Brave New World
THE
How occupational therapy is adapting to and embracing the ‘new normal’
MAGAZINE Issue 38 | Jan/Feb 21 | Improving Independence
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COLU M N S
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PRO DUC T S
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CPD
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EVENTS
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MENTAL HEALTH
About us
The Team
Editor: Rosalind Tulloch Staff Writer: Katie Campbell Designer: Fionnlagh Ballantine Production: Donna Deakin Sales: Danny McGonigle Contributors: Kate Sheehan, Heather Manktelow, Rose Bradshaw, Alexandra Broadbent, Emily Stuart, Gina Hopkins, Aaron Preston
This month’s issue...
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Get in touch 2A Publishing, 20-23 Woodside Place, Glasgow, G3 7QL 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 2021 © 2A Publishing Limited. All Rights Reserved. ISSN-2056-7146
elcome to 2021, it may not be beginning the way we all hoped it would, but things can only get better, right?
Even though we are still in various forms of lockdowns and restrictions, a new year offers the chance to reflect on what you can learn from last year and use this in 2021 to help guide your practice and ensure you are adapting to the “new normal”, and most importantly helping your clients adapt to the “new normal” - whatever that may be. This issue we hear from OT Heather Manktelow, who has started a new online service for people living with dementia and their carers to help them create a LifeStory Book to be used for reminiscence therapy, as a communication passport and to be passed on as a family treasure, you can read more about this on page 14. We also hear from Aaron Preston, a paediatric OT who took his therapy on the road to the Scottish Highlands to deliver OT to children living there, and we take a look at an organisation delivering adaptive martial arts from the comfort of your own home for people of any abilities. Plus our regular product focuses, our column from Kate Sheehan and much more. This may be a difficult start to the year and we may be in for a few more months of restrictions, but there is light at the end of the tunnel, so let’s make sure we emerge from it stronger, more understanding, and more resilient than ever before. Stay safe. The OT Magazine, Editor
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What’s inside 07 What’s New
Keeping you up-to-date with all the latest news from the healthcare sector
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13 What is the Purpose
of Therapy?
Columnist Kate Sheehan ponders the need to consider what the purpose of an OT’s therapeutic interventions are
14 Capturing Memories Heather Manktelow explains her new business, Teacup Dementia Therapy
19 Product Focus The latest products on the market to aid independent living
22 Sweet Dreams Meet the innovative, nonmedical solution to sleep problems
25 A Day In the Life Rose Bradshaw shares a day in her life as a highly specialised neuro OT in Bedfordshire
26 The Lavender
Rooms
OT Alexandra Broadbent explains how health and wellbeing rooms help both patients and staff in rehab units
28 Dining with Dignity Exploring dysphagia and the solution of texture modified food 4
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30 Show and Tell Amazon’s Echo devices launch a game-changing new feature for blind and partially-sighted users
32 The Rehab Game There’s more to video games than Grand Theft Auto and FarmVille
35 Product Focus More of the latest products on the market to aid independent living
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39 Positive Reflections Searching for the positives that we can take from 2020
40 Overcoming
Obesity Stigma
40 Product
Focus 35
Can occupational therapy help reduce internalised stigma in people living with obesity?
42 Inclusive Access Muirfield Riding Therapy Centre has increased accessibility for all visitors
44 Martial Arts at
Home
Learn adaptive self-defence from the comfort of your own home
49 OT on the Road Aaron Preston explains why he took occupational therapy to the Scottish Highlands last year
53 Food Therapy At what point does fussy eating require the intervention of an occupational therapist?
54 Worrying Wee Ones Helping children and their carers combat anxiety or worry brought on by the global pandemic
56 Kids’ Products Innovative products for your younger clients
58 Passion Project If your passion for your work has taken a hit this year, how do you get it back?
63 Pandemic
Reporting
A new report from Sensory Integration Education explores how COVID-19 has affected the ability to offer and receive care -magazine.co.uk
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We explore what’s happening in the healthcare sector, from new products and services to inspirational stories
What’s new? AHPF ANNOUNCE FUNDING FOR
BAME FUTURE LEADERS PROGRAMME The Allied Health Professions Federation have announced that they will begin funding places on its Future Leaders Programme for Black, Asian and ethnic minority (BAME) RCOT members, with a view to improving the presence of BAME leaders in professional associations. Conceived by the British Dietetic Association, the programme has been approved by the Institute of Leadership and Management and will guide successful applicants in matters relating to strategic corporate issues, like finance, governance, leadership skills, risk management, and many more aspects relevant to their professional associations.
months developing these skills, using a mixture of online learning and selfdirected study. If you would like to apply to be part of the programme, send a CV and a letter that outlines your reasons for wishing to complete the programme to info@ahpf.org.uk by 12 February 2021.
The course will see applicants spend 50-60 hours over a period of six months”
The course will see applicants spend 50-60 hours over a period of six
DERRY OTS SLEIGH CHRISTMAS A team of kind-hearted OTs from Derry have turned their Christmas woe into cheer for a local charity through an incredibly selfless donation. As with many others, the team were disappointed that they’d have to cancel their annual Christmas night out due to restrictions put in place to stop the spread of coronavirus, but instead of getting frustrated with their inability to have a night on the town, the team decided they’d instead use the money for their night out to donate
toys to the Society of St Vincent de Paul. The Society of St Vincent de Paul is the largest charitable organisation in Ireland, and the toys donated by the occupational therapists will be distributed to families over the Christmas period, thanks to Grangewood Hospital staff, who Derry Now named as Kelly McGilloway, Ciara Stewart, Karl Fullerton, Colm Harkin, Finovla Kelly, Laura McGinley, and Chris Moore, amongst other colleagues. www.
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AUTO-VISA EXTENSION SCHEME CONTINUES FOR ALLIED HEALTH PROFESSIONALS Occupational therapists who are living and working in the UK on a visa will be eligible for a free oneyear extension due to the COVID-19 pandemic, the government have confirmed.
SOUTHWARK OTS USE VISUAL TECH TO SUPPORT ADLS Southwark Council’s Children and Adult Services department has begun using virtual technology to hold training on the practicalities of stairclimbers as a realistic intervention, in association with provider AAT.
application for technical training, in situations where the healthcare professionals need to actually see how the function and scope of a device can be appropriate, and how it integrates with the PEOP model for a positive outcome.”
The virtual session allowed occupational therapists to explore the range of devices on offer and provided practical knowledge on prescribing stairclimbers.
Clare Weale, lead occupational therapist at Southwark, explained why the session was so important for her team: “We need to have practical sessions to develop a technical framework as to what is feasible and therefore realistic as an intervention. With current working practices because of COVID, a virtual session was the closest we could come. Adoption of such new practice is essential for our team to continue to build on our professional skills, and deliver outcomes to improve people’s wellbeing, where stairs or steps present as environmental barriers to participation in daily living.
Technical director of AAT, Gareth Brown said: “If someone has impaired mobility, the perception on the whole is that they need a fairly major adaptation to their home to enable them to get up and down stairs. With COVID impacting so much on the practicality of occupational therapy teams across the country to undertake home assessments and expediate adaptations, there is growing need for alternative strategies that are realistic, practical interventions. “Virtual conferencing is becoming an accepted methodology for meetings, home assessments and CPD sessions. It made logical sense to Southwark and us to extend its
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“The AAT virtual workshop was interesting and informative. It gave our clinicians the necessary knowledge of what may be a technically feasible option with more complex equipment prescription, that may not otherwise have been considered.”
The confirmation comes after lobbying from RCOT in April of 2020 to have Allied Health Professionals included in the auto-visa extension scheme, allowing more than 6,000 people who have spent the last year working on the front line to continue the incredible work that they have been doing during the pandemic. Occupational therapists are amongst the professions eligible for visa extensions, which includes nurses, speech and language therapists, social workers, and physiotherapists. In order to qualify for the extension, the individual’s visa must expire between 1 October 2020 and 31 March 2021 and they must work for the NHS or an independent healthcare provider in an eligible profession. Those who have already applied for an extension and paid the required fee, but are eligible for the free extension, can claim the payment back. For more information on the visa extensions scheme, visit gov.uk.
set to be created in the Midlands, five in London, and more around the country. In order to be seen at one of the clinics, patients will require a referral from a GP or another healthcare professional. This comes as the NHS has also launched a new taskforce with the aim of tackling post-COVID syndrome, and establish a better understanding of the condition.
NHS LAUNCH “LONG COVID” CLINICS NHS England has begun opening more than 40 clinics which will allow interdisciplinary teams to conduct physical and psychological assessments of individuals living with the symptoms of “long COVID”.
Thought to affect more than 60,000 people in the UK, postCOVID syndrome can cause pain, breathlessness, continuous fatigue and brain fog, with a number of test sites set to be established, with ten
Government announces £600m for NHS upgrades The government announced last month that it has assigned £600 million from a £1.5 billion budget to fund 1800 projects across 178 NHS trusts, with the aim of eradicating the maintenance backlog that exists in NHS hospitals. The investment aims to tackle these projects by March 2021, and is targeted towards a number of
areas, including building new, or refurbishing buildings that deliver key services, and improving safety and ventilation systems. Among the projects earmarked for completion are a new paediatric integrated unit for Croydon Health Services NHS Trust, and a new critical care centre at Northampton General Hospital.
NHS Chief Executive Sir Simon Stevens said: “Long COVID is already having a very serious impact on many people’s lives and could well go on to affect hundreds of thousands. “That is why, while treating rising numbers of patients who are sick with the virus and many more who do not have it, the NHS is taking action to address those suffering ongoing health issues. “These pioneering ‘long COVID’ clinics will help address the very real problems being faced by patients today while the taskforce will help the NHS develop a greater understanding of the lasting effects of coronavirus.”
Secretary of State for Health and Social Care Matt Hancock said: “Alongside delivering on our manifesto commitment to build 40 new hospitals and 20 major hospital upgrades across the country, this investment will help our NHS build back better. “These crucial maintenance projects will deliver immediate benefits and provide NHS staff with the facilities they need to provide world-class care to their patients this winter, helping ensure the NHS is always there for you when you need it.”
SLOUGH ANGEL HONOURS OTS A series of angels were illuminated on Slough High Street as part of its Christmas decorations, each honouring a member of staff or team from the nearby Wexham Hospital who have been labelled as “unsung heroes” for their hard work and dedication throughout the COVID-19 crisis. Funded by the Slough Business Improvement District, the 12 angels line the High Street and represent staff from throughout the hospital, including its housekeeping and
portering staff. Wexham Hospital’s occupational therapy team had an angel dedicated to them. The team is made up of staff members Nicola Bobyk, Yusra Alanez, Renee Corsie, Maureen Ricketts. Tracey Solarz, Niamh McMahon, Avneet Sahota, and Rowena Ingalla. Amanda Mason, marketing manager for Slough BID, told the Slough Express: “COVID has been the main focus of 2020 and as Christmas
looks very different this year we wanted to make Slough a little bit brighter to celebrate the festive season. “Our local businesses and communities are extremely grateful to NHS staff and their enormous efforts working during the pandemic. “The angels are a fitting tribute to symbolise our gratitude to everyone at Wexham Park Hospital and to invoke the true spirit of Christmas for local businesses and residents.”
