The OT Magazine – May / Jun 2020

THE

Thank You To all the NHS staff and key workers who are going above and beyond in the fight against COVID-19

MAGAZINE Issue 34 | May/Jun 20 | Improving Independence

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PRO DUC T S

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CPD

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EVENTS

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MENTAL HEALTH

Celebrating 40 years

providing excellence in specialist postural seating

Our award-winning P Pod provides sociable postural support & our Mobile Base fits through standard door frames and is available with powered tilt function.

CE 1980

24 hour posture management for children and adults

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MSI MoJo Customised to the individual, the MSI can be used with a variety of bases including our own Mojo wheelbase

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The Miko buggy offers a fully reversible seating position and accommodates SOS seating such as the lightweight Flexi Seat aiding the daily management of children requiring postural support

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BRATI E L

Call us today on

01283 520400 www.specialisedorthoticservices.co.uk

About us

The Team

Editor: Rosalind Tulloch Staff Writer: Katie Campbell Designer: Fionnlagh Ballantine Production: Donna Deakin Sales: Jacqui Smyth Contributors: Kate Sheehan, Chloe Kitto, Charlotte Warburton, Lucy Leonard, Esther Dark, Anna Braunizer, Alice Gair, Susan Griffiths, Rachel Johnson, Naomi Johnson

This month’s issue...

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would like to begin this issue by saying thank you to all the occupational therapists throughout the country.

Whether you are working on the front line in hospitals, facilitating teams behind the scenes, working in an officebased role, or working in a virtual capacity from home, you are all doing vital work supporting the population through this difficult time.

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

Disclaimer

The OT Magazine is published by 2A Publishing Limited. The views expressed in The OT Magazine are not necessarily the views of the editor or the publisher.

Reproduction in part or in whole is strictly prohibited without the explicit written consent of the publisher. Copyright 2020 © 2A Publishing Limited. All Rights Reserved. ISSN-2056-7146

At a time when many of us have lost the ability to engage in meaningful occupations, a time where anxiety and stress are prevalent, and our lives have changed overnight removing our ability to work, socialise and function as we did before – occupational therapy has never been more relevant.

This issue highlights some of the amazing work that OTs are doing throughout the world to support people during these difficult times.

From the OT leading a wellness team at the Nightingale Hospital, London, equipping the staff with psychological PPE, to the new website beyondCOVID.com that brings together health professionals to help global citizens through online resources and advice.

We have created a toolkit of sorts, inspired by one created by Occupational Therapy New Zealand, to equip you with resources, ideas and contact information to help you, your patients and even your family and friends to make it through this difficult time.

We hope that by the next issue we will have returned to some form of normality, but until then, stay safe.

The OT Magazine, Editor

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

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What’s inside 07 What’s New

Keeping you up-to-date with all the latest news from the healthcare sector

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13 Kate Sheehan

Kate reflects on the current lockdown situation and wonders if it will change how we practice

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15 The Nightingale OTs Chloe Kitto is leading a wellness team at the Nightingale Hospital to equip staff with psychological PPE

19 Product Focus The latest products on the market to aid independent living

22 Staying Connected Sport For Confidence has developed an initiative to allow OTs to keep in touch with their clients during lockdown

25 Day in the Life Charlotte Warburton shares what her role as a wheelchair therapist involves 4

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29 Activity Toolkit We have created an activity toolkit for OTs and patients who may be struggling through lockdown

32 Single Handed Care

and Toileting

Lucy Leonard explores the benefits of single handed care in the bathroom setting

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50 Crafting in the

Sunshine

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38 35 Product Focus More independent living products to help your patients

38 Conference Calling We bring you the best video calling software and apps for maintaining face-to-face contact during lockdown

41 Beyond COVID A team of OTs and AHPs from around the world are contributing to an online resource designed to help global citizens to engage in meaningful occupations

Product

Focus 35

46 Tackling Pica Rachel Peek has used a successful intervention with young children displaying signs of the eating disorder pica

Activities for your younger clients to enjoy in the summer months, even if we are still in lockdown

52 Paediatric Products Innovative products for your younger clients

55 Out of Routine The importance of establishing a routine, whether you are working from home or wondering how to fill your days

56 The Face Mask

Barrier

As an OT with hearing loss, Susan Griffiths discusses the communication barrier that has come with the wearing of face masks

58 Early Intervention An OT team at Optalis have trialled a project to reduce waiting times for clients who require bathing aids

61 Events Check out the new dates for many events taking place later this year

48 From the Other Side 62 Professional Paediatric OT, Alice Gair, shares the journey she embarked on after her son was born with a limb difference, and how this has changed her perspective as an OT

Social Media

OT Rachel Johnson has created a simple guide to using social media in a professional capacity to help further both your career and your knowledge base -magazine.co.uk

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Introducing the new Domus 3D mattress system from APEX Medical Ltd. Domus 3D is an essential system for care and nursing homes offering key functions including alternating & CLP modes designed to fulfill the individual needs of patients in medium to high risk of pressure injuries.

This new system with its Digital pump makes precise pressure control possible for better patient care enabling the compressor to work smarter thereby creating a more comfortable, longer-lasting and more cost-effective alternative.

With the option of an 8� cell structure supporting user weights up to 250kg the Domus 3D is the essential solution you have been looking for.

For more information please email us: sales@apexmedcialcorp.co.uk or call us on 01905 774695.

Alternatively visit our New Website being launched mid-May 2020: www.apexmedicalcorp.com

@ApexMedicalUK

ApexMedicalUK

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

What’s new?

BELOVED OT DIES FROM CORONAVIRUS Tributes poured in from occupational therapists and the wider allied health professional community, following the death of Vivek Sharma of 17 April.

Vivek was 58-years-old and the Clinical Falls Lead at Medway Community Healthcare. On Monday 20 April they issued a statement stating: “We are sad to share that Vivek Sharma, our Clinical Falls Lead, died on Friday. He was a valued colleague and a member of our employee forum. Colleagues describe him as ‘generous’, ‘a gentleman’ and ‘a gentle soul’ who will be missed. Our thoughts are with Vivek’s family and friends.”

Vivek was married and had two sons. It was reported that he had

ADOPT A GRANDPARENT

been isolating due to underlying health conditions, but he had sadly contracted coronavirus.

More than 100 NHS and care staff have died from the virus, as well as many key workers in other areas.

The UK held a minute silence to commemorate this tragic loss of life on 28 April.

Colleagues describe him as ‘generous’, ‘a gentleman’ and ‘a gentle soul’ who will be missed”

A Surrey-based carehome group called CHD Living started a scheme last year called ‘Adopt a Grandparent’.

It was designed to pair up residents with local children and adults who either don’t have any grandparents or don’t see their grandparents.

was to promote intergenerational communication and the relationship between children and older people, which is very valuable.”

Following the announcement of the lockdown they had to digitise the scheme and this has allowed them to reach volunteers across the globe who want to get involved.

Ms Hasham has described the response as “overwhelming” and staff have commented that the volunteers are getting as much out of it as the residents.

More than 28,000 people across the world have signed up to provide virtual companionship to the residents of the 16 CHD Living carehomes in Surrey.

It has been a beautiful example of human kindness and connectivity in a period of isolation. They hope to widen the reach of the scheme to include other carehomes in the future.

Shaleeza Hasham, head of communications for CHD Living commented: “The idea behind it

“By taking it digital, we felt it was so valuable to relieve potential feelings of isolation and loneliness.”

You can ‘Adopt a Grandparent’ at chdliving.co.uk/adopt-grandparent. www.

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HEROES HELPING HEROES The Field Guide to Self-Care has been created to support healthcare workers across the country who are working in conditions that are not dissimilar to those that military personnel may have faced. They have therefore drawn on the experiences and advice of wounded veterans to produce this package of care, which is available as a free online resource.

“We understand some of what they are up against. Help for Heroes has supported more than 25,000 ex-service personnel and families, many of whom have faced similar situations to those our NHS staff are facing around the country right now: challenging environments, working outside of normal areas of work, working with protective equipment and putting themselves at risk. Many have also been taken away from family, friends and colleagues for extended and uncertain periods of time.”

due to illness or injury are often complex, and we believe that those who have already embarked on a recovery journey often have the best insight into what will help others.

Shelley Elgin, the charity’s community recovery manager said:

She continued: “The challenges faced by those leaving the military

You can access the Field Guide to Self-Care at helpforheroes.org.uk.

Military charity Help for Heroes has created a guide to help hospital staff and key workers during these difficult times.

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“It is a resource of tips and tools our recovery teams deliver to veterans who have experienced traumatic events or have been affected by working in high intensity situations.

“We hope this is a useful resource for our NHS heroes, and for anyone else who may be feeling stressed or anxious during these difficult times.”

NEW EVENT DATES Many events, seminars and exhibitions that were due to take place over the next few months

have sadly had to be postponed or cancelled due to the coronavirus pandemic.

Most of the bigger events and exhibitions have been postponed until later in the year or into 2021, but many are introducing virtual events online through the hosting of webinars and live video chats.

OTAC and Kidz to Adultz are just some of the events who are moving to a more digital presence for the time being, offering those who

The OT Awards 2020 Postponed It was with great sadness that on 25 March we announced the postponement of The OT Awards 2020. Due to the unprecedented times we currently find ourselves in, we do not believe it would be right to continue to plan and promote The OT Awards 2020.

The awards ceremony was due to take place in October this year, but we feel with the uncertainty

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of the current climate that it would be remiss of us to continue planning towards this date. We have therefore taken the difficult decision to postpone The OT Awards until October 2021.

We would like to thank everyone who has supported us so far and everyone who has taken the time to enter. We received such a wonderful response to these awards

would usually attend an event the opportunity to learn from exhibitors, listen to seminars and be introduced to new products - all from the comfort of your own home. Check out Facebook for updates on their live webinars and videos.

Big events like Naidex and Dementia Care and Nursing Home Expo have been moved to 9-10 November.

We have outlined all the new dates that have been announced so far on page 61.

and it has been difficult taking the decision to postpone them until next year. However, we assure you these awards will go ahead, OTs will be recognised and a glittering evening will take place to celebrate the incredible work occupational therapists do every day.

HANDICARE LAUNCH REMOTE ASSESSMENT SERVICE

Handicare, manufacturers and suppliers of mobility equipment and transfer aids, have developed EthosGPS - a new remote assess and supply service from Handicare Patient Handling to support occupational therapists and discharge teams to help make everyday life easier during COVID-19.

A remote assessment is conducted with a Handicare moving and handling professional via Skype, WhatsApp, FaceTime, Zoom or a phone call. The remote assessment will follow a sequence of questions and a concise practical EthosGPS assessment to ascertain whether your client can GPS – Grip, Push and Shuffle.

The system offers direct access to speak with a ROSPA moving and handling level 4 professional, instructional videos to aid understanding and equipment recommendations and deliveries can also be arranged.

Visit handicare.co.uk/education/ ethos-gps to find out more.

Duty to Care

Looking for an OT job?

A new online initiative has been developed to provide free mental health services to NHS staff to assist them with their wellbeing throughout this time.

The website provides one-toone access for NHS workers to CBT therapists, psychotherapists, mindfulness teachers, meditation experts, breath-work experts, nutritional therapists, personal trainers, yoga teachers and life coaches.

These experts are offering their services at a very reduced rate and that rate is being covered by fundraising efforts. This ensures the service can remain free for our NHS workers to support their mental health and wellbeing throughout a time where they are experiencing an inordinate amount of pressure in their daily lives.

To access this resource, to donate, or to volunteer your time and expertise visit dutytocare.info.

ot-magazine.co.uk/jobs

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A BIG THANK YOU! from

Coronavirus Pandemic To all the front-line staff working in healthcare, social care and special educational needs, including nursing homes, residential homes, hospitals, the community, hospices, SEN schools and colleges, supported living, day services, clinics and so many more... THANK YOU! EDGE Services will re-start our fully accredited people, children and inanimate load handling training courses as soon as we can in line with government guidelines.

