The OT Magazine – Sept / Oct 2020

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THE

MAGAZINE Issue 36 | Sept/Oct 20 | Improving Independence

Virtual Placements Could virtual placements be the next big thing for OT students?

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COLU M NS

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PRO DUC T S

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CPD

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EVENTS

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MENTAL HEALTH


ROTA PRO LOW Rotational Chair Bed

Offering comfort and ease of access Apex Medical knows that people come in different shapes and sizes and so have introduced the new Rota Pro Low Rotational Chair Bed. Designed to cater for customers of a smaller stature or with limiting conditions, the bed achieves an incredibly low 34cms from the floor; This enables users who have some weight bearing capacity to enter and exit the bed independently day or night often without the need for carers or possibly with reduced care - not only enjoying a great night’s sleep but also regaining their mobility, dignity and independence. Listening to our customer’s needs and reacting to them is what we are passionate about and this bed now forms the fourth product in our Rota Pro family catering from the petite to the bariatric user.

For a Free Demonstration or to find out more about the Rota Pro Bed Family please contact us: Tel: 01905 774695 or email us: sales@apexmedicalcorp.co.uk

@ApexMedicalUK

ApexMedicalUK


About us

The Team

Editor: Rosalind Tulloch Staff Writer: Katie Campbell Designer: Fionnlagh Ballantine Production: Donna Deakin Sales: Jacqui Smyth Contributors: Kate Sheehan, Lydia Oh, Chloe Tivendale, Melissa Spurling-Purkis, Katie Taylor, Joanne Robinson

This month’s issue...

A

Get in touch

s things begin to return to some form of normality, we are all having to adapt to new ways of working and interacting. It has been an extremely challenging few months for everyone, and many OTs have been battling on the frontline through this pandemic.

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

The aftermath of COVID-19 is being felt in patients in a number of different ways, both long and short-term effects are coming to light as people begin to recover. OTs will be in high demand to help assist recovering COVID patients to regain their independence and support them with any lasting impairments. We take a look at this more in-depth on page 29. An interesting new concept for placements has arisen during lockdown too. As many OT students were left stranded when their traditional placements were cancelled, Georgia Vine was able to continue her virtual placement as planned. The concept of a virtual placement was set in motion last year between Georgia and her mentor Margaret Spencer and it has proven a great success, particularly during lockdown. Find out more about this fascinating venture on page 64. This issue also includes articles on life drawing for patients engaged in mental health services, a look at adaptive clothing, the science behind weighted blankets, an innovative product that allows wheelchair users to push prams and our regular instalment from Kate Sheehan. Sadly, we won’t be seeing any of you at any of the OT events this year, but we have our fingers crossed for next year and we are already in the process of making plans for an exciting and busy 2021. 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 26

07 What’s New

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

13 Virtual Etiquette Kate Sheehan discusses the appropriate way to attend a virtual meeting

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14 Accessing Style New York-based OT Lydia Oh discusses adaptive clothing and accessible shopping

18 Product Focus Latest products on the market to aid independent living

22 The Pain of Racial

Bias

We explore the dismissive attitudes from medical professionals when Black women present with pain 4

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25 A Day in the Life

of…

This issue Chloe Tivendale shares her experience as a rotational OT at Manchester Vascular Centre

26 Life Drawing A life drawing class in East London has been given funding to allow individuals engaged in mental health services to attend

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42 Work From Home Helping your clients create the perfect work station in their home

46 A Weight on the

Mind

The science behind weighted blankets and their benefits

48 Digital Detox

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42 29 The Post-COVID

World

We take a look at the effects of COVID-19 and how OTs can assist those recovering

32 Building Resilience Equipping yourself with the tools to deal with difficult situations

35 Product Focus

Product

Focus 35

More of the latest must-have products to aid independent living

39 Active Management Keeping your clients active at home

41 Fab Stuff The online platform that allows you to share your wonderful work

Stepping away from technology for the benefit of your mental health

50 Wheels of

Communication

Getting to grips with the numerous communication apps on the market

52 Kids’ Products A range of products for your younger clients

56 Newborn Ideas Precision Rehab have created a great adaptation for wheelchair users to attach a pram to their wheelchair

60 A Team Reaction Find out more about the Rapid Emergency Assessment and Care Team

62 Going Digital How to get the most out of your CPD online

64 Virtual Placements Discover more about the reality of virtual placements -magazine.co.uk

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PRIMA TOILET AID RANGE

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PRIMA SUPERIOR

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FOR MORE INFORMATION PLEASE CONTACT US: EMAIL: ENQUIRIES@GORDONELLIS.CO.UK PHONE: 01332 850277 WEB: WWW.LANGHAM-GE.CO.UK


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

What’s new? SENSE SIGN SCHOOL A digital campaign run by the charity Sense saw over 50,000 people in the UK sign up to learn British Sign Language (BSL). The Sense Sign School was launched during lockdown and was fronted by 15-year-old Tyrese Dibba, a Deaf and partially sighted student from Birmingham. By signing up, individuals were treated to a new BSL video lesson every day for five days, from the charismatic Tyrese. The initial target was to reach 7,000 sign ups, but the first week saw this number exceeded and Tyrese’ charming performance was soon being credited for the campaign’s success. Tyrese commented: “I want

THE OT SHOW

POSTPONED It has been announced that The OT Show 2020 has been postponed until 24-25 November 2021. The organisers have taken the decision to reschedule the event despite mass gatherings being given a potential go-ahead from

more people to learn to sign, so Deaf people don’t get excluded. You should be able to chat to someone, whatever their disability might be. After all, no one likes feeling left out.”

of supporting more families and disabled people in the future.”

Sense’s director of engagement, Chris Jarrett, said: “Hundreds of thousands of people who are Deaf use BSL as their first language, and if more people are able to use it, we can ensure that less people are left out, which is our charity’s mission. “Everyone at Sense is tremendously excited about the campaign and believe it will help us acquire new supporters which will be vital for achieving our ambition

the government from 1 October. The concerns over a second wave of COVID-19 combined with health concerns of the OT community and the patient groups they work with have led to this decision being taken. In a statement the organisers said: “The last few months have had a huge impact on both the mental and physical well-being of our community and we are dedicated

to protecting the safety of our delegates, sponsors, and speakers as our top priority. “With the possibility of a second COVID-19 wave, the feedback we have received from all our partners is, as the largest and most established gathering of OT professionals in the UK; we should not run the show this year. OT’s work with the most vulnerable in our society and we have a responsibility to protect them and their clients, and we feel strongly that the risk of attending any event this year is far too high.” To replace this year’s event they have launched the Virtual Care Festival which will take place on 25-26 November 2020. This will be run in conjunction with the Care Show and will offer opportunities to gain online CPD through lectures, speakers and seminars. You can register for free at theotshow.com. www.

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COACHING COURSE LAUNCHED As lockdown restrictions ease across the UK and more sport and physical activity providers are looking towards restarting sessions and opening up facilities, what better time to ensure that all coaches, staff members and volunteers are trained to ensure activities are inclusive and accessible for people with a visual impairment.

providers to feel more confident including people with a visual impairment. Whilst predominantly sport-related, this course also provides users with transferable skills such as guiding, understanding of the different

types of sight loss, risk assessment best practice and effective communication skills, which are crucial for all individuals supporting someone with a visual impairment. Find out more at britishblindsport. org.uk.

Along with UK Coaching, British Blind Sport created an eLearning course, Coaching People with a Visual Impairment, to raise awareness of the crucial role coaches play in helping people with visual impairments overcome barriers to participation in sport and physical activity. The course is designed to enable sport and leisure

Robotics Rehabilitation Askham Village Community, based in Doddington, is now bringing all its rehab services together with the launch of Askham Rehab, a specialist rehabilitation service incorporating cutting-edge robotics and sensor assisted technology. Askham Rehab is a dedicated service that’s been launched in the wake of significant investment, enabling the introduction of stateof-the-art robotics equipment – a move which puts it at the forefront of rehabilitation in the East of England and beyond. Able to enhance the treatment of a range of conditions, including spinal injuries, brain injuries, and various traumas, as well as strokes and other neurological conditions, the technology is set to prove a “game changer” in their offering. Priscilla Masvipurwa, head of rehab and nursing services at Askham, said: “This is going to be a game changer in our approach

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to rehabilitation. Robotics helps to bridge the gap, increasing the frequency and repetitiveness of treatment, something that’s an essential part of the process. We anticipate that this will enable us to support our patients to reach their goals in a more efficient and sustainable way.”

Askham Rehab’s wide-ranging capabilities incorporates a variety of disciplines, including physiotherapy, hydrotherapy, psychology, occupational therapy, speech and language therapy and nursing. The introduction of robotics augments Askham Rehab’s traditional disciplines. Alongside this, the results and outcomes achieved via the new robotics and sensor assisted technology are second to none, thereby enhancing the overall rehabilitation offering delivered by Askham. Priscilla added: “Working alongside

our patients to establish their personal goals, we deliver a tailored approach to suit individual needs. Enabling patients in this way helps to aid them in their recovery, as they become fully invested in the process. The ethos at Askham Rehab is very much focused on a person-centred approach, and the introduction of robotics serves to enhance this further. This is very much a team effort, and with each patient we are their own personal team, empowering them to reach their goals.” To get in touch and find out more about the new offering or to enquire about a potential career, please email info@askhamrehab.com.


ONLINE REHABILITATION A pioneering programme to empower people living with complex long-term conditions such as a stroke or multiple trauma manage their own rehabilitation has been kept on the road during the coronavirus pandemic – thanks to an expert from Kingston University and St George’s, University of London taking the service online. Professor Fiona Jones, founder of the Bridges Self-Management programme, and her team worked

CALL FOR FUNDING The findings of a new survey by the disability charity Sense, has highlighted the struggle of families in the UK caring for disabled adults during the pandemic, with 52% saying the additional caring responsibilities they have had to take on has impacted their health and wellbeing. The national survey of one thousand families caring for their loved ones at home, reveals that three quarters of families who have had their support and care reduced during the pandemic received no advance information, with one in three still waiting for it to be reinstated. The reduction in support has led to families denied access to vital local services, such as therapies and medical treatment, daycentre

tirelessly in the wake of the COVID-19 lockdown to ensure health and social care staff across the country could adapt their support to patients that were not able to receive rehabilitation in person. The Bridges Self-Management team reached out to people with disabilities to see how they could cope in isolation, together they created films and podcasts on how to self-manage their rehabilitation. “Due to lockdown, some people

and respite services, and care support at home. Without this vital support, families have been left to provide care alone, 24/7, which can include tasks such as lifting, feeding, personal care and physiotherapy. Half of all families believe the government have failed to provide enough guidance and support, and say they fear they couldn’t cope if there was a second lockdown.

went from receiving three or four homecare visits a day to none - that must have been really difficult. We wanted to create something to fill this gap and support NHS staff to continue to ensure patients still felt valued and could continue their rehabilitation remotely,” Professor Jones said. “Our whole focus with Bridges is how we can be person-centred and help people self-manage. We pride ourselves on how we network with people - if you’re going to have one interaction with someone make it meaningful and worthwhile,” the Professor of Rehabilitation Sciences at Kingston and St George’s added. Professor Jones launched Bridges Self-Management in 2013 as a social enterprise and it has since helped the rehabilitation of thousands of patients with diverse and complex long-term conditions through new approaches delivered by health and care practitioners across the UK.