Naidex Virtual As we await the physical exhibition taking place, Naidex has forged ahead with some free virtual taster sessions to provide attendees with information, advice and solutions.
The first session, ‘Room to Improve: Independence in the Home’, will take place on 3 February 2021 at 2pm and will focus on the need for increased accessibility in the home. It will cover home adaptations, accessibility standards, technologyenabled solutions and will include additional support and resources. All the webisodes will be free of charge and Naidex are looking for
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input from the disabled community and allied health professionals to guide these sessions, so if you want to let them know what you would like to hear about you can get in
touch at naidex.co.uk.
Don’t forget to register for Naidex Virtual to get unlimited free access to all webinars, webisodes and product showcases.
FLOW X The Next Generation
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The Motability Scheme enables disabled people to lease a new car, scooter or powered wheelchair without the worry of owning and running one. Parents and carers can drive on behalf of the customer. The vehicle should be used by, or for the benefit of, the disabled person.
Making life easier for disabled people
Who can join the Motability Scheme? Your patient may be eligible to join the Scheme if they receive one of the following: • Higher Rate Mobility Component of Disability Living Allowance (DLA). • Enhanced Rate of the Mobility Component of Personal Independence Payment (PIP). • War Pensioners’ Mobility Supplement (WPMS). • Armed Forces Independence Payment (AFIP).
What’s included on the Motability Scheme? Insurance Breakdown assistance Servicing and repairs Tyres and battery replacement
To find out more about the Motability Scheme visit motability.co.uk or call 0800 093 1000 (quote OT Magazine)
“Learning to drive and having my own car has helped tremendously. I have gained a new independence and the freedom to move around easier.” Allison
How Motability, the Charity can help Motability is a national charity which oversees the Motability Scheme. Motability may be able to provide charitable grants towards vehicle Advance Payments, adaptations or driving lessons to support disabled people who would otherwise be unable to afford them.
Do you have patients that could be eligible to join the Motability Scheme? Visit our website to order your free information pack
motability.org.uk/advisors or call 0800 500 3186 Motability is a Registered Charity in England and Wales (No.299745) and is authorised and regulated by the Financial Conduct Authority (Reference No. 736309). The Motability Scheme is operated by Motability Operations Limited under contract to Motability. Motability Operations Limited is authorised and regulated by the Financial Conduct Authority (Reference No.735390).
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
WHAT IS THE PURPOSE
OF THERAPY? A
strange question to ask, but as we are starting a new year, and I thought it would be interesting to explore what it means to us and how our understanding can impact a client/patients physical and mental wellbeing. The definition of occupation according to the World Federation of Occupational Therapists is:
“Occupational therapy is a clientcentred health profession concerned with promoting health and wellbeing through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment to better support their occupational engagement” What happens in acute care where the pressure is to facilitate discharge or where patients have been labelled “medically optimised” or medically fit for discharge, but this cannot happen as they are awaiting a nursing home bed or the care agency cannot provide the care package immediately? Does therapy stop? Therapy is not just about achieving the maximum level of function, but also to maintain what function a patient/client has achieved through the use of purposeful activities that they want, need, and have to do. By not providing ongoing therapeutic
interventions, even if they are deemed “medically optimised” we could be reducing their functional abilities which could potentially have a long-term effect on them living a fulfilled and purposeful life. A personal example of this was during the first lockdown in March 2020, when an elderly relative was moved out of an acute bed into a community hospital. Once in this hospital, they were cared for in single rooms, with the necessary precautions to avoid contracting COVID-19.
However, what did not occur was a risk and impact assessment on not providing ongoing therapy - both OT and PT - and social activities, resulting in significant physical and cognitive deterioration, which removed choices for her and her family, and impacted where she would like to live in the long term. The removal of physiotherapy, inappropriate seating, limited manual handling plans, and poor positioning in bed resulted in contractures of the knees, and due to no effective treatment plan being in place, no passive range of movements was undertaken. Not one of the ward staff noticed the contractures developing. In addition, no one thought about the effects of social isolation and the impact this would have on her cognitive wellbeing. As an occupational therapist, I was struck by the lack of treating the patient as an individual, and the absence of purposeful occupation
and meaningful activities which could have been used to maintain their functional abilities. When reviewing this further, it made me think about our profession and the occupational science underpinning our practice, and in particular, occupational justice which is defined by Wilcock and Townsend as “the right of every individual to be able to meet basic needs and to have equal opportunities and life chances to reach toward her or his potential but specific to the individual›s engagement in diverse and meaningful occupation.” If we are not thinking about occupational justice for our clients/patients, are we actually enabling, supporting, or facilitating occupational injustice, be that in the form of occupational alienation, deprivation or disruption, and therefore not meeting our code of ethics or standards of practice?
My challenge to you is to reflect. Have you discussed with your patient/ client their goals? What is the purpose of your therapeutic intervention? Are your employers restricting your therapeutic interventions, which could lead to occupational injustice? Do you and I need to review what we are doing and why? Should we be challenging the status quo or the medical model and putting our patients/clients at the centre of all we do, and truly standing firm to the core values of our profession of occupational justice? -magazine.co.uk
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Capturing Memories
Heather Manktelow and Kate Bartlett have embarked on a new online service supporting people living with dementia and their carers to create a LifeStory Book that will serve as a resource for carers and a nostalgic keepsake for families
I
am Heather Manktelow. I have been an independent OT since May 2014. Prior to this, I was working as an occupational therapist in a dementia care nursing home. However, I gave that up after a shock diagnosis of breast cancer. Following successful treatment, I felt that I didn’t have the same energy that I used to have, so I became an independent OT. This allowed me to take on work at my own pace. Pre-COVID-19 a typical day for me was facilitating cognitive stimulation therapy (CST) at a private activity club for people living with dementia from 9.30 am till 4.30 pm. We usually had a theme for each day, which would include a variety of activities, and some fun. During my four years there I was also practice placement educator to twelve OT students. However, when COVID-19 hit last March, all groups had to cease and the activity club closed its doors. I later found out that the club would sadly not be reopening. During the lockdown, I worked on a two-month pilot project delivering cognitive stimulation therapy to people living with dementia, via video-link for a dementia service called TanDEM Care. Now I am starting a new business with fellow occupational therapist, Kate Bartlett. The business is called Teacup Dementia Therapy Ltd and will offer a service via video link, helping people with dementia and their carers to capture their memories, and put them into a LifeStory Book with photographs. This will be designed to also act as a ‘Communication Passport’ and a resource to help with care planning right up to end of life. We believe that person-centred care should always start by getting to know the individual, and Jackie Pool has kindly allowed us to base our LifeStory work on her personal history form. From there, we will be offering individual CST, carer support, and also training carers how to deliver individual CST at home with their loved one. This includes collaboration with TanDEM Care. Our pilot LifeStory participants reported to us that they thoroughly enjoyed the process of reminiscence therapy with our therapists, and working with their families to gather photographs and documents for inclusion, thinking up the name, selecting a cover photo for their book, and writing a message to future generations.
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...helping people with dementia and their carers to capture their memories, and put them into a LifeStory Book with photographs Families can of course produce LifeStory Books for loved ones, but it seems to make a difference relating memories to someone who is genuinely interested and hasn’t heard the stories before. Our therapists will all be allied healthcare professionals, primarily occupational therapists employed by Teacup Dementia Therapy on a self-employed basis. They have the skills to get the best out of people living with dementia and conduct sessions in a way that will build on what they remember, not dwelling on things they have forgotten. My challenges at present involve getting everything ready to launch a new business, rather than working with people in a therapeutic way. For example, I am presently writing contracts, terms and conditions, policies and procedures, and training for new staff. Challenges also include working with three other people (who I have only met on Zoom) to amalgamate ideas and decide jointly what to include in the website, and what to leave out! However, the benefits outweigh the challenges. My business partners are younger than myself, meaning that between us we have a broad range of skills and we complement each others’ talents; clinical experience, knowledge, business acumen, IT understanding, marketing strategy and financial expertise. We all have enthusiasm and drive, and are all working towards the same goals of offering a quality service to help people. In this world of COVID-19 where social interactions for
people are very different and a lot of community groups have stopped, I felt that I had to diversify in the services I was already offering, and to embrace this new age of technology to help people living with dementia and their carers to reduce their isolation. I still feel that I will be helping people with dementia and their carers to live well, sharing my knowledge and skills, and working in the best interests of the people who will be engaging with Teacup Dementia Therapy Ltd. I will be building upon what I have learned already about how people with dementia progress through the illness, and how a simple book can help as a valuable resource both now (reminiscence therapy), helping with transitions, helping future carers understand and appreciate the individual for who they really are, as an end-of-life aid. Finally, it will be a beautiful book to pass down to future generations.
FIND OUT MORE To find out more about this new service visit teacupdementiatherapy.com, or contact Heather on heather@teacupdementiatherapy.com.
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Are You Sitting Comfortably Peter Wingrave, sales director AAT GB, explains the benefits of variable vacuum postural support systems
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e all know the benefits of the beanbag concept in terms of its all-round support. But is the accepted norm - applying a fixed mould to ensure the client remains in the correct position - the best solution? It’s not the only one for sure.
HEALTH AND WELLBEING FOR ALL INVOLVED
The one inevitable in life is that client needs change with time- they grow, their condition deteriorates, or they develop other issues. These all impact on the size and shape of the mould. Changing that mould takes time, costs money, and puts big pressure on getting it right the first time!
I was talking with a client, Fab Betts, who put it into harsh perspective. On the recommendation of her OT, she has tried one of our Stabilo vacuum posture cushions with our bath board to support her young son Ted during bath time. She said: “All the other equipment we tried was so uncomfortable for him, it would end in tears. Now, he loves bath time. That’s better for all of us.”
PHYSICAL AND SENSORY SUPPORT INFINITELY VARIABLE ALTERNATIVE There is an alternative, rapidly growing in popularity with OTs and clients alike: Chilli Bean. It uses vacuum technology, whereby removal of the air between the ‘beans’ in the cushion provides a precise, uniform postural support without pressure points. It can be infinitely re-shaped. It holds that shape for weeks. And, with modern technology, we can ‘pressure map’ the supporting area, to eliminate any potential danger points at the outset. As needed, the client’s carers can simply attach a pump to re-plump or re-mould the shape, without any need to organise a re-assessment and implement the procedure for a replacement mould. We’ve even developed a roller base, so the Chilli Beanand its occupant- can be easily moved from one room to another. Chilli Bean has been such a success that it has evolved into all aspects of life: now, as well as sitting systems, we have Grande for sleeping, Bath Board for bathing, Smart Cradle for shower seats, Multiseat for travelling by car, Bagel for swimming, plus a raft of additional shapes to enable equipment to be made as supportive and comfortable as possible.
The structure also means the bag can be used as a sensory aid: pop an appropriate music player underneath, and the sound, beat and rhythm will transfer through the cushion. Small, velcro-fixed versions mean a single limb can be stabilised during a period of therapy. Large versions replace bed mattresses and can be exactly formed to shape and support the trunk and limbs as needed, even allowing the creation of abduction wedges. One client has even undertaken a multi-disciplinary activity challenge and used the cushions to adapt his canoe! Whenever a degree of stabilisation is needed, there’s an AAT Stabilo. To find out more about how AAT Stabilo vacuum posture cushions can support your clients in daily life, visit aatgb.com/posture-cushions, call 01978 821 875 or email sales@aatgb.com. Do note, AAT’s specialist team will work alongside you with a fee-free assessment for clients.