In the meantime, we have released guidance on moving and handling and risk assessment during the covid-19 pandemic; please see our website for details.

Our office is currently being staffed by colleagues working from home. Please feel free to enquire about training courses and please continue to use our Post-Training Support Service.

Public Courses Availab le Acro ss the UK from Septem ber 2020

Keep well and stay safe!

Level 4 Award EDGE Services will, upon request, issue extension certificates for all EDGE people/children/inanimate object handling or managing challenging behaviour ‘Key Trainer’ certificates due to expire between 9 March and 30 June 2020.

EDGE services 01904 677853 enquiries@edgeservices.co.uk

edgeservices.co.uk

Kate Sheehan Director, The OT Service

The OT Service provides high quality advice, consultancy and training to manufacturers, retailers and service providers. It also provides occupational therapy clinical services in housing and equipment to case managers, solicitors and private individuals via its handpicked network of occupational therapists.

For more info email kate@theotservice.co.uk

LOCKDOWN REFLECTION ...maybe this period of lockdown will have allowed us to look at how we work with our clients and patients and whether we can do our assessments, meetings and interventions differently

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t the point of writing this we have been told to expect another four weeks of staying at home, unless you are a key worker. Having had more time to stop and think, I am in awe of my colleagues working in the NHS and social care, their dedication, adaptability and complete selflessness is outstanding.

been absolutely outstanding.

An example of this is my mother, she has been in hospital since December and was moved to a community hospital in preparation for discharge, there was no occupational therapist in the hospital due to long term illness and vacancies, which was slowing down her discharge.

There are occupational therapists all over the country striving to provide the best outcomes for all their clients and patients and to those at the front line, I say thank you.

An occupational therapist was redeployed from outpatient hand therapy to the ward to support safe discharges, the first thing she raised with me was this was not her area of expertise but her skills were transferable and she welcomed any help and support I could give as a daughter and an occupational therapist. The relationship was therefore one of collaboration and trust and her insight into my mother’s health and wellbeing has

In a time when you cannot see your loved ones, her skills in providing sensitive and clear communication was our families lifeline and I cannot thank her enough. I am sure this is only one example of how our profession has adapted and changed due to the challenges we find in front of us.

We are all working differently and have a significant amount of stress, be this through work, worry for our families or financially. Due to this we must never forget to look after our own mental health, this means different things for different people, however some of the following may help.

1 Do make time for exercise, that walk or cycle can help us relax and process the tough decisions we have had to make throughout the day.

2 Maintain a routine, even if you are working from home, get up,

get dressed and ‘go to work’, give yourself breaks and switch off when not in work time.

3 Eat a healthy diet.

4 Avoid reading the news all the time, concentrate on good bits of news, check out Captain Tom Moore the 100-year-old veteran fundraising for the NHS, he has raised millions!

5 Stay connected with your loved ones, be that family or friends.

6 Start planning on who and where you will meet people when the lockdown is lifted.

7 You can only look after others if you first look after yourself and remember this will not last forever.

And my final thought is, maybe this period of lockdown will have allowed us to look at how we work with our clients and patients and whether we can do our assessments, meetings and interventions differently and more effectively in the future. Sometimes being pushed out of our comfort zone is good for our practice and enables us to reflect on why we have been doing things the same way for years when there are other potential ways to do things.

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PRIMA LIFT ®

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THE DISCREET WAY TO RAISE YOUR TOILET SEAT 2” / 5 cm RISE SMOOTH, HIGH GLOSS, HYGIENIC FITS ALL PAN SHAPES EASILY REMOVED USE YOUR OWN SEAT & LID FIXINGS SUPPLIED To find out more visit: gordonellishealthcare.co.uk/prima-lift or scan the QR Code

Follow us:

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call:

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email: enquiries@gordonellis.co.uk

Nightingale OTs The

Chloe Kitto is the OT leading a team of AHPs who have created and implemented training to psychologically equip the staff at the Nightingale Hospital in London for the unprecedented work they are taking on. Here, Chloe explains what this has involved and how it has been received.

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...if you’d told me back then that I’d be leading a wellness team for a field hospital in London with 4000 beds in a global pandemic developing a psychological preparedness session from a psychedelic room made for Bieber - I’d have spat out my flat white in shock

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am writing this article from a dressing room in the O2 Arena which I’m told was designed for Justin Bieber.

I think all of us can rightly say that our worlds have changed in the last eight weeks, but if you’d told me back then that I’d be leading a wellness team for a field hospital in London with 4000 beds in a global pandemic developing a psychological preparedness session from a psychedelic room made for Bieber - I’d have spat out my flat white in shock.

But, lo and behold - here I am.

I’ve been an occupational therapist for 13 years. I originally trained in Australia specialising in mental health, and upon moving to the UK six years ago, I have enjoyed working within the chronic pain rehabilitation team at the Royal National Orthopaedic Hospital, London. In a move toward clinical academia, I have been on a career break since September last year, to complete my MSc Mental Health Sciences Research at University College London (UCL). It is because of this career break that I felt able to volunteer my time when the call for help was made to support the development of the NHS Nightingale, London.

In the last week of March, a 24/7 operation began with the sole aim of being ready to train and induct staff from all over the country to start working in the Nightingale in just five days. Specifically, over the next five days, we needed to research and develop training sessions to teach essential ITU skills to a variety of staff for a COVID19-specific patient population. And in those five days I 16

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saw the very best of people; strangers to begin with, but now close colleagues with whom to laugh, cry and drink a lot of coffee. There were about 30 of us volunteers initially, and those of us with mental health expertise or interest in wellbeing formed a team to begin developing an induction session.

The wellbeing team included myself and another mental health occupational therapist, Georgia Twigg who works at the University of the Arts, London. As we sat down to discuss how to best provide wellbeing support to staff, we immediately began to explore the models of occupational therapy practice that influenced our work.

We enjoyed the visual imagery of the Kawa Model, and its emphasis on context matched well with the uniqueness of the Nightingale Hospital environment.

Also, the Canadian Model of Occupational Performance (CMOP) provided a highly sensitive framework by highlighting spirituality at the core of a person, as well as capturing all the many factors influencing occupational performance. Lastly, we drew upon our mutual experience using Mary Ellen Copeland’s Wellness Recovery Action Plan (WRAP) to help structure our skills session.

The result of this five days of work - and subsequent five weeks of work - is a concept called ‘Psychological PPE’.

Coined by one of our core team, it is the product of a strong multidisciplinary approach, iterative development, and feedback from the staff we have trained to work at the Nightingale. The aim of the 30-minute session is to

facilitate the practice of introspection (“checking-in”) for the purpose of being psychologically prepared for the Nightingale ward and the anticipated risks to wellbeing that it poses.

The PPE analogy has a high impact. We are all fully aware of the protective role PPE has against the viral risk of COVID-19. Psychological PPE is the activities and habits we ‘don’ to help protect us from the psychological risks of COVID-19 work. Psychological PPE is not prescriptive and it’s not a one-size-fits-all. The skill of introspection is practiced within the session as a vehicle to help each person identify what their psychological PPE might be. We ask our staff to think about: 1 How they might adapt their normal wellness activities to fit within the Nightingale context 2 What difficulties or challenges do they anticipate on the Nightingale ward 3 What their early warning signs of stress look like 4 What new activities or habits might be helpful to manage stress We particularly emphasise the role of sleep for the maintenance of wellness and as a protective factor against future mental ill health following trauma.

We provide a space to have frank discussions about death, moral injury, uncertainty, overwhelm, imposter syndrome, and the public image of being a “hero”.

Group after group, the feedback we are receiving from

the staff is that this should be in every hospital induction programme. It has been made clear to us that there is a significant need and openness to psychological preparedness training. Healthcare staff being given the space and the framework to explore their own stressors, early warning signs, and wellness needs, and to be encouraged to practice the skill of “checking in” to identify wellness activities and habits which become their psychological PPE. We are continuing to train six days a week and have just finalised our psychological PPE resource kit to begin disseminating to the public. My parallel role as a psychiatric research student has provided me the skills and ambition to take what we’ve accomplished in wellbeing support at the Nightingale into future research.

I’m extraordinarily proud of the occupational therapy input into what has become such an impactful and meaningful part of the Nightingale Training and Induction Programme. The focus on “doing” wellness to support occupational performance in an unprecedented work environment is a tangible example of occupational therapy in the current COVID-19 pandemic.

Acknowledgements: Dr Krishna Bakhai, GP Registrar Alex Margetts, Clinical Psychologist Georgia Twigg, Occupational Therapist Jeanne Hardacre, Independent Consultant

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Fit to work

Get drivers back on the road sooner by recommending the osteopath-designed Morfit custom-fitting lumbar support.

25% of all adults suffer from lower back pain*. With over 40 million drivers in the UK**, that means 10 million people – many of them your clients – who might be distracted or even prevented from driving.

Morfit provides long-term reduction in pain. Using air-set technology, Morfit moulds itself to fit the vehicle seat to the driver, then holds that shape to provide solid, lasting support. Support that makes driver and their vehicle fit for work.

For more information visit morfit.co.uk or phone 07757 541144.

*

RHMHRA Class 1 Medical Device.

The Prevalence of Low Back Pain: A Systematic Review of the Literature from 1996 to 1998. Walker, Bruce F. ** Statistical releases Department of Transport March 2018.

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

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GEBERIT AQUACLEAN MERA CARE

Billed as the ultimate solution to independence in the bathroom, Geberit’s AquaClean Mera Care shower toilet is adaptable yet stylish. With a free five-year warranty and shower chair compatibility, the toilet benefits from a host of simple and intuitive features. These include a pleasant water spray and oscillating spray arm to guarantee pure cleanliness, a warm-air dryer and programmable user profiles. geberit-aquaclean.co.uk/care 2

PLANTING ROLLING CART

This rolling seat allows your clients to move around the garden planting seeds or getting on with weeding in a more comfortable position.

The seat swivels around to allow full access and it comes with a tray to store tools, plants or seeds in. Helping your client get back to enjoying their garden without sore knees or backache. manomano.co.uk

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BEURER ST100 STRESS RELIEF AND RELAXATION DEVICE

This device uses heat, light and vibration to calm you when you feel stressed. It has three different timed breathing patterns to help you focus on your breaths until you feel calm and relaxed. Holding the device next to your chest allows you to be soothed by its warmth and the blue light can aid relaxation.

01482 496 931 | stressnomore.co.uk 4

PEDAL EXERCISER

This pedal exerciser offers low impact rehabilitation and exercise for legs and arms. It features a digital display that shows calories burned, duration of exercise and cycles per minute. You can adjust the resistance to suit any level and gradually increases this to build strength. It features rubber pads on the feet to stop sliding and toe straps to keep feet secure.

0345 121 8111 | nrshealthcare.co.uk 5

BUDDI

This discreet wrist band features alert buttons, a fall sensor and it works through an app that allows your client to select who they would like to be contacted in the case of an emergency. It has a long-lasting rechargeable battery and is designed to be worn at all times, even in the bath or shower.

0800 978 8800 | buddi.co.uk

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EXPLORE 5 ELECTRONIC MAGNIFIER

The Humanware Explore 5 is a handheld electronic magnifier for people with medium-severe low vision. It has a 5-inch high definition screen that focuses over items like labels, menus, newspapers and much more, allowing the user to see text and images more clearly.

It features large, bright and intuitive buttons and is simple and easy to use.

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01872 261 110 | isightcornwall.org.uk 7

ISOTHERMAL COOL BAG

If you have clients who carry medication that must be kept cool, this stylish bag is ideal. Designed to hold medical supplies for people who live with diabetes, the internal section is split into two pockets, with space for peripherals and testing equipment, as well as a cold gel pad to maintain an even, cool temperature.

01473 845 453 | diabeticsupply.co.uk 8

SALIJOL PAGE INDOOR ROLLATOR

This unique indoor rollator allows the user to propel themselves from a seated position or walk with the support of the rollator. It offers the user increased independence in their home as it allows them to move independently from room to room, even increasing access to the toilet by using the rollator as a stable support.

