Enable Professional 2019

2019

The UK’s leading disability and lifestyle magazine

enablemagazine.co.uk

A HELPING HAND

Becoming the foundation of support for carers

professional BEHIND THE LENS

A look at the future of virtual therapy

COMING HOME

Discover simple adaptations for a client’s home

Mental health care

How will mental health funding and training improve specialist care for those in need?

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13/11/2019 15:30

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Welcome

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Enable Professional is back for another year!

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areers are continually changing, and working as an occupational therapist is no different: that’s why this issue we’ve discovered all the latest advances related to working as an OT. From products on the market, CPD courses to home adaptations – you name it, we’re talking about it.

On page 6 we’re looking at the importance of continued mental health funding for clients, and ask: what more can the government do to support OTs working in mental health? It’s no secret that the work you do is imperative for clients, but also for loved ones, too. Head to page 18 to learn how you can be a helping hand for a carer. You won’t want to miss our spotlight on technological progressions to aid your career either, over on page 24.

Don’t forget to let me know what you think about this issue. You can email me on, editor@dcpublishing. co.uk or follow us on Twitter @EnableMagazine

Lorne Gillies, Editor

STAY CONNECTED Never miss the latest disability news and interviews from Enable, www. enablemagazine. co.uk

PUBLISHER Denise Connelly denise@dcpublishing.co.uk EDITOR Lorne Gillies lorne.gillies@dcpublishing.co.uk STAFF WRITERS Emma Storr emma.storr@dcpublishing.co.uk Saskia Harper saskia.harper@dcpublishing.co.uk DESIGN AND PRODUCTION Lucy Baillie lucy.baillie@dcpublishing.co.uk SALES Marian Mathieson marian.mathieson@dcpublishing.co.uk ENABLE MAGAZINE www.enablemagazine.co.uk

DC Publishing Ltd, 198 Bath Street, Glasgow, G2 4HG Tel: 0844 249 9007 ©DC Publishing Ltd 2019. All rights reserved. No part of this publication may be reproduced or used in any way without prior written permission from the publisher. The views expressed in this magazine are not necessarily those of DC Publishing Ltd. The publisher takes no responsibility for claims made by advertisers within the publication. Every effort has been made to ensure that information is accurate; while dates and prices are correct at time of going to print, DC Publishing Ltd takes no responsibility for omissions and errors.

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What’s inside On the job

6 FUNDING MENTAL HEALTH TRAINING How is funding impacting your clients?

21 OT AT SCHOOL Giving a helping hand to the education system.

Training

8 LEARNING ON THE JOB Here are our picks of the latest CPD courses.

10 THE IMPORTANCE OF MANUAL HANDLING A crucial qualification, we speak with a moving and handling practitioner.

Patient support

15 UNDERSTANDING COMMUNICATION Take verbal skills further.

17 THE ART OF CARE Shining a light on the importance of working in a hospice.

18 A HELPING HAND How can you provide guidance for carers?

22 BEHIND THE LENS Is virtual reality a step in the right direction?

24 TECHNICALLY AHEAD A look at tech on the market.

At home

12 MAKING A HOUSE A HOME What adaptations work in the home?

On the road

28 KEYS TO INDEPENDENCE Supporting your client behind the wheel.

Products

27 PRODUCT ROUNDUP The latest products on the market.

Voices

30 BECOMING A SPECIALIST An OT shares their career journey.

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enable news

News

Occupational therapy degree-level apprenticeships made available through the NHS THE NHS HAS INTRODUCED their brandnew apprenticeship scheme, to enable more students to launch their career in occupational therapy.

Offering a different route into the profession, participants will earn while they learn, achieving a Bachelor’s degree at the end of the apprenticeship.

Not only does this make the profession more accessible to those who don’t wish to, or can’t, attend university, but the apprenticeships looks to tackle the

continuing workforce recruitment and retention issues within the profession.

The apprenticeships aims to guarantee a more diverse skillset, allowing more people to pursue a career in occupational therapy.

Apprentices have already commenced work in both London and Leicester, working as occupational therapy assistants, while also splitting time studying at university, in a more handson approach to learning.

NEW GUIDANCE ON STROKE CARE ANNOUNCED THE NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE (NICE) has released new guidance for occupational therapists to assist in care for stroke patients.

Within the NICE report, it highlighted the need for more regular post-stroke reviews: in 2017/18, 92 per cent of people agreed their rehabilitation goals within five days of arriving in hospital, however there are currently no records of whether these goals were achieved.