Looking for an OT job?

Sense is calling on government to provide local authorities with sufficient funding, resources and support, so that families can have their care and support reinstated in full. Sense is asking supporters to sign their letter, calling on the Secretary of State for Health and Social Care, Matt Hancock, to take action to secure and reinstate community services and support, such as short breaks for disabled adults and their families. Visit sense.org.uk for more information.

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RCOT IDENTIFY TOP 10 RESEARCH PRIORITIES

The Royal College of Occupational Therapists (RCOT) has identified the top 10 priorities for occupational therapy research in the UK. OTs will be encouraged to undertake and contribute to research related to these top priorities and funding that is available through the RCOT Research Foundation will be focused on these identified areas. The top 10 priorities for occupational therapy research in the UK are: 1 How does occupational therapy make a difference and have an impact on everyday lives? 2 How can occupational therapists ensure that person-centred practice is central to how they work? 3 How can occupational therapists work more effectively with the family and carers of people who access services? 4 What are the long-term benefits 10

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of occupational therapy intervention? 5 What are the benefits or impact of occupational therapy in primary care settings? (e.g. services delivered by your local general practice surgery, community pharmacy, dental and optometry (eye health) services) 6 How can occupational therapy services be more inclusive of both mental and physical health? 7 What is the role of occupational therapy in supporting selfmanagement? (e.g. helping people with illness to manage their health on a day-to-day basis) 8 What is the role or impact of occupational therapy in reducing hospital admissions? 9 How can occupational therapists work most effectively with other professionals to improve outcomes for people who access

services? (e.g. multi-disciplinary teams, commissioners, community agencies) 10 What is the cost-effectiveness of occupational therapy services? These priorities were identified through surveys and a workshop with service users, carers, occupational therapists and other healthcare professionals. RCOT state on their website: “Having this clear agenda for research takes RCOT a step closer to achieving its vision for research which is to have, within the next decade, a UK-wide culture that embraces engaging in and with research as every occupational therapist’s business embedded within the profession. “Research builds the evidence base underpinning occupational therapy and improves the experiences and outcomes for people accessing our services.” Find out more at rcot.co.uk.


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! The EDGE Moving and Handling ‘Key Trainer’ Package includes: • a 256 page professionally printed full-colour textbook; • online access to our exclusive Resources Library and E-learning programme; • access to our Post Training Support Service. Our online Resources Library hosts detailed training materials and paperwork for onward training delivery. It also hosts Info Sheets, Skills Sheets and Training Tools to help advance the skills, knowledge and resources of our ‘Key Trainers.’ These are updated regularly and have been done so throughout the Covid-19 pandemic. The Resources Library also hosts our exclusive E-learning

training module and 80-minutes of practical skills videos. Give your ‘Key Trainer’ staff the EDGE in moving and handling and contact us today!

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

EDGE services 01904 677853 enquiries@edgeservices.co.uk

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

theospreygroup.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

VIRTUAL MEETING

ETIQUETTE O

ver the last five months I have been on a significant number of virtual calls and it has made me reflect on what is the appropriate etiquette for these meetings. Over the last few months I attended sessions where people were dressed in their pyjamas, I watched someone pick their nose and eat it, I spoke with someone sprawled across their bed with the image of their breasts prominent on the screen, and I had someone pop off to get a gin and tonic and then proudly own up to what they were drinking. None of these actions make for a professionally engaged meeting. So, I have read, reviewed and digested some of the rules that we should take on board. Here are my top seven, however, I am sure there are many more: 1 Test the technology Always check that the technology is working, download the app and make sure it is compatible with your computer, there is nothing worse than trying to work out the technology two minutes before a meeting starts. Most systems allow you to be in a waiting room prior to the session starting and it is far better to be 10 minutes early looking calm and prepared, than five minutes late looking frantic. 2 Be prepared Just as you would prepare for a face-to-face meeting, read the agenda, make sure you are

prepared for your agenda items and have a notebook handy to jot down actions and notes.

3 Environment Be aware of where you have set up your laptop or positioned your desktop computer. I know not everyone is lucky enough to have a home office, but try to have a clear wall behind you without any distractions. It allows your fellow attendees to concentrate on what you are saying and not what IKEA poster you have on your wall or trying to work out if you are sat on your bed or not. Make sure the lighting does not reflect badly on your sreen, creating a silhouette, attendees want to be able to see your face and your non-verbal communication. 4 Dress What would you wear to an office meeting? The same applies to online meetings, dress appropriately as this not only affects your own attitude to the meeting but also how others perceive you. You may choose to dress your lower half more comfortably in jogging bottoms but remember not to stand up and show off your beloved 20-year-old, hole-ridden, baggy pyjama bottoms. 5 Food Have your snack, breakfast or lunch before a meeting, no one really wants to sit and watch

you tuck into last night’s leftover Chinese whilst discussing a client’s needs or other clinical issues. Not only is it distracting to others, you will not be concentrating on the subject matter in hand and you will also be worrying what you are dropping on your keyboard. Having a hot drink or soft drink is acceptable, but make sure you are on mute; no-one wants to hear you slurp. 6 Mute your microphone when not talking Background noise can be really distracting and cannot always be managed, for example, your dog barking or your child shouting “Mum” at the top of their voice or the neighbours mowing the lawn. Mute yourself when not talking and then concentrate on the person speaking. 7 Stay seated Don’t keep changing where you are sitting or move to another room, it is very off putting for other attendees and distracts from the essential content of the meeting. Don’t get up and leave a blank screen, you may still be able to hear what’s being said but the other attendees will think you are not engaged, and you would not do it in a physical meeting so do not do it in an online one. And finally, please, please do not take your phone into the bathroom with you, no one needs to see or hear you on the toilet.

...no one really wants to sit and watch you tuck into last night’s left-over Chinese whilst discussing a client’s needs -magazine.co.uk

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ACCESSING

STYLE Lydia Oh is a New York-based OT with a passion for adaptive apparel and web accessibility. She has created an online resource that helps people source appropriate clothing and here she shares the importance of advocating for increased accessibility online for people of all abilities.

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Adaptive fashion is apparel designed for individuals with impairments and disabilities. It is meant to make dressing easier by modifying clothing to meet the end user’s needs. While adaptive fashion continues to make its mark among the fashion industry and individuals with disabilities, the accessibility aspect of adaptive apparel must now be considered.

Unfortunately, this process is not always as effortless and automatic as it is for others. There are many skills to consider to successfully complete these steps, such as cognitive and visual skills, money management, and fine motor coordination, to name a few.

According to the American Occupational Therapy Association, shopping is considered an occupation that involves the preparation, selection, purchase, and transportation of items. Shopping also includes “Internet shopping and related use of electronic devices such as computers, cell phones, and tablets�. Therefore, occupational therapists play a significant role in providing individuals with disabilities with optimal ways

iven the current state of the global pandemic, online shopping seems to be rapidly increasing as people stay home and find new activities to participate in. It is easy to overlook the simplicity of finding a desired item, adding said item to a virtual cart, pulling out a credit card, and quickly typing in the correct billing and shipping information.

It is imperative that occupational therapists make the most of their diverse roles as holistic professionals to advocate for an online environment that is simple and accessible for all

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with optimal ways of accessing items they wish to shop for. Beyond the improvement of dressing skills, occupational therapists must think of how individuals can access the apparel they desire. It is crucial that occupational therapists collaborate with individuals with disabilities and fashion designers to not only create adaptive apparel, but advocate for web accessibility as well. While the introduction of assistive technology, such as screen readers and adaptive computer equipment, is important and beneficial for individuals with disabilities, another question is raised; if individuals with disabilities already have to concern themselves with adapting their physical and social environments, why should they also have to worry about fitting into a virtual environment? Accessibility should be reviewed internally in a virtual setting to allow the end user to be able to effectively use their assistive technology device. It is imperative that occupational therapists make the most of their diverse roles as holistic professionals to advocate for an online environment that is simple and accessible for all. There are always ways to support adaptive fashion and incorporate web accessibility standards as mentioned below: Considerations for web accessibility: 1 Add alternative text, or words used to describe the content of photos, to images 2 Transcribe product demonstrations and advertisements for those with auditory impairments 3 Ensure the contrast of web pages are sufficient for those with visual impairments 4 Offer alternative ways for individuals to contact customer service other than telephone for those with speech impediments 5 Make the navigation of web pages simple and easy to use for those with cognitive challenges 6 Provide sufficient time for online checkouts so that items do not expire after a certain time frame

Advocate, collaborate, and disseminate: 1 Contact adaptive fashion brands to discuss opportunities for consultation, collaboration, and web accessibility 2 Utilise resources to locate adaptive apparel that meet the needs of your patients 3 Explore accessibility features on mobile and smart devices to create shortcuts and alternative methods of accessing online shops 4 Promote web accessibility by sharing information with your colleagues and peers who run their own practices About Lydia Oh Lydia is an occupational therapist and candidate for New York University’s Post-Professional Doctor of Occupational Therapy program. She is the founder of Ball of Wax Community, LLC, an adaptive fashion guide and online resource for individuals with disabilities, caregivers, and professionals seeking adaptive apparel in America. Website: ball-of-wax.com Facebook: facebook.com/ballofwaxcommunity Instagram: @ballofwaxcommunity Twitter: @ballofwaxcom

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The Glenmore, shown in Morris - Acanthus Velvet

How can reading boost health and wellbeing? With the darker nights starting to close in, there’s nothing quite like cosying up with a good book in your favourite chair. Not only is it an enjoyable pastime, it’s also great for wellbeing. It has been proven to lower stress, improve sleep, slow cognitive decline and boost intelligence. Lowers stress levels

Improves sleep

According to Stress.org, stress is said to contribute to about 60% of all human disease and illness. As such, we should seek to lower stress levels wherever possible. Of course, the nature of everyday life means that it’s near impossible to eliminate stress entirely, but we can certainly put things in place to stop it from becoming a serious health issue. One approach is reading.

HSL’s independent Occupational Therapist, Julie Jennings Dip COT HCPC, says that:

A study, by the University of Sussex, found that reading could reduce stress levels by as much as 68% - coming ahead of going for a walk and listening to music. Study co-author Dr David Lewis and colleagues found that people who took part in as little as 6 minutes reading experienced a slowed heart rate and reduced muscle tension.

“If your body doesn’t get enough sleep it can react by producing an elevated level of stress hormones, resulting in higher incidents of depression and anxiety, plus other mental and emotional problems. Sleep helps to reduce stress by encouraging deep breathing and lowering heart rate.” What do we think would be a good way to “switch the brain off” before bed? Reading, of course. The Mayo Clinic suggests that creating a bedtime ritual – such as reading a book, can “promote better sleep by easing the transition between wakefulness and drowsiness”


Slows cognitive decline

Boosts intelligence

There are many studies that have cited reading as being able slow down cognitive decline. Some even suggest that it can decrease the chances of developing Alzheimer’s.

There have been many studies which look at the correlation between reading and intelligence. One of these was published in the ‘Child Development’ journal in 2014 and found that children with better reading skills by the age of 7 had higher scores on IQ tests than those with weaker skills.

A study from Rush University Medical Centre found that reading, and other forms of mentally stimulating activities, help slow down dementia. Over the course of many years they studied participants, asking them to complete memory and thinking puzzles. They found that those who engaged in reading, writing etc. were less likely to show physical evidence of dementia – such as brain lesions, plaques and tangles.