0333 207 2080 | rollz.com

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STAYING CONNECTED Sport For Confidence has developed an initiative that allows its occupational therapists to continue delivering support to thousands of vulnerable adults in Essex

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ollowing the closure of leisure centres and the official lockdown restrictions that came into play at the end of March, Sport For Confidence recognised that their clients would still need their support to keep fit and healthy.

They quickly developed a specialist ‘at home’ service designed to enable its entire team of occupational therapists and sports coaches to keep regular contact with clients and to deliver the support they need.

The new initiative called Stay Connected, was launched on 1 April and is fully funded by Essex County Council. In addition to supporting the 2,500 Sport For Confidence clients, the service has also closely aligned itself to the Essex Welfare Service, accepting referrals across the 14 Active Networks from learning disability

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and autism social work teams and supported living providers, widening the reach to a significant number of vulnerable adults across the county.

Lyndsey Barrett, senior occupational therapist and founder of Sport For Confidence explained:

“Sport For Confidence is a social enterprise which places occupational therapists alongside sports coaches in mainstream leisure venues to deliver inclusive physical activity sessions for those who face barriers to participation.

“When the leisure centres closed their doors, our principle concern was safeguarding our participants.

Typically, participants include adults with learning disabilities, people living with dementia, poor mental health, physical disabilities and long-term health conditions. Whilst we fully support the government’s social-isolation strategy, we were also acutely aware of the negative impact this could have on such a vulnerable group that already face challenges to getting involved in physical activity. So, we immediately went about building a solution which would enable us to continue to offer a person-centred support solution despite the challenge of physical distancing.”

Weekly Routine Stay Connected will offer each and every participant a weekly, highly personalised telephone support call from one of the eight Sport For Confidence occupational therapists. For Sport For Confidence participants, the call will take place during a time they would usually be attending a group at the leisure centre. This maintains a degree of familiarity and routine. Those referred via Essex County Council will agree a weekly time slot directly with a Sport For Confidence staff member.

Calls will give guidance aligned to that provided by the Royal College of Occupational Therapists relating to social distancing and the occupational disruption experienced during this time.

Topics covered will include: How to establish a daily routine The importance of self-care Healthy eating Rest and physical activity Goal setting Alternative ways to engage with family, friends and neighbours.

Lyndsey adds: “Participants are allocated to an occupational therapist based on geography, so each of our eight occupational therapists will take responsibility for their own caseload. In addition, our team of five specialist sports coaches will support through the provision of highly personalised physical activity home workout videos to keep participants active.”

The specialist telephone support service is backed up by the provision of information, advice, video workouts and signposting to other support services, posted on a dedicated Stay Connected page on the Sport For Confidence website, with selected materials also pushed out through Sport For Confidence social media channels.

Jess Stewart, head of commissioning at Essex County Council, says: “There are many members of our community who have the potential to really suffer as a result of being isolated. We identified a need to offer a specialist, professional service to help them through the next few weeks and months. Sport For Confidence has a team of allied health professionals and sports coaches ready and able to deliver exactly the service we need so I am very confident that, together, we will steer the most vulnerable in our society through these unprecedented times.”

Stay Connected has capacity to support thousands of vulnerable individuals across Essex with funding secured at least until the end of June. At this point funding will be reviewed based on the wider COVID-19 situation.

For more information visit sportforconfidence.com.

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E BL A !

IL A OW AV N

Up Supporting safe patient transfer and rehabilitation The Up is suitable for patients who require standing assistance but are able to contribute effort to the process. By encouraging user participation, the Up can play a key role in patient rehabilitation and on-going independence.

Key Features

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Safe Working Load 200kg / 31st / 440Ibs

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Among the lightest in its class

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Adjustable legs for access around furniture

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Padded, contoured swing-away seat pads

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5 year warranty as standard!

Contact Joerns Healthcare for more information:

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Automatic Pill Dispensers and Medication Reminders Our products are widely used by Health and Social Care professionals for vulnerable older people and those with learning difficulties who need to be reminded of essential daily tasks such as taking their medication.

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otte l r a h C urton Warbe Warburton aisir

n i y a d A .

ch ott Charl tric wheel aladr ia d d e a C w She a pa Betsi t a t is oard. therap ity Health B ht into sig rs Unive vided an in Posture e o r h has p through t G). e p (PM l u o o r r r G e h obility and M

Working in a wheelchair service is not something I had ever considered prior to taking up my current role, but I have been in the post for almost three years now and haven’t looked back. Although it did take me two years to feel fully confident, as there is a lot more to wheelchairs than I had realised!

I see children with a wide range of postural and mobility issues, and treat everyone on an individual basis, because the same condition can affect each client differently; there can also be comorbidities, including behavioural or mental health issues. I have found that my therapeutic use of self is key in these situations, as I adapt myself to each client to ensure that the process is as smooth as possible for both the client and their parents or carers.

Within my role, it can be a challenge to manage expectations regarding what the service can provide. Occasionally clients come in with pictures of what they want, or state they would like the same equipment as another client they know. This is where treating all clients as individuals, and ensuring I have clinical justification for all equipment, is key to providing equipment that meets their needs in an equitable manner. Once the needs, and how the equipment will meet them,

. f o e f i l e th e t t o l r a h C

Each month ..

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

n o t r u b War

are discussed with clients/parents/ carers, this usually alleviates any issues regarding expectations.

Occasionally, it is difficult to know which equipment will be most suitable during the actual assessment. However, I really enjoy researching and problemsolving, which these cases allow me to do. Before I started this role, I did question whether issuing wheelchair after wheelchair could become repetitive, but this has not been the case at all - I really have to think about all the different elements of equipment, and use clinical reasoning to justify my choices. However, I soon learnt that there are often compromises to make when choosing equipment; something which took the perfectionist in me a little time to get used to!

Requests for buggies can be particularly challenging. For example, it is not always age appropriate to issue a buggy; as an occupational therapist I always prefer the option that promotes independence where appropriate and, in my view, a self-propelled wheelchair gives this advantage over a buggy.

However, sometimes parents/carers are not ready to accept a wheelchair and will refuse to use it, so this must be taken into account. I would rather provide equipment that will be used, allowing the client to engage in

meaningful activities and activities of daily living, than provide equipment that is not used and therefore limits their participation in such activities.

One of the most unexpected challenges was the technical element of the role. When I was given my toolbox in the first week, I have to admit I didn’t know how to use half of the tools! But I am pleased to say, I can now make adjustments to equipment, fit hip belts and back rests, and I do also have support from some wonderful technical instructors.

The wheelchair therapist role can be undertaken by an occupational therapist or physiotherapist, therefore, it is important for me to keep my occupational identity. One way I do this is using occupational terminology throughout my notes, assessments and intervention plans whilst also ensuring my assessments are holistic and client-centred. I am proud of my profession and want to ensure I stay true to its core philosophies.

I thoroughly enjoy my role within the wheelchair service and would encourage anyone to explore available opportunities within this setting.

Find out more about PMG at pmguk.co.uk.

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Weed out bad posture.

In the UK, gardening is a hugely popular hobby for all generations. There’s nothing quite like the sense of accomplishment of seeing a flower you have nurtured, growing and blooming into something beautiful, or the satisfaction of eating your own tasty home-grown produce.

The Aysgarth, shown in Wolseley Red.

Whether your clients are the “potter about” type, or a daily all-weather green fingered gardener, you need to be sure they’re doing it in a way that limits any damage to their muscles and joints. Whilst discussing posture in gardening, HSL’s independent Occupational Therapist, Julie Jennings Dip COT HCPC said: “When carrying out activities like gardening, there is no such thing as a “perfect posture”, given the range of

actions necessary and the positions needed to get the job done. The key to avoiding damage whilst gardening is to avoid remaining in positions that cause discomfort or puts unnecessary strain on your body, whilst remembering good general posture advice.”

A starting tip that Julie recommends is if they’re going to be spending a while working in the garden, they need to warm their body up. Thankfully, she doesn’t mean the full blown moves you might see in a gym; they simply need to start out with the smaller, lighter tasks before moving on to the bigger and more strenuous jobs. If the body is more relaxed and nimble, then the larger strains aren’t going to have a damaging effect on it.

Another easy to follow tip you could suggest to your clients is to vary their

posture. Whatever it is they’re doing, encourage them not to stay in the same position for too long. This means they’ll limit the impact on any one particular area of their body, which might have led to pain developing. A great practical way to do this is to alternate the gardening tasks – you could suggest they set a 10-15 minute timer whilst weeding, then take a small break, a stretch, a swig of water and then move on to tending to hanging baskets, and so on until they come round again to weeding.

Image above: Burrows Relax 3 Seater Sofa shown in Bennington Plum fabric, Burrows Chair and Footstool shown in Volante Ruby fabric and Glenmore Fireside Chair in Saloon Smoke leather.

After they’ve spent the morning busying themselves in the garden, they’ll probably need to rest. A great way of maintaining good posture after carrying out such physical tasks is to sit in a chair or sofa that fully supports their body and encourages good posture.

Thankfully this doesn’t have to mean sitting upright in an uncomfortably stiff position.

At HSL, they make chairs and sofas are

ergonomically designed so that their customers have ultimate comfort, whilst also supporting the natural contours of their spine. Their furniture holds each and every part of the body in luxurious support.

HSL have been making quality, handmade furniture in the UK for over 50 years and have developed CleverComfort™ so you can be sure your client’s green fingers, and the rest of their body, are in the very best hands.

To see the difference HSL’s range of chairs, sofas and beds can make, request a FREE Catalogue; call 01924 507050 or visit hslchairs.com.

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Anti-slip and grip for independent living

THE OT MAGAZINE’S

Activity Toolkit

Inspired by Occupational Therapy New Zealand, we’ve created an activity toolkit for OTs and their clients who may be struggling in the lockdown

W

hakaora Ngangahau Aotearoa - or Occupational Therapy New Zealand - have said kia ora to New Zealanders on the third week of their quarantine, and introduced their fantastic COVID-19 activity recommendation toolkit (CART), which casts the eye of occupational therapy on the country’s lockdown. It’s an absolutely fantastic list of free online resources, which includes community groups and referral agencies, which will help to keep you mentally, emotionally, and physically in check for the duration of the lockdown.

The basis of their toolkit is to provide meaningful activities that will give New Zealanders who are in isolation or lockdown the potential to thrive.

“As occupational therapists,” OTNZ writes in the toolbox’s introductory paragraph, “we really understand the importance of doing meaningful activities to improve your health and well-being. That’s what the ‘occupation’ in occupational therapy refers to – doing activities of selfcare, productivity and leisure. Finding the right balance of each will help you live your best life.”

Their toolkit is absolutely fantastic and endlessly comprehensive, and you can view it on their website over at otnz.co.nz, where it isn’t hidden behind a paywall or registration.

We at The OT Magazine were deeply inspired by it, and have used it as the basis of our own version of the toolkit, that better applies to people in the UK. Hopefully, it’ll be useful to you, to your clients, and even your friends and family.

Important Numbers For your mental health CALM - thecalmzone.net 0800 58 58 58 Mind - mind.org.uk - 0300 123 3393 Samaritans samaritans.org.uk - 116 123 Cruse Bereavement Care cruse.org.uk - 0808 808 1677

For your safety Refuge - refuge.org.uk - 0808 2000 247 NSPCC - nspcc.org.uk 0800 1111 (for children), 0808 800 5000 (for adults) Urgent emergency service calls - 999 Non-emergency Police number - 101

For your physical health Don’t put off calling the NHS if you’re worried about your health because you think you might be a strain on the system. They’re there to help you. If you’re worried that you’re experiencing symptoms of coronavirus, or you have a concern, call NHS 24 on 111. You can ask them anything, whether it’s related to coronavirus or not, so long as it pertains to your health.

For financial support If your income has dropped dramatically because of the pandemic, or you’re worried about making ends meet, Citizens Advice can help you work out if you’re now entitled to benefits of some kind to help you. You can speak with them online at citizensadvice.org.uk, or call them on the following numbers: 0800 144 8 444 (England), 08000 241 220 (Wales), 0800 023 2581 (Scotland).