In the same year, only 30 per cent of stroke survivors received a six-month assessment; an improvement from 20

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per cent in 2012/13.

And, NICE is calling for continued improvement of more regular reviews of rehabilitation targets. Their recommendation includes a structured health and social care review six months after the stroke, then annually.

New framework launched to support OTs working in social care A NEW RESOURCE FROM Skills for Care and the Royal College of Occupational Therapists (RCOT) has been launched to support OTs working in adult social care.

The Learning and Development Framework has been developed to provide support and guidance to OTs who are newly qualified, new to working in social care, returning to work in social care after taking a break, and managers of OT staff.

The framework is based on the four pillars of practice from the RCOT Career Development Framework, which are widely used.

Created by Skills for Care, in partnership with RCOT, the framework had input from OTs, managers, and staff from the social care sector, to ensure it reflects the nature of the profession and is practical for busy professionals.

It is estimated that it will take around 12 months for individuals to work through the framework, but this will depend on working hours and patterns, and specific employer requirements.

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“The Motability Scheme has been life-changing; it has allowed me to care for my husband and also continue my voluntary work.�

Angela

Making a difference to the lives of disabled people

The Motability Scheme enables disabled people to use their government-funded mobility allowance to lease a new car, scooter or powered wheelchair.

Carers and family members can also drive on behalf of the disabled person.

What’s included on the Motability Scheme?

Insurance Breakdown assistance Servicing and repairs Tyres and battery replacement

Today, over 600,000 disabled people and their families benefit from the freedom and independence provided through the Motability Scheme; people like Angela (pictured above), who was able to apply to Motability for a charitable grant which paid towards the cost of a Drive-from-Wheelchair vehicle that met her needs.

How Motability can help Motability is a national charity which oversees the Motability Scheme and may be able to provide charitable grants to disabled people.

We provide charitable grants for: Car adaptations which help make travelling as comfortable and safe as possible

Do you have clients that could be eligible to join the Motability Scheme?

Vehicle Advance Payments to cover the total leasing cost for more expensive vehicles Driving lessons

Sign up today for your FREE information pack motability.org.uk/enable or call 0300 123 3367 quote Enable

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).

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13/11/2019 12:18

Funding

MENTAL HEALTH TRAINING

At the start of November, the UK Government announced ÂŁ1.4 million worth of funding to develop and test new training. This is sure to be beneficial within the OT profession, but what else needs to be done to support autistic people with their mental health?

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enable on the job

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e all have mental health, however, not everyone experiences mental illness.

When working with people living with complex needs or disabilities, mental health conditions might arise – knowing how to care and treat for various mental illnesses adequately is imperative.

OVERHAUL

A number of autistic people who have mental health problems may need more specialist input

health problems may need more specialist input, general mental health practices won’t be enough. In every area we think there should be a special autism team. Most of their job will be based around diagnosis and immediate post-diagnosis support, so understanding what a specific diagnosis means and signposting to the right place is made available.

“That is absolutely vital,” emphasises Tim. “Our research shows that 76 per cent of autistic adults have reached out to mental health services in the last five years, but only 14 per cent told us there were enough mental health support services in their area for autistic people – there is a clear disconnect from supply and demand.”

On 5 November 2019 a pioneering move was made by the UK autistic,” continues Tim. Government: to overhaul the level “What autistic people tell us is of care and training provided for that, for autism, you do need that people living with a learning disability diagnosis. When you have that or autism. It has been an ongoing diagnosis then professionals know campaign, but, now, real change how to better support you. We often could be on the horizon for people take understanding ourselves for with learning disabilities and autism granted, for autistic people it can be in mental health hospitals and COMMUNICATION a great struggle because they haven’t professionals, such as yourself.

Further training on mental health realised they’re autistic, services Calls from the government have conditions for people with a learning haven’t realised and, actually, you’re revealed that 2,250 inpatients of disability or autism can see your own not getting the support you need and mental health hospitals in England career development. Communication that can be incredibly distressing and with learning disability or autism are is essential in utilising the new damaging.” to have their care reviewed. Of the training that is being funded by Through improved professional announcement, Health and Social Care the government – Tim hopes that training, understanding of autism will Secretary Matt Hancock said: “For introducing a specialist autism be clearer and help those who are in those living with learning disabilities team will ensure that there is a mental health hospitals or currently and autistic people, the current system knowledgeable place for other health undergoing mental health treatment. can leave them in isolation for long professionals to turn to for guidance.