Reading has been shown to help with fluid intelligence (the ability to reason and solve problems) as well as emotional intelligence – meaning you make smarter decisions about yourself and those around you.

The Aysgarth 3 Seater Sofas, shown in Windsor Plain Silver & Windsor Floral Silver

Whilst people read, it’s important to look after their posture – especially if they’re reading a particularly gripping book which keeps them rooted to the spot for a long time. A great way to do this is to use a chair, sofa or bed that fully supports their body and encourages good posture.

Their furniture holds each and every part of the body in luxurious support. The adjustable beds can lift people into a sitting position with the simple touch of a button meaning there will be no neck strain whilst they delve into the pages of a good book.

HSL make chairs, sofas and beds that are ergonomically designed so that their customers have ultimate comfort, whilst also supporting the natural contours of the spine.

HSL have been making quality, handmade furniture in the UK for over 50 years and have developed CleverComfort™ so you can be sure your clients 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.

Quote: OTM20


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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FLEXSTEP

This innovative solution is designed to function both as a set of steps and a wheelchair lift. The clever design sees the steps collapse away smoothly and transform into a wheelchair lift. This 2-in-1 solution is ideal for small spaces and ensures inclusive access to all members of the public. liftup.dk 2

ROTUNDA

Wherever the setting, hospital, care home or your own home, the Rotunda is a safe uncomplicated and dignified way to transfer a patient from one seated position to another, with the help of only one assistant. enableaid.co.uk

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EZ STAND N GO

This stander is designed to discreetly help anyone struggling getting up from a chair or sofa to more easily rise to a standing position. Armrests on chairs can often be too low and do not provide enough leverage, this device can be adjusted to fit any chair, sofa or recliner. designed2enable.co.uk 4

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REST AND REFRESH BOX

Ideal for anyone needing a little recuperation, this box contains a handmade eye mask filled with linseed, buckwheat and lavender, a pillow sachet and dropper with a soothing combination of essential oils and a vanilla and cocoa massage melt to massage into sore muscles. You will also find bath salts and some Pukka Sleepy tea bags, all packaged in a beautiful box. etsy.com 5

FACE MASK EXEMPT BADGE

Accessible review charity Euan’s Guide, have produced Face Mask Exempt badges for disabled people to wear when they are out and about in public spaces. These badges are free to request and help identify the individual as exempt from wearing a face mask, in a bid to stop harassment or questioning. euansguide.com

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BRADLEY CLASSIC TIMEPIECE

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An inclusive watch that has been created with the collaboration of visually impaired people, the Bradley works by touch and sight as it features raised distinct markers at each hour. The inside track indicates the minutes and the track on the outer edge indicates the hour by use of two ball bearings.

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SHOP N SIT

This clever shopping trolley offers a contemporary and stylish look and it doubles as a seat. This lightweight shopping trolley has a solid space for all your shopping to be stored and a seat that folds down to allow the user to rest when necessary. Available in lime green or slate grey. manageathome.co.uk ANTI-SLIP BATH DISCS

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Tenura’s anti-slip bath discs are a quick and easy solution to provide safe surfaces in the bath or shower. Made from strong non-abrasive material, these discs are soft on the skin whilst helping to prevent slips and falls in the bathroom. A great alternative to a bath matt as they do not house mould or bacteria. tenura.co.uk

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The Pain of Racial Bias Women’s pain is undermined by the medical community, and pain in Black patients is routinely dismissed. What chance, then, do Black women have when seeking treatment for pain?

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n the medical community, there is an ongoing trend that sees women’s pain ignored or condescended. Just last month, Frances Bell received £500,000 in compensation after waiting 17 years for her endometriosis to be diagnosed, leading to constant pain, misery and, eventually, infertility. On average, in the UK, it takes seven years for doctors to diagnose a person with endometriosis. In Dr Kate Young’s 2018 paper on clinicians’ discursive constructions of medicine and women with endometriosis, she noted that doctors fill in gaps in their knowledge of the condition with age-old narratives regarding “female hysteria”; Gabrielle Jackson of the Guardian notes that a male GP told her: “I’ve never had a fibromyalgia patient who wasn’t batshit crazy.” Evidence suggests that one in 20 people may be affected by fibromyalgia; it’s seven times more likely to affect women than men. Despite this, there’s debate that the condition even exists. A study by BMC Health Services Research found it takes over two years for most people to get a diagnosis, and even then, it’s frequently misdiagnosed as other conditions like arthritis and multiple sclerosis. Black women, therefore, find themselves in a precarious position when they take their pain to a medical professional: they experience not only the bias that comes in association with women’s pain, but the racial bias that exists with pain management, too. In 2016, the PNAS published an assessment of the racial bias that exists in the assessment and treatment of pain between Black and white patients, led by Dr Kelly Hoffman of the University of Virginia. The study showed the presence of a wide assortment of racially biased beliefs amongst medical students and residents - there was even a belief amongst some that Black people’s nerve endings are less sensitive than white people’s. The study concluded that ideas regarding “biological differences” between Black and white people which date back to slavery are associated with the idea that Black people, somehow, feel less pain than white people do, which results in inadequate treatment of Black patients’ pain. In 2017, the publishers of a medical textbook called 22

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Searching “Black women’s pain” on Google turns up hundreds, even thousands of results, where Black women recount instances where they have continued to be mistreated and disbelieved by the medical community

Nursing: A Concept-Based Approach to Learning issued an apology for what many identified as a deeply racist approach to how pain is perceived in non-white cultures. It claimed that Black people “often report higher pain insensitivity than other cultures,” and that “they believe suffering and pain are inevitable.” Black women’s bodies have, historically, been treated with less respect than their white male counterparts. Gynaecology exists as we know it because J. Marion Sims, the “father” of the field, performed experimental procedures on enslaved Black women. Medical researchers have created a cure for polio, cancer treatments, the HPV vaccine, and so much more, from the immortal cell line HeLa - which was cultivated from Black cancer patient Henrietta Lacks without her informed consent in 1951. When the racial biases behind pain management are considered in conjunction with this, it’s no wonder that many Black women find little trust in the people who, through their jobs, are supposed to be helping them. Searching “Black women’s pain” on Google turns up hundreds, even thousands of results, where Black women recount instances where they have continued to be mistreated and disbelieved by the medical community. A Today article from the summer of this year tells the story of Amy Mason-Cooley, whose doctor rejected her request for self-advocacy when he tried to take her off medication to treat her sickle cell disease when she was in so much pain she couldn’t walk; in other instances, she went to the hospital to receive help from her pain, only to have a nurse dismiss her as faking it to attain opioids. Writing in Vice, another Black woman explained her experience with pain in her right shoulder, which hurt so much that she was crying in her sleep. Doctors repeatedly dismissed her, saying there was nothing wrong, until it was discovered that she had a slap tear in her muscle. On Wear Your Voice, Jasmine Joyner explores her experience with being diagnosed with endometriosis, explaining that both she and her mother - who had 20 years of nursing experience - were both dismissed as “hysterical Black women,” despite her writhing around the hospital in absolute agony due to the baseball-sized tumour on her fallopian tube.

In the broadest terms, it is no longer enough to be an ally to Black people; as a society, we all must work to be actively anti-racist

In the broadest terms, it is no longer enough to be an ally to Black people; as a society, we all must work to be actively anti-racist. In this, non-marginalised people must confront their biases to effectively work in support of marginalised communities, including Black women. While occupational therapists of course have no recourse in correcting the actions of the wider medical community, it is important to remember that OTs are still part of the medical community. As OTs, it is vitally important to help challenge racial biases where they are found in the treatment of Black patients. It is not enough to know what racism and racial biases are; we must, moving forward, challenge those biases. OTs form a vital aspect of pain management for many, including Black women, and understanding the implicit biases which have formed in the medical view of pain management against Black women is a vital part of removing them altogether.

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n i y a d A . dale n e v i T l Chloe nal occupationta

a tatio rking is a ro tly wo n e r Chloe r r t n e, ist cu lar Ce u c s therap a rV ary. heste nfirm I l a y Manc ithin r Ro ked w heste r c o n w a M e has eral d gen sly, sh n u a io e v r e a c Pr ards. ediate erly w d l interm e e f th care o

. f o e f i l e th

ordered as needed.

Currently I am a rotational occupational therapist on a busy vascular ward.

I also assess a patient’s mood following amputation, as well as the phantom limb pain they are experiencing through the use of questionnaires, this allows me to plan interventions accordingly. We may carry out relaxation or mindfulness with patients.

Describe a typical day

Usually we would do personal care assessments with patients and teach them ways to maintain their independence despite their amputation. At present due to COVID-19 we are unable to go out to do access visits when there are people in the property. We are relying on pictures from families and friends which comes with its own complications when you’re trying to set up a home for someone following a life-changing event. These pictures will be discussed between the MDT and equipment

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.

Chloe e l a d n e Tiv

What is your current role?

Many of our patients have just had major amputations and their life has changed considerably. My typical day would usually involve carrying out transfer practises. Many OTs think all amputees use a banana board to transfer, but this is actually pretty uncommon in vascular OT. We prefer to get creative!

Each month ..

Practising getting on and off the floor back to a wheelchair or up and down steps using upper body strength is something we like to practise with those amputees who are able as this may allow some patients to be able to access more of their property. For other patients being able to get back to their wheelchair following a fall can increase their safety and independence. We tend to carry out discharge home visits with patients in order to ensure they can safely manage getting around their home environment and can iron out most teething problems! Specialist amputee follow up therapy is also arranged.

What’s the hardest part of your job? The hardest part of my job is discharge planning for patients who are new full-time wheelchair users in a house which is not appropriate for a wheelchair at all. Issues such as steps into a house with extremely small rooms isn’t uncommon, and we have to problem solve around this!

What’s the best part of your job? The best part of my job is seeing people regain function and independence following a major amputation. Working collaboratively with patients, their families and outside services to provide the best possible outcomes for patients going home.

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LIFE DRAWING OT and fine art graduate Melissa Spurling-Purkis tells us about a life drawing class that has secured NHS funding for individuals who are engaged in mental health services

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en Wakeling is an artist based in Hackney Wick, East London and has run his life drawing class for seven years. Classes originally took place in an artist’s warehouse, then moved to a local art gallery and the top floor of a pub in Victoria Park. Ben now runs twice weekly classes via Zoom which reaches an international audience of over 40 participants and attracts aspiring artists of all ages. The exciting news is that Ben has recently secured NHS funding for places at his life drawing classes for people who are engaged in mental health services. Referrals can be made via healthcare professionals such as GPs, OTs, mental health care teams, psychologists and more. This social prescribing is currently only available for people in the Haringey, Hackney and Tower Hamlet boroughs. Doing things differently and putting new ideas forward is something that is often challenging to introduce in larger organisations. I remember my first role, band 5 rotation on an acute medical ward, I had so many ideas and heaps of enthusiasm, OT superhero Melissa was going to save the world one patient at a time. However, this idea was slowly quashed. It made me sad to see how many patients came in with acopia or functional issues. They really needed, (and still need) more support in their local community. Try as I may services such as community mental health teams or charities providing befriending were often overrun or did not fit the criteria.

