrics • Neurology • TORVAT OT’s
We are looking to recruit across England particularly in and around London, Herefordshire, Hampshire and the North East areas. We need inspiring OTs to assess client’s needs, plan their rehabilitation journey, implement and coordinate rehabilitation and services and monitor and evaluate the client’s progress.
To become a member of the Bank you must have a least 6 months clinical experience.
Unite Professionals Ltd provide regular clinical supervision, CPD opportunities, admin support and a full induction programme.
For further information or to register please call
To find out more please email Katherine Best at katherineb@uniteprofessionals.co.uk , including a full CV.
0333 577 3392
Barts Health
Staff Bank Salaried positions or Self Employed Consultant
Barts Health Staff Bank
P2343_Barts_OT_advert.indd 1
positions available.
Find out what you are worth today.
20/06/2016 14:13
PIP Absorb Analyse Assess , It s what you trained to do.
Disability Assessors – UK wide We’re looking for permanent Occupational Therapists As a Disability Assessor, you will undertake a face-to-face assessment of an individual who is making a claim for the Personal Independence Payment. You will need to take into account all of the information presented including any supporting evidence and then carry out a face-to-face consultation in a professional manner. Once you have gathered all the necessary information you will complete a structured report to be presented to the DWP. You must have at least two years post-registration experience as an Occupational Therapist (OT), Physiotherapist, Nurse, or Paramedic with a licence to practice and must be registered with the NMC/HCPC/GMC with a valid PIN. You should also have the ability to work autonomously across a geographical area and hold a full UK Driving Licence. When you work for the best, you can expect the best: • Salary of £34,000 per annum • 23 days paid holiday (plus 8 statutory holidays) • Travel expenses reimbursed • Life Assurance • Company pension • Career development opportunities • Working for a progressive and cutting-edge employer with exceptional standards If you are interested in becoming a Disability Assessor and you meet the specification we require, please email your CV to: PIPrecruitment@capita.co.uk It's what you trained to do.
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20/12/2016 17:43
Recruitment & Training Join our expanding team of
Experienced Occupational Therapists
Jacqueline Webb Britain’s No.1 Rehab Cost Consultancy
medico-legal consultancy
Occupational therapists play a key role acting as expert witnesses in clinical negligence / personal injury litigation. We require experienced OTs who are confident, have excellent communication skills (verbal & written), enjoy a challenge, are intrigued by the forensic nature of this work, and above all are keen to learn new skills. We offer: Regular work on a case by case basis to fit in with other work commitments Excellent remuneration Full & on-going training, supervision on every case & support You will work on a self employed, flexible basis, alongside your “day job” – want to know more about how this works? Email recruitment@somek.com to request an information pack You will be working at a senior level with a minimum of 8 years post qualification experience as an OT and/or case manager Somek & Associates, run by OTs, is the largest provider of HP expert witnesses in the UK, renowned and respected in the field
Maximise your potential as an Expert Witness with J Webb About You:
About Us:
• You regularly work with Orthopaedic, Brain or Spinal trauma injuries on both short-term and long-term goals. • You are confident in giving and standing by your opinion. • You are frustrated that others’ professional standards do not match your own. • You are ready for your next professional challenge, to run alongside your current clinical position. • You are looking to maximise your potential as a clinician.
• We are the UK’s longest standing Rehabilitation Cost Consultancy. • Medico-legal work is all we do. All of our resources are focused on being the best in the industry. • We are not a typical ‘agency’. We work very closely with our Experts to provide the right level of work. • We provide the best training, both initially and throughout your Expert career. • We pride ourselves on the quality of our reports and timely service to our customers. Our reputation speaks for itself.
Still interested? Then please contact Simon Dickinson, Manager of Expert Recruitment for more information t: 01722 342 512 e: recruitment@jwebb.co.uk Come and meet us at our open evenings in Watford on 25 January 2017 and Cambridge on 8 March 2017 to discover more about Expert Work www.jwebb.co.uk/recruitment
Case Managers
wanted
ILS is one of the UK’s leading case management and rehabilitation companies, with 25 years’ experience in the industry. We are seeking case managers from across the UK to complete our team.
Key requirements: Occupational Therapists with extensive experience of working with adults or children who have sustained catastrophic injuries. The ability to provide in depth holistic assessment of complex situations coupled with the ability to develop personalised solutions leading to positive outcomes for clients. Current professional registration and an up-to-date CPD portfolio. We have a variety of contracts available, including employed roles on a salaried or hourly basis, or on a self-employed basis. Roles are home based with travel and client visits within your geographical area. For an informal chat about the role please contact Phil Perry and Sarah Ransome, Operations Managers on 01722 742442, or send your CV to: ilshr@indliv.co.uk
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20/12/2016 17:43
Find events for you... Wednesday 1 & Thursday 2 February 2017
Tuesday 28 - Thursday 30 March 2017
Moving & Handling People South
Naidex
NEC Birmingham
Croydon Conference Centre, London
This will be the 23rd annual Moving & Handling People to be held in London, and comes 25 years after the Manual Handling Operations Regulations were instituted. To mark this, the 2017 event will have a special focus on promoting vigilance in identifying manual handling risks, suggesting ways in which these can be minimised and promoting a culture of organisational excellence. For more information visit www.movingandhandlingpeople.co.uk.
Wednesday 22 February 2017
RISE 4 Disability Peterborough
RISE 4 Disability is an exciting conference and exhibition for health professionals and disabled people to ‘Resource and Identify Suitable Equipment’. The day will comprise a co m p r e h e n s i ve t i m e t a b l e of seminars and unique speed sourcing workshops, as well as showcasing a multitude of products and services to aid independent living. For more information visit www.rise4disability.com.
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Throughout 2017
Kidz Exhibitions 2017
• Kidz to Adultz Middle: 16 March, Jaguar Exhibition Hall, Ricoh Arena, Coventry • Kidz to Adultz South: 8 June, Rivermead Leisure omple , ichfield Avenue, Reading • Kidz to Adultz Scotland: 14 September, Highland Hall, Royal Highland Centre, Edinburgh • Kidz to Adultz North: 16 November, EventCity, Manchester All Kidz exhibitions run from 9.30am – 4.30pm. The Kidz to Adultz exhibitions from Disabled Living take place across the country, dedicated to children with disabilities and special needs, their parents, carers and professionals who work with them. Over 130 exhibitors offer information on mobility, funding, seating, beds, communication, access, education, toys and much more. A full programme of CPD seminars run alongside each exhibition. For more information about each of these events call 0161 607 8200 or visit www.disabledliving.co.uk/Kidz/Welcome.
Naidex is back once again and this year promises to be bigger and better than ever. There will be a dedicated Moving and Handling Stage that will host an extensive conference schedule for the health and social care sector professionals involved in moving and handling patients no matter what age, size or physical condition. Professional experts, lecturers and researchers will discuss a range of topics, including improving patient health and safety during moving, moving young or elderly clients, and the new equipment available to facilitate moving and handling. To find out more visit www.naidex.co.uk.
BAPO 2017
ANNUAL CONFERENCE
17-19 March
BAPO Conference Ricoh Arena, Coventry
The British Association of Prosthetists and Orthotists (BAPO) was established to encourage high standards of prosthetic and orthotic practice. The BAPO conference is the event for prosthetic and orthotic professionals. For more information, please visit www.bapo.com.
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