Similarly, it is a step forward for the periods of time, with no prospect of And you, too, can aid in further committed health professionals release into the community. awareness, learning and – such as OTs – who are “I am determined to put this right understanding. Tim advises: working tirelessly to give and today we are committing to “Be inquisitive, find out all people the best care for £1.4 million is reviewing the care of every patient you can. And actively seek their needs. being put forward with learning disability and autism over out training, this can be the next 12 months – alongside a clear difficult, but it is vitally by the UK Government TRAINING plan to get them discharged back into important; and share your Within the government for training their homes and communities.” knowledge within your announcement it was However, a significant push forward, circle and network. Don’t revealed that every NHS charities such as the National Autistic underestimate the insight and social care worker will Society have been calling for improved you can get from the autistic receive mandatory training training for a significant period of time. person themselves, even if they can’t relevant to their role. Focusing directly “Autistic people, just like everyone communicate.” on understanding learning disability else, can develop issues particularly For now, the announcement – which and autism; legislation and rights; plus, around anxiety and depression,” consulted the views of over 5,000 making reasonable adjustments, it is explains head of policy at the National people, charities, and professionals believed these steps will change the Autistic Society, Tim Nicholls. “When – will see much needed funding face of mental health support. people first seek help from medical injected into an essential area of care.

Tim explains that reasonable professionals, people tell us that With governmental uncertainty at adjustments can be as simple as they’re sometimes told that their present, it is hoped whoever takes differentiating how to communicate, to anxiety is just part of their autism. on the next stage of this review will utilising different therapies.

“Similarly, some forms of autism continue to see the importance of your “Some of the processes and may have been misdiagnosed as a professional training and invaluable interventions don’t work well for mental health condition. We often skillset. autistic people,” he adds. “Talking hear from women and girls who, therapies can be difficult, particularly in particular, have had a at times of real anxiety FOR MORE INFORMATION HAVE diagnosis of borderline it can be challenging to This is a continuing story, follow the YOUR personality disorder and it’s communicate verbally.

SAY progress with the National Autistic Society only been later they have “A number of autistic How would you (www.autism.org.uk), RCOT (www.rcot.co.uk). been correctly diagnosed as people who have mental like to see mental health care improve? Let us know @EnableMagazine

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enable training

Learning on the job Further advancing you skills doesn’t have to be a hardship, there are a wealth of courses on offer.

From short online courses to a full-time Masters degree: there is a form of continued professional development (CPD) to suit your career specific needs

MASTERS If you would like to advance your skills and knowledge or specialise in an area of occupational therapy, a full-time Masters will give you a range of subject choices and an additional degree when complete. This is the perfect option if you are able to take a sabbatical or you are currently between jobs.

Completing a Masters part-time will allow you to work and study at the same time.

Mental health awareness and care is essential for all healthcare professionals to be skilled and knowledgeable in. The Mental Health MSc postgraduate course at Anglia Ruskin University (www.aru.ac.uk) can be completed part-time or full-time and includes a module on collaborative mental health care, perfect for OTs.

ONLINE COURSES

OUT OF OFFICE

Like distance learning, completing courses online gives you the freedom to study at a time that suits you, but without the pressure to meet strict deadlines. With options to fit every time scale and budget, online courses are a way for everyone to access CPD. FutureLearn (www.futurelearn.com) brings together short courses from multiple education providers. The Digital Wellbeing course from the University of York takes just three weeks to complete and looks at how digital technologies affect overall wellbeing. As 78 per cent of people now have a smartphone this knowledge is more indispensable than ever.

Turn your automatic replies on and head out of the office for a conference or networking day to get inspired and gather new ideas.

The Royal College of Occupational Therapy (RCOT) runs a number of workshops, meet-ups and masterclasses throughout the year on a range of topics.

Bookings are now open for RCOT events in 2020 including a specialist session on Communication and Advance Care Planning on 2 April and a course in keeping records on 23 January to keep your essential skills up to date.

DISTANCE LEARNING The appeal for distance learning is continually growing as it is the ideal method of learning to allow you to earn a degree while studying at a place and time that suits you. In a nutshell, if you have time to complete studying whilst still working, distance learning could be an option.