INDEPENDENT LIVING
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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THERMOGEN QUILTED HEATED JACKET
Ideal for clients with a sensitivity to cold weather, or those whose conditions are soothed by heat, this quilted jacket is stylish and functional. Available in sizes small to 3XL, the discreet heating feature even allows you to charge your mobile phone from its hidden battery pack, and features a safety cut off for peace of mind. regatta.com 2
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POWERDOT 2.0
Connecting to any standard smartphone via Bluetooth, you or your client are able to control more than ten muscle stimulation programs that are designed to alleviate pain while increasing blood flow to the affected area through electrical muscle stimulation. Available in both uno and duo versions and different colour ways, it’s a smart and handy addition to an OT’s arsenal. recoverfit.co.uk | 0333 444 3007
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KANGO STAND UP STOOL
Designed with environments in mind where clients may have to stand for significant periods of time - such as within the catering industry or retail - the ergonomic design of this stool relieves 2/3 of the user’s body weight. Height adjustable and comfortable to use, it features a stable steel base and takes up little space. posturite.co.uk | 0345 345 0010 4
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PRIDE JAZZY AIR 2 POWERCHAIR
The Jazzy Air 2 powerchair features an elevated seat, which allows the user to feel more comfortable and closer to eye level when having conversations with people. Sporting a sleek, modern design, it also boasts performance enhancements on previous models which make it more stable in use both indoors and outdoors. store.easylivingmobility.co.uk 0800 193 4588 5
HOMCOM LEG EXERCISER
When the weather changes and the paths and walkways become icy, it may not be as safe for your clients to go outside to get exercise. While it’s no substitute for movement, the HOMCOM leg exerciser helps keep patients moving, promoting body movement and minimising the risk of swelling and discomfort that can occur when a client is stationary for long periods of time. fruugo.co.uk
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RING PEN ULTRA
Designed to aid clients who write a lot and experience discomfort, or who live with repetitive stress syndrome, this pen provides additional support to the index finger, while simultaneously decreasing pain that may be felt around the wider hand and wrist. A universal implement, the Ring Pen Ultra can be used with virtually any pen.
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completecareshop.co.uk 03330 160 000 7
OT REFERENCE POCKET GUIDE
Perfect for student OTs and those who like to have a little quiet reassurance at their side, these 16 double-sided cards offer lots of reference material for OTs who focus on adult rehabilitation. Designed by an OT, different topics on the cards are colour-coded to ensure they can be found quickly. etsy.com/uk/shop/scrubsandstuff 8
BAMBOO FURNITURE RAISERS
Easily used with beds, chairs, table legs and castors, these strong and hard-wearing bamboo raisers are designed to improve stability and reduce transfer risk for clients who may find it difficult to stand up from low furniture. The raisers come in packs of four, and are available in both four- and six-inch heights. nrshealthcare.co.uk | 0345 121 8111
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SWEET DREAMS The importance of sleep is undisputed, but sleep problems can be hard to resolve. Meet Fidgetbum, an innovative, non-medicinal solution designed to help people of any age experiencing sleep problems
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e spend approximately a third of our lives asleep. It is widely accepted that most people need around eight hours sleep a night to function properly, although this does vary between individuals. For many people of varying ages, achieving this amount of sleep is simply not possible due to a variety of reasons ranging from anxiety, a medical condition or disability which can, in turn, lead to physical discomfort, tiredness, trouble settling and sensory issues. Sleep problems within the home can affect the whole family. From parents of young children and siblings to
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children with elderly parents who may be living with them. The ripple effect can reach all members of the family. For the person struggling to sleep, the lack of sleep can leave them feeling irritable and frustrated, and if they are of school age, they can struggle to concentrate at school due to tiredness. Siblings can also find it hard to perform at school as their sleep can often be disrupted by their parents trying to settle their brother or sister. There are many options available for carers and people living with family members who have trouble sleeping, including various organisations offering support, therapies and possible medical intervention. However, there are very few, if any, completely non-medicinal solutions. That is until Mel Wood came up with Fidgetbum. Fidgetbum is a soothing, non-medicinal sleep aid which is available in a range of sizes. A stretchy wrap-around device that snugly holds the covers in place, without restricting the person in bed, it also provides a sense of security that sleep experts have likened to a warm hug and can be used on people of any age, from toddlers to older people. The lightbulb moment for Mel came seven years ago when she was a sleep-deprived stay-at-home mum, as she explains: “My youngest daughter’s frequent nightwaking had left me exhausted. I was desperate for a solution to stop her kicking her covers off and waking cold throughout the night, but couldn’t find anything to help. So, I took matters into my own hands and invented the Fidgetbum, and began a journey to create and build a brand, promoting a product that I’ve put my heart and soul into and, in doing so, helping other sleep-deprived families get some much-needed rest.”
Fidgetbum is helping people of all ages across the UK who have previously struggled with their sleep, such as 13-year-old Elliott from Oxfordshire. Elliott has kernicterus, a condition which has symptoms similar to athetoid cerebral palsy, but also effects Elliott’s hearing, speech and eye movement, and can cause muscle spasms that can cause arching of the back and neck. Another side effect is difficulty in getting to sleep and general restlessness during the night. Over the years, Elliott’s parents, Peter and Caroline, have struggled with helping Elliott to sleep as his mother Caroline explains: “We have always avoided any medication but have tried various other solutions to help Elliott sleep, such as pegging his duvet to the bed to stop him kicking it off, but nothing seemed to work.” From the first night of using Fidgetbum, Elliott slept better. With the Fidgetbum secured over Elliott’s duvet he no longer kicks his duvet off resulting in a better night’s sleep and not feeling as tired the following day. “I am so grateful to Mel for coming up with such a simple but effective idea and I would not hesitate in recommending it to anyone of any age with sleep issues. I have already shown it to Elliott’s occupational therapist so she can tell her other clients about it.” Elliott also loves his Fidgetbum: “I find it really comfortable to sleep with and it is just tight enough to hold my duvet in place but not too tightly. I also really like the material.” For more information on the full range of products available from Fidgetbum call 020 3714 4497, email mel@fidgetbum.com or visit fidgetbum.com. You can also follow them on Twitter @fidgetbumsleep.
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-magazine.co.uk
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RECRUITING NOW! If you’re an ambitious Occupational Therapist looking to make a positive career change, we have excellent opportunities for you to become a qualified Disability Assessor. • • • •
Industry leading benefit package On-going CPD and revalidation support Improve lifestyle and work life balance Fantastic opportunities to progress your career with clear pathways to senior roles • Work and support individuals with disabilities • Maintain and develop your HP skills/broaden clinical knowledge We are looking for Occupational Therapist thoughout the UK for these roles and offer induction/training dates all year round. To find out more or for a confidential chat please contact: Hannah Macfarlane | hmacfarlane@meridianbs.co.uk | 07507 565394 www.meridianbs.co.uk
n i y a d A . aw h s d a r highly Rose B w is a y a h s d herap ra
B and t Rose o OT r u itation e n list ehabil r ia c y r e p ju s in nit in ABI U brain s a t t h a ig e lead ton H e t Man a it rdshir n o u Bedf
What is your current role? I currently work as a highly specialist neuro occupational therapist and therapy lead at a brain injury rehabilitation unit. I have been in this role for just over a year but I have worked within brain injury rehabilitation for over four years.
Describe a typical day I don’t know if there is such a thing as a typical day in brain injury rehabilitation, but mine often includes the following… Team meetings, management meetings, individualised tailored therapy sessions with my patients, cooking assessments, feeding assessments, cognitive assessments, personal care assessments, upper limb rehabilitation, rehab groups, home visits, access visits, ordering equipment, writing reports and referrals, writing care plans, goal setting, liaising with external organisations, speaking to family members, completing supervision with my team members, MDT meetings, timetable planning sending emails – lots of them! Now,
. f o e f i l e th
Each month ..
we talk to a differen occupati onal thera t pist to see wh at a typic a l day is for the ma a little mo nd explain re about their role.
Rose w a h s d Bra
of course I don’t do all of these everyday but this is what I would achieve over the course of a few days, and shows just how diverse my job role can be.
What is the hardest thing about your role? The hardest thing about my role is juggling my clinical caseload as an occupational therapist and my clinical managerial duties. Sometimes one takes over the other and it can be hard to find the right balance. I find that to do lists are becoming an essential way for me to prioritise my day.
What is the best thing about your role? The best thing about my role is easy, it’s seeing the difference we make to people’s lives. Helping them regain independence, achieving their goals and waving them off when they leave the unit to return home. Knowing that we have made a real difference, not only to their lives, but also their loved ones who are over the moon for them to be coming
back home and seeing how well they have done. The second-best thing in my role is working with my amazing team, who make me laugh and smile every day. Everyone I work with in the unit is so passionate about what they do and I think that’s what makes my job role so enjoyable.
The best thing about my role is easy, it’s seeing the difference we make to people’s lives
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THE
Lavender Rooms Alexandra Broadbent is an OT based in the Intermediate Care Residential Rehab Units within the Bolton Foundation NHS Trust Intermediate Tier Services. Here she explains the introduction of health and wellbeing rooms implemented throughout the Trust to help both patients and staff
T
he COVID-19 pandemic has taken its toll on NHS health professionals and care workers. Now, more than ever, the health and wellbeing of health and social care workers matters. The World Health Organisation (2012) highlighted that “a health-promoting and protecting culture� whereby managers and workers work together is key in providing a healthy workplace. Towards the end of 2019, the Intermediate Care Bed Based Occupational Therapy Service in Bolton NHS Foundation Trust developed a Health and Wellbeing Room which soon became known as The Lavender Room due to its scenic lavender wall wrap and lavender plants. The purpose of the room was to provide a private, welcoming space for both workers and patients to retreat to, absent of any work-related paraphernalia, and designed to allow time for reflection and to promote relaxation and mindfulness. Mindful Mondays soon followed where an occupational therapy-led, guided meditation and relaxation session was available for both patients and staff to attend. The response to these sessions was overwhelming, with patients and colleagues reporting they had never felt more relaxed. Therapeutic herbs were used including lavender, thyme and mint to provide sensory elements to relaxation. The motivation for creating a health and wellbeing space in the workplace came after I returned from maternity leave. The challenges which came with such a transition, regardless of the fantastic support from colleagues, were difficult to overcome at times. I have always been passionate about health and wellbeing in the workplace and wanted to do something practical to promote selfcare at work. I spoke with my team leader and suggested that we could transform the small family room into a health and wellbeing room. The room would be
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-magazine.co.uk
designed to create a safe and welcoming space where both colleagues and patients could retreat to. The layout of the room was small with a window facing a courtyard garden. It had blackout blinds and comfortable seating. It later had a lavender wall wrap with a lavender field scene. To further promote a relaxing and peaceful atmosphere, we purchased a light projector, a speaker, and some sensory paints. The room was used by staff as a safe space to escape for some quiet time where needed. It afforded more comfort and privacy than the staff room or toilets. Many of the patients on the units complained of boredom and frustration of being “stuck” in the same four walls, despite having activities and therapy interventions available to them. When offered the chance to take part in mindfulness and guided relaxation sessions in the Lavender Room, I was surprised by how many were enthusiastic to get involved. The small space was perfect to enhance the mindful and relaxing atmosphere for relaxation sessions and we were able (pre-pandemic) to facilitate sessions for up to four
patients at a time. Staff were also invited to join in too. We obtained feedback from staff and patients who were involved in the sessions and the response was great. Participants enjoyed the sensory aspects including the ocean waves light projector; the sounds including birdsong, ocean waves and a woodland stream, and the visualisation and imagination that came with the guided relaxation. Other feedback highlighted the enjoyment gained from having the opportunity to feel relaxed and calm and to focus on breathing. Many of the participants said they hadn’t thought of relaxation as an activity before and were glad to be involved. When the COVID-19 pandemic hit, many similar rooms were set up throughout the Trust to provide a space to break away and to encourage self-care. The idea that there is a designated space welcoming staff to engage in self-care is key. Often workers feel that having time out is “taboo” and “frowned upon” in the work place. However, when needed it can be crucial in increasing productivity and job satisfaction, as well as promoting wellness and motivation in the workforce.