For information on the rules of the current lockdown If you’ve found yourself in a situation and you’re not sure what the rules are regarding the lockdown, you can check the UK government’s website for clarification. It can be found at gov.uk/coronavirus.

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Physical Health If you’re worried that you’re not getting enough exercise, there are loads of resources available for children and adults that are very easily accessible!

PE With Joe Body coach Joe Wicks is broadcasting PE lessons aimed at children from his YouTube channel every morning at 9am. The 30-minute workouts are fun for big kids too, and they encourage you to stay healthy and positive.

LV Yoga Fareham This Portsmouth-based yoga studio is offering three daily classes for free via their Facebook page. They do children’s yoga at 11.30am, and adult classes at 6pm and 7.30pm every day.

Nutrition

Keep Cooking and Carry On Airing daily on Channel 4, this cooking show from Jamie Oliver gives simple, nutritious recipes that can be cooked with ingredients you’re sure to find in the kitchen already.

He’s made everything from Korean-style chicken wings to chocolate cake.

Jack Monroe’s Lockdown Larder When you need expertise on making good, nutritious food using only a few ingredients, Jack Monroe is exactly who you should consult. Jack is taking questions on their Twitter account every day at 5pm, where you can ask what you can make from the random tins you have in the back of your cupboard.

Move it or Lose It Another company offering videos over Facebook, these classes are aimed at older people. In addition, they’ve created a support pack for older people to give them guidance on exercising at home, which is available at their website: moveitorloseit.co.uk

Emotional Health Streaming services Many streaming services require a premium subscription, but there are lots you can watch content on for free in the UK, or access as part of your license fee: BBC iPlayer - bbc.co.uk/ iplayer ITV Player - itv.com STV Player - stv.tv My4 - channel4.com My5 - my5.tv YouTube - YouTube.com Crunchyroll crunchyroll.com You can also get free trials or significantly reduced price memberships with streaming services like NowTV, Netflix, Shudder, Disney+, Apple TV, and

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Amazon Prime. Just remember to cancel them if you don’t want to continue using the services!

There’s also the option of using libraries to check out eBooks, which you can do with most memberships across the UK. If you can’t access that, WikiBooks and the Internet Archive both contain phenomenal collections of public domain literature, which can be accessed completely free of charge and is compatible with screen readers.

Podcasts are also a great way to pass the time, and you can even use them to get CPD!

Spiritual Health Staying positive is difficult, but it’s important to preventing you from

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feeling overwhelmed or out of control. Try not to take in too much from the news, and take time to perform self-care as much as you need.

Yoga, meditation, and mindfulness can help keep you grounded. The Breathe and Yoga apps are great for mindfulness and yoga, respectively.

Religious Health If you’re struggling without being able to visit your place of worship, there are lots of religious leaders who are now hosting services on Facebook Live or YouTube which will allow you to engage with religious practices from the safety of your own home. If you can, contact your religious leader and they can direct you to a service that you can take part in virtually.

Mental Health

Staying on top of your mental health is important right now. Remember - you’re not annoying or burdening anyone by reaching out. Many people will be experiencing anxiety, sadness, and loneliness just now, and you should not be afraid to reach out to a doctor or mental health professional for any help you should need.

Social Health Get on Social Media In small doses, social media can help us feel more connected to our friends, family, and acquaintances who are in the same boat as us. Social media doesn’t just have to be speaking to friends - you can browse content on Reddit, watch funny videos on Tik Tok, or get pinning on Pinterest.

Schedule Video Chats

Intellectual

Using Facebook Messenger, FaceTime, or any of the video calling clients we’ve mentioned in our article on the subject in this very issue, you can feel like your family and friends are in the same room on a video call. Remember to be patient with those who aren’t good with technology!

Learn a Language

Hangout Online

Use apps like Duolingo to finally commit to learning a new langauge. They have courses for Welsh, Gaelic, Irish, lots of European languages, and even Klingon!

Google Chrome add-ons like Netflix Party let you watch movies with friends in a group; Pretend You’re Xyzzy is a Cards Against Humanity clone that lets you make private rooms to hang out with your foul-minded friends; and websites like Tech Radar and Polygon have great guides on how you can play pen and paper role playing games like Dungeons and Dragons over websites like Discord for all the D&D nerds out there.

Learn to Draw RapidFireArt has a great website and YouTube channel which can give you all the basics you need to get into drawing as a hobby. Their website is free and easy to get started with: rapidfireart.com

Learn to Code Coding is unbelievably useful - even knowing very basic coding can get you out of lots of binds when it comes to problems with your computer. Codeacademy provides free courses in a wide variety of languages on their website: codeacademy.com.

Learn Almost Anything Khan Academy is an incredible free resource that provides concrete understanding of an astonishing number of topics. You can learn maths, physics, cosmology, microeconomics, art history, electrical engineering - there’s something for everyone and every level. Access their website at: khanacademy.org

Maintaining and Creating Relationships Familiarity breeds contempt, so if you find yourself on rocky ground with the person or people you’re living with, don’t be afraid to spend some time alone. Communication is always key! Regardless of whether you’re spending every waking hour together or apart from your significant other, you should still endeavour to create time for yourselves, and establish “date nights” to enjoy time with each other. If you’re still on the hunt for a significant other, dating apps like Tindr, Bumble, Her, and Grinder will allow you to meet other people, but remember to respect the rules of the lockdown and avoid meeting up.

Creating work/life balance Many will now be working from home, which can greatly upset your work/life balance, and you may find yourself working outside of your allotted hours as it’s difficult to maintain a schedule at home.

Using tools like Trello can keep you up-to-date with your colleagues’ schedules, and sticking to your standard work day routine will bring structure to your day, which will help see you through the working hours. If you can, try to establish a set location that you work in, and use that place for work only. This will allow you to create a physical working space, and establish better boundaries for your work/life balance.

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SINGLE HANDED CARE AND TOILETING

By Lucy Leonard on behalf of Closomat

Exploring the financial, physical and emotional benefits of single handed care in toileting As an occupational therapist, the focus of my assessments and intervention are based upon the principles of being client-centred, whilst maintaining independence, dignity and choice for the people I work with. Despite our creative methodology to enabling and rehabilitation, there are times when formal and informal care support is required to assist someone with their daily occupations. Single handed care is an approach that looks at the use of equipment and techniques to reduce the number of carers required to assist with the necessary manual handling of a person.

The drivers influencing single handed care According to the Office of National Statistics (2018), by 2041 25% of the population will be over 65. Local authorities are keen to invest in reduction in care packages to best manage their resources. However, breakdown in informal care can lead to increased cost in health and social care.

Social care in the UK has twice the average turnover of staff and this can lead to difficulty in establishing rapport, trust and continuity for people receiving care services.

HOW CAN SINGLE HANDED CARE BE SUPPORTED

BY OCCUPATIONAL THERAPY? Creative solutions using technology can reduce the number of carers required and address issues regarding budgets, dignity and independence. This needs to be supported by a robust risk assessment.

intimate care and cleanliness is one of the fundamental activities of daily living (ADLs). Do you consider toileting as an occupation when carrying out an assessment?

An activity analysis of the occupation of toileting demonstrates how it is a complex process of cognitive function, fine and gross motor movements and executive functioning. Issues such as skin integrity, cultural needs and choice also need to be analysed. We should never assume how someone carries out a task based upon our own experience.

Frequently, the provision of a raised toilet seat, or toilet frame with rails, is considered as a solution to difficulty with toilet transfers. However, we should consider the rest of the household – is this suitable for everyone else in the family?

As occupational therapists, we should also reflect upon the impact of carrying out intimate hygiene tasks on life roles, such as a father carrying this out for his teenage daughter. Is it appropriate to expect a family member to undertake this task?

If we are being truly client-centred and the person we are working with values independence and dignity over the assistance of carers, the provision of a Closomat Toilet and Aerolet Lifter could allow them to engage in this occupation without the need for carers. This of course, would be subject to an individual risk assessment.

ASSESSMENT AND CLINICAL REASONING

All too often, occupational therapists state that funding for innovative ways of working is not supported by their local authority. However, The Care Act is important when defending any clinical decision making.

A client’s ability to go to the toilet and deal with their

Section 1 of the Act states that social services have a

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duty to uphold the wellbeing of an individual. Wellbeing is defined to include nine components, among which are: PERSONAL DIGNITY Physical and mental health, together with emotional wellbeing.

CONTROL OVER DAY-TO-DAY LIFE Suitability of a person’s living accommodation.

PERSONAL RELATIONSHIPS Toileting assisted by a carer could impact on personal dignity. Waiting for a carer to call to assist toileting at a given time reduces a person’s control over day-to-day life. It could also impact on their emotional wellbeing.

MANUAL HANDLING It is necessary to consider the manual handling risks.

NHS data indicates that falls are a common occurrence among those aged 65 or over and they are most likely to happen in the bathroom. The process of helping someone on and off the toilet, and cleaning them, could pose significant risk to carers (and clients), particularly if this is not carried out effectively. The client’s hygiene should also be considered, whether they are trying to clean themselves, or a carer is performing that task.

Faecal or urinary residue could transfer via hand or body contact. Inefficient cleaning and drying could lead to moisture lesions, incurring additional healthcare costs.

year if the client needs a carer for 14 hours per week to assist with toileting.

However, if equipment is used in place, specifically a Closomat wash dry toilet and (Aerolet) toilet lifter over, the total capital equipment cost is less than £6,000.

It may be possible depending on the local authority’s policy on funding of Disabled Facilities Grants and use of Regulatory Reform Orders to further include a total 10 years’ worth of service and maintenance of the equipment as part of the purchase cost (currently £3510).

In this scenario, the equipment would pay for itself in just over nine months.

SMALL CHANGE, BIG IMPACT Adopting such a client-centred approach goes beyond monetary savings as benefits include: Dignity for the user Independence for the user Better cleansing leading to better skin integrity and improved hygiene Increased sense of wellbeing Reduced risk, to client (falling) and care giver (back injury)

THE FINANCIAL REASONING

The financial benefits are easily recognised, but more importantly this maximising of independence can have unrivalled positive effects on both a client’s and carer’s physical and emotional wellbeing.

From a financial point of view, a care package costs approximately £15 per hour. That equates to £11,000 per

For more information on Closomat products please call 0161 969 1199 or visit closomat.co.uk.

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PREMIUM RANGE WHEELCHAIR ACCESSIBLE VEHICLES Supporting case workers, OTs and other healthcare professionals Lewis Reed is the leading UK vehicle supplier specialising in the conversion of luxurious wheelchair accessible vehicles to aid the mobility of wheelchair users.

Call us on 0800

247 1001 or email priority@lewisreedgroup.co.uk

www.lewisreedgroup.co.uk

Product FOCUS

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

1

PERSONAL GPS TRACKER

Families of patients living with dementia or other conditions which may see them wandering without telling people will feel safer knowing they can locate their family should something happen. These discrete and tasteful trackers can be attached to keys, necklaces, landyards, or popped in bags, and are easily tracked via the internet.

03300 10 14 18 | techsilver.co.uk

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EMPATHY DOLL

These dolls are specifically designed to help patients who have experienced cognitive loss. They do not cry, and feature realistic proportions to a “real life� baby. The doll comes with two sets of clothing in two different colours, so their outfits can be swapped and washed if needed.

024 7642 2224 | alzproducts.co.uk 3

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RED FLORAL CRUTCHES

Ideal for service users who value style just as much as they value practicality, these crutches are available in single or in pairs. As well as a stylish design, they feature a detachable and flexible arm cuff, elbow rest, soft and washable neoprene grips, height adjustment clips, and cushioned ferrules.