Most universities will provide a distance learning option for undergraduate and postgraduate courses. Popular distance learning providers include the University of London (www.london.ac.uk) and the Open University (www.open.ac.uk).

Courses like the Childhood and Youth masters at the Open University are perfect if you would like to learn more about a particular area of your work.

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Find additional CPD opportunities and ideas visit www.rcot.co.uk

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11/11/2019 12:57

Free assessment and measurement training with DM Orthotics We are offering CPD opportunities with our FREE Training.

Training will give you: - Accredited CPD - FREE access to our online ordering system - Measuring capability to share our quality assured “fit first time” ethos - One-two-one clinic support - Opportunities to work with a world leading designer and manufacturer of orthoses

If you’re a qualified occupational therapist, orthotist or physiotherapist visit www.dmorthotics.com/events to book on to our latest sessions.

For more information email: admin@dmorthotics.com www.dmorthotics.com

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enable training

The importance of

MANUAL HANDLING Manual handling is integral to the occupational therapy profession, which is why it’s vital to ensure your qualification is always current. An expert shares why quality training is so important

IMPORTANT

“Manual handling is extremely important,” explains Kate Sheehan, director of The OT Service. “We have to be able to support our clients to move from one

position to another, to enable them to carry out the activities they need to do and want to do. It’s about the client’s goals, and what they want to achieve.”

Manual handling can be classified as any activity that requires an individual to lift, move or support a load. In the field of occupational therapy, this usually involves moving a client: this could be into a more comfortable position, between equipment, or into a different room.

It is your role to help clients find effective and practical solutions that pose minimal risks to both the individual, and the person moving them; whether that be a carer or family member.

“There are various things to consider,” Kate advises. “The first is the client’s ability: if the client can assist in that move, we should be encouraging them to do so. The second is the ability of carers – paid and unpaid.

We need to know what their abilities are, how well-trained they are, what they’ve done in the past and whether they’ve got any physical health issues.”

It is vital that you assess all areas prior to moving a client, including the environmental conditions and the available equipment, to support people in a way that is suitable for their needs.

QUALIFICATION

Though an official additional qualification is not necessary to carry out manual

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OTs need to know what is appropriate and what is to be avoided

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n such a fast-paced profession, with new research continually being carried out, it’s vital that OTs remain up to date with the latest manual handling practices. This ensures not only the utmost safety of the client during transfer, but the safety of the OT, and means you’re acting in a professional and legally compliant manner.

The best way to do this is by carrying out additional training, to ensure you have the most recent qualifications, and are trained on the newest practices.

handling, regular training can provide new, innovative methods of working with a client, while also ensuring peace of mind that you’re assisting clients in the best way.

“Practices change,” Kate stresses.

“When I trained 32 years ago, we did moves that now would be completely inappropriate. New practices come in following evidence-based research and OTs need to know what is appropriate and what is to be avoided.”

With regular training, you can ensure that you’re up to date and able to provide quality care to your clients at all times; care that will enable them to be more independent and widen their opportunities.

FOR MORE INFORMATION

Visit The OT Service (www.theotservice.co.uk), ROSPA (www.rospa.com), and Edge Services (edgeservices.co.uk) to book a course.

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11/11/2019 14:13

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13/11/2019 15:16

Making a house

a home

Home is where the heart is, but for many disabled people, their home isn’t functional for their needs. We take a walk through the house, to find out how you can help your clients turn theirs into a home

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ome is the place where people feel most comfortable and relaxed, but if a space doesn’t enable people to carry out their daily tasks, this can have a knock-on effect on physical and mental health. It is vital that OTs work closely with their clients, discovering how they use their home, to make adaptations that will be useful for them.

“When people are in their own homes, they’re more able to take the lead,” explains home adaptations specialist OT Claire Miller. “We can truly see what’s important to people. Home brings security, comfort and safety.

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When clients aren’t able to manage in their own home, it can have a profound impact on every aspect of their life.”

LIVING ROOM

The living room is where most people relax and wind down after a busy day, watching TV, catching up with family, or curling up on the sofa with a book. It is essential that adaptations are made, to ensure the room is the haven of comfort it should be.

It doesn’t have to cost a lot to make the living room more functional, without compromising on comfort. Raising blocks can be purchased cheaply, to

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Making those simple changes can make the world of difference

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enable at home

BEDROOM

The average person spends roughly a third of their day in the bedroom, be that sleeping, resting or relaxing. This means it’s vital that the room is safe, practical and comfortable.