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-magazine.co.uk
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DINING DIGNITY
WITH
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Dietitian Emily Stuart explores the challenges presented by dysphagia and using texture modified food as a solution
T
he ability to enjoy eating communally can often prove problematic, especially as we get older. We’ve seen alarming evidence of social isolation during the current COVID-19 pandemic, as family members are having to socially distance themselves from elderly relatives. Various health problems can lead to dysphagia - otherwise known as swallowing difficulties – which in itself presents a huge barrier in the ability to enjoy meals with others. The potential embarrassment and social awkwardness which can accompany the feeling of eating something completely different to everyone else can be hugely debilitating for some. This, in turn, can contribute to an increased risk of developing malnutrition due to a drop in nutritional intake, or a reduction in the nutritional quality of the food consumed. Equally important is the visual appearance of food and the additional element of dining with dignity, something which can be challenging for people who are living with dysphagia. Not only can the complications of this medical condition be life-threatening, but it also has a significant impact on quality of life, something which married couple Andy and Lesley experienced first-hand for themselves. When it emerged that the lump on Andy’s throat was in fact cancer, the couple was understandably devastated. Having always cherished spending mealtimes together, their lives changed dramatically when Andy’s condition worsened after intense treatment: “Seven weeks of chemo and radiotherapy had an awful effect on my throat, which became very sore. My jaw started to shrink, impacting how wide it could open. I’d developed a lymphedema on my neck and throat which stayed closed and led to dysphagia.” After attempting to blend his own food, which brings with it its own challenges - such as inconsistencies in the textures achieved and the likelihood of diluting the nutritional content - Andy wasn’t getting the sufficient calories and other nutrients that he needed on a daily basis. Lesley explains the challenges they faced following the impact treatment had on Andy’s diet: “We were struggling to find something different every day that he could eat, as it needed to be this really smooth consistency. We mentioned it to the hospital team, and they recommended trying texture modified meals, which isn’t something we’d ever considered before.” The range and variety of texture modified meals really impressed Andy; having endured home-blended food for so long, being able to go back to more appropriately textured food was a revelation: “It helped tremendously to build up the calories I need on a daily basis. I’m a curry man, I love a curry. I’m not able to eat a proper one yet,
but I’ve had a texture modified one and really enjoyed it.” Now that the couple can eat meals together again, their lifestyle has changed dramatically: Andy simply places his meal in the microwave and Lesley will cook for herself so it’s all timed and they can enjoy their respective dishes. Andy’s experience proves that a condition like dysphagia doesn’t necessarily mean you have to miss out on sociable mealtimes. When someone is living with dysphagia, it can be extremely tough to manage the condition and ensure they do not become malnourished, dehydrated, or both. Whilst some people can successfully blend their own foods to a safe texture, this is simply not possible for most. One of the keys to ensuring the safety of texture modified food is the consistency of the texture. For example, if you have been recommended to have a level 4 puréed consistency by your speech and language therapist, your food should meet several criteria, such as to all be of a consistent puréed texture, without any lumps, and not require any chewing. This can be very difficult to achieve using home-blending equipment, which can lead to the meal becoming unsafe for the person. Food that is not of the appropriate texture for someone with dysphagia can lead to serious consequences. These include, but are not limited to, aspiration pneumonia and choking. When someone is experiencing difficulty with their nutrition due to a condition such as dysphagia, it can be easy to focus purely on what they are eating. Yet, how they are eating is of great importance too. Many studies demonstrate that eating alone can have a significant impact on overall nutritional intake, and on the quality of the food eaten. We know that dysphagia can lead to isolation, due to potential feelings of embarrassment around eating a meal that looks ‘different’ to everyone else’s. It is essential that people living with dysphagia and those who may be caring for these people are aware of the ways in which they can maintain or improve their nutritional status. Helping them to dine with dignity by offering them tasty, nutritious and recognisable meals, can not only help them prevent social isolation but can ensure they get the vital nutrition that they require. Wiltshire Farm Foods offers a range of texture modified meals, try a complimentary selection by registering for them here: specialistnutrition.com/healthcareprofessionals/tasting-boxes-for-hcps.
SHOW ANDTELL Alexa launches a game-changing new feature for blind and partially sighted users
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mazon’s Echo devices are well-known in the healthcare industry for being used to help people live more independently. Recent years have seen allied health professionals recognise and implement Alexa, the friendly female voice, as a support system for daily tasks. Alexa can set reminders to take medication, she creates shopping lists, and she can remind users what day it is, and tell them the time or weather. She even tells bad jokes! The Echo Show devices are essentially a smart speaker with a tablet-style screen, but much more sophisticated than that. The Echo Show enables users to use Alexa to video call, stream programmes, watch cookery shows in the kitchen to cook along with, they also link up to smart doorbells, security cameras, and can be linked to all the smart home functions like heating and lighting. Amazon has taken Alexa’s helpful technology and gone one step further to help blind and partially sighted people. The latest feature to be launched in the UK, available on Echo Show devices is a show and tell 30
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-magazine.co.uk
function. Customers will be able to simply say, “Alexa, what am I holding,” or “Alexa, what’s in my hand” to get started with their Echo Show devices. The new feature will help customers identify items that are hard to distinguish by touch, such as canned or boxed foods. Users will simply have to hold an item they wish to be identified about 30cm away from the device’s camera and ask, “Alexa, what am I holding?” Alexa will then respond and ask the user to turn the item around slowly, allowing all sides of the item to be identified. Alexa will even help with positioning and guidance, before calculating what the item is and reporting this to the user. The benefits of using a device like this for daily tasks will transform the lives of blind and partially sighted people. No longer will people risk a guessing game when trying to identify items in their cupboards or rely on others to assist them, this function truly offers independence to the user. You have to commend the retail giant for using its technology in this way and let’s hope it continues.
Dennis Stansbury, UK Country Manager for Alexa, said: “The whole idea for Show and Tell came about from feedback from blind and partially sighted customers. We understood that product identification can be a challenge for these customers, and something customers wanted Alexa’s help with. Whether a customer is sorting through a bag of shopping, or trying to determine what item was left out on the worktop, we want to make those moments simpler by helping identify these items and giving customers the information they need in that moment.” Commenting on the new feature, Robin Spinks, Senior Innovation Manager at the Royal National Institute of Blind People (RNIB), said: “Computer vision and artificial intelligence are game-changers in tech that are increasingly being used to help blind and partially sighted
people identify everyday products. Amazon’s Show and Tell uses these features to great effect, helping blind and partially sighted people quickly identify items with ease. “For example, using Show and Tell in my kitchen has allowed me to easily and independently differentiate between the jars, tins and packets in my cupboards. It takes the uncertainty out of finding the right ingredient I need for the recipe I’m following and means that I can get on with my cooking without needing to check with anyone else.” For further details on all accessible features, you can visit Amazon’s Accessibility Hub online. The hub includes how-to guides for Alexa accessibility features, as well as stories from Alexa customers on how they have benefited.
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-magazine.co.uk
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THE REHAB GAME
Senior residents are being treated to an innovative rehabilitation trial through an interactive gaming platform
V
ideo games are often discussed with negative connotations. Accused of being addictive and full of senseless violence, teenagers across the globe have their parents despairing over the number of hours their children spend with their eyes glued to a screen. However, this does not give the full picture of video games when we consider the number of different games, consoles, and applications available. Didn’t you know video games can be used for good as well as evil? 32
A report published by Korean university researchers in February 2020 Commercial Video Games and Cognitive Functions: Video Game Genres and Modulating Factors of Cognitive Enhancement – suggested that video games could also be used to enhance six key brain functions: attention, working memory, visuospatial awareness, probabilistic learning, problem-solving and language learning.
...there has been a noticeable uplift to resident physical and emotional wellbeing
The benefits of playing video games can also be recognised as their engaging nature captures the user’s attention. They can act as a form of escapism, engaging the player and offering a goal-driven environment that allows the player to focus and concentrate. They often call for problem-solving abilities, and can help reduce stress or anxiety, as well as encouraging social interaction.
OBIE
A rehabilitation centre based in Surrey has been among the first in the UK to trial the innovative Obie, an interactive gaming platform that can be projected onto any surface. Kingston Rehabilitation Centre treats residents recovering from life-changing brain and spinal cord injuries, and they have been trialling the award-winning Obie as part of their rehabilitation programme. The Obie uses video game-based technology to allow participants to engage in active play, using body movements, hand-eye coordination tactics and touching the displayed images. The games and images can be projected onto any clear surface, including walls, floors or tabletops, making it easy to set up in most rooms. EyeClick are the brains behind this product and CEO, Ariel Amos, told Authority Magazine more about the concept: “Obie’s interactive games are bringing fresh ideas and enhanced innovation to senior living facilities all over the world. Many senior facilities have told us that they have been interested in incorporating more emerging technology into their facilities for a while but they found it hard to find a product that their residents would easily understand and not be overwhelmed by. Obie presents an easy opportunity for senior living facilities to seamlessly incorporate digital technology and revamp the current way of working, integrating digital in a sector which was excluded from this revolution. “Obie’s interactive quality brings an entirely new dimension to games and entertainment, especially since the device can be pre-set to run on its own. With old school games, a staff member needs to set it up and initiate residents to play and take part. Obie can be pre-programmed, so while the device provides independent visual stimuli, it also encourages residents to move and reacts to the residents’ slightest touch, readily drawing people in to engage. “The cause and effect that happens with Obie’s games are also very different compared to other interactions. With Obie, residents can play with a ball on the floor, and everywhere it touches, a beautiful field of flowers emerges. This immediately draws the group into the game, and encourages movement and participation in a way that traditional games don’t have the ability to do and in a much more safe and hygienic way.” Since its introduction at Kingston Rehabilitation Centre last month, there has been a noticeable uplift to resident physical and emotional wellbeing, with residents enjoying use of the product during their physical therapy sessions and also choosing to utilise the equipment in their free time, finding it as fun as it is beneficial to their rehabilitation. Marta Pape, a physiotherapist at Kingston Rehabilitation Centre, said of the product: “The Obie is a really good way to complement patients’ rehab journey. All of the games included in the Obie combine not only the physical, but also the cognitive function. They are not only working their upper limb mobility, coordination, strength and reaction but it also works as a brain stimulant. “All the patients that are using the Obie shared really positive comments about it, saying that it is something that is positive and enjoyable to do as part of their rehab journey. We look forward to seeing how Obie continues to assist in the recovery of our residents.”
