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
THE RIGHT TO
REHABILITATION
T
The term rehabilitation is being used more and more in the mainstream media due to the effects of long-COVID, and the need for ongoing and long periods of therapy input. The World Health Organisation (WHO) defines rehabilitation as: “…a set of interventions designed to optimise functioning and reduce disability in individuals with health conditions in interaction with their environment.” The aim of rehabilitation is to enable that child or adult to achieve their goals and be as independent as possible in their day-to-day activities, enabling them to engage purposefully in their life. This leads to dignity, self-confidence and provides them with quality in their life. The profile of rehabilitation has been raised over the last year; the pandemic has shown the difficulty of how we access rehabilitation for our clients, who assesses for it, who provides the interventions, and what time scales are there. We are all acutely aware that different acute and community services offer different provision, and it can be a real postcode lottery in regards to if, when and how a client or patient receives the necessary support. There is a huge group of forgotten people, who due to lockdown have lost physical function, cognitive abilities and confidence to access the community independently. These are a group of clients who are struggling to access any
we need to fight for the right to rehabilitation for all clients and patients
rehabilitation, let alone a quality service.
after an illness, deterioration in health or injury.”
A client came to us recently who had been trying to access these services. She had early stages of Alzheimers, and was cared for by her husband - who was immunosuppressed and recovering from bowel cancer surgery. She hadn’t been out the house for eight months due to fear of catching COVID. She had been referred to the reablement team after significant involvement from her GP and family.
The lead for this really should sit with a qualified professional, in my opinion, an occupational therapist, and the therapy interventions should be supported by well-trained, consistent carers with regular reviews and re-assessment of personal and therapy goals.
Her assessment was carried out over the telephone by a social care support officer, and a “package of rehab care” put in place. There was no face-to-face assessment, or even observed function via a virtual call; no goal setting, and no therapy input to create a baseline of function to be able to work towards achievable outcomes. The client was told that she would have two weeks of rehab, and then she would have to pay. This caused huge frustration, and the couple were confused when a care agency carer turned up to make dinner and help with teeth cleaning neither of which had been raised as an issue! According to the Social Care Institute for Excellence (SCIE): “Reablement is a strengths-based, personcentred approach that promotes and maximises independence and wellbeing. It aims to ensure positive change using user-defined goals and is designed to enable people to gain, or regain, their confidence, ability, and necessary skills to live as independently as possible, especially
Reablement sits within the Care Act 2014 (section 2) legal framework of preventing, reducing or delaying the need for care and support and interventions can last anything from a week to 12 weeks and be free of charge. There is a clear duty of care within law. For this client, we advocated for statutory occupational therapyled reablement, and they are now receiving a more personalised, goal-centred service. We knew what to ask for, we could talk the same language and used the legal framework to facilitate what they needed. Not all are so lucky and fall between the gaps of provision or are provided with an inappropriate service. As a profession we need to fight for the right to rehabilitation for all clients and patients, as this is about working with them to maximise their abilities, add quality to their lives, enable them to do what they want to do, how they want to do it, and when they want to do it. The by-product of this is that it costs less to the country in the long run, as they need less support from carers and more importantly it gives them a greater quality of life. -magazine.co.uk
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