The heart of any bedroom is, of course, the bed. An uncomfortable bed can have huge physical implications, as well as making sleep more difficult, so choosing the right bed is of the utmost importance.

If your client is a wheelchair user, the mattress should be at the same height as their wheelchair cushion, for an easy transfer and minimal discomfort during the process. You might also consider installing a bed rail, or an emergency cord near the bed.

The placement of the bed is also something that must be considered.

It should be placed in such a way that the client can easily move around it, and access the door, windows, wardrobe and drawers without any obstructions.

Simple and cost-effective options can include mattress elevators, to assist with getting into and out of bed; hoists; heel protectors and over-bed tables.

Companies such as NRS Healthcare (www.nrshealthcare.co.uk) and DM Designs (www.dmdesign.com) can provide inspiration for adapting the bedroom.

KITCHEN

heighten sofas, chairs and loungers, making sitting down and standing up easier. Coffee tables and TV stands with wheels, and remote controls with larger buttons are just a few of the budget items that can make a big difference.

If you’d prefer to start from scratch, companies such as Mobility Solutions (www.mobilitysolutions. co.uk) and The Ability Superstore (www.abilitysuperstore.com) provide accessible furniture ranges in a variety of sizes, shapes and materials. Work closely with your client to find out what will be most beneficial for them, and to get a sense of their taste and style.

When planning the adaptations to a kitchen, it’s important to consider how your client uses the space: does it function as a space where they cook, or is it the social hub of the house?

Adaptations such as lower counter tops and sinks, more ground-level cupboard space and different handles for easier grip can be simple to change, but can make the world of difference and ensure the kitchen is considerably easier to navigate.

Ovens and hobs can cause accessibility problems, which can create hazards. Installing a cooker with an electric or induction hob is not only more stylish and modern, but can reduce risks and the likelihood of injury. Similarly, adding an oven with a sliding door can make cooking hasslefree and more enjoyable.

Small changes such as kettle tippers,

light-weight pans and adapted cutlery can also make a huge difference. The Disabled Living Foundation (www.dlf. org.uk) can provide more information about adapting the kitchen to make it more accessible.

BATHROOM

Being clean and feeling presentable helps improve confidence and sets you up for the day, therefore convenience is key when it comes to adapting the bathroom.

According to Claire, bathroom adaptations are some of the most popular and important in the house.

“People fundamentally want to be clean and hygienic, to feel happy to leave their homes,” she advises. “When there are additional needs, such as confidence issues or skincare issues, it becomes all the more important for hygiene needs to be met.”

Clients may wish to convert their bathroom into a wet room, with a stepfree shower instead of a bath. Other purchases can include a seat, for sitting in the bath or shower, and rails for gripping whilst washing. Padded toilet seats, non-slip mats and bath hoists can also have a huge positive impact on the functionality of the bathroom.

IMPACT

As an OT, the most important thing is to work with the client and the other family members living in the home, to ensure they’re happy with your suggestions and that the space works effectively for all inhabitants.

“Making those simple changes can make the world of difference and can be what helps a client back into family life,” Claire enthuses. “Home adaptations can have a really positive impact on mental health and wellbeing.

They could be helping them return to education or the workplace, so they make such a huge difference and it’s so rewarding to see the outcome of that.”

You might only be making tiny changes to a client’s home, but for them, it will make a big difference.

FOR MORE INFORMATION

Support and advice on how you can help your clients with home adaptations, contact Claire by visiting her RCOT profile www.rcotss-ip.org.uk/profile/claire-miller

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ACCESSIBLE VEHICLE HIRE

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Driving aids and adaptations Tel: 0800 916 0079 www.alliedmobility.com 13/11/2019 12:20

enable patient support

Understanding

Communication

Without the means to communicate, a client is unable to express their wants, needs and emotions.

We look at how you can improve your client’s communication skills and in turn, their day-to-day life

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rain injuries, physical impairments, intellectual disabilities, developmental disorders and emotional disorders are just some of the reasons your clients might struggle with communication. Finding new ways to assist and adapt how a client communicates is even more essential if they cannot do this verbally.

Having good communication helps clients to feel at ease, in control and valued. Being able to communicate effectively opens doors for clients to let you and others know when they feel concerned, anxious or unhappy, and will build their self-confidence.