01451 870 884 | coolcrutches.com

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4

ELISSE SKIN BARRIER & ELITE ADHESIVE REMOVER

The ultimate combination to help soothe and prevent sore skin caused by tough adhesives. Ideal for anyone living with a stoma. Elite is for the pain-free removal of adhesives while Elisse soothes sore, itchy and reddened skin, and creates a barrier between skin and the new adhesive for added adhesion. Available on prescription from a GP. 0800 531 6280 | trioostomycare.com 5

GEEMARC CLA2 VIBRATING PAD BLACK

This vibrating pad can be easily placed under a patient’s pillow to quickly alert them to an alarm, providing additional security in the home. It’s compatible with a number of other Geemarc products, all of which are designed for people who live with hearing loss or are Deaf, including phones, alarm clocks, and doorbells.

0800 032 1301 | hearingdirect.com 6

THERMAL ARTHRITIC GLOVES

Patients who experience hand pain due to arthritis or other conditions which affect the hand may benefit from these thermal gloves.

Available in three sizes, they offer convenient relief from pain, and feature Thermoskin and Trioxon construction to provide optimal heat and ventilation to prevent irritation caused by perspiration.

0345 121 8111 | nrshealthcare.co.uk

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Product focus

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COMFORT PILLOW

This Mystery&Melody back pillow is suitable for reading, or even catching up with some work in bed, with sturdy arm supports and a washable cover. This pillow also comes in a variety of colours and patterns for your preference, ensuring it will fit into your home dĂŠcor and keep you comfy wherever you are sitting. amazon.co.uk 8

ARCTIC TURNING BED

A multi-functional turning bed that enables single-handed care and hands-free turning with its automatic turning feature. The Arctic will turn someone from side to side through the night with its programmable design. It is also fully profiling enabling a client to turn whilst in a sitting position and, if needed, profile each leg individually.

01233 635 353 | centrobed.com

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Conference Calling We highlight some video calling software and apps that let you maintain face-to-face contact without putting anyone at risk

T

he world has been turned on its head, and no-one is entirely sure how to begin creating their new normal for the time being while we’re unable to see family, friends, or clients.

Some OTs may have been called back to work by

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the NHS in the front lines - the most honourable of tasks - and equally, some OTs may find themselves on furlough, unable to work in the job that brings their lives purpose. In the middle are the people in limbo; the ones working from home, still trying to

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maintain a semblance of some form of normality.

Video calling is a great way of maintaining both private and professional relationships, and for some OTs, it’ll be second nature at this point, either with them having done it before, or being a dab

hand with technology. For the rest of us, it’s a case of trying everything out and seeing what works best. If you’re trying to find a way to still maintain face-to-face contact with service users, your team, or even just looking to set up some family video conferencing, we’ve scoured the web for the best apps and services that will let you do face-to-face without putting lives at risk.

ZOOM

PLATFORMS: WINDOWS, macOS, IOS, ANDROID, WEB CLIENT

Zoom has risen to prominence since the mass migration towards remote working began, and it has very obvious advantages over a lot of its competitors. It has a number of pricing plans which may suit larger businesses, but small business owners and novel users will be pleased to find out that Zoom offers a very comprehensive free usage plan. In its free plan, up to 100 participants can take part in video conferencing, featuring HD video and voice, for a maximum of 40 minutes, which is more than enough time for most weekly office meetings.

There’s no limit on the number of meetings you can hold, too. Zoom will work on your computer, phone, or tablet, so there’s no need to worry if your laptop or home computer doesn’t have a camera attached. To use Zoom, all you need to do is sign up, which is free, and download the app.

FACETIME PLATFORMS: macOS, IOS

The sheer convenience of FaceTime makes it a great option for many, especially in situations where you may be calling people who you know make use of an Apple device, like an iPhone or iPad, but don’t feel confident downloading and installing new apps. Ultimately, it may be easier to use FaceTime for many video conferencing scenarios, as group video calls are convenient and simple to do, and only rely on the “host” - the person instigating the video call - knowing what to do. There are obvious downsides to FaceTime, however: you need to have the mobile numbers or Apple IDs of whoever you’re calling, which may cross professional and personal boundaries should you decide to try using it with clients, but it would likely be one of the go-to apps for personal video calls.

GOOGLE DUO PLATFORMS: ANDROID, IOS, WEB CLIENT

If your main concern with video calling is that you don’t have a particularly fast or stable internet connection, Google Duo is a great choice. The lesser-known app is optimised for use on phones, so it doesn’t use very much bandwidth, while still offering 720p HD video calling, meaning there’s no loss in quality when compared to its competitors like Zoom. Duo allows for small group video calls, and supports up to eight people in one video call, making it an ideal choice for small teams, and allows participants to drop in and out whenever they like, so it’s also convenient for those who find things getting in the way of their call. The app is free, and can be accessed from mobile devices, tablets or using Google’s web client. Unlike the others, it also allows you to send short video messages, which is a great voicemail-like function of the app.

DISCORD

PLATFORMS: WINDOWS, macOS, ANDROID, IOS, LINUX, WEB CLIENT

Discord is a favourite of many streamers and content creators who value its use as the kind of spiritual successor to Skype as the go-to VoIP (voice over internet protocol) for people to chat while they play video games. Its usage has evolved outwith gaming, and it’s a valuable piece of software for those who want to take part in online conference calls. Video and audio calling are available, and it also allows you to simultaneously send text, images and video in a connected chat, so if you have files to send to multiple people in a call, it’s worthwhile investigating. It’s also available on almost any platform, which makes it ideal for expansive teams with different levels of tech knowhow.

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Specialist Insurance Packages for Occupational Therapists In Private Practice

BALENS

Specialist Insurance Brokers Balens provide specialist packages to cover Occupational Therapists & Case Managers » Professional, Liability and Malpractice Cover » Public and Products Liability Cover » Limit of Liability of £6,000,000 » Multi Therapy cover (subject to qualifications)

» Cover for working abroad

(temporary trips abroad excluding USA and/or Canada)

» Legal Protection Cover » Automatically provides cover for your business activities online (USA & Canada by referral)

Telephone: 01684 580771

Web: www.balens.co.uk

Email: info@balens.co.uk

Balens Ltd is Authorised and Regulated by the Financial Conduct Authority

INSURANCE CONSIDERATIONS FOR OTS, CASE MANAGERS AND OTHERS DURING COVID-19 LOCKDOWN

By Claire Squire, Balens Specialist Insurance Brokers

I

n these strange times that we are all currently faced with, many are now working from home, possibly for the first time, either completely or perhaps on a part time basis, whilst they are still visiting clients. Here are few insurance and Risk Management points to consider during this time: Inform your home insurance provider that you are working from home. Although the government have requested that we all work from home where possible; it is a requirement of your contract with your insurance provider to inform them of all material facts relating to the risk to be insured. Providers may have clauses relating to home working that you will need to be aware of.

Similarly, if you have empty business premises, check with your insurer whether there is an unoccupancy clause. Many may be offering extensions during these unprecedented times, but it is important to check to ensure that you are still complying with terms and conditions as necessary. We have further risk management guidance related to this at balens.co.uk/covid/ covid-unoccupied.aspx.

If you are having trouble paying for your insurance policies as a result of COVID-19, particularly when paying by credit, contact your provider or broker in the first instance, as new rules relating to finance may offer assistance.

We have further articles and information related to Risk Management on our website, please visit balens.co.uk.

Remember to stay safe.

For those of you that don’t know us, Balens, established in 1950, are a fourth generation, ethical, family run Insurance Brokerage focusing on guidance, support and service. We have been providing tailored insurance policies for occupational therapists and related professions since the mid-1990s, offering a wide range of services for individual and business requirements.

Contact Balens at on 01684 580 771, email info@balens.co.uk or visit balens.co.uk.

BEYOND

COVID A new online platform has been created to connect and empower global citizens to engage in meaningful occupations. Anna Braunizer and Esther Dark are two of the OTs behind this resource, and here they explore population-based practice using online enabling strategies

Occupation determines the chief rhythm of our life, balances it, and gives meaning and significance.

An organ that does not work atrophies and the mind that does not work becomes dumb Sigerist, 1955

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uman beings are fundamentally occupational beings; that is, through the medium of occupation, one develops health and wellbeing.

With the COVID-19 restrictions in place, we are all experiencing occupational deprivation, where a person or group of people are barred from what is necessary or meaningful in their lives due to external restrictions.

Furthermore, the opportunity to perform occupations with social, cultural and personal relevance is rendered difficult, if not impossible. Not only this, but we are also experiencing occupational imbalance, which occurs when a person is unoccupied, under-occupied or over-occupied. Many of us are experiencing feelings of depression and anxiety as we lose connections with our meaningful occupations, particularly our social occupations.

Occupational apartheid, as stated in Kronenberg, Simo, Algado, & Pollard, 2005, in Precin et al., 2018, is the “systematic marginalisation of specific groups in society in ways that deny or restrict access and/or ability to engage in meaningful and purposeful occupations of daily living”. During COVID-19, occupational apartheid continues to exist: the lives of marginalised communities within the global population continue to be disproportionately impacted by policies developed in response to the pandemic. From an occupational justice perspective, occupational therapists have a lot to offer in the current climate. We can support and empower individuals with participation in daily life, address inequities and promote opportunities and choice.

Anna Braunizer – Canadian-based OT Esther Dark – UK-based OT

Population-based occupational therapy practice addresses occupational injustices affecting public health and wellbeing to minimise inequities in participation and wellbeing at the population-level. As an emerging practice area, AOTA’s Centennial vision and vision for 2025 identified the potential for occupational therapists to act on a global scale and address societal

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occupational needs. With COVID-19, this global interconnectedness is developing rapidly through online spaces, communities, and forums. The potential for occupational therapists to play a role in contributing to the reduction of occupational apartheid, promote occupational balance, and enable community wellbeing during and beyond COVID-19 is apparent. In their community-centred practice framework, Hyett and colleagues identified ‘Facilitating Online participation via Social Media’ as one of the key participation enablement strategies. In a world where we are all physically distancing, we need to use the means available to us and get creative. It makes sense to use online platforms for virtual service delivery.

Esther has been responsible for editing the blog contributions from authors from around the globe; sharing their tips on doing, being and stories of hope. It has been insightful, inspirational and humbling to read the narratives of so many, and just how resilient we can be in the face of such uncertainty. Whilst Anna has been directing and managing beyond COVID and supporting a team of volunteers to contribute to the website.

In response to the COVID-19 pandemic and as a way to enact population-based occupational therapy, with the population being those impacted by the COVID-19 pandemic, Anna Braunizer, a Canadian-based occupational therapist, gathered up a team of OTs and other AHPs across the globe, including myself, to launch an occupation-based online platform: beyondcovid-19.com and @beyondCOVID (Twitter, Instagram, and Facebook).

Beyond COVID is an online platform that has been developed to enable and empower global citizens to engage in their meaningful occupations, routines, and roles, and move from surviving to thriving. Exploring emerging roles for occupational therapists, the website hosts: What Do You Need - a simple needs assessment for citizen engagement The Doing Library - a plethora of educational, academic, and online activity resources for promoting public health and wellbeing during COVID-19 Daily Doing missions - behavioural activation through the @beyondCOVID social media channels. Missions are designed to target the domains of experience outlined in the Do-Live-Well framework The ‘Do What You Love’ blog - people from around the world can connect, share, and offer advice on adapting and re-engaging with what is meaningful to them The ‘For Hope’ gallery - images and words to inspire hope, resilience, and compassion

Also in development: A ‘For Health Professionals’ section - for the online health professional community. Here you will find resources on professional development opportunities, strategies for pivoting to telehealth, and resources for those on the front lines The beyond COVID podcast - to increase the accessibility of our content and reduce potential screen time One of our key values is community - we are exploring options to host co-occupations, occupations that can be performed by more than one person in a shared social, temporal, and spatial (in this case online) space, and collective occupations, community occupations with socio-political intentions.

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If you would like to contribute to the blog or get involved with the team, please email anna@beyondcovid-19.com, or complete the form available at beyondcovid-19.com/join-the-team.

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WHAT IS REBOUND THERAPY?

By Eddy Anderson and Paul V Kaye

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

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

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

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

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

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

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

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

Sunken Trampolines are the experts in providing trampoline solutions for schools, care institutions and families across the UK.