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-magazine.co.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 clients
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ELK EMERGENCY LIFTING CUSHION
An invaluable piece of kit for dealing with patient falls, the Elk emergency lifting cushion gently and safely helps someone who has fallen into a seating position. Designed to support up to 450kg of weight, it sports a compact design, perfect for use in small spaces, and comes with its own Airflow compressor. nrshealthcare.co.uk | 0345 121 8111 2
RING FIT ADVENTURE FOR NINTENDO SWITCH
A great way of making exercise fun, Ring Fit Adventure gamifies fitness, requiring the player to physically move in order to move their character, and makes you fight monsters through the medium of squats, lifts, and yoga. It features a host of accessibility options to assist players who may live with impaired movement, too. store.nintendo.co.uk | 0345 60 50 247
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-magazine.co.uk
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STAY-WARM FEEDING DISH
Perfect for people who need a little extra time to get dinner finished without the additional worry of having to tackle cold food. A section underneath the plate can be filled with hot water, ensuring the food stays toasty, and the non-slip ring on the underside prevents it moving around. It can also be filled with cold water or ice for cold food! essentialaids.com | 01273 719 889 4
LONG BAMBOO KNITTING NEEDLES
Knitting is a highly therapeutic activity, but it requires a degree of manual dexterity which some clients may find difficult to attain. These bamboo knitting needles are thick, easy to hold, and best of all, don’t get cold, unlike traditional metal needles. They’re ideal for making big, chunky knits, keeping everything nice and easy to see. stitchandstory.com 5
ECHO APP
From Lloyds Pharmacy is Echo, an app which allows clients to easily schedule prescription deliveries to their door. The app is completely free, and allows you to order your prescription with ease, even providing reminders for when the next round of medication is required. The service delivers to any UK address. echo.co.uk
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-magazine.co.uk
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LIBERATOR SEX POSITION WEDGE
Made of high-density champagne foam, the Liberator wedge enables clients who may have trouble with sexual intimacy a convenient and comfortable solution, which provides ideal support to both parties. The soft cover is removable and can be washed with ease, while the wedge’s design is subtle and unobtrusive.
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LAKABUY THERMAL GLOVES
Keep hands warm this winter without sacrificing warmth to use your phone with these thermal gloves for touch screens. Compatible with any kind of touch screen, the gloves are waterproof and feature an antislip design, making them ideal for outdoor activities or driving. Available in three sizes.
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NATRACURE SOCKS
Ideal for patients or clients who find that cold therapy helps alleviate pain from chronic conditions like plantar fasciitis and arthritis, these socks have a chilled gel pack inside them that quickly cools and soothes the feet. Available in two sizes, the socks are washable and reusable, providing convenient pain relief. amazon.co.uk 9
PRECIOUS PETZZZ CAT
This cute cat is a great cuddly companion for someone living with dementia or Alzheimer’s offering the comfort and reassurance of a pet without the responsibility that comes with animal ownership. Made of 100% synthetic fur, it “breathes” via one D battery for up to three months. Includes a pet bed. shop.alzheimers.org.uk | 0300 124 0900
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-magazine.co.uk
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Mains water control at your fingertips
Flick of a switch
Approx 30 mins to install
The days of struggling with a stopcock tap underneath the kitchen sink are over. Surestop brings you an easy and effective way to protect your customer’s property from the risk of water damage.
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• Gives control of mains water via a web portal, mobile app or a switch fitted in the property
• Can also be used in conjunction with leak detector • Available from national and independent merchants
• WRAS approved Click of an App New
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Patient Transfer Aids
Light and easy to manouver Transfers can be carried out by a single carer Semi-encompassing frame gives assuring sense of security High visibility features for hand and feet placement dignified and safe transfer for patient and A digni carer Minimises the risk of back injury for the carer Helps to keep patients at home Accessories – knee support, arm supports, riser blocks.
For more information please contact our sales team on tel 01440 702811 or email sales@enableaid.co.uk
Positive Reflections We may be full of doom and gloom as we ring in a new year in another lockdown. Last year was not an easy year for anyone, but if we think really hard we may be able to find some positives to take away from 2020
NEW SKILLS The overnight rise of virtual technology as a means of communication for many saw even the most selfproclaimed dinosaur of tech embrace new ways of connecting. Although many occupational therapists were still performing on the front lines and interacting with patients, many had to adapt the way their services were offered. Zoom calls were the order of the day and Microsoft Teams allowed staff meetings to still take place. Service users of all ages had to adapt to virtual appointments as the comfort of human interaction was lost, but they did it. This year has seen the population take ten steps forward in terms of technology use; grandparents are FaceTiming, GP surgeries are holding virtual consultations, and OTs throughout the country have been honing their own tech skills, as well as supporting their patients to make use of the technology available to help them stay connected with family and live independently.
FAMILY TIME You may feel like you have had enough of them by now - it is not completely natural to be cooped up with your family 24/7 - but there is no denying that they are the ones who have been there for you throughout this pandemic. As the pace of life slowed when lockdown hit, families had to get creative for recreational activities. Play parks were cordoned off, cinemas closed, bars and restaurants shut; gardens became havens of adventure as imagination flowed and families created team games
to fill the days. Board games were looked out, living rooms were filled with dens, and families bonded over cooking and baking in the kitchen.
DOORSTEP DISCOVERIES How many of us have been so busy in our lives that we haven’t even bothered to explore our local surroundings? During the lockdown, green spaces and local woodlands were discovered on our doorsteps, simply because everyone was encouraged to take their daily exercise each day in their local area. Walks and bike rides were welcomed as a daily moment of freedom, and they allowed everyone to take in their local area with a new perspective and a realisation that the simple things in life can sometimes be the best.
REFLECTION As OTs, reflection is a very natural process, and particularly this year when there has been so much to reflect on and learn from. The drastic and overnight changes that occurred this year have prompted thoughtprovoking re-evaluation of practice for many OTs. 2020 may have opened your eyes to new challenges that are experienced by your patients as new obstacles and barriers were thrown down throughout the year. Hopefully, this year will allow you to reflect thoughtfully and use what you have learned to positively guide your practice in 2021.
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Overcoming
Obesity Stigma Can OTs help combat the stigma of living with obesity by improving individuals’ ability to participate in activities of daily living?
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ne in every four people in the UK live with obesity, and are therefore at an elevated risk of developing a number of chronic illnesses, which include diabetes and cardiovascular disease. This is discussed frequently; any overweight or obese person who has ever set foot inside a doctor’s surgery for anything from an ingrown toenail to a broken leg has been informed of this. Society keeps people who live with obesity well-informed of the increased dangers that come with the condition; of course, the vast majority of these warnings come from a place of absolute care and concern. What is often less discussed is the stigma that comes with living with obesity. According to the World Health Organisation, almost one in four (19%) obese people have experienced stigma relating to their weight, and that number rises significantly to 38% of people who live with severe obesity. Obesity stigma is both internalised and externalised: people living with obesity may find themselves experiencing stigma from health professionals, the media, friends and family, and most worrisome, themselves. With this stigma comes a social impact on people who live with obesity: even if the individual does lose weight, they still encounter negative comments regarding their weight, per writings by Norwegian OT Björg Thordardottir, who noted that the social stigma that comes alongside living with obesity results in less participation in meaningful occupations. Indeed, in research by Dr Rebecca Puhl and Dr Kelly Brownell, they noted that “it has been said that obese persons are the last acceptable targets of discrimination” - the same study reported that 28% of teachers said that “becoming obese is the worst thing that can happen to a person”, while 24% of nurses said they were “repulsed” by obese people. Is there a role occupational therapy can play in helping 40
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people living with obesity, especially in the challenge of working through internalised stigma? Research by Randi Nossum et al in the Scandinavian Journal of Occupational Therapy sought to explore what barriers may be in place for people living with severe obesity from the perspective of an occupational therapist; they noted, that, while a majority of OTs do not consider weight management as an area of professional practice, there were still aspects of occupational performance where occupational therapists could assist. For example, the 63 individuals these researchers spoke to reported a number of problems where an OT’s intervention could absolutely improve their quality of life. They reported that: “The occupational problems individuals with obesity most frequently prioritised comprised playing with (grand)children, purchasing clothes, implementing regular meals and going to the swimming pool, while the barriers they most frequently described were dyspnea, musculoskeletal disorders, narrow chairs and seats, fear of glances and comments from others, and social anxiety.” With the help of an occupational therapist, the above activities of daily living could be reintroduced into the individual’s life, which could serve to improve their participation in said ADLs. Interventions by OTs may both encourage and allow people living with obesity to achieve independence where this is not already the case, through the introduction of assistive devices, meal preparation, and energy management strategies. If a person living with obesity finds themselves in a situation where they are struggling with dressing themselves independently, or bathing safely, who better to assess and provide assistance or solutions than an occupational therapist? Studies which examine the relationship between the effects of an individual’s ability to perform activities of daily living and their self-worth, such as those by C E Blair in 1999 and Anderson et al in 1992 show
that, while not directly relating to patients living with obesity, an individual who is provided with the skills or equipment to independently achieve their ADLs feels greater self-esteem. Perhaps this approach could help alleviate the internalised stigma that people living with obesity face? The intervention of an OT may also address the community-based aspect of living with obesity, including participation in outdoor activities and engaging in leisure. Publications from the American Occupational Therapy Association support several different approaches in the management of obesity in children, and they report that common findings in post-occupation based interventions for children show that a client-centred, occupational therapy-based approach to living with obesity can offer individuals the framework to support their engagement with meaningful and satisfying occupations.
The occupational problems individuals with obesity most frequently prioritised comprised playing with (grand)children, purchasing clothes, implementing regular meals and going to the swimming pool
INCLUSIVE ACCESS
Muirfield Riding Therapy Centre in East Lothian, Scotland has recently completed the construction of a purpose-built accessible changing facility
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he staff at Muirfield Riding Therapy Centre are delighted to have completed a new accessible changing facility on their premises to ensure their visitors are well-catered for. Due to a lack of space, the new facility is not classed as an official Changing Places unit as the team involved had to improvise with the space they had, but it has vastly improved the accessibility for visitors to the centre. The work involved knocking two individual toilets into one room to create a large accessible toilet and changing room which has enough space for wheelchair users and is suitable for centre visitors with varying levels of mobility and independence. The project was overseen by volunteer Audrey Arthur, the charity’s Riders, Parents and Carers Representative, and Morven McLelland who is a qualified occupational therapist and also a member of the centre’s board of trustees. As space within the new unit was at a premium, Morven undertook in-depth research to ensure the equipment they installed would be best suited to all involved. As a charity, the centre has to ensure every item it purchases offers value for money while also meeting the needs of its users, and Morven’s input was invaluable with her knowledge gained from many years as an OT. Morven looked at various changing benches, hoists and basins and concluded that the Ropox Swing Wash Basin was the perfect solution as it offered the flexibility they 42
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-magazine.co.uk
needed as it is extremely compact, well designed and manoeuvrable, while also offering excellent value for money. “I was delighted to be part of this project which was volunteer-led. I was able to offer insights into the essential equipment we needed to make this space as accessible as possible including the swing washbasin which provides greater accessibility for those people using wheelchairs. As an OT it is great to see companies such as Ropox producing products which are thoughtfully designed to improve people’s independence and dignity for use in a centre such as ours, yet would also blend into a bathroom in a domestic home,” said Morven.