COMMUNITY

Once you have assessed the ways in which your client could improve their communication skills, collaboration with other healthcare professionals is key. Depending on your client’s circumstances speech and language therapists, psychologists and even social workers can help them with the skills they need to improve.

Along with professionals, a client’s family can help them to enhance these skills. After a plan is in place to support your client, share this with their loved ones to see how it can be incorporated in the home. This will ensure your client feels heard in their day-to-day life.

Communication doesn’t have to come in the form of speech, especially if this is inaccessible or daunting for a client. In order to encourage a client to communicate, incorporate activities they enjoy into your recommendations. It is important to ensure communication is meaningful for a client, or they might not feel driven to improve.

MENTAL WELLBEING

Emotional and mental wellbeing can affect the way a client communicates and their desire to do so. Communication can be especially difficult for clients who struggle to process or convey their feelings in an

effective way.

Introducing practices like meditation and mindfulness can help your client to understand their feelings, why they are experiencing them and how to explain them to others. These practices can also aid clients if they experience frustration when learning to communicate in new ways.

TOOLS

If a client is non-verbal or losing their speech but isn’t able to communicate through modes like sign language, communication aids can provide a lifeline to maintaining independence.

They can also be helpful for clients who use tools like sign language but those around them don’t. Communication aids can range from low-tech to high-tech and can be tailored to a client’s abilities or needs.

Hearing aids, cochlear implants and symbol systems are all examples of

Having good communication helps clients to feel at ease, in control and valued communication aids, but technology like smartphones and tablets can also be used. Showing clients how they can use text relay services, hearing loops and other aids will help them in their everyday life.

FOR MORE INFORMATION

Communication Matters (www.communicationmatters.org.uk) provides resources and research to help you improve clients’ skills.

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enable patient support

The art of

Care Hospice care is an integral aspect of ensuring everyone has the best support reaching the end of their life. As an occupational therapist working within a hospice, your care is a defining part of a client’s experience

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s a healthcare professional, you will understand the importance of providing compassionate care for patients and supportive guidance to their loved ones.

Transitioning into working within hospice care may be an avenue that you have considered over the years, and it is an enriching way to allow your skills to not only flourish, but bring positivity and comfort to a client’s final weeks or days.

LIGHT UP A LIFE

The Prince & Princess of Wales Hospice, based in Glasgow, has been providing care to more than 1,200 patients on an annual basis, and Kirsty Hamilton is an OT working to bring care within a rehabilitation team giving support to the hospice, inpatient units and within a person’s home.

A varied role, Kirsty’s care is led by an individual’s specific needs. “People often want to be independent and my role is to help a person optimise their independence within the limitations of their condition,” explains Kirsty. “As a result, input may include giving advice on how to adapt a task, how to manage symptoms such as fatigue while trying to be independent or adding in equipment if appropriate.”

Going beyond equipment, Kirsty helps run educational groups for patients on how best they can manage their breathlessness and fatigue. An entirely patient led role, the main outcome is for a client to achieve their goals.

HOPE

“When we talk about hospice care people often think it is a negative place/ service, something people fight against accepting,” continues Kirsty. “I am surprised every day by the hope that the hospice gives to a person with a life limiting illness and their loved ones.”

A hospice is a place for people to find hope and joy during the last phases in their life; alongside providing loved ones a place to turn during the challenging times. Working within a hospice is, in a sense, a holistic and valuable level of care.

Kirsty says: “I don’t think I recognised that some patients die with little or no support and that as a result the person has suffered needlessly. The hospice demonstrates on a daily basis how good care within the dying phase can improve the quality of life and how the person and their loved ones feel.”

EXPERIENCE

Anyone currently working as an OT can

Read our full interview with Kirsty online at www.enablemagazine.co.uk

I am surprised every day by the hope that the hospice gives to a person utilise their skills within palliative care.

For Kirsty, whilst training, she completed a placement in an oncology ward in Aberdeen and in a HIV/AIDS specialist hospital in Uganda. This experience was the turning point in Kirsty’s career, she enthuses: “I saw first-hand how patients can have a good death, with them and their loved ones supported throughout.

“I think a good variety of clinical experience is essential to a good hospice occupational therapist,” adds Kirsty.

“I love working as an occupational therapist in the hospice and I get job satisfaction every day when working with patients and their loved ones.”

FOR MORE INFORMATION

Learn more about hospice care from The Prince & Princess of Wales Hospice (www.princeandprincessofwaleshospice.org.uk) and Hospice UK (www.hospiceuk.org).