Image by Ben Wakeling

Isolation and loneliness are more prevalent than ever at this time and people have commented on how the Hackney Wick Life Drawing group has helped them before and during lockdown with feedback such as “this group is saving my life”, “being part of a community of people of varying ages, genders, artistic abilities, cultural backgrounds and exchanging ideas”. Personally, for me, it gets me into my “flow state” where time flies, I don’t have to think about what I am doing and I am totally immersed in the present moment. An unexpected silver lining due to COVID restrictions, is the loosening of traditional procedures and permissions. This has resulted in an increase of sharing within the arts, via online participation. This medium has enabled people who have physical and or mental health issues to be able to access the arts and other services online. Future plans are for life drawing sessions to be live streamed when it is possible to return physically to being in a space together. Image by Melissa Spurling-Purkis

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You can find out more about Hackney Wick Life Drawing by using the links below: Email: hwlifedrawing@gmail.com (referrals can be emailed here) Instagram: instagram.com/hwlifedrawing Facebook: facebook.com/hwlifedrawing/ Outsider Gallery: facebook.com/outsidergallerylondon

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The Post-COVID World As more people recover from COVID-19, we are beginning to discover the virus’ lingering effects. How can occupational therapy assist those living with post-COVID syndrome in achieving their ADLs?

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s we continue to live in a world battered by COVID-19, we learn more about how it affects our bodies both in the long- and short-term. Coronavirus may lead to a long list of complications - multi-organ failure, septic shock, acute respiratory distress syndrome, pneumonia, blood clots, heart inflammation, and heart failure. All of these carry long-term effects in their own right, which an occupational therapist is poised and ready to assist with per the patient’s own needs. What is not apparent now - but will be in many years to come - is how patients will be affected by what some are currently calling “post-COVID syndrome”. Post-COVID syndrome is a very real issue for many people who have, sadly, been infected with the virus, but how it affects the patient seems to vary widely. In March, the South China Post reported that doctors working for the Hong Kong Hospital Authority found a drop in 20-30% in lung capacity in some people who recovered from COVID-19, leading to them raising concerns regarding the sequelae of the disease. This concern has led to a huge surge in the need for occupational therapy - and by extent, occupational therapists - who are well-equipped with the vital tools to assist people who are living with postCOVID syndrome, and require adjustments to be made in their life to assist them in achieving ADLs. One of the main issues related to post-COVID syndrome seems to be the onset of extreme fatigue, which echos the symptoms of myalgic encephalomyelitis, or chronic fatigue syndrome (ME/CFS). After the 2002 SARS outbreak, University of Toronto psychiatrist Harvey Moldofsky conducted a study which seemed to suggest that a number of people who had recovered from SARS - severe

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Four months after contracting COVID-19, she still experiences a racing heart, tinnitus, chest pains, gastrointestinal problems, and she cannot sit in the sun for long periods of time as it saps her energy

acute respiratory syndrome, and itself a type of coronavirus - were living with disturbed sleep, daytime fatigue, muscle weakness that affected the entire body, and depression, per the New Scientist. All of these symptoms parrot those of ME/CFS. ME/CFS is known to present in patients after recovering from certain viral infections. Epidemiologists have discovered a link between patients recovering from the Epstein-Barr virus, which causes mono, also known as glandular fever; one study found that 22% of patients who recover experience chronic fatigue six months later, with 9% being diagnosed as having ME/CFS. There is also evidence that ME/CFS can develop in patients who have recovered from mononucleosis, dengue fever, and query fever. Writing in The Conversation, epidemiologist and assistant professor at Lamar University in Texas, Margot Gage Witvliet detailed her struggles as, in her words, “a COVID-19 long-hauler”. Four months after contracting COVID-19, she still experiences a racing heart, tinnitus, chest pains, gastrointestinal problems, and she cannot sit in the sun for long periods of time as it saps her energy. She notes that “brain fog” is another symptom many people like her are experiencing; a concussionlike symptom in which the patient struggles to achieve mental clarity. Issues pertaining to cognitive function could also affect people living with post-COVID syndrome. Researchers at University College London found that a number of COVID-19 patients had experienced “temporary brain dysfunction” among other issues relating to their cognitive function. This is, as with all other aspects relating to post-COVID syndrome, still an area which needs to be greatly investigated before solid claims can be made. Historically, there is a basis for the concern; UCL’s Michael Zandi cited the encephalitis lethargica outbreak of the 1920s and 30s as a model which was comparable to the COVID-19 pandemic, and saw some patients develop neurological complications during their recovery. From an occupational therapy perspective, RCOT has published a guide on how to manage post-viral fatigue, which is aimed at patients, using their “Three Ps” principle - pace, plan, prioritise - to help both people who have recovered at home and those who recovered in hospital. The ME Association recommend the introduction of good sleep hygiene into the routines of people who may need to manage postviral fatigue. Activity pacing was also recommended by the NHS, which is used currently by many people living with ME/CFS; some patients do not find this to be particularly helpful, however. While we continue to navigate a world where millions of people are being affected by both COVID-19 and its lingering after effects, we will be better able to treat it when research and study has been done to establish fully these effects. However, there will be no profession better suited to assisting those living with post-COVID syndrome and post-viral fatigue than the highly adaptable occupational therapist.

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BUILDING RESILIENCE Finding the strength to cope with difficult situations

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he effects of the pandemic are still rippling through our communities, although lockdown restrictions are lifting and the ‘new normal’ is trying to emerge, we are still very much enclosed in a strange and uncertain time that has taken its toll on healthcare professionals both physically and emotionally. The fear and uncertainty of the last few months has weighed heavily on everyone’s minds, and occupational therapists have been steadfastly serving on the frontlines throughout. The impact these events have had on OTs will be very varied, but they will have left their mark in some way on each and every one of you and recognising this is key to ensuring your wellbeing.

RESILIENCE

Resilience is essentially a word used to define how well you can cope with difficult circumstances. Being resilient helps you to cope with traumatic circumstances or stressful environments and helps you to bounce back from them. Research has shown that resilience is somewhat inbuilt to you as a person, but it also shows that resilience can be learned too, helping you prepare for any tough times ahead. Here are just some of the ways you can practice building your resilience to help you cope with difficult or stressful circumstances in both your professional and personal life. These skills can also be passed onto patients you are working with too.

OTs are likely to be relied on even more in the wake of the pandemic, which will bring increased pressure on roles that were already pushed to breaking point. More people will be looking at ways to remain at home and be as independent as possible and many families will be opting to take care of elderly loved ones rather than looking at care homes. As an OT it is likely that you will be called on for support and advice more than ever. These will be demanding times and OTs, while we know you are all actually superheroes, must be prepared emotionally to deal with the demands, ensuring your mental health and emotional wellbeing are kept intact.

SELF-ESTEEM Confidence and self-esteem play a big part in resilience. It is important to believe in yourself and your abilities. We are all guilty of self-doubt at times, but you must remind yourself that you are a capable individual that was chosen for your role because you have the skill set to do it. Prepare a positive pep talk for yourself to use in times like these.

SUPPORT NETWORK Having a supportive network of family, friends and colleagues is of vital importance. Talking about the issue at hand may not solve it straight away but it will help getting support, feedback and advice from those who love you. You need people you can confide in and bounce ideas off, this can often help you arrive at a solution. 32

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OLD NEW

EMBRACE CHANGE Change can be hard. No one really likes change, but if often brings new opportunities and new ways of working that have positive outcomes. Embracing change and allowing it to happen will begin to alleviate your concerns and may even open doors you never knew were there.

MAKE A PLAN When you are feeling overwhelmed in a professional or personal situation, the best thing to do is to take a step back. Don’t look at how you can solve the big problem immediately, break it down and write down an action plan of each step you can take to fix the problem. Having a simple, well laid out, achievable plan that will get you to your goal, will make the problem seem much smaller.

CONTROL Accepting that you cannot control everything that happens in life is the first step to relieving stress from your mind. There are certain things that are in your control that you can change or act on, however there are many external factors too. You cannot control what others do, you cannot control the weather, and you have no control over when a global pandemic decides to hit.

ACTIONS Don’t let problems fester away, weighing on your mind like a dark cloud. Do something as quickly as you can, even if it is a small action, it will lift that dark cloud and let in a little bit of light. Problems won’t go away on their own, taking action, even if it is just talking to someone, will help you feel more focused and prepared to tackle the issue at hand, and you will feel more positive by doing something to forge forward.

SELF-CARE Taking time to check-in with yourself each day is really important, especially if you work in a demanding role. Recognising when you need to talk to someone, or take some time for yourself can prevent you becoming overwhelmed or disillusioned in your role. Try to find 30 minutes each day to listen to your favourite podcast, read a book or just people watch in the park, it will do you the world of good.

OPTIMISM A positive outlook is a powerful tool. It may be difficult to muster in difficult times, but understanding that most situations are only temporary and remaining hopeful for brighter outcomes will help you cope with whatever situation you are dealing with. Hope and positivity can help you get you through dark times, and remaining positive that you have the skills and capabilities to deal with hard situations will help.

PROBLEM SOLVING The ability to come up with solutions to problems naturally helps. Some people are natural problemsolvers and so challenges don’t phase them as much, some people even relish seeking solutions for problems. The key is that this can be something that comes with practice and experience. Every time you come up against a small challenge write down a list of all possible solutions and test out those strategies to help you understand logical ways to solve your issue.

KEEPING PERSPECTIVE This can be difficult at times, especially when challenges seem insurmountable, but taking a step back and reassessing the reality of a situation can help you deal with it. Putting things in perspective will help you understand where the problem ranks in the grand scheme of your world and it will hopefully help you understand that things are not as bad as they might first seem, solutions can be found and long-term perspectives can look more positive.

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WHITE STUFF PONCHO

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PRETTY LEGS SILKY SMOOTH COMPRESSION SOCKS

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GRANDPAD

Specially designed for older people who may find technology difficult to understand, the GrandPad is an extremely easy-to-use tablet which is designed from the ground up to meet the needs of older people, down to its operating system. It does not require a wifi connection, but allows unlimited streaming and video calls through 4G. techsilver.co.uk | 03300 10 14 18 9

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Candles are great for creating a relaxing atmosphere, but forgetting about an open flame is extremely dangerous. Flameless candles can be used in their place to create the same relaxing ambience. These candles can be set on a timer, are soft to the touch, and come with a remote control for easy use. amazon.co.uk

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Wiltshire Farm Foods introduces pioneering meals to its Level 5 Minced Range

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iltshire Farm Foods has launched a groundbreaking selection of shaped dishes, as part of its new and improved Level 5 Minced meals range. The visually enhanced collection provides more choice and variety than ever for Wiltshire Farm Foods’ customers whilst being developed in line with the IDDSI framework and comprising the same safe texture for those recommended a Level 5 diet by a healthcare professional. The company’s development team wanted to visually enhance the dishes which form part of its Level 5 range, whilst simultaneously providing its customers with more variety and choice. The innovation lies in the shaping of the protein component in each of these dishes, something which has traditionally been a feature of the company’s award-winning ranges. The four new meals include: minced salmon in dill sauce, served with mashed potatoes, broccoli and carrots; minced beef grillsteak in gravy served with west country heddar mashed potatoes, broccoli and cauliflower; minced mixed vegetables in west country cheddar cheese sauce, with mashed potatoes and broccoli and minced beef in gravy, served with west country cheddar mashed potatoes, broccoli and carrot. Emily Stuart, registered dietitian for Wiltshire Farm Foods, says: “These new shaped dishes have been developed specifically for those with swallowing difficulties, a condition also known as dysphagia. The texture of the main meal components has been designed in line with the requirements for an IDDSI level 5 meal, in an extremely thick sauce or gravy. A Level 5 meal should require little to no chewing, ensuring a safe consistency for those on a Minced and Moist diet.” All the Minced meals come ready-prepared and are delivered directly to customers’ doors, to eliminate the hassle that often accompanies home-blending. There are numerous challenges in creating safe, compliant meals via home blending with the process being both time consuming for carers and potentially hazardous for patients if the correct texture is not achieved. In addition to this, the nutritional content can also be significantly reduced when water is added to liquify the food. It is vital for healthcare professionals to ensure appropriate nutritional needs are being met, as they support their patients with advice on dietary requirements. Otherwise, other serious conditions, such

as malnutrition, can arise. This is a condition which currently accounts for 2 million of the population and is costing the NHS £2 billion per year, according to NHS England. Committed to creating dishes which are eaten with the eyes first and foremost, Wiltshire Farm Foods understands how the aesthetic appeal of a plate of food can impact one’s appetite. Giving its customers the ability to eat independently ensures dignity in dining, something which the company is passionate about. For the opportunity to receive complimentary samples of Wiltshire Farm Foods’ new level 5 meals and other dishes from its extensive range please visit specialistnutrition.com/healthcare-professionals. For practical advice on solutions for managing swallowing difficulties and malnutrition, including videos on the different IDDSI food tests please visit specialistnutrition.com/swallowing-difficulties/ iddsi-food-tests.