For a free consultation and site survey please contact us and we would be more than happy to help.

Contact: Joel: 07801 573278 / Angus: 07765 256537 sales@sunkentrampolines.co.uk / www.sunkentrampolines.co.uk

Paediatrics All the latest from the world of paediatrics

SECTION lice Gair is a paediatric OT and personal blogger on Instagram – you can find her at @themummyot and she is well worth a follow. Last year, following a dramatic arrival, Alice gave birth to a beautiful baby boy, Reuben. Reuben was born with a limb difference and here Alice has shared her experience of the journey she had as a mother and an OT in understanding the implications of his difference. She explains how this experience has improved her perspective as an OT when working with parents. You can read the full

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article on page 48.

Summer is nearly here, and even though the world is essentially closed for business, there are still plenty of fun activities you can get your younger clients involved with.

Time to get messy in the name of fun interventions.

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You will also find our usual array of colourful kids’ products to help and entertain your younger clientele. As always, we would love to hear any recommendations of interventions, products or activities that could aid your peers and benefit kids, please contact ros@2apublishing.co.uk.

Read on to find out more...

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Tackling

PICA Occupational therapist Rachel Peek, from charity Together Trust, has implemented an innovative way to help vulnerable children who are showing symptoms of the eating disorder pica

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ica is a compulsive eating disorder that involves eating items that are not typically considered food and that do not contain any nutritional value. These items can include hair, dirt, leaves, paint chips, paper, soap and many other non-food items.

It can occur in young children, adolescents and adults, and it has been recognised to often occur in individuals who are living with autism, a learning disability or other mental health disorder.

It can be common in pregnant women as well, this is often in response to an iron or zinc deficiency.

If left undiagnosed it can cause a serious risk to the health of the individual.

By ingesting non-food items your body is put under a lot of strain trying to break these down and if this behaviour is occurring frequently it can result in stomach pain, constipation, diarrhoea, vomiting, blockages or infections.

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Rachel Peek works at the charity Together Trust and she has created an innovative way of helping the young disabled children she works with who are affected by pica.

Rachel explained: “I first became interested in Pica when Mary, my line manager, gave me an article detailing a case in which a young man suffering with the condition tragically died.

That set me thinking about the children on my own caseload and when I observed some students sitting under a tree eating leaves and twigs I decided there and then to do something about it.

“I worked with teachers and teaching assistants to draw up a list identifying students who had either already been diagnosed, or who often sought out non-edible items. We found five children who manifested classic pica symptoms, only one of whom had a pre-existing diagnosis.”

Rachel set about researching interventions

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to implement with the five children they had identified with pica symptoms. Her research led her to discover the pica box, a concept initially put forward in 1995 by Mike Wilson.

Since then there have been successful examples of the use of a pica box with children displaying pica symptoms.

WHAT IS A PICA BOX? A pica box is a box with compartments in it to separate items. These compartments are then filled with edible items to replace the non-food items that the individual has been eating. The food items used must represent the texture or look of the non-food item that the individual has been consuming to encourage them to choose these.

Rachel implemented this intervention with the children she was working with and utilised a homemade pica box of her own.

“When I read about the Pica box I knew that this was an intervention I

could introduce to the children I was working with and so the next step was a trip to my local DIY store, where I bought a plastic box into which I fitted some compartments.

“We’d already compiled a list of the non-edible items the children most often ingested and into each compartment I put edible alternatives, in terms of both appearance and texture. For example, twigs were replaced with vegetable sticks, Twiglets and celery sticks. Leaves were replaced with spinach leaves and crisps; sand with grape nuts and gravel with crushed digestive biscuits and cornflakes.

“I filled that first prototype box with the edible alternatives, labelling each item and listing what non-edible item it was replacing and I put the picture of the first student we were working with on the front of the box.

On the back of the lid I posted a short explanation of what a pica box is, for the teachers and teaching assistants. On the back of the box I also posted some additional pica strategies”.

The first implementation of this technique was an instant success, as Rachel explained: “I approached the student, who was sat in the playground eating twigs, and I offered her a celery stick and asked her to drop the twig. Not only did she do so she also tapped the box when she’d finished the celery stick and asked for more!”

Following this success, Rachel met with the teachers, teaching assistants and her fellow

occupational therapists to train them in how to utilise the pica box effectively.

She went on to create each individual child that had been identified as showing signs of pica, their own pica box.

Jill Sheldrake, Service Director at the Together Trust commented on the success of the intervention: “Rachel may only have been with us as an occupational therapist for a year but she’s actually been working for the Together Trust for more than seven years, having started off as a support worker.

“Through hard work and determination she’s made the most of the opportunities available within the charity. With work like this she’s not only continuing to progress in her career but she’s also making an important contribution to furthering awareness of pica, both at the Together Trust and in the wider professional community.

box intervention she’s made real and positive changes in the lives of some of the children we support. We couldn’t be more proud of her.”

Find out more at togethertrust.org.uk.

I observed some students sitting under a tree eating leaves and twigs I decided there and then to do something about it

“And by successfully implementing the pica

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Other Side FROM THE

By Alice Gair

When paediatric OT Alice Gair’s beautiful baby boy was born with a limb difference, she realised how important it is to view the parents’ perspective as an OT.

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’m Alice, a paediatric OT, NHS England clinical entrepreneur, and personal Instagram blogger over at @themummyot. I’m part of a small, but close-knit OT team, and we see children in the community from birth up to adulthood for any functional difficulty. I love my job; how diverse it is and how I can work with children to help them achieve what’s really important to them (playing Marvel characters is a personal favourite). I’m especially interested in the sensory side of things and recognise the importance of its role in emotional wellbeing and in a child being able to achieve their full potential. With this in mind I founded The Sensational Thinking Project which aims to better meet the needs of these children through OT. My future aspirations are to branch out my work into Neonates and to join up with more services under the wings of the project.

About this time last year I was a career driven, passionate, albeit a little whacky paediatric OT, working to a tight deadline for the project before I went off on maternity leave to have my little boy

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at the end of May. I was quite worried about this as despite the support from my Trust, manager and team; I knew that it was inevitable that my career was about to take a step back.

The tables turned for me in April when things became complicated. I had to leave work early and I had to prepare for a baby that may need some time in the special care baby unit (SCBU). I spent six weeks at home worrying about what was going to happen, by which point I was certainly not your typical glowing and bouncing mummy-to-be. One planned induction-turned emergency c-section later, and our gorgeous tiny little Reuben was born. We consider ourselves lucky that despite the weeks of worrying, of what ifs, and figuring out the logistics of having a baby on SCBU (where will I stay; how often can I have skin to skin and so on) that he was fine and didn’t need any of this specialist intervention. He was however, born with a cleft hand, that was completely unexpected and never detected on any of the zillion scans we had. The shock from this tainted

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the first few months of life with Reuben (along with some sedativeinduced expletives on the operating table).

I honestly could not believe that as an OT that this had happened, and I repeatedly said this in complete disbelief on a daily basis for weeks.

What followed is what I can only describe as an emotional rollercoaster, and a battle between my heart and my OT head. My head was telling me he would be fine, he would learn to adapt and there are amazing options out there. Whilst my heart (as well as dealing with the ‘baby blues’) was overwhelmed with grief, anger and fear about how he was going to cope with being different to other children. Every time I woke, for a split second, I wished it had all been a dream and I would roll over and he would be there with two perfectly

formed hands. Then the tears would roll. I couldn’t face leaving the house; I was afraid to take him to groups and every time anyone came over to see him (as they do with newborns, even complete randoms! What is all that about?) I felt sick about the moment I would see their face when they spotted his hand.

When I did start to venture outside I hated seeing other people with their perfect, happy bundles of joy, and I hated it even more when they talked about how wonderful their birth was and how precious this time is.

“Isn’t maternity leave the best,” they’d say, blissfully unaware that I was seething with resentment, jealousy and wished them the biggest poonami woman has ever known (yes I was a bitter, twisted woman). Being told that being an OT, I’m the perfect mum for him just

This whole experience has completely changed my perspective on my approach as a children’s therapist of what our patient’s parents might be going through made it worse - and I got this a lot. Then followed the feelings of guilt as I reflected and thought about all the people out there who do not have the gift of having a child, and about the children who have much more

serious conditions that are facing their own battles.

Why am I telling you all of this? This whole experience has completely changed my perspective on my approach as a children’s therapist of what our

patient’s parents might be going through - the key stakeholders in our future generation.

I understand now the impact of a complicated pregnancy both physically and mentally; that having a baby sometimes isn’t the most joyous thing in someone’s life, and that despite being surrounded by people, you feel like the most isolated person in the world, the frustration of having to repeat your story to countless numbers of professionals, not being given the answer that you wanted, or even an answer at all!

It emphasised to me the importance of mental health and wellbeing - I tried to skip forward, be the practical, problemsolving OT and suppress the emotion, but it was just too great for me.

Looking back, I am so glad I rode that wave - I actually cringe thinking about how unrealistically positive I may have been when working with some families and not recognising what their journey has been like.

My counsellor hit the nail on the head when she said to me that I just wanted someone to acknowledge what

had happened - this whole journey has not been what I wanted, or imagined and my child does have a disability.

I don’t want the mini violin brought out; I just needed someone to say it is ok, even as a health professional, not to be ok.

I thought I knew where I was going, and how I was going to get there, but the rocks and riverbeds cropped up, shifted my own occupational needs drastically but to be a good parent and a good OT, I needed to look at and listen to them. I’m pleased to say that I have made it past most of the big rocks now and every day Reuben surprises me with things he can do that I never thought he would be able to. I do (sometimes over) apply my OT skills with him and I can see how this is a silver-lining for him as he grows older and encounters various problems, and I am proud to be able to say I am his mummy OT. With thanks to Caz at Mind, the Great North Children’s Hospital and to Reach Charity for Children with Upper Limb Differences for all of your much-needed support over the last 12 months.

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CRAFTING IN THE

SUNSHINE Summer’s coming, so why not introduce a little sunshine and fun into crafting activities that benefit children while they entertain them?

When the schools break for summer, the first place many people go to keep children occupied is the arts and crafts box. Whether it be painting, cooking, or papercrafts, the act of making something engages both the imagination and fine motor skills, allowing children to hone their hand-eye coordination without ever really knowing they’re doing it. Projects like these, which benefit a child in a number of therapeutic ways, are easily disguised as a fun activity that they can show off the results of to their families and friends.

Bubble Wrap Painting (Adapted from learning4kids.net)

This is a fun, messy activity that provides both auditory and tactile stimulation for children, and allows them to express their creativity through painting. It’s also great for developing hand-eye coordination and developing shape recognition!

What you’ll need: Long trays - like the kind meat from the supermarket comes in Bubble wrap Paper Scissors Washable paint How to make it:

Watermelon Bark (Adapted from hellowonderful.co) This recipe is ideal for improving understanding of spatial awareness, motor skills, and dexterity. Children will enjoy the challenge of creating the shape of the watermelon using just the right amount of pressure from the piping bags - but they’ll enjoy eating it more afterwards!

What you’ll need: 500g unflavoured greek yoghurt Green and pink gel food colouring Chocolate chips Piping bags 8 inch round cake tin Parchment paper How to make it: Line your cake tin with a round piece of parchment paper at the bottom. Separate your yoghurt out into two bowls; add 150g of yoghurt to the first, and 350g to the second. Add green food colouring to the 150g of yoghurt, and pink food colouring to the other bowl of yoghurt. Decant them into separate piping bags, and pipe an outer circle of green around the edge of the cake tin to form the rind. In the centre, pipe the pink yoghurt, right up to the edge of the green yoghurt. Add in the chocolate chips to represent the seeds, then freeze for at least 4 hours. Once it’s frozen solid, take it out of the freezer, let it sit for a few minutes, then crack it into pieces and enjoy!

