10 minute read
The Right to Rehabilitation
Kate Sheehan
Director, The OT Service
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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
rehabilitation, let alone a quality service. 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. 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 after an illness, deterioration in health or injury.” 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. 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.
THE RIGHT TO
TThe 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
Unmissable CPD courses for OTs
Two fascinating new online courses written by OTs for OTs have launched this year, by world-class training provider Sensory Integration Education (SIE). Here’s an overview of both courses.
Feeding is one of the most complex things we require our bodies to do because it involves every sensory system integrating information about our body and the world around us. Would you know how to recognise when sensory-based issues are impacting on your client’s feeding difficulties and which strategies to advise and which to avoid?
Supporting Individuals With Feeding Difficulties: Sensory Integration in Practice - A
Multidisciplinary Perspective is a 10-hour online course comprising videos, presentations, interactive quizzes, worksheets and clinical discussions between your highly experienced and engaging trainers Laura and Louisa. Laura Osman is a Highly Specialist Speech and Language Therapist, Advanced Sensory Integration Therapist, Feeding Therapist and Teacher. Louisa Hargett is a Highly Specialist Occupational Therapist, Advanced Sensory Integration Therapist, Feeding Therapist and Teacher.
This course will provide you with a multidisciplinary perspective to understanding the complexity of feeding and will provide strategies that will inform therapeutic and educational planning to support children with feeding difficulties to improve their relationship with food. It is great value at £65 , is CPD Accredited and includes free Affiliate Membership to SIE.
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Have you ever dreamed of designing your own Ayres’ Sensory Integration (ASI) space? Ever wondered how you could make a rented room work for your SI therapy? What equipment would you need if you decided to offer mobile SI-informed therapy in schools, homes and workplaces? This new course from SIE has all the answers for you.
Designing Your Own ASI Space
is an online course, packed with helpful and practice advice from Moyna Talcer - a Consultant Occupational Therapist with 20 years’ clinical experience, both in NHS and private practice, and an Advanced Practitioner in Ayres' Sensory Integration.
This course is a must-see if you are thinking of adding SI-informed therapy to your practice. It comprises 5 hours of content using slides with voice-over, captioned videos, worksheets, downloadable handouts and recommendations for further reading. All advice is linked back to the evidence base for ASI and maintaining fidelity for ASI interventions. The course also includes a bonus video of an interview with Mike Brooke of Southpaw UK, who discusses the precise requirements of the different kinds of suspension equipment that are suitable for owned or hired spaces and for mobile therapists.
If you want to be guided through the decision making process about designing an ASI space or a mobile ASI therapy service, then this is the course for you. Priced at only £45, it is CPD Accredited and also includes free Affiliate Membership to SIE.
Search: bit.ly/ASIspace
For more information on these courses, as well as SIE’s universityaccredited postgraduate SI Practitioner training, and live webinars on CPD topics, see:
www.sensoryintegration.org.uk
One of the most difficult ones to come to terms with is the lack of a work-life boundary; what was previously enforced by the act of arriving and leaving one’s office at the designated time has now become fuzzy and decayed as our workstations enter our homes. When we cannot physically leave our work to go to the place where we relax - when the place we work becomes the place we relax - our work-life balance shifts into an unhealthy territory. Not only this, but we are permanently tethered to our work through technology. Our inability to remove ourselves from the responsibilities of our work worsens as technology marches on: we are reachable 24 hours a day, seven days a week through our smartphones where we can be emailed by clients or managers, and the act of switching off our phones comes with the tremendous guilt that fosters when you feel like you’re “ignoring” your responsibilities, when in fact you are being contacted outside of your working hours. How many times have you just sent a few quick emails at dinner, answered a few calls on a day you’re off, or been contacted by management on your paid time off? A survey by the Mental Health Foundation found that the mental health of people with a poor work-life balance is negatively affected by the former: one in three are unhappy about the time they devote to work; more than 40% neglect other aspects of their life because of work; and more feel depressed, anxious and irritable. The report also found that it can impact productivity, increase stress, and make employees worry more about their work, which feeds into a vicious cycle of anxiety. The Office for National Statistics showed that almost a quarter of people in the UK (24%) are working exclusively from home, so how do we readdress the work-life balance at a time where work and life seem so incredibly out of balance? In April, the Irish government’s Workplace Relations Commission (WRC) published new guidance that gives employees the so-called “right to disconnect” - that is, the right to not work outside of their mandated hours, and not to be punished for refusing to attend to workrelated matters in the time that they are not contracted to be in work. It also gives employees a duty to respect other workers within this period, for example, by not routinely calling them for work matters outside of working hours and so forth. Ireland was not the first to guarantee the right to disconnect by law: it exists as part of the El Khomri law in France, which came into force on 1 January 2017, and similarly gives employees the right to disconnect from their working environment, which the government deemed necessary for the health of French employees. Italy introduced a similar law in the same year, as did the Philippines. In Germany, the right to disconnect is more of a cultural force than a legal guarantee: there are no laws to ensure the right to disconnect, but a multitude of large German firms, including Volkswagen and Allianz, have internally implemented the concept. Volkswagen introduced a policy in 2011 that would prevent employees from receiving work emails when not working. Employees will receive no work emails between the periods 30 minutes after their shift ends, and 30 minutes before their next shift begins following complaints from staff that their work-life balance was being affected by this. Similarly, Daimler, another German car manufacturer, introduced software called “Mail on Holiday” that would prevent employees from getting emails while they were on holiday to ensure that they returned to work refreshed and relaxed. Trade union Prospect has written to the British government to implement a similar law to the one recently passed in Ireland, and a poll conducted by Opinium (and commissioned by Prospect) has found that almost two-thirds of workers in the UK support the introduction of a law which would guarantee employees the right to disconnect. Prospect Research Director Andrew Pakes said: “It is clear that for millions of us, working from home has felt more like sleeping in the office, while remote technology means it is harder to fully switch off even if you work in an office most of the time. “Remote working and the use of technology are here to stay but with proper dialogue between employers and their employees, coupled with government intervention, we can make the UK a model of fair, effective and productive flexible working. “Including a Right to Disconnect in the Employment Bill would big a big step in redrawing the blurred boundary between home and work and would show that the government is serious about tackling the dark side of remote working.”