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DO I GET FAB STUFF HOW INVOLVED? Discover the online platform where you can shout about your amazing work

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he Academy of Fabulous Stuff is a social movement that allows people to share innovative health and social care ideas, services and solutions. Started in 2015, this free-to-access website is deigned to be a “repository of best practice in the NHS”. The website is incredibly easy to use and offers a unique platform for any individual or organisation involved in health or social care to share projects, boast about successes, ask for advice and knowledge share with peers. Networking and knowledge sharing are key components in the health and social care community and there are so many innovative and dynamic projects happening across the NHS and further afield, yet there is nowhere to shout about this wonderful work. Enter The Academy of Fabulous Stuff, a space to celebrate patient care, successful initiatives and interventions and also seek out answers or advice from peers. The idea behind this resource is to better connect those working in the NHS, to arm everyone with the knowledge and ideas to create better environments of care, to improve efficiency and services, and to boost the morale of everyone working in these services. How often have you been searching for a solution to a problem, struggled motivating a patient or been in need of inspiration for a new project for a patient group? This website could give you the answer you have been looking for. No matter the scale of your dilemma, it could be a very niche or local problem you need advice on, or it could be a service wide query you have – there will no doubt be someone on this platform who can offer advice.

It couldn’t be easier to get involved with this online resource, simply visit fabnhsstuff.net, register your details and you are good to go. This will allow you the ability to post your own success stories and share valuable information to others in the health and social care community. You will also be able to access the full library of ‘Fab Stuff’, where you can search with specific keywords or scroll through specific categories depending on your area of work. In today’s increasingly digital world, and with our greatly reduced chances of attending face-to-face events in the coming months, The Academy of Fabulous Stuff could be an excellent resource of advice and inspiration for OTs across the UK.

#FABCHANGE20 Seven years ago Change Day was created with the simple idea that “people doing the job knew best how better to do the job” and it is now a permanent fixture in the NHS calendar. #FabChange20 will take place on 21 October this year and will be run virtually. The focus will be to reflect on the global pandemic and the impact it has had on our health and social care services across the world. It will comprise of 2 separate activities: 1 Sharing learning, resources, how to guides and best practice exemplars to ensure that we learn and discuss the things that didn’t work initially and the strategies employed to turn them into successes. 2 A global virtual conference #ChangingForTheBest #NoGoingBack. The proposed themes are: Digitally Enhanced Care/Virtual Services; Staff Wellbeing/ Support and Resilience; Operational Redesign; Organisational Relationships; COVID Workforce Redesign and Absolutely Fab Stuff. Visit fabnhsstuff.net to get involved.

The idea behind this resource is to better connect those working in the NHS, to arm everyone with the knowledge and ideas to create better environments of care

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WORK FROM

HOME With so many people being told they will be working from home for the foreseeable future, how can occupational therapy be helpful in establishing and maintaining home workstations?

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he world is returning to work, and while many an OT’s patients will be in amongst the millions of people returning to the workforce after a prolonged period of furlough, they might find that the office is still very much out of reach. While many occupational therapists will have helped their patients to ensure their office workspace is adapted to suit their needs as much as possible, some people may find that they are struggling to establish a workstation or routine within their own home that suits their needs and requirements.

MAKING SPACE One of the biggest challenges with creating an appropriate home workstation is striking the balance in terms of space. Creating a space that is specifically for work is important in ensuring a work/life balance can still be adequately maintained while the lines of “home” and “work” continue to blur. For those who are able to set up a home office in a room outwith the bedroom or living room, this is a slightly easier transition. Having a room all of its own where you do nothing but work creates a physical boundary between rooms where sleep or relaxation happens, and where work happens. This is not the case for many people, however, for whom the presence of this kind of space would be an absolute luxury. In this hugely common situation, creative workarounds must be made. Making the space might seem like a big ask, but there are lots of different ways that a small home office can be created in the corner of a room, and imaginary boundaries can be drawn through clever use of furniture. Repositioning a bookshelf or dresser so that its shortest side lies flush against the wall can create a little nook beside which a desk can be placed; if there is a little more space to play with, a running rail or room divider can be used to create an almost closed off space which feels almost like a room in its own. Regardless of the amount of space available, there should be a way to create a specific area in which to work, which will encourage good sleep hygiene, and not impede the process of relaxation. 42

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PACE IS THE TRICK As with the creation of an appropriate workspace in the home, it’s important to encourage good timekeeping, and establishing boundaries. Yes, you could answer your work emails at 2am, but is that going to negatively impact on your work/life balance? It more than likely will. In our own workplaces, especially for people who work in “conventional” office settings, things often work to a set schedule: tea at 11am, lunch at 1pm, break at 3pm, home at 5pm. Making sure that your patients and clients are trying - as much as is possible - to stick to a schedule is important in ensuring sleep hygiene, promoting restfulness and relaxation post-work, and encouraging an attitude of “leaving work at work”. Of course, this is not possible for everyone: some people have little children running around their ankles while they’re trying to work, and people living with disabilities may find a variable working schedule gels better with their needs and requirements. Regardless of whether or not a rigorous or fluid working schedule is employed, the need for time away from the “office” must be encouraged as much as possible. Sometimes that can be walking away from the home office for the night, or as small a gesture as just muting an email app or turning off a phone when the working day is done. Regardless, these gestures have a huge impact on mental health and the ability to achieve restfulness.

ADAPT AND OVERCOME For some, the office space may require adaptations to ensure their working day is as comfortable as possible. Occupational therapist approved aids, like additional lumbar support which can be purchased and installed on wheelie chairs, or even something like a wrist support can improve the working day tenfold for those who have had to create office space at home. If someone has been warned that they may be working from home for the long haul, it may be worth encouraging them to see if their company could provide some of the adaptations necessary to comfortably work from the home office, especially if these adaptations are already present in their office. Adjustable tables, high back chairs, single handed keyboards, and many other products can greatly improve the working day of those who need them, and as occupational therapists, you will of course be able to recommend the best adaptations and products based on the client’s needs. It’s worth remembering that not everyone has access to a desk where they can work, and that’s ok. Occupational therapists can encourage clients to take time out of their days to perform stretches and actions which will negate some of the discomfort brought about by working in less than ideal conditions. Again, recommending products like wrist exercisers, or encouraging yoga may greatly assist in combating pains brought about in those who are unable to work at a desk or table.

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Paediatrics All the latest from the world of paediatrics

SECTION t’s hard to believe we are almost at the end of 2020, in what can easily be described as one of the toughest years many of us have ever had to go through. For younger people, it could not possibly have been easy in any way: taken away from their school friends, locked away inside as we fight an invisible enemy, and still not entirely out on the other side yet. Many will have turned to social media to keep up to date with their friends and the news, but the effects that “doomscrolling” - that is, looking through a constant, near

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unending stream of bad news - may have had on their mental health is scary to think about. With that in mind, we explore the importance of putting down phones and staying offline for a while on page 48.

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We also examine weighted blankets on page 46; what is the science behind them, and how exactly is it that they work? As usual, we also have a host of brilliant kids’ products on page 52 which may be helpful for your younger clients! If there’s anything you would like to see featured in our kids’ section, please don’t hesitate to email us at: ros@2apublishing.co.uk.

Read on to find out more...

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WEIGHT ON THE MIND

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Occupational therapists have long used weighted blankets to help reduce overstimulation in patients living with autism, but how effective is their recent co-opting by the mass market in the name of anxiety and insomnia?

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ccording to the Mental Health Foundation, there were 8.2 million cases of anxiety in the UK in 2013 - and these figures will only have increased, especially with the the mentally and emotionally taxing aspects of the lockdown and global pandemic weighing heavily on the minds of many people in the UK. Weighted blankets have long been used by occupational therapists as a means to help people - usually children - who live with autism or sensory processing disorders. These very same blankets are now being advertised as a means to help people living with anxiety disorders, or those who find it difficult to sleep, including people who live with sleep-interrupting disorders like insomnia. Of course, the reasons for feeling that a weighted blanket may be beneficial in some way to assisting an individual calm down or improve their sleep are often linked; people living with autism may experience restlessness, and people living with anxiety will frequently have difficulty sleeping, per the DSM-5.

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These blankets are considered by some as an alternative to medication - both prescribed and self-inflicted - which can help people sleep. Weighted blankets are exactly as their name would suggest: a soft material designed to be laid over the body, which is covered in small pockets, themselves filled with materials like plastic pellets. This gives a sensation of pressure which envelops the user. There are limited studies which explain exactly how weighted blankets offer respite from feelings of sensory overload or anxiety, but Brian Mullen et al explored the use of weighted blankets as a form of deep pressure simulation in 2006. Occupational therapists will be extremely familiar with deep pressure therapy, which is a commonly used and effective method of treatment when people present feelings of anxiety, stress, or mental and sensory overload. According to Bristol Autism Support, it can be used both on its own, or as part of a wider range of therapeutic interventions. They note that it can be


...anecdotal evidence seems to show that weighted blankets have real means to provide relief - it seems that science just needs to find a way to prove that on its terms applied in two ways; either in the form of a hug or squeeze, or by allowing the individual to wear or hold a weighted item - like a weighted blanket or weighted toy, which are also a popular way of delivering the intervention. Weighted blankets have found themselves in a kind of resurgence outside the realms of use with occupational therapists recently; trendy start-ups are Kickstarting their latest weighted blankets which “guarantee” a restful night’s sleep, and you can even buy one now in John Lewis. Researching the effectiveness of the blankets online becomes more difficult as the market is flooded with websites wanting to show you their new products, offering up few peer-reviewed studies or scientific backing to explain the effectiveness of their specific product to deal with insomnia, anxiety, and other problems people may be coming to face head-on during the lockdown. With the weighted blanket, it exists in a strange state of scientific flux, where its properties are genuinely very helpful - occupational

therapists have known for years that it helps to calm children living with autism, and swaddling them in the blankets is a helpful intervention which can easily be implemented by parents or carers - but its scientific basis is, in some aspects, a little more lacking than many would expect. For people living with anxiety and insomnia, the Harvard Medical School’s journal notes that there is little “robust evidence” to support the effectiveness of the blankets. Speaking to the journal, Dr Christina Cusin of Harvard Medical School said that it’s a difficult thing to scientifically establish the effectiveness of; a blind comparison can’t be done because people can immediately determine if they’re wearing the blanket or not, and finding financial backing for studies has proven to be difficult. Many studies focused on neurodivergent children echo Dr Cusin’s concerns. Gee et al’s 2016 study into improving rest in children who live with autism sought to prove whether weighted blankets could reduce sleep disturbances, found overall that there were minimal positive changes when the weighted blanket was used. A 2014 study from Lancaster University by Gringras et al which assessed the same conditions as the previous study (while also including a control group) reached the same conclusion. Interestingly, this study concluded that, while there were no measurable changes, the weighted blankets were favoured by both children and parents, which is echoed by similar studies carried out under these conditions. Weighted blankets are an interesting thing; they have been co-oped somewhat in the name of commercialism, where people who require an escape from the negative emotions incurred by modern living are encouraged to pay upwards of £100 for a blanket which they are told by the seller will change their lives, but outwith information on their own websites, there is little to support that. Yet, anecdotal evidence seems to show that weighted blankets have real means to provide relief - it seems that science just needs to find a way to prove that on its terms.