Due to the current pandemic, users have not yet been able to use the new facility but staff and volunteers have all been impressed. In addition to the Ropox Swing Wash Basin, the unit also features a ceiling track H hoist system which provides full coverage of the room and enables users to transfer to the height-adjustable bench and accessible toilet with dignity and ease. The unique ergonomic design of the height adjustable Swing Wash Basin from Ropox ensures it will fit in even the smallest of rooms. The 180˚ swing allows people with reduced mobility to position the washbasin in front of the toilet so they can wash their hands while seated as opposed to having to move across the room to reach a basin. There is also plenty of room under the basin for a wheelchair making it ideal for wheelchair users. The Swing Wash Basin is available with or without manual height adjustment and depending on the model, the range of adjustment is 15cm for models without a dock-in and 20cm for models with a dock-in, this allows the user or their carer to set the height at the optimum level. The rotation and swing of the basin are not affected by which model is installed. As with all Ropox equipment, the Swing Wash Basin has been designed to look equally at home in a domestic or care setting while still meeting the needs of the individual and their carer. Muirfield Riding Therapy, a member group of Riding for the Disabled UK, (Scottish Charity ref SC028674), has been providing life-changing therapeutic riding, for free, for people of all ages with various disabilities from East Lothian and Midlothian since 1989.  This year it is also celebrating the 10th anniversary of its partnership with NHS Lothian, The Children’s Therapeutic Riding Service. This service provides hippotherapy, a specialist form of physiotherapy, on horseback and was the first, and is still the largest service of its kind in Scotland. The centre is fully self-funded, and volunteer-led, with around 200 volunteers on its books, and can accommodate 120 riders each week. Visit muirfieldridingtherapy.org.uk to find out more. For more information on the full range of accessible bathroom and kitchen solutions available from Ropox visit ropox.com call 07444 577609 or email ms@ ropox.com.
Martial Arts at Home
Adaptive Martial Arts Community Interest Company (CIC) specialise in martial arts training for people of all abilities. In response to the pandemic, last year they launched AMA@HOME, an innovative training package which brings the gym to the comfort of user’s homes
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hen the first lockdown hit due to the pandemic the health and fitness industry was hit hard. We had to adapt and we were quickly forced to adjust our training from our regular face-to-face sessions to using Zoom like many other organisations. However, this transition was very hard for some of our students. We had always wanted to create more online content but struggled for time as a very small CIC. COVID-19 forced our hand, we had great initial uptake for our online sessions, but not everyone had a partner to work with, the right equipment, or a safe space to join in. With this in mind, we started to develop the idea for AMA@HOME, where people could join an initial 12-week programme to learn martial arts and self-defence, but
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-magazine.co.uk
also loan the right equipment to use. After the 12-week course, people could then move on to more advanced training if they wanted to. To add to our online content, we have been making the techniques from the classes available online to support practice. This means for those who can’t manage training three times per week, or if someone were to miss a class they can catch up online. Thanks to the generous support of grant providers we now have enough equipment for 20-30 participants to join up. A typical equipment pack is delivered in a large holdall and includes; a kick shield, boxing or MMA gloves, focus mitts, resistance bands, agility markets, 5KG slam ball and a grappling dummy. We also have a limited supply of free-standing boxing bags and aqua balls.
Our plan was to launch and demonstrate this programme at Naidex during the provisional date in November; unfortunately, when this was delayed we had to soft launch without this platform. However, we are still looking forward to showcasing our AMA@HOME equipment packs on our stand at Naidex in March – providing there are no more COVID-related delays - as well as using the sports arena to demonstrate effective techniques which are adapted for different client groups and to answer any questions visitors may have. As part of this programme, we will also be collecting data for most suitable times and days to run our classes. Then we can adapt, pick relevant techniques and modify techniques from Brazilian Jiu-Jitsu (BJJ), wrestling, boxing and self-defence to suit our group, alongside a dedicated fitness class. All the classes will be open to everyone with a disability or permanent injury from the age of six upwards. This project also entitles any of our project members to discounted one-to-one tuition. With the flexibility of Zoom and the launch of AMA@ HOME we are no longer limited to just the Bristol and Bath regions and are able to teach anyone across the country via Zoom. Our reach is almost endless, we have students hundreds of miles away and from many rural locations, but we do ensure each class has a limited number of participants for safety and quality tuition.
Additionally, if we get a dedicated group of interested parties in one area we can look to set up a regular faceto-face training group in the local area with either AMA coaches or trusted and vetted coaches who are local to the area. Since starting Adaptive Martial Arts we have seen the huge range of benefits that martial arts can bring to people whether that is fitness, confidence, or the social aspect. Most of our feedback demonstrates this as users report reduced stress and anxiety, reduced social isolation, increased physical health, routine and leading people into making healthier lifestyle choices, in very difficult circumstances. We hope in the future also to be able to launch a competition team to demonstrate adaptive martial arts across the country and abroad. Our CEO and founder Gina, has previously competed in competitions across the UK and in America, in non-disabled and disabled competitions, with the connections made and the likeminded community we hope this project will come to fruition soon. To register your interest for AMA@HOME or to find out more information on the services Adaptive Martial Arts CIC provide visit adaptivema.co.uk/ama-home, email info@AdaptiveMA.co.uk or call 07468 608 018.
Post COVID-19, we will be continuing AMA@HOME alongside our face-to-face classes, when it is safe for return and when the public confidence increases, giving members of AMA@Home the opportunity and option to come and train face-to-face with us, or to mix it up!
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-magazine.co.uk
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Paediatrics All the latest from the world of paediatrics
SECTION hile 2020 is finally - finally behind us, its effect lingers on. There’s still so much about the world that wasn’t this way a few years ago, and we’re still trying to find ways to work effectively in these unprecedented times. In this issue, we look back at simpler times with founder of The Great Little OT Practice Aaron Preston, who took his skills as an OT to the Scottish Highlands just before the lockdown began in March 2020. Adam talks us through what life is like with his family-owned practice and the changes he’s had to make
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over the year on page 49. Alongside this, we’re exploring how occupational therapists can help children who are problem eaters, and clients and their parents manage the anxiety that has come alongside the global pandemic on pages 53 and 54, respectively. If you’re on the lookout for some fabulous new products for your younger clients, you can find them on page 56. Should you come across anything you’d like to see featured in our paediatrics section, please don’t hesitate to email us at ros@2apublishing.co.uk.
Read on to find out more...
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-magazine.co.uk
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OT ROAD ON THE
Aaron Preston, the founder of The Great Little OT Practice, tells us about a project he took on last March to deliver OT to children in the Scottish Highlands
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an you explain a little about your practice and the changes you have had to make during the pandemic?
The Great Little OT Practice is a family-owned, independent OT practice based in North Essex. We focus exclusively on the treatment of children and young people and our passion is helping young people to be as independent as possible. We are able to provide comprehensive OT support to children with various conditions ranging from mild delay through to complex brain injury and autism. I set the company up in 2018 and we have gone from strength to strength, meaning that we have been able to expand the service we offer as well as the team we have in place. We now have me and three additional professionals. Nobody could have predicted the scale of the pandemic and it seemed to hit all sectors hard almost immediately, this was certainly not what I had anticipated within the first two years of practice. The very nature of our practice means that we are working face-to-face with some of the most vulnerable young people in society. Face-to-face therapy stopped overnight and we had to
think very quickly around how we could continue to support these families at arm’s length throughout the first lockdown. We were able to switch our business model to a virtual one within a few days, this enabled therapy to continue for some of the families and meant that as a business we were able to ride out the lack of income which lasted for almost four months. The virtual model is not suitable for all children and it requires a confident person at the other end of the lens to facilitate instructions as well as additional planning and materials from the OT. Those that did engage well continued to make progress, it also provided a valuable link during what was and still is a challenging time for everyone. Our return to work in June was littered with confusion over PPE, risk assessments, dilemmas over what equipment we can and can’t take, but we found our way through and have been back successfully seeing families again which has been amazing. Our earlier experiences with virtual working during the first lockdown meant that in lockdown 2.0 we were able to refer back to that model as well as see those families that were happy to have us visit them in their homes. How did your work in the Scottish Highlands come about? Being my own boss has led to various things that I never thought possible, the one I am most proud of is the links we now have with the Scottish Highlands. Last year I was contacted via my social media pages by a daily from Inverness. They had already had a physiotherapist and conductive educator travel up to offer an intensive week of therapy for various children with additional needs, and wondered if this is something I would consider. I had never done anything like that before, it sounded exciting but slightly worrying at the same time! What would I need for the week of intensive therapy 600 miles from home with children I have never met before? How would I manage to deliver it? Obviously, I jumped at the chance and my first trip up there was in March 2020, just before the country went into lockdown.
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Can you explain the project and the patients you have been working with? The project has now led to a return trip which I will be completing at the end of November. I see this as a long-term investment into helping these families in the Highlands. The Scottish Highlands is such a vast area and local services, despite their amazing work and best efforts, are simply unable to deliver the intensity of treatment that so many of these children need. During my time there I am able to work with a range of children with complex needs, this includes varying types of cerebral palsy, autism, ADHD, developmental delay, Retts syndrome and many more. I take a holistic approach to treatment which incorporates direct therapy, environmental assessment, equipment assessment/ advice and training support to the parents. It sounds a lot, but the benefit of an intensive week is that we have the time to make real progress across many areas, and in a short space of time. I take with me a car packed full of kit ranging from electrical stimulation devices, toys and consumables, weighted blankets and a pop-up sensory room. The Craigmonie Hotel in Inverness kindly let me use one of their function rooms for the week which enables me to set up a temporary therapy centre where the kids can come and have some fun. I would like to give a shout out to a charity called Dream Believe Achieve Highland. They work tirelessly to fundraise in order to provide grants to children in the highlands which they can then use to pay for some of their private therapies. Their ongoing support makes a real difference to these families.
What are the key outcomes/benefits for the children and families taking part? The key benefits to the families initially are the intensity and variety of what I can offer over the course of the week. All therapy is goal-focused and agreed with the family before we start. This enables me to do some planning before I get there. The frequency of sessions within the week allows us to constantly review, evaluate and change as we go. A good example of this is with a patient called Lola, she came with strong food aversions and wouldn’t eat any vegetables. We broke down this barrier using structure play and by the end of the week, she was handling, cutting and eating vegetables. She maintained these skills once I had left. A longer-term benefit is the relationships built whilst I am there, you can’t achieve that with occasional visits. The children and families need to know you have trust in your ability to help them. I believe we can achieve that initially in the week and then when I am back in Essex they know they can always call on me for advice whenever they want. I continue to provide support via Zoom and social media in between my visits. What have you taken away from the experience? This is a hugely rewarding experience for me, I am passionate about my job and just the thought that I am now able to support so many families 600 miles from home is just amazing. Children never give up and we should not give up on them, I simply provide opportunities for them and their families to learn, and they always surprise us. I have always valued the importance of building a good relationship, taking the time to listen and understand is equally as important as the therapy I deliver and this is why I will continue to support these families in whatever they need, all year round.