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Get your roll of bubble wrap and cut out an assortment of shapes - squares, triangles, circles, and so on. Lay out the paper on a safe surface, like a table covered with a protective cloth or outside on garden slabs, and add coloured paint to the long trays. From here, the children can take over - smoosh the textured side of the bubble wrap into the tray full of paint, and create all sorts of colourful, vibrant and cool designs with the bubble wrap.

It’s a fun activity to get involved in, but make sure you’ve got easy access to somewhere that everyone can easily wash their hands, otherwise you may find paint all over the walls and doors!

Fizzy Glitter Potions (Adapted from artfulparent.com) The best thing about summer is getting to do arts and crafts activities outside, because it makes cleaning up the inevitable mess so much easier. In that respect, this is probably the premier outside crafting idea, because it’s the most fun children can have in a mess. It’s a great sensory craft, too, stimulating visual and textural senses.

What you’ll need: Baking soda White vinegar Biodegradable glitter Gel food colouring Cheap containers Spoons Pipettes How to make it:

Toilet Paper Bird Feeder (Adapted from theresourcefulmama.com) With a lot of these kind of crafts, you end up with something that you either have to eat or throw away, and while eating is always fun, you may not necessarily want to encourage children to eat sweet treats too often. This is a fun sensory activity that, once it’s done, you can hang out in the garden and enjoy waiting for the birds to come and enjoy it.

On a table or a flat surface that’s been set up outdoors, and preferably covered with a removable protective cover, set out the items you’ll need to make the potions in easily cleaned containers. From there, it’s just a case of encouraging children to experiment with what they want to create. Give them a bowl, and encourage them to mix the baking soda and white vinegar to create a fizzing reaction. From there, they can add food colouring and glitter to make it all their own. There’s no real set structure to this kind of play; it’s just a case of encouraging children to make their own glittery potions and enjoy the sounds of fizzing, the textures of the mixtures, and visual stimulation that the colour, fizzing, and glitter provide!

What you’ll need: Smooth peanut butter Ice lolly sticks Bird seed Empty loo rolls String How to make it: In a long tray - like a baking tray or crafting box - pour in loose bird feed. Take the empty loo rolls and coat the outside in a thick layer of peanut butter using the ice lolly sticks, making sure you cover the entire outer section of the cardboard roll. Once this is done, take the cardboard roll and carefully roll it over the bird seed that has been laid out in the tray. Do this as many times as you need in order to cover it completely. Once you’ve covered all of the loo rolls, pop them in the fridge for an hour to harden up a little bit. Take them out, and thread a piece of string through the roll, then tie in a knot. Hang it up in the garden somewhere that can easily be seen from the windows, and wait for little birds to come and nibble at it.

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

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SMENCILS SCENTED PENCILS

These fun pencils are made from 100% recycled newspapers, and provide an assortment of colourful smells that are guaranteed to last for at least two years. They provide sensory stimulation for children, and may help to encourage them to write or draw, with pencils scented like strawberry cheesecake, rainbow sherbet and more.

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BODY MASSAGE SENSORY BAG

Ideal for those whose work makes use of the Wilbarger protocol, this massage sensory bag offers everything a child may need for therapeutic deep pressure and tactile simulation. The bag features a wide assortment of textured toys and brushes which can be used as part of therapeutic intervention.

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MAGNETIC SKETCHPAD AND DRAWING BOARD

A great tool with a wide variety of uses, this magnetic sketchpad helps to foster creativity while developing fine motor skills, handeye coordination, spatial awareness and visual perception. It’s also great for use with non-verbal patients, and can be a very useful learning tool for children who live with dyslexia or dyspraxia.

020 8953 4484 | happypuzzle.co.uk

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WEIGHTED TOY KOALA

An ideal companion for any child who needs additional sensory feedback, Kevin the Calming Koala is a soft, fuzzy, weighted bear who can help encourage feelings of calm. At 33cm tall, he’s larger than traditional weighted toys, but is smaller than a weighted blanket, meaning he can be carried around with ease while out and about.

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PEANUT BALLS

Perfect for use with patients who need to develop balance and coordination, these peanut-shaped therapy balls encourage children to build strength and improve posture by using their core muscles.

Four different colours and sizes are available, all of which are large enough for a child to comfortably sit on.

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BUNGEE HOP AND JUMP POGO

A fun way of developing core strength, developing gross motor skills and balance, and vestibular and proprioceptive input, this foam board pogo is also much safer than a traditional pogo stick. The Bungee hop is really easy to use, and is a great summer activity that’s easily folded away when not in use.

0800 138 1370 | tts-group.co.uk

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Rebound Therapy Training Course

We are the largest provider of HP expert witnesses in the UK, renowned and respected in the field

Join our expanding team of experienced Occupational Therapists

Rebound Therapy has a huge number of benefits for children and adults across virtually the whole spectrum of disabilities.

The Rebound Therapy team of approved tutors provide accredited training courses throughout the UK for: Occupational Therapists, care staff, schoolteachers and TAs, sports club and centre staff, and more.

The course includes training in planning, measuring and recorded progress using the internationally recognised Winstrada programme and the Huddersfield Functional Index

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

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You will be working at a senior level with a minimum of 8 years post qualification experience as an OT or/and case manager Request an information pack at admin@somek.com

For further information, or to arrange a training course, please contact us at: email: info@reboundtherapy.org or Tel: 01342 870543 or visit our website at www.reboundtherapy.org Rebound Therapy - Top Right RHP

OUT OF

ROUTINE The world has come to a crashing halt, but establishing a routine may be exactly what you need to restore a little order to your world

Remember when you were young how exciting the summer holidays were at first? You’d leave school on the last day of term and emerge with all these wonderful ideas of what you would do, where you would go, and how you were going to pass all this time you’d been blessed with. A few weeks in, you would find yourself unbelievably bored, and it would only get worse.

For many who have been placed on furlough or have had to stop working to protect themselves and their families, you’ll be weeks into the boredom stage. As adults, we find purpose in work, and many of us don’t realise or question the structure and routine the working week provides us.

As OTs, you’ll understand the importance of

establishing a routine.

It’s one of the primary methods employed when getting people back into their ADLs: you make a routine out of the intervention, and ask your client or service user to perform that as much as is needed in order to get them back into the lifestyle they want.

When it comes to turning the mirror inward, we seem to forget how to apply techniques like these to our own lives, in spite of how helpful they are. Creating a routine for your day will help you establish some semblance of order in the chaos we’re experiencing right now, and can even help to alleviate some of the anxiety, while also helping to establish a sense of purpose.

They say it takes 28 days

to establish a habit, so give yourself a month to get into the swing of things as much as no-one wants to go another month of lockdown.

Even if your routine is as simple as establishing when you need to get out of bed, eat lunch, and eat dinner, it’s still providing your day with structure. If you’re the kind of person who needs structure to thrive, then just having basic points on the clock with which to associate your routine will greatly benefit you in the long run.

Structuring your day to create a routine does not mean you need to find time to write your magnum opus or compose a great symphony unless you want to do that. It’s not a means to regulate

the productivity you’ve convinced yourself that you absolutely must have now that you don’t have to go to work. But it may encourage you to “eat the frog” - a fun expression which means doing the thing you want to do least.

Or maybe you’ll finally commit to doing yoga when you wake up or before you go to sleep.

Maybe you’ll give yourself an hour to sort your CPD once a week; maybe you’ll read the journals you’ve been meaning to get on top of.

The choice is entirely yours, and your routine is entirely yours to decide.

Once you get structure in your days and establish your routine, you may find it easier to cut through the chaos and find a little peace in what is now a restless world.

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FACE MASK

BARRIER THE

Susan Griffiths is the ASD occupational therapy lead in Children’s Therapy Services at Poole Hospital NHS Foundation Trust. Susan is a hearing aid user and lip reader, and she is raising awareness of the vital communication barrier that face masks are currently posing to the hearing loss community, and many others who rely on facial expressions and facial cues for effective communication.

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here are 12 million people with hearing loss across the UK – that is one in six of us. I am one of those people. I am a hearing aid user and lip reader and I rely on both to be able to communicate effectively with people, especially in my role as an occupational therapist.

As a Deaf person and as an OT, I have always been aware of the impact the environment has on our disability. If we do not get the environment right then our

environment can be our worst enemy. At the beginning of April 2020, one single change to the environment has made me more disabled than I have ever been in my life – the introduction of face masks.

I work in Children’s Therapy Services at Poole Hospital NHS Foundation Trust and as a result of the coronavirus, my colleagues and I have been asked to support on the adult in-patient wards.

After spending two weeks completing all the training required to be able to support on the adult in-patient wards, I found myself on the orthopaedic ward surrounded by staff and patients all wearing face masks.

I could no longer use my lip reading skills to help me determine between different sounds and words to ensure that I interpret what I hear accurately. To give you an insight, I am able to interpret 95% of what is said using both hearing and lip reading. With hearing alone, I can only interpret around 30 - 40% of what is said, and only if the environment is quiet.

I had seriously underestimated how much I rely on lip reading until that ability was taken away from me. As a result, I am no longer able to work directly on the wards to support my colleagues and work with patients.

I had so many emotions running through me. Guilt that my colleagues are putting themselves at risk every single day whilst I am office bound. Frustration because I know I can do so much to help as an OT, but I can’t because the face masks prevent me from using my lip reading skills to be able to communicate effectively.

I have so much anxiety about the future. Will wearing masks become the new norm and how will I overcome this communication barrier? I also feel a sense of disappointment as I have been let down by society. This pandemic has really highlighted the lack of Deaf awareness in our society. Why has it taken a pandemic to realise that face masks are a significant

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communication barrier, not just for the hearing loss population, but also for people with dementia, learning disabilities and very young children.

For people that can use their residual hearing, ensure the environment is quiet, speak loudly and clearly.

As an OT, this has made me realise that if I am struggling with masks, how many out of the 12 million people with hearing loss living in the UK are also struggling. Currently the government are not recommending face masks to be worn in public but this could change at any time.

The impact of this on our ability to engage in everyday activities such as shopping, meeting friends for coffee and attending medical appointments will be devastating.

You can follow Susan on Twitter at @SusanGriffiths5.

The single flaw in the design of face masks is the fact that they are not see through. On Twitter, an American college student generated a lot of interest after she shared a homemade clear mask that she made.

However, this is only beneficial if it is recognised that every single mask needs to be replaced by a see through mask and worn by every single person in society. In addition, for see through masks to be used in health environments, they have to be economical and meet stringent standards to ensure they are safe and protect us from viruses.

Finally but most importantly, please continue to raise awareness of the communication barriers that face masks pose for the people who rely on reading facial expressions and lips to support their communication.

Many of the online BSL courses are being offered for free during this pandemic so make the most of this opportunity

The reality is that this is not going to happen, at least not now during the pandemic when face masks and other PPE equipment are scarce. However, I do hope that in the future, this is something that we can learn from and hope that see through face masks become the norm.

What can we do?

Check with your employer if you can purchase see through masks such as the ClearMask (theclearmask.com) or The Communicator Surgical Mask (safenclear.com).

Check with your family, friends, colleagues and patients who are lip readers and ask them how they prefer to be supported.

If you work with patients, ensure there is a plan in place on how you are going to communicate with them, especially if the removal of masks or see through masks is not an option.

Use gestures and sign language. If you don’t know how to use sign language, now is the time to learn. Many of the online BSL courses are being offered for free during this pandemic so make the most of this opportunity.

Write things down using pen and paper. If you are working on the wards, then use a mini white board which is easy to clean. Alternatively, text or type to your patient using your phone, tablet or computer.

Use communication apps that convert speech to text such as Google Live Transcribe or Otter. For BSL users, use the ‘Now Interpreter’ app where you can video call a BSL interpreter for free.

Use video calls. If you work on the wards, then go to a room where you can safely remove your mask and then talk to the patient via video calls. If possible, use video conferencing apps with live caption functions, for example, Microsoft Teams or Google Hangouts Meet.

This means that automatic transcribed closed captions (also known as subtitles) will appear on the screen as people talk.