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DIGITAL DETOX Put down your device and switch off for your mental health

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oung people have been warriors through this pandemic. They may have been driving their parents crazy at home, but they really had no option. Lockdown imposed huge restrictions on young people’s lives, disrupting education, extracurricular activities, sport and social lives. What felt to many like a bit of a holiday at the beginning, enjoying late nights and lazy mornings as there was no school to attend, bingeing on Netflix and posting lockdown selfies on Instagram until 3am, soon took a turn for the worse. Exams were cancelled, leaving many students in an anxiety-ridden stretch worrying what the future held for them with no control over what the outcome would be, and with no last-ditch studying attempts to secure their grades. Many felt helpless and angry, and with the recent media coverage of the exam results, it is easy to see why. To combat boredom and anxiety most young people and teenagers spent most of their time online. Screen time soared, it was the only way to communicate with the world they had been cut off from. At a time when they should be out with friends, having fun, growing up and learning valuable life lessons getting up to all the things their parents warn them not to do, they were stuck at home in their bedrooms glued to their phone or tablet.

Digital Detox Day will take place on Saturday 5 September and it asks participants to step away from social media for the whole day, taking a time out to focus on their mental health

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While this digital world offered valuable connections for everyone during lockdown, and in many ways was a really positive lifeline, the reality is that social media can have a really negative impact, especially on young impressionable minds. Negative effects Social media is well-known to have negative effects on users when it is used without boundaries. It can also be a cruel platform for bullying and can have a serious impact on the way young people see themselves. Scrolling through images of seemingly flawless individuals can take its toll on the young, self-conscious minds of both girls and boys. Body image becomes skewed and selfworth and confidence is lowered, all because these young people are comparing themselves to unrealistic images. Digital Detox Day #IAMWHOLE is a mental health campaign fronted by Jordan Stephens (aka Rizzle Kicks) aimed at encouraging young people to speak out, seek help and get support. This year they have launched a world-first collaboration with well-known vlogger and businesswoman Zoe Suggs (founder of Zoella) and handmade cosmetics brand LUSH.


Digital Detox Day will take place on Saturday 5 September and it asks participants to step away from social media for the whole day, taking a time out to focus on their mental health. The project aims to raise awareness of the negative effects that social media can have on our mental health and it hopes to help young people build healthier relationships with these platforms and with their devices. The week prior to Digital Detox Day will see #IAMWHOLE release a series of discussion panels around five key talking points on Zoe Sugg’s IGTV channel: body image, cyberbullying, anxiety, human connection and setting digital boundaries. On Friday 4 September participants will be asked to draw a circle with the word “OFF” in the middle on the palm of their hand and post it to their social media accounts to signify that they will be switching off the following day. Talking about the project Jordan Stephens said: “Social media has become such a huge part of all our lives, and I know all too well the negative impact it can have on mental health if we don’t set boundaries. Digital Detox Day is all about taking some time out to reflect, so we can form better relationships with ourselves and our devices. As someone who has really grown up online, Zoe is the perfect person to lead this campaign. I’m proud that #IAMWHOLE is able to partner with both Zoe and LUSH to raise awareness as well as funds for grassroots mental health charities.” LUSH have confirmed that over 40 of their locations across the globe will be participating in Digital Detox Day and to mark the occasion LUSH inventor Jack Constantine and Zoe Sugg have created a limited edition bath bomb, encapsulating Zoe’s happy place of a beachside sunset. All money raised from the bath bomb will go into a fund where grants will be available for grassroots mental health organisations. Zoe Sugg commented: “I love social media, it’s incredible in so many ways and it has helped build communities and businesses, and given people a platform in order to share their stories that might not otherwise have been heard. However, as the years have progressed and social media has grown in size, it’s clear that it has its flaws too. Comparison, criticism, cyberbullying, a disconnect from reality and real life. All of these things and how often we are scrolling can have such a negative impact on our mental health. This is why I am so happy to be working with LUSH and #IAMWHOLE on the very first Digital Detox Day campaign, a day to reflect offline about how we live our lives online and to introduce boundaries into our social media usage. I have been a huge fan of LUSH for years so to be able to create a bath bomb for this campaign in order to raise money for grassroots mental health charities has been an absolute privilege and I can’t wait for everyone to enjoy it.” Visit whole.org.uk to find out more.

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WHEELS OF COMMUNICATION Finding the right communication tool can be key for your younger clientele

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orking with young people who have difficulty communicating can be challenging for even the most experienced OT. Children living with autism, Asperger’s syndrome, learning disabilities and other complex communication support needs will all communicate in a different way. Understanding their individual personalities and abilities is key to finding a communication tool that will work best for them. This could be anything from picture cards to more high-tech apps that can be downloaded to a device for communication purposes. Allowing a child the ability to communicate clearly with family, friends and teachers is of vital importance. Being able to tell someone what you need, how you are feeling and what you want to do is the most basic of communication needs and technology to facilitate this must be afforded to every child. For children in education, the ability to communicate effectively in the classroom and in the playground, is intrinsic to their development, confidence and selfworth. Feeling valued and able to participate in class is crucial to a child’s school experience and will have a direct impact on their education.

CALL Scotland

Communication, Access, Literacy and Learning (CALL) Scotland is a government-funded initiative that began in 1983. They exist to break down the barriers to learning that children with disabilities face. They work as a research and development centre as well as a service unit, providing pupils, families, local authorities and healthcare professionals with support, advice, training and assistive technology loans. CALL Scotland loan assistive technology equipment to individuals and education settings on a free-of-charge trial basis of up to two months, and longer if required. This allows users and healthcare professionals to fully ascertain whether it is the right communication tool for the user. The loan bank is currently suspended due to the coronavirus, but hopefully it will be back in operation soon. They do only operate on a Scotland-wide basis for services, however, their website is packed with some great information and detailed resources that can be of great benefit to occupational therapists. Their ‘download’ section includes instructional guides, posters and leaflets, reports, newsletters and handy info cards, all that can be printed off and pinned up or 50

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handed out. Everything from ‘A complete beginners guide to the iPad’ to a step-by-step poster that helps you address reading difficulties, and a poster that highlights what iPad apps can support creativity.

WHEELS OF APPS

One of the most useful tools for any OT working with a child who requires the use of augmentative and alternative communication (AAC) is the detailed ‘wheel’ that CALL Scotland have produced to categorise the many different apps on offer. There are seven wheels that have been created: 1 Android apps for complex communication support needs 2 Android apps for learners with dyslexia 3 ChromeBook apps and extensions for learners with dyslexia 4 iPad apps for complex communication support needs 5 iPad apps for learners with complex additional support needs 6 iPad apps for learners with dyscalculia/numeracy difficulties 7 iPad apps for learners with dyslexia CALL Scotland recognised how difficult it could be to identify the right app from the numerous choices on offer, so they have categorised them on an easy-to-use wheel to help you identify or narrow down the apps that could be appropriate for your client. We have displayed one example here, you can find out more at callscotland.org.uk.

Being able to tell someone what you need, how you are feeling and what you want to do is the most basic of communication needs


Pathways for Core First * AAC Evaluation Genie

Flip Writer AAC

Grid for iPad has a variety of vocabulary sets and fits equally into text and symbol based AAC. It also appears in the PODD section

H

Quick Type AAC Predictable

H

H

Bitsboard* See.Touch. Learn. *

Early Language Screening Tool Bundle

Sesame Talking Keyboard*

AlphaTopics

Jabberwocky* Verbally* AAC

Widgit

S ee Me Talk Grace

PEC

nimu Com tion ca es ativ

r Nar toPho s rie Sto

Bas ic tem s

Visual Scene Display

Me No Verbal Me

Snap Scene * Make a Choice AAC Buttons GoVisual Experience*

Yes/No*

SceneSpeak

n

e rag e

sto

Alexicom AAC *

Mighty AAC

Widgit Go (Widgit) GoTalkNow* (Widgit) (SymbolStix) (PCS)

InnerVoice: Communication*

Alternative Access

Identifying AAC Apps from the many available can be a difficult task, we hope that this wheel will help with that purpose. It includes a selection of Apps organised by category, that we broadly find reliable, useful, stand out in the category, and have continued support from the developer. Due to their features, some Apps could be listed under multiple categories, so we have chosen to assign them according to their primary feature(s).

Switch -

When selecting Apps, most individuals prefer to ‘try before you buy’ to avoid inappropriate purchases. It is wise to first seek out specialist assessment from an AAC expert/service such as CALL Scotland, who may have equipment available for trial. Some App developers if approached, may offer a specific trial, otherwise some Apps have free versions allowing this. They usually have features limited in some way. These are marked in the wheel with an * next to the App name.