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Children never give up and we should not give up on them, I simply provide opportunities for them and their families to learn I have recently returned from a week of intensive therapy up there which was fantastic, albeit delivered slightly differently due to the COVID-19 pandemic. This meant full PPE, temperature checks, risk assessments, an air purifier running all day in the room and fewer families to witness the progress as the week went along.
Absolutely, I will continue to travel and provide therapy for as long as they will have me. We already have two single week blocks planned for March and September this year which we are very excited about. For more information please visit thegreatlittleotpractice.co.uk.
I managed to cram a lot of things into my car for the journey, which meant I was able to set up quite an exciting pop-up therapy clinic within the Craigmonie Hotel (who provide a function room for free) inclusive of a large sensory room which went down a hit with the kids. It also meant I was able to accommodate treatment options for a wider range of kids, including Cameron who recently had spinal fusion surgery to correct his scoliosis, he has been unable to sit independently outside of his equipment for many years. During our second session, we gave him the chance and the correct base of support and he amazed us. This was the first time he had sat on his own for years and he loved it. Is this something you anticipate continuing?
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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:
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FOOD THERAPY While most children go through a “picky eating” stage, a few are problem feeders who could benefit from the help of occupational therapy
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any children go through the “fussy eater” stage, and it’s a completely normal part of childhood. It may be that they’ve looked at a food and assessed that it is simply not for them without so much as trying it, or they may be averse to a certain texture or smell. Each of us likely went through this very same thing, and came out of it exactly the same way we went in. For some children, however, limits on their diet can become problematic and worrisome for parents, as they may be concerned that they’re not getting all of the vitamins and nutrients they need to help them grow. Children who live with autism, for example, may only eat a very small number of foods due to issues with texture, or exclude entire categories of food. This is where occupational therapy finds its place at the proverbial table, and the intervention of an occupational therapist can help young people on limited diets to gently reduce them. What is important, however, is that the difference between a fussy eater and a child whose limited diet has become problematic. Per the SOS approach to feeding - the sequential oral sensory approach, a popular intervention employed by OTs that was developed by paediatric psychologist Dr Kay A. Toomey - the difference can be categorised as “picky eaters vs problem feeders”. While a picky eater will be experiencing a little road bump in their journey of developing their own tastes, problem eaters will likely require the intervention of a professional to assist and support them.
As stated above, OTs primarily employ the sequential oral sensory (SOS) approach when a client presents the signs of eating difficulties. Per Magnificent Munchers, a food therapy service based in Hertfordshire, led by OT Jacqueline Parkinson, these signs can include: a diet that is limited to fewer than 20 different foods, the refusal to eat entire categories or textures of food, an excessive emotional reaction upon being presented with new foods, gagging or vomiting when around new food, excessive reaction to food on or around the face, and children who may present issues when in a situation that requires social eating. The SOS approach examines the underlying cause of feeding difficulties, usually as a multidisciplinary approach including paediatricians, OTs, dieticians, and speech therapists. It examines the “whole child,” assessing organ systems, muscles (including oral motor), sensory processing, learning behaviour and cognition, development, nutrition and environment. The approach aims to increase a child’s comfort level around food by offering them a safe environment to interact with and explore the food before eating even comes into play. The child will be given the space to tolerate being around the food, before going on to the smell, how it feels, and then finally, tasting it. This could mean looking at the food, followed by the child allowing it to touch their skin, then smelling it, and touching it with a part of their body. Finally, after that, the child may feel comfortable tasting it: that doesn’t mean eating it, it may simply touch their tongue, or the child might put the food in their mouth, chew and spit it out. Using this evidence-based approach, OTs as part of a multi-disciplinary team can help children who may have a limited diet expand and develop a healthy, safe understanding of the joys of food, all within a safe and reassuring space.
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Worrying Wee Ones Children may be worried about returning to school, their family, or what they’ve heard in the news - so how can that sense of anxiety be combatted?
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hildren take in and understand much more than we give them credit for. The nature of the world just now is setting everyone on edge, and it would be remiss to believe that this was not also an issue with the children in our lives, who may be experiencing anxiety, stress or uncertainty in a way they can’t fully compute. While some children will be more than able to verbalise their worry regarding the pandemic, others may find it difficult. If your clients or their parents are expressing anxiety about the ongoing global crisis, it’s important to guide them with a gentle hand. If you’re not sure where to start - or you could use some help yourself - we’ve got a good jumping-off point for you.
BE CALM, AND INFORMATIVE While it’s a terrifying thought for some, we adults are who children look to for guidance and reassurance when they’re hit with a wave of anxiety or worry. Children respond well to adults following the same advice that they’re being given, so alleviating the worry of spreading the virus by showing them how you wash your hands properly will give them a very small-level reference that they can work from. Children also aren’t as closed-off from the world as we think; they hear a lot more than we mean them to, so explaining everything that’s happening in their own language is a helpful way of calming them. It’s the same principle as when you go to the dentist and hear them talking in code about your teeth - you might not understand it, which causes you to panic. A kind dentist will explain that their concern regarding your xerostomia does not require each of your teeth to be pulled from your head like your anxious brain is telling you, but is in fact simply the medical term for a dry mouth. Eliminating jargon and speaking in a language your client can understand isn’t condescending: it’s necessary for eliminating extraneous worry and ensuring their understanding of an issue is as good as it can be. “Fake news” about COVID-19 is as prevalent in some circles as the virus itself, and it’s a good idea to dispel any weird, anti-scientific rumours you might be presented
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with. If a client tells you a fellow student told them that rubbing Brussel sprouts on the soles of their feet cures COVID-19 it’s a good idea to calmly and reasonably inform them of why that’s not the case. You’re an excellent judge on the level of information that they can comprehend, and you don’t have to offer them a subscription to the BMJ when you explain it - it’s just a case of being kind and reasonable. Also - it’s ok to say you don’t know when you don’t know!
ENCOURAGE ACKNOWLEDGEMENT One of the main tenants of cognitive behavioural therapy in combatting anxiety is taking the time and space to acknowledge how you feel. This is important; it validates the feelings and allows you to take control of them. Fighting the feeling leads to more anxiety. It’s completely reasonable that your client would be anxious right now: when they look around, they’re probably seeing a lot of anxious adults having an awful lot of anxious thoughts. Whether they mentally label that anxious feeling, or look an anxious thought square in the face and tell it to “stop,” they’re acknowledging the feeling, and that’s a good, healthy thing to do. Acknowledgement also comes from listening: sometimes, we need our feelings validated, especially as a young person. An adult hearing out these anxious thoughts and saying, “it is absolutely understandable that you feel worried right now” is worth more than that adult will know. Offering them kindness is a wonderful way to help their overall wellbeing, given how much mental health can affect an individual’s ability to complete their activities of daily living.
PROMOTE EMPOWERMENT Giving clients tools that they can use to empower themselves is a great way to ensure they are able to combat their feelings of worry or anxiety at any time. Letting them know what they can do as an individual to combat COVID-19 provides them with a feeling of control; teaching them how to wash their hands properly and with soap, wearing a mask, and social distancing are all things that they can do to feel in control, and alleviate their worry. Often, feelings of anxiety come from an individual feeling out of control, or feeling like they have no handle on the things that are happening around them; by providing clients with the tools to embrace control, you are allowing them to take back control from anxiety.
...they’re probably seeing a lot of anxious adults having an awful lot of anxious thoughts
Kids
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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PABOBO WHALE PROJECTOR
Pabobo offers children a wellrounded multi-sensory experience, and its cordless, battery-operated design means that it can be used on the go as well as in the home. The cute blue whale features a soft, plush body - which can be washed - a soothing light projector, and the option to play lullabies or white noise. jojomamanbebe.co.uk | 0333 240 0700 2
EXPLORATION BLOCKS
Made of wood that’s been sourced with the environment in mind, and painted in colourful non-toxic paints, these cute wooden blocks will encourage children to develop visual attention, spatial awareness, and fine motor skills. Children will delight in the sensory experience that the wooden blocks provide. kidly.co.uk
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B.TOYS LOOKY-LOOKY
This intriguing toy features a mirror mounted to two wheels, one with rattling balls inside, and the other with a mesmerising pattern. Small children can chase their reflection along the floor, making for a fun way to develop gross motor skills, while building a proximal base of support, and helping to improve bilateral coordination. btoys.co.uk | 01206 984 454
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-magazine.co.uk
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PLAN TOYS TIMBER TUMBLE
The aim of this cute wooden game is to help our good friend beaver build a dam using the logs he’s sitting on. Each player takes a turn with the wooden stick to poke a log out from underneath them, and once there are none left, that player wins. Timber Tumble is a fun and funny way to develop hand-eye coordination and strategic skills. scandiborn.co.uk | 0203 143 0031 5
WEIGHTED PUG CUDDLY TOY
Soft, plushy, and weighted, this adorable cuddly friend is perfect for children who find that deep pressure helps alleviate worry in those living with ADHD, autism, anxiety, and other conditions. This sweet little pug comes in a variety of weights, which are safely packed inside the toy and evenly distributed throughout it. etsy.com/uk/shop/Barnfabrics 6
EXPERIA PORTABLE INTERACTIVE FLOOR SYSTEM
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-magazine.co.uk
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PASSION PROJECT If you’ve found your passion for your work take a hit this year, don’t let it worry you: instead, use it as an opportunity for change and growth
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o-one really expected the global pandemic to last as long as it has. Well over a year on from the first reported case of COVID-19, we are still drowning in the virus’ wake, chewing on terms like “the new normal” which explain away our inability to see friends, family, and loved ones. More than that, the strain on some parts of our society have been horrendous: there was a reason we clapped for NHS workers every Thursday night for two months. Alongside retail workers, people who work in public transport, delivery personnel and many other unseen facets of society, they kept us running when no-one else could. Now, it feels like the end is in sight: as we write this, the first vaccines are being administered to the public outside of trial environments. Margaret Keenan, a 90year old from Fermanagh, Northern Ireland, became the first to receive the Pfizer virus, and hopefully, as you read this, many more will have received it, too. As we glimpse at the light at the end of the tunnel, there’s a lot of feelings to begin processing. For some - not just OTs, but nurses and other healthcare professionals - the past year has been one that weighs heavy on the heart and soul. There was nothing easy in the work that was being done, and some of the experiences being reported by medical staff on the frontline - including but not limited to the issues relating to PPE and the over 600 NHS staff and social care workers who have died from COVID-19 - are harrowing, to say the least.
WHAT MADE ME WANT TO BE AN OCCUPATIONAL THERAPIST?