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EARLY

INTERVENTION Optalis provides care and support services to older people and adults with disabilities, across the Berkshire region. Minoeska Teeuwen is the lead OT service manager there and her knowledge, experience and ability to drive change is being utilised to support and develop the occupational therapy service

Occupational therapists and OT assistants at Optalis offer years of experience and thorough knowledge of techniques, theories and technologies to ensure people’s support needs can be met as

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efficiently as possible.

Lead occupational therapist service manager for Optalis, Minoeska Teeuwen along with the Optalis occupational therapy team have worked to trial an alternative way

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of working to address the high amount of preventative, bathing OTA referrals in Windsor and Maidenhead at the end of 2019.

Maintaining personal hygiene is important for all of us. The ability to bathe independently is considered important by many people. Bathing is often the first type of support needed due to balance coordination and sensory feedback; and with that an early response is required to remain safe and independent.

As occupational therapists, we fundamentally believe

that health and wellbeing is achieved when a person is able to do the everyday activities they want, aspire, or need to do, and in a way of their choosing.

Not all clients will have the medical requirement to bathe, however it provides many with a sense of physical and emotional wellbeing.

This is especially the case when they feel loss of control in other aspects of their lives. Benefits often verbalised by people, relate to their increased resilience to cope with the psychological impact associated with living with a long-term condition.

The project, which has been tailored to the local area, specifically aimed to reduce the number of referrals for a daily task considered desirable but non-urgent within context of the long-term occupational therapy service. The team wanted to offer timely and early

As occupational therapists, we fundamentally believe that health and wellbeing is achieved when a person is able to do the everyday activities they want, aspire, or need to do

intervention alongside a standardised and transparent approach; a focus on preventative work.

The OT team had a desire to explore options of addressing these referrals in a more effective way and suggested for several residents, in one area, to be assessed on one day while not being given a set time. Equipment would be taken along to trial and potentially provided during this assessment.

The aim was to be a timelier and more costeffective service, reducing dependency amongst

residents while remaining person-centred in our approach.

Practically, the project was led by one senior OT, Clodagh Chapman, and one OTA, Carol Farry, assessing up to six residents in one day, either once or twice a week.

Small and regularly used bathing adaptations were taken on visits in order to assess, demonstrate and be provided at time of assessment if applicable. If needs are unable to be met with minor adaptations, the OT explains the next steps and if the resident would

be eligible (for a DFG application) the OT can take on the case or the referral may be placed on the OT allocation list.

A review following an eight-week trial of a new way of working within the PDOPT OT Service has shown promising results: The OTA Greenpreventative-referrals for bathing needs were reduced by 84% within the first seven weeks of the project.

53 residents were assessed by the OT and OTA during the project, of which 83% received some type of adaptation to assist with their bathing needs.

The average waiting time for a bathing assessment was reduced by two months.

As equipment was provided or demonstrated at the time of assessment, this resulted in a large reduction of the need for follow up visits.

The occupational therapy team are continuing with the bathing project with the aim for further reductions in bathing assessment waiting times. The team started introducing a similar approach for residents on the Disabled Facilities Grant allocation list.

COVID-19 has put a temporary hold on the team’s way of working on non-essential assessments. Lessons learned from the project will be pivotal for the occupational therapy service in returning to the most effective way of working when they can.

Find out more about the project and the services that Optalis provides at optalis.org.

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Check out the new dates of many of the events that have been postponed

Over the last few weeks many events and exhibitions have been postponed due to the current pandemic. Here you will find many of the new dates that have been announced for later in the year.

If you know of any other events you feel would benefit your fellow OTs please don’t hesitate to get in touch by emailing ros@2apublishing.co.uk.

Kidz to Adultz Events 2 Jul - Wales and West, International Convention Centre (ICC), Newport 10 Sept – Scotland, Royal Highland Centre, Edinburgh 30 Sept – South, Farnborough International Exhibition & Conference Centre, Farnborough 12 Nov – North, EventCity, Manchester Dedicated to children and young adults with disabilities. This show offers free CPD-accredited seminars and a large exhibition of companies showcasing independent living products and services to help young disabled people. kidzexhibitions.co.uk

9-10 NOV

Naidex NEC, Birmingham The UK’s largest disability event, you will find hundreds of exhibitors all under one roof. They have a dedicated OT seminar programme and the opportunity to network, learn and discover new innovations and hear disabled people talk about issues important to them. naidex.co.uk 9-10 NOV

Dementia Care and Nursing Home Expo NEC, Birmingham

2 Sept – Cambridge, Hallmark Hotel

Ideal for anyone working in social care settings.

This show boasts over 100 seminars and 50 masterclasses all designed to help you expand, evolve and innovate your social care business. carehomeexpo.co.uk

9 Sept – Southampton, Hilton at the Ageas Bowl

9-10 NOV

OTAC Events 8 Jul – Virtual OTAC, online event

21 Oct – Newcastle, Newcastle United Football Stadium 4 Nov – Kent, Salomons Estate 9 Dec – Chester, Hallmark Hotel – The Queen The UK’s only Occupational Therapy Adaptations Conference (OTAC). Free to attend and packed full of seminars, networking opportunities and a chance to speak to experts showcasing relevant products and services. otac.org.uk 2-4 NOV

PMG Conference The International Centre, Telford Posture and Mobility Group’s annual conference provides an educational programme, industry exhibition and networking events for professionals working in the field of posture and wheeled mobility. pmguk.co.uk

European Neuro Convention NEC, Birmingham This is Europe’s only trade event for brain and spine experts. It has CPD-accredited presentations dedicated to improving patient outcomes and the latest innovations in the medical arena on display. neuroconvention.com 25-26 NOV

The OT Show NEC, Birmingham The unmissable show sees in excess of 5000 OTs descend upon the NEC to knowledge share, network, attend seminars and workshops and discover innovations that can help individuals lead independent lives. The education programme is packed with integral presentations and on stand demonstrations take place throughout. theotshow.com www.

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Professional Social Media Rachel Johnson is the lead OT at the Seashell Trust and with the help of her daughter Naomi Johnson who is a media student, they have compiled a useful guide for OTs on how to use social media in a professional capacity.

U

se of social media is on the increase. 3.5 billion people worldwide used social media in 2019, which equates to 46% of the total population.

In this time of social distancing and self-isolation, use of social media will have an increased role to play as training and networking events are cancelled to reduce the risk of cross infection. Professional use of social media by occupational therapists is on the increase to share ideas, ask professional questions, participate in continuing professional development opportunities, promote the role of occupational therapy, network with others and seek services, and advertise services and jobs.

As a ‘mature’ occupational therapist, I did not grow up in a world of social media and, despite using Facebook and Instagram for social reasons, I have found the development of a professional social media profile a bit of a minefield. My limited understanding of the difference between the social media platforms and how (or why) to use hashtags has posed challenges!

Fortunately, I have the benefit of advice from my daughter Naomi, who is currently studying media at Liverpool Hope University; we thought it might be helpful to share those tips with others in a similar position.

The Health and Care Professions Council and Royal College of Occupational Therapists have produced social media guidelines. If you are employed, it is important that you check your company’s social media policy. You should never disclose information on social media that allows readers to identify any individual receiving services. Here we take a look at what each social media platform can offer you as an OT.

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Twitter

Twitter is a social networking website that allows users to post short messages (known as tweets) that are 280 characters or less. It is a quick and easy way of sharing key pieces of information with your ‘followers’. It is relatively easy to set up an account and it is possible to have more than one account, so easy to keep your work and personal accounts separate. To raise your Twitter profile, it is necessary to be active on Twitter following others, use hashtags to make sure your post can be viewed in a search of that topic, for example, #OT or #autism. Tagging people or organisations in your tweet will encourage them to retweet. The limited number of characters in a Twitter post can be a drawback, but it does encourage us to be succinct. Twitter is a public platform so it is not possible to create closed groups to share information with specific people.

PROS The use of hashtags allows messages to be spread easily to a wider audience Retweeting means that followers can share information and links quickly and easily Users can connect their Twitter profile to other social media accounts such as Facebook CONS Limited by a character count – only allowed 280 characters per tweet It is easy to make fake Twitter profiles – so spam is possible

It is a quick and easy way of sharing key pieces of information with your ‘followers’

Instagram Instagram is a great way of sharing photos. It has more active users than Twitter and is a quick and easy way to spread a visual message, but gaining appropriate permissions to share the photos can be a challenge. It is important to check your organisation’s social media policy before sharing any photos of service users, particularly those without capacity to consent.

...social media that blurs the boundaries between professional and personal life

PROS Perfect for photo sharing Easy layout to see previous posts It is possible to have multiple accounts (therefore easy to separate personal and professional) and log into more than one account at a time You can set ‘close friends’ if you would like to follow some accounts more closely.

CONS You cannot share web links on a post for further information, you have to include a link in your profile bio. You can share a link on a ‘story’ but it will only last for 24 hours Need access to a camera which can be difficult in some organisations (due to safeguarding and data protection policies) or you have to find other creative means of sourcing an appropriate image to portray your message.

Facebook

Facebook is the most popular social media platform, with 2,230,000,000 monthly users. It is a different way of using social media that blurs the boundaries between professional and personal life. Officially, it is only possible for an individual to have one Facebook account, which leads to some people sharing professional information on their personal account. An alternative option is to set up a Facebook page that others can ‘follow’. Multiple people can host and post on a Facebook page with all posts stored in one place. For example all the OTs in a team could all post on the same page.

Facebook groups are a helpful method of sharing information about a specific topic, such as journal clubs, diagnosis specific information or ideas about a specific topic such as sensory integration. Groups can be ‘open’, so any group members can post, or ‘closed’ where only certain people can join dependent on the group rules. Closed groups require someone to take on the role of ‘admin’ approving requests to enter and monitoring the posts. Facebook groups are great for asking (anonymised) clinical questions where the goal is only intended to be spread amongst a specific group.

They are less beneficial for advertising and promoting as they are only seen by group members.

PROS It is possible to have multiple pages Groups are a great way of sharing professional information or gaining anonymised advice Most popular social media platform, consequently may reach out to people that other platforms do not Can set close friends – this allows you to focus on certain friends/contacts and their posts will be boosted to the top of your newsfeed.

CONS Rules determine that it is only possible to have one account per person making it difficult to separate professional and personal life, unless you have set up a company page

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YouTube

YouTube, which is one of a number of video sharing websites, is a possibility for the more advanced media users. Creating videos can be time consuming and requires a reasonable degree of knowledge about editing, however the opportunity to share videos can create advertising opportunities as well as being an excellent opportunity to raise awareness about great project work which can help to generate interest and sponsors.

PROS Great way to share knowledge or deliver training videos Can be used to demonstrate techniques or showcase project work The video links can be shared through other social media accounts CONS You need to have some basic knowledge of editing or at least be able to use your phone to create a decent video It can be time consuming to create an appropriate video

LinkedIn LinkedIn is a business-orientated service designed specifically for professional networking, it is not typically used to contact service users.

...the opportunity to share videos can create advertising opportunities

PROS Only used in a professional capacity, so there is no cross over with personal life Beneficial for recruitment (recruiters can check out the profile of applicants, applicants can check out the profile of interviewers and other team members) Can receive and give endorsements and testimonials to connections Can join professional groups Many recruiters are on LinkedIn, making it a great way to find a new job.

CONS Can only private message first connections (unless you pay the subscription fee) Supports itself by adverts, allows advertisers to target specific groups It is possible to have a basic membership for free, however to use LinkedIn to its full advantage, there is a monthly fee.

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Social media is a great way of free marketing. It provides great networking opportunities, particularly in this time of self-isolation and social distancing when face-to-face networking is not possible. Established social media accounts are a great way of providing free advertising and help with recruitment. It can be time consuming and a little bit addictive but there are so many benefits of using social media in a professional capacity. When used properly, it can improve your knowledge, provide a support network and help you further your career.

YOU CAN FOLLOW RACHEL ON: Twitter: @RJOTSeashell Facebook: Rachel Johnson (Seashell Trust)

9 & 10 NOV 2020

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