Avaz AAC * (SymbolStix)

LAMP Words for Life Expressive (Unity) (Smarty)

Identifying Suitable Apps

Trialling Apps & Free Versions - *

BRIDGE Communication Pro

CoughDrop* Speak for Yourself (Open Symbols) (Smarty) (Free Symbols) MyChoicePad Pro (PCS) (Makaton) SymboTalk * (ARASAAC) aacorn Plus

iSpeak Button Collection Scene & Heard (Widgit)

Snap Core First* Clicker (PCS) Communicator (SymbolStix) H Widgit) (PCS) TouchChat HD (SymbolStix)

Chatable (PCS)

m

Smooth Talker AAC*

S ounding Board*

pp dA s bri Hy cture u Str

Star ter Voca bula ry Sets Prov ided

Sono Flex *

TalkTablet* PRO (SymbolStix)

Message Bar

ph

Click n’ Talk

Text-To-Speech

ual Unus res Featu

Book Creator*

Full Communication Systems

Recorded Speech

Sys

Proloquo2Go (SymbolStix)

t

ha

C

ly mon Com d Use bol Sym Sets

or

Pictello

Q

ba s AA ed C

Sy

n w O es ag Im

ui

xt-

on ss Le mm ls o Co b n ow os ot

My Pictures Talk

Simple Communication

ge Ba r

Story Little Story Special Stories Creator* Creator*

Communication Skills

ck

Symbolbased Grid Systems

Visual Schedules

My Own Interactions* FTVS HD

My Story School eBook Maker *

S Ap pec pr ifi oa c ch es

S

Te

ssa

Choiceworks

ictio

e

DD

Grid for iPad (SymbolStix) (Widgit) (PCS)

Abilipad

ras

ag ll Ski g ldin Bui

PO

Proloquo4Text

ClaroCom Speech Assistant AAC Pro UK

Pred

ent Assessm Support

gu

PECS IV+

n La

Grid for iPad (SymbolStix) (Widgit) (PCS) PODD with Compass (PCS)

SayIt! *

Ph

Talking Mats*

Symbols2 Write

Keyboard

Vocab

simPODD (Symbolstix)

and Head Tracking (Face ID/ Attention) - H

Relatively few Apps are designed wth in-built alternative access, such as switch scanning and the newer head tracking (only iPad Pro with a TrueDepth front-facing camera). These Apps offer the most usable and widest range of access options, and may be the ‘safest’ choice for users needing effective alternative access. Apps with switch access are marked in the wheel with a red border around the App image, head tracking is marked with an H. Accessibility settings built-in to the iPad can improve access to all Apps and the iPad itself and include Touch, Switch control and Face ID/Attention (iPad Pro), however due to the App design, not all are usable with alternative access. Downloadable Version A digital version of the wheel can be downloaded from callscotland.org.uk/downloads/posters-andleaflets In this, App names are clickable and link to the Apple App Store UK.

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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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Kids

SQUIRREL AND NUT SENSORY PANELS

Perfect for any paediatric-orientated establishment, these fun panels will add some fun decoration, while also being useful in play-based therapies. Children can engage with the panels, helping to improve fine motor control and co-ordination skills, playing with the cute squirrel’s fuzzy orange tail and easy-grip handles which adorn both panels. theclassroom.co | 03330 14 33 55 2

FISHER-PRICE BUSY ACTIVITY HIVE

Colourful and cute, this toy is a great addition for sensory play. The Activity Hive features a wide variety of textures, making it ideal for tactile play, as well as having the capability to make noises using the clackers, beads and spinners. Ideal for use in improving hand-eye coordination and fine motor skills. argos.co.uk | 0345 640 0800

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FIDGET XL

If the standard six-sided fidget cube isn’t enough to hold a little one’s attention any more, this massive 12-sided toy might just do the trick! Renowned for helping to alleviate feelings of stress and anxiety, children can click buttons, slide sliders, roll gears and rotate dials until their heart’s content. officialfidgetcube.com

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LALABOOM EDUCATIONAL BEADS AND ACCESSORIES

These fun and creative beads will provide children with hours of educational fun, as well as helping to improve pattern recognition and manual dexterity. Each of the blocks stimulates senses in a different way through texture and use, and can be snapped together, allowing children to subtly improve motor skills and problem solving skills.

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jojomamanbebe.co.uk | 0333 240 0700 5

GIANT RAINBOMAKER

This colourful toy makes a noise that imitates the sound of falling rain, making it an ideal toy for use in musical or sound-based interventions. It’s an incredibly soothing toy to play with, and can calm a child while they develop hand-eye coordination. Its large size means it can be gripped easily.

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CLOUD CEILING FABRIC

Make a sensory room extra special with this beautiful fabric ceiling cover, hung to resemble billowing clouds. Add fairy lights to create a beautiful sensory experience, which can be utilised to make a calming room for anxious or worried children to collect their thoughts and feelings in. specialneedstoys.com/uk

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LIGHT UP LIQUID FLOOR TILES

Available in red, green, blue and orange, these fantastic floor tiles are waterproof, non-slip, and can carry loads of up to 500kg - meaning they’re child, adult, and wheelchairsafe. When a child steps on the tile, the pressure changes the position of the liquid, which is backlit by white LEDs. A fantastic addition to sensory play.

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glow.co.uk | 0345 505 9090 8

BALANCING GONGE BODY WHEELS

These can be used in lots of fun physical activities which can positively benefit children’s strength and balance. Made of soft rubber, the wheels are comfortable to sit or lie in, and feature a rim which will protect stray fingers and toes. Children can jump in and out of multiple wheels, or roll around on their stomachs. tts-group.co.uk | 0800 138 1370 9

BEAN BAG TUNNEL POUF

Children can sit on or inside this pouf, hide in it, squeeze through it, or jump into it, thanks to its durable, lightweight cotton material and comfortable polystyrene bead filling. The colourful pouf can be used to stimulate the proprioceptive and tactile system in a fun, safe way, through squeezing, pressing, and massaging. sensoryowl.co.uk | 01215170441

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UK Leader in Multi Sensory Rooms, & Therapeutic Resources • FREE bespoke sensory room design • On-site sensory expertise & advice • Rooms starting from £3000 • Free handover training • Wide range of sensory resources & portable equipment

www.rhinouk.com

01270 766660

sales@rhinouk.com


Newborn Ideas

In this day and age, you would believe that a simple adaptation would exist to allow a wheelchair user to push a pram, wouldn’t you? Sadly, this is not the case. Luckily for new parents, Luke and Yasmin Hamill, they were put in touch with Matt James, director of Precision Rehab, whose expertise and innovative mind created a solution that has allowed them to enjoy pushing a pram just like any new parent.

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uke and Yasmin are both wheelchair users as a result of spinal cord injuries and when they embarked on starting a family, they knew they would have to find other ways of doing certain things. One of which was how would they be able to push a pram from their wheelchair, as Luke explains: 56

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“Bobby was born in June; however, our problem was that from the end of March when we thought we would be buying and researching various items, pretty much everywhere was shut so this became something of a challenge. This was especially the case when it came to looking for a way of connecting the pram to our wheelchairs when we went out of the house and as far as we could tell there was nothing available which I found very hard to believe in this day and age.” Luke discussed this with his friend Patrick who said he knew Matt at Precision Rehab and thought he might be able to help. “Being introduced to Matt was fantastic, we met up, I explained what we were looking for and he went away promising to come back with a solution – and he did not let us down.” “Once we had sat down with Luke and Yasmin and discussed their requirements, I knew that as the preferred supplier in the disability sector for Ram Mount UK we would be able to offer a solution by combining several items from the Ram Mount range. I visited in late May to test my initial idea in theory, we then ordered the parts I thought would work best and visited again in July to test it and was delighted to see how well it worked and how easy Luke and Yasmin found it to use. Luke bought the solution there and then and we have already received requests from other mums-to-be who are also


manual wheelchair users,” explained Matt.

and Bobby all the best for the future,” concluded Matt.

The final version consists of a medium Tough-Claw HD Mount with 18” Pole, a heavy duty medium ToughClaw™ with 1.5” diameter solid rubber ball and a single socket Arm 1.5” ball with 0.5” NPT thread and metal knob, all of which were sourced from Ram Mount and then slightly tweaked where necessary. One end connects under Luke or Yasmin’s wheelchair with the other end connecting to Bobby’s pram while a tether also connects them to the pram as a safety back-up.

Thanks to Matt’s ingenious adaptation, the family can now enjoy days in the park or trips to the shops and to see family and friends without worrying about pushing Bobby in his pram – especially when they encounter any inclines.

“Here at Precision Rehab we pride ourselves on always going the extra mile to ensure every client receives the powerchair and adaptations they need to ensure they can be as independent as possible and we wish Luke, Yasmin

Luke was overjoyed with the solution and the service: “We cannot thank Matt enough for all his hard work in resolving what was a real concern to us as a family. As soon as we met Matt, he installed a feeling of confidence, he knew how worried we were but put our minds at rest and came up with a great solution which I am sure many other families could benefit from. I would urge anyone in a similar situation to us to give Matt a call today.”

For more information on the full range of powerchairs and adaptations available from Precision Rehab call 01256 300111, email info@precisionrehab.co.uk or visit precisionrehab.co.uk.

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Kidz to Adultz Exhibitions Free events organised by Disabled Living

Who attends our events?

Children & young adults with disabilities and additional needs, their parents, carers and all the professionals who support them.

Where can you find us?

5 events throughout the year in: Farnborough, Newport (Wales), Manchester, Coventry & Edinburgh. Register for your FREE tickets at: www.kidzexhibitions.co.uk

100+ Exhibitors

CPD Seminars

Fun & Features

Accessible Parking

Email: info@disabledliving.co.uk Tel: 0161 607 8200 Facebook & Twitter @KidztoAdultz, Instagram @kidztoadultz_exhibitions Kidz to Adultz is a trademark registered to Disabled Living. Charity no: 224742

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MAKING MOVES Gyms, pools, and community centres are opening back up, but some still don’t feel safe returning - but never fear, there are home substitutes

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YOUTUBE One of the best things to come out of lockdown is the number of fitness professionals who have given their time and energy to make great exercise videos that are available for free on YouTube. There are truly videos for everyone: low impact, high impact, videos for wheelchair users, yoga for people who have limited use of certain parts of their bodies - the choices are seemingly endless. What’s even better is that they require no equipment, and can be played and paused as much as necessary. What’s important about these fitness videos - which can act as a great stand-in for exercise classes for a motivated individual - is that the aim is simply to finish them to the best of your ability, not to get them perfect first time, allowing you to go back and re-do them as much as you’d like.

ith gyms, pools, and other activity centres like bowling greens and community centres - being closed due to the global pandemic, it’s been challenging for some to maintain a regular exercise schedule. For those who rely on classes or centres for their weekly or daily dose of exercise, the lockdown may have proven challenging, and with concerns being raised regarding the safety of returning to these locations, people continue to look for fun and engaging ways to exercise at home. If you’re struggling to motivate clients to engage in exercise at home, or need some new ideas on finding accessible exercise that can be done at home, we’ve got a few suggestions that could help.

RING FIT ADVENTURE

WEARABLE TECH

Gamification is a big trend in exercise, and Ring Fit Adventure is the latest in a line of games from Nintendo which aim to improve gamers’ “quality of life” by encouraging exercise. Unlike other exercise games, this one takes the form of a turn-based role-playing game, kind of like more well known game series Final Fantasy or Dragon Quest. The game uses the motion controls built into the Switch’s controllers, Joy-Cons, to track the players’ movements as they complete exercises to progress in the game, like yoga poses, and specific movements for the legs, arms, and core. The game is a single-player experience, meaning it can be used alone in the comfort of one’s own home. The only real downsides to the game are the price, and the fact that it is not designed for strength training.

Some of us need a gentle reminder to get off our bums and go for a walk. If motivation to exercise is an issue, wearable tech is a great way to provide gentle yet constant reminders. They can also provide goalorientated support to the wearer as they both prompt exercise and reward them for completing their goals. Using Fitbits, Apple Watches, and other wearables allows you to set and monitor goals, which is great when your clients are struggling to find the motivation to get themselves moving.