For some people, it was a life-altering interaction with an OT who helped them through their own issues with recovering meaningful activities; for others, it is simply a means to help people, and through the provision of assessment and intervention, they take incredible joy. These, and every single reason in-between, are all valid reasons to have found a passion for occupational therapy. Sometimes, when we experience occupational burnout, we find that our connection to the passion that made us want to pursue our career paths in the first place is weakened, or in drastic cases, severed. The thing is, people change, and so do our passions. That is not the death knell for your role as an OT, it simply means that you have an opportunity to find somewhere else to place your passions. If taking time to reflect on what got you to where you are now doesn’t help in rekindling your love affair, it might be worth taking the opportunity to explore other areas of specialisation. This could give you both a break from the area you’ve been in and an excellent chance to rekindle the flames of your passion.
WHO CAN I TALK TO ABOUT THIS?
At this point, if you were to say out loud that the stress, anxiety and weight of expectations that the last year has placed upon you have caused you to lose your passion for your work as an OT, very few people could blame you. What is important, however, is to recognise that it is not gone, it is simply lost, and lost things have a tendency to turn up when we choose to go hunting for them.
Communication is, above all else, the most important tool you have at your disposal when you’re feeling despondent about your work. Sometimes, taking the time to sit down with a trusted member of staff and outlining your feelings can lend you vital insight into your own feelings; sometimes, they can even reassure you. Often we don’t realise how important a cog we are in the engine that is our work, until someone points it out to us. As underwhelming as it seems, having someone point out that you are, in fact, a valued member of staff in your workforce can do wonders to helping you ease the negative emotions you’re feeling towards your work.
With that said, if you do feel like your passion for your chosen profession is waning, or you’re having a crisis of faith in your career, it’s time to take a step back and ask yourself what it was that led you to pick such an incredible, life-changing career in occupational therapy in the first place?
It is also important to ensure you have a good network of people who you can speak to, not only mentors or senior staff. Other OTs, family and friends can offer valuable opinions on how to correct your course. Often, feelings of dismay with our work can be brought on by the feeling of being overwhelmed, and that’s
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perfectly ok, especially at a time when the strain on our health service is so severe and OTs are playing such an important role. It’s absolutely ok to feel overwhelmed, but what isn’t right is letting that eat into your love for your job. Discussing feelings like these - being overwhelmed, stressed or despondent - can help you work through them and emerge out of the other side as a happier, more passionate OT.
ARE THERE CHANGES I CAN MAKE TO ALLEVIATE MY FEELINGS? Hear us out here: sometimes, we take on too much. This is likely shocking to you, dear reader; sweet OT who is presumably spending their downtime trying to do 800 things at once, including reading The OT Magazine. It is easy to simply say that you took on too much in the
Often we don’t realise how important a cog we are in the engine that is our work, until someone points it out to us last year. The world feels like it’s falling down around us, no wonder you might feel that way. If you are able to take some time to rest, that might be helpful. If you can delegate out some of your workload to trusted colleagues in order to lower your stress levels, that is also a fine idea. Are you engaging in good self-care? Occupational therapists are forever telling other people these very things, but are you, an OT, doing them yourself? OTs, you are important. You’re valued and you play a vital role. If you do find your passion waning, it’s worth taking a step back, and trying to remember that. We (quite literally) wouldn’t be here without you.
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TAKE ANOTHER LOOK AT PRIMACARE
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DLF LAUNCHES FREE ADAPTATIONS WEBINARS The DLF is running a series of free webinars over the winter period featuring techniques and advice for assessing for major adaptations. Presented by DLF Trainers and leading OT practitioners in the field of adaptations the practical talks are based on DLF’s level five ‘Home Adaptations for Professionals’ training course.
T
he series began in December with Practical Assessment for Home Adaptations: Kitchen Design presented by Marney Walker. You can contact the DLF to access this talk.
UPCOMING FREE WEBINARS Practical Assessment for Home Adaptations: Bathroom Design January’s talk takes place at 1pm on 20 January 2021 and focuses on bathroom design. The bathrooms webinar will be led by Louise Powell, an experienced OT with a career spent specialising in adaptations mainly based in housing teams. As team manager for the HEART Partnership in Warwickshire, she manages an integrated housing adaptations team covering the whole county. The HEART team includes OTs, housing assessment officers and housing duty officers who work with a technical team to provide a wide range of housing solutions. Louise’s talk will examine considerations around bathroom solutions, a review of showering and bathing options along with accessories essential to successful bathroom design.
Practical Assessment for Home Adaptations: Multiple Levels The final webinar in the series is on 18 March at 1pm. Multi-level solutions is the theme of this webinar which looks at solutions to access multiple levels within the home. The session will focus on considerations for through floor lifts and how to measure for these, along with other alternative solutions. Cathrine Ruston is a DLF trainer and writer, previously a commissioner in Cheshire and an OT specialising in independent living. With a track record in service transformation, she brings a wealth of experience to the topic.
REGISTER TO ATTEND The webinars are free to join and you can register to attend them at https://yw753.infusionsoft.app/ app/form/zoom-registration-form. To find out more about DLF’s programme for professionals involved in assessing for adaptations please email enquiries@dlf.org.uk or phone 0300 123 3084.
Practical Assessment for Home Adaptations: Access Solutions
ABOUT THE DLF
This webinar takes place on 18 February at 1pm and focuses on access solutions. Claire Miller, one of DLF’s trainers is an OT in private practice with over thirty years’ experience. Based in Derbyshire she takes a holistic approach to assessment and writes and trains extensively.
The DLF is a 50-year old national charity and part of The Shaw Trust. It specialises in impartial information, advice and training on equipment for independent living. Free services for the public include Living Made Easy (livingmadeeasy.org.uk) their impartial online marketplace, AskSARA an online guided advice tool (asksara.livingmadeeasy.org.uk) and Youreable the thriving forum (youreable.com).
Claire’s talk will look at the possible solutions to enable a person to enter their home safely and cover some of the measurement considerations when planning an access solution.
Services for professionals include their DLF Training courses and DLF-Data the prescribing tool for professionals which is free to use during the pandemic, you can contact them for a login, visit dlf.org.uk.
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Pandemic Reporting A new report from Sensory Integration Education has examined how the COVID-19 pandemic has affected how people are able to offer and access care for sensory difficulties
T
he COVID-19 pandemic has changed the way that almost every industry operates, in some ways forever. One of the most difficult challenges we face as we move through the pandemic is establishing firmly the damage or good that the necessary restrictions placed on all of us have done. Sensory Integration Education (SIE) have attempted to do just that in a new report examining how professionals who work with people who live with sensory difficulties - most notable, occupational therapists - have been affected by the pandemic, and how it has impacted their ability to deliver face-to-face therapy or support. The report, Sensory Challenges During a Pandemic: Providing and Accessing Therapy, builds on the selfreported experience of 231 health and education professionals (72% of whom were occupational therapists) who work with people living with sensory challenges, and the additional input of 31 people who live with sensory challenges, or their parents or carers.
clients could not access or benefit from either of the aforementioned, thus, I was left with creating a treatment space/clinic for families that had limited access to therapy services.” 2 “Total rethink of how we work, how best we can continue to support schools and deafblind students (for whom video calls may not be accessible) remotely.”
The majority of respondents (83%) said that the pandemic had changed the way that they worked
CHANGES IN WAYS OF WORKING SIE’s survey, the results of which form the backbone of the report, asked how respondents found their ways of working in offering support to people living with sensory difficulties, many of whom are children. 38% of respondents said that the most difficult challenge they faced was not being able to deliver face-to-face therapy or support. The majority of respondents (83%) said that the pandemic had changed the way that they worked, with many respondents citing the push towards using technology over face-to-face therapy or support as a barrier to their working. Respondents also spoke frequently about the difficulties that came with working from home, something many industries had to adapt to over the course of the pandemic. Responses: 1 “The pandemic limited the physical or manual therapy aspect of my work and shifted to a primarily consultative or coaching approach with my caseload of children aged 2-12 years. Supporting parents, caregivers, and educators in this process has pushed me into using technology, providing webinars and teletherapy initially. Once I realised that only some clients were benefiting from this platform, I began using home based therapy outside, when available. It was clear that still many
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-magazine.co.uk
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CREATIVITY AND FLEXIBILITY
LACK OF FACE-TO-FACE CONTACT
Many respondents found themselves having to be creative in finding new ways of working, integrating parental support into their assessments, or coaching parents in ways they could help their children while at home.
15% of respondents said that pandemic restrictions interfered with their ability to perform face-to-face assessments with clients, and this in turn impacted some from taking on new clients at their practice. Almost half of respondents (48%) said that this lack of face-to-face contact impacted their ability to form a relationship with their clients, and 6% noted that they faced problems with accessing equipment for clients or pupils.
Responses: 1 “As a play therapist I have been unable to practice 1-1 with children and have changed my practice to parent consultation which has worked with some but not all cases.” 2 “Being creative with new ways of assessing & providing interventions via virtual platforms.”
Not seeing my young people has been difficult
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-magazine.co.uk
Responses: 1 “Made it harder to see the same level of progress with my students due to remote sessions being less effective when discussing emotional and sensory regulation plus mental health needs of complex individuals.” 2 “Not seeing my young people has been difficult. 50% have enjoyed virtual input but my younger clients were very frustrated after always an initial curiosity and excitement. Now adjusting to face masks which only some are accepting.”
I am reaching more families as families in very rural areas can now connect via video calls DELAYS IN ACCESS TO THERAPY OR SUPPORT
TOUGHEST CHALLENGE OF THE PANDEMIC
Almost one third of respondents (31%) reported increases in waiting times for therapy or support, noting difficulty in carrying out initial assessments, a lack of referrals from schools due to closure, and an overall reduction in the number of appointments they were able to carry out due to time required to clean equipment and prepare PPE both pre- and post-appointment.
Respondents were varied in their answers for what the toughest aspect of the pandemic was: 38% said the inability to carry out face-to-face therapy or support, 19% said changes to working practices, 11% said the impact on their mental health, 7% said the impact on clients’ or pupils’ mental health, 7% said using technology, 7% said work-life balance, 5% reported managing the risks of coronavirus, and 4% were most worried about income and job security.
Responses: 1 “Delays to complete assessments and interventions. Higher waiting times and carrying bigger caseloads.” 2 “Only 1:1 sessions allowed so this reduces the number of patients I can see on my caseload. I work in an inpatient mental health ward, and at times the ward has closed leaving me unable to see patients.”
POSITIVE ASPECTS Some respondents noted that they felt the changes brought on through the pandemic have had a positive effect on their work, and the time they can dedicate to clients. Responses: 1 “Satisfied that we have continued to provide a useful service. We will take on remote meetings on a long term basis as the team I work for is geographically widely spaced.” 2 “I am reaching more families as families in very rural areas can now connect via video calls which is positive but has added to my work load.”
Responses: 1 “Not being able to physically see and have sessions with students. The barriers of delivering distance intervention were difficult to overcome, as many parents and carers felt overwhelmed and unable to engage themselves.” 2 “Being re-deployed out of my normal OT role into an unfamiliar role, new setting in a pressured environment. Also, managing expectations and anxieties of parents who are frustrated that services are not resuming when other more mainstream and general services are resuming.” 3 “Vulnerable adults missing out on vital input. Lead AHP at Board level minimising/disregarding contribution of OTs to mental health field. Losing face to face appointments and adjustments to assessment processes.” To read the full report from Sensory Integration Education, visit their website: sensoryintegration.co.uk
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