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A TEAM REACTION

OTs Katie Taylor and Joanne Robinson work for a therapy assessment and discharge team called REACT (Rapid Emergency Assessment and Care Team) which is based within the Emergency Department and Acute Medicine areas at University Hospitals Coventry and Warwickshire (UHCW) NHS Trust. Here, they share the work that their roles involve

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he team consists of occupational therapists, a physiotherapist and assistant practitioners, with services provided on a seven-day basis - 8.30am to 7.30pm, Monday to Friday and 8.30am to 4.30pm Saturday and Sunday (including bank holidays). Our work involves completing assessments alongside medical and nursing staff to gain a holistic view of a person’s medical, social, functional and cognitive level, identifying their acute and long-term needs. We focus on rapid identification of the impacts of illness, trauma and other factors on an individual’s ability to return home, while using problem solving alongside activity analysis to create a timely and safe discharge plan in an attempt to prevent further admission to hospital where possible.

We faced these challenges and overcame them all by working together and looking after the health and wellbeing of ourselves and team members

We also provide advice and education on adapting and changing behaviours to support healthier lifestyles, including falls prevention. If discharge cannot be avoided we contribute to identifying the most appropriate discharge pathway. We are the gate keepers to essential community services individuals may require for additional assessment following discharge, which has meant working together with our community partners in building strong connections, especially with admission avoidance services and the voluntary sector. This process is in keeping with a person-centred approach, enabling people to make decisions regarding their acute and long-term care needs. We are the therapists at the front of the hospital and our ethos is to ensure that the people who can return home, do, and the people that can’t, are put on the right pathway to suit their needs. We have been involved in setting up a Front Door Frailty Service Pilot which has enabled us to support the development of staff on the front line in the assessment and management of frail older people requiring an emergency admission. Using our ‘frailty expertise’, we’ve been able to educate staff in use of the Clinical Frailty Scale (Rockwood/CFS) in triage, enabling the identification of people 75 and over attending the Emergency and Acute Medicine areas. Through our education in nurse handovers and dropin sessions in the departments, this has successfully been embedded into the triage areas in the Emergency Department and the Medical Decisions Unit, enabling patients to be flagged up as needing a comprehensive geriatric assessment (CGA) if they have a CFS of six/ seven/eight and then can be transferred directly to the newly developed Frailty Unit. Alongside this, we have completed some successful joint work with key frailty multidisciplinary team members to develop the Frailty Unit criteria, integrated CGA paperwork, shared learning and create a service vision. Regularly participating in service review meetings, we

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make changes to improve the patient experience. We also lead on maintaining integrated working between all essential stakeholders involved in the management of frailty patients in and out of the hospital by using Microsoft Teams to bring services together. This has proved successful in strengthening links and encouraging joint decision making and problem solving.

up-to-date and relevant written material has been provided prior to discharge, such as AGE UK coronavirus information.

Prior to COVID-19, REACT would screen all over 75s to determine if a full holistic discharge assessment was required. There have been changes to the way we screen and assess people, from paperwork to pathways, guided by government directives. Initially this was a challenge to change our way of thinking and working but did lead to improved efficiency and less duplication in recording assessment information.

2 Adapting communication when wearing PPE while assessing patients (as they cannot see our faces, expressions or lip read)

There is a greater focus on assessing for discharge and formulating a safe discharge plan to allow individuals to return home or to an alternative destination (housing with care, residential home, nursing home). This is to prevent admission to hospital during the pandemic, putting more of an emphasis on ongoing assessment of needs in the community to prevent decline. This has led to smoother and faster hospital to community response, with one Trust-wide agreed ‘discharge to assess’ referral paperwork for all pathways of care. Other teams that have supported our role in rapid discharge include a more rapid equipment provision over seven days which can support a same day or next day discharge. In order to keep our patients and care providers informed during the COVID-19 period, we have ensured

Certain challenges come to mind during this period of rapid change: 1 Becoming familiar with Personal Protective Equipment (PPE) donning and doffing

3 Having to liaise with family members via telephone who may have been concerned or anxious about their family member and potential discharge plan, and ensuring relatives feel their loved ones are being cared for during visiting restrictions 4 Constantly rapid changes in processes and the need to adapt day-to-day working 5 Personal concerns about the pandemic and how this may affect day-to-day work life. We faced these challenges and overcame them all by working together and looking after the health and wellbeing of ourselves and team members. We are extremely proud to work on the front line and always aim to offer our patients a positive experience with the best outcome to meet their needs. We receive a lot of feedback as a team, for example, “let’s go and ask REACT because they can help” or “let’s refer to REACT so that we know the patient will be safe to return home”, this really makes us feel like valued members of the Emergency/Acute Medicine team.

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GOING DIGITAL With the global pandemic eliminating face-to-face contact as we know it, how can OTs still get their required dose of CPD - and find out what’s going on without in-person networking and conferences?

THE VIRTUAL CARE FESTIVAL This year, everything has been cancelled. What hasn’t been cancelled has been moved online, in what seems to be the only place in the world we can come together right now to chat, hang out with friends, and network. As was the case with many other events this year, The OT Show made the wise decision to postpone its in-person event which was due to take place in November, citing public safety concerns, of course, as its main issue. However, the show must still go on, and with that being the case, The Virtual Care Festival is a welcome addition to 2020’s line-up. The Virtual Care Festival will see many of the stalwart events from The OT Show move to an online setting, which will take place on 24-25 November, as the show at the Birmingham NEC would have. Signing up at The OT Show’s website will give you access to webinars which can be counted towards your CPD totals, amongst other relevant and exciting information.

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JOIN A COMMUNITY The easiest way to find out things going on around you is to join communities of likeminded individuals and get involved in the discussion. As OTs and avid readers of our magazine, you’ll no doubt be aware of OTalk, a Twitterbased forum for discussion which takes place every Tuesday on the team’s account. OTs are encouraged to join in with discussions, engage in friendly debate, and confer with other members of the profession. As these sessions are headed by experts, it’s a great way to both get to know the leaders of your field, and be directed towards great opportunities for CPD. Twitter is not the only place to go, however: there are huge communities of OTs on Instagram, Facebook, and even Pinterest, so while sitting on social media might not feel like a great way of acquiring CPD, it’s a fantastic place to start for those looking for people in the know.


CHECK IN WITH RCOT If anyone is going to know where you can find CPD opportunities, it’s the Royal College of Occupational Therapists. RCOT continue to offer practice resources to OTs throughout the pandemic, and if you’re a member, they’re not difficult to find. RCOT also maintains a rolling list of events, all of which are currently being held virtually. If you’re comfortable using Zoom (who isn’t at this point), Microsoft Teams, or other conferencing software, you’ll find that you’re able to attend a whole host of events from the comfort of your own home. The great thing about online events is that they’re often recorded too, so you can re-watch them for note-taking, or pause them and pick the events up again when you’ve got more time.

TAKE IT TO YOUTUBE As with their events, the Royal College of Occupational Therapists has a great presence on YouTube, taking a deep dive into CPD. If you’re looking to expand your learning, take to YouTube and search for something relevant to your framework. Even if you can’t use the videos for CPD, they give you a starting place to look further into topics, information, and communities. Our very own Kate Sheehan has a great video on the site explaining a client-centred approach to bathing, for example, and if you’re interested in exploring the CAPE recovery model, Dr Shawn Phipps, an occupational therapist from the United States, has a fantastic TED Talk which explores the power of occupational therapy and neuroplasticity to recover from a severe traumatic brain injury after a motor vehicle accident.

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VIRTUAL PLACEMENTS In our brave new world we are all adapting to new ways of working, studying, networking and applying OT over Zoom. Virtual placements are the next step in embracing the technology we have at our fingertips

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irtual placements? We know, it is a strange concept to get your head around when you are so used to traditional placements, but could virtual placements be the next big thing for OT students? There is no denying that traditional placements offer vital hands-on experience, preparing you for your future role, allowing you to witness and participate in the daily challenges that will soon face you as a qualified OT. However, we are now in the year 2020 and the importance of utilising online spaces for both personal and professional purposes cannot go unnoticed. Developing your online skills will only open doors for you as an OT. The online communities that exist for OTs and the disabled community are numerous, and what they offer to students is a platform of knowledge sharing, advice, networking and connecting. At a time when human contact has been abruptly minimised, online platforms have been our saviour. Consultations and team meetings have happened over Zoom, lectures have been delivered online and social media has played a vital role in keeping us all connected. So why not explore virtual placements?

#VirtualOTPlacement

Georgia Vine is an OT student at Sheffield Hallam University about to go into her third year. Georgia has cerebral palsy and writes a blog called Not So Terrible Palsy – she was also recently named CP Teens UK Upcoming Disability Blogger of the Year 2020. Georgia, alongside her mentor Margaret Spencer, this year embarked on a world-first in OT placements as they put the very first virtual OT placement into practice. This placement was not created in response to the difficulties of COVID-19 as you might think, but was an idea put into motion in 2019 when Margaret visited Georgia half way through her traditional placement on a paediatric ward. In a recent interview on the podcast OT – What’s Your Focus? hosted by OT student Farrah Money, Georgia and Margaret spoke about the process of setting up this placement and how it was conducted throughout. They shared that following a discussion about Georgia’s role-emerging placement that was coming up in 2020 and Georgia expressing an interest in working with the online disabled communities, Margaret believed that this 64

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The online communities that exist for OTs and the disabled community are numerous, and what they offer to students is a platform of knowledge sharing, advice, networking and connecting


could be a great fit for a virtual OT placement.

...for a placement format in its infancy it sounds like it has a solid foundation for becoming a popular avenue for OT students to embrace

Following a lot of discussion on how the placement would work, how Georgia would meet the required competencies and the general logistics of this new venture, Georgia embarked on the self-titled #VirtualOTPlacement and it has sparked great interest from OT students, educators and practitioners alike. Speaking about how they began Margaret commented: “First of all we just had the idea, then when we got to September/October time we started to drill down how Georgia could give evidence of all the competencies, because clearly we have exactly the same competencies as we do for all the placements and they have to be passed. So we were trying to look at how a virtual placement would evidence all the things that are in all the assessment booklets that we all have at all the universities.” She also explained that they researched the guidelines from RCOT, WFOT and HCPC to ensure that all the areas were being covered and regulations were being met. When asked about whether she felt she got as much out of a virtual placement as a traditional one, Georgia said: “Well a role-emerging placement is very different to a traditional placement, but I still feel like I got an equal experience and if anything, this is the placement I got the most out of as I have been really independent. I am just hoping that I take this confidence with me to my next placement. I do feel like if I were to do this more traditionally and have a client group and a caseload then it would be possible to have Zoom calls with clients individually or as a group. I could also create online groups so people could connect in a private community.” They go on to describe the placement as being very “organic” as they took each week and challenge as it arose, but for a placement format in its infancy it sounds like it has a solid foundation for becoming a popular avenue for OT students and educators to embrace. Many students have missed out on traditional placement opportunities this year due to COVID-19, introducing the option of virtual placements going forward would be a great solution to tackle unforeseen circumstances. They could also open up a more inclusive environment for OT students with disabilities who would benefit from a more flexible working schedule that allows them to conduct their placement from home.

FIND OUT MORE If you are interested in finding out more about this virtual placement we would recommend listening to Farrah Money’s podcast interview on spotify on her show OT – What’s Your Focus? As part of Georgia’s virtual placement she wrote a weekly blog on her website notsoterriblepalsy.com which gives a great insight into her placement experience. You can also follow Georgia on Twitter @GeorgiaVineOT and her mentor Margaret Spencer @margaretOT360. Both Georgia and Margaret have encouraged queries and communication from those interested, so don’t hesitate in contacting them to find out more.

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