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Carers play an invaluable role in the lives of clients, but they may also require professional support. As an OT, there are many ways you can work with carers, to improve their confidence and the overall care delivered to a client

A HELPING

HAND

C

arers are absolutely integral to the healthcare service, on the frontline providing support to clients every day.

“Without the support of carers our clients would often not be able to live in their own homes, participate in daily activities, vocations, social activities and valued interests,” explains OT Catherine Manley, who works closely with carers and family members. “No matter how much or little support is needed, everything a carer does makes a massive, vital difference to the lives of our clients.”

OTs should work closely with carers to demonstrate how to use new equipment, offer moving and handling advice, and show the best ways to assist with personal care, such as dressing, washing, moving around the home and going outside.

Providing practical advice and support to carers not only ensures they’re well equipped to work with the client, but also reduces risks and ensures the safety of all parties when carrying out a move or working unfamiliar equipment.

IMPORTANCE

Though carers hold such an important role in clients’ daily lives, their needs are often swept under the rug, which can result in a decreased quality of care.

“Carers have often expressed that they’ve had times when they have felt confused, upset, pulled in different directions, powerless and ‘fed up of fighting’,” says OT and carer specialist, 18

Lisa Thacker. “I’ve also worked with clients who have been resistant to having care as they do not wish to feel like a burden, particularly where the carers are family members.”

When a family member takes on the role of a carer, they’re often already one of the people who knows the client best, which can aid in the care of that individual. However, lacking in practical experience, it helps to have an OT on board who can provide that level of hands-on support and navigate the best ways for the carer to take on the caring role.

“A client’s carers are often the first people to raise any concerns, knowing the client so well and typically being the most involved,” Lisa explains. “Changes in clinical needs, physical presentation, emotion and mood are often picked up by carers first. Having a carer that feels empowered and part of a wider team means they have more confidence to know who to share this with, no matter how small their concern is.”

UNPAID CARERS

An estimated seven million people in the UK act as unpaid carers for their loved ones. 6,000 people become a carer every day, giving up their own careers, often without time to plan or adapt to their new circumstances.

According to Carers UK, the work of unpaid carers saves the government an estimated £132 billion each year – almost the cost of a second NHS. But, being an unpaid carer can take a physical toll, and can impact mental

health. It’s vital, therefore, that OTs are able to identify when a carer needs more support, and is equipped to provide that help.

“In the majority of cases it will be the family member or spouse who is the first carer for the client,” says Lisa. “If the client is in hospital, the care role begins with advocacy, regular visits, bringing items to and from the hospital, maintaining the home and rest of the family while the client is receiving their treatment and recovering.

“With progressive illness or developmental problems, it’s often the family member or spouse who notes changes and accompanies the client to appointments, supporting them as information is gathered and results are received.”

And Catherine emphasises: “Unpaid carers provide countless hours of support, often on top of other family and work responsibilities – the role is

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often unrelenting and exhausting.

“The risk of mental health problems, social isolation as well as physical strain or injury is much higher, making it all the more important they have the support, training and advice they need.”

SUPPORT

As well as taking on the responsibility of caring for their loved one, an unpaid carer may also struggle with the physical demands of the role, alongside isolation, and stress relating to finances.

Carers are entitled to an assessment of their needs, to see if they are eligible to any additional support. This is usually carried out by a social worker or care manager, but it can be useful for an OT to be involved in the process, to advise on practical aspects that can be beneficial for a carer to know.

“I’ve found that taking time to listen is often appreciated,” Lisa continues. “It can take a long time, but working with

the person and their family or carers, listening to their anxieties and wishes can result in really positive outcomes.”

CONFIDENCE

The difference it can make to have a carer who is confident in their own ability and happy in their role makes all the difference in the world: not only is their own quality of life improved, but the impact it can have on their client is unrivalled.

“Confident and happy carers know the client well and know when to step back and give the client space,” Lisa enthuses. “They also are in tune with their own needs. A confident and skilled carer will often help the client to achieve their personal goals.”

Through continued support from OTs and other healthcare professionals, both paid and unpaid carers can continue their valuable work, ensuring clients receive the best care possible.

Carers, whether paid or unpaid, are incredibly important in the daily lives of clients

FOR MORE INFORMATION

Further knowledge can be found at www.evergreenot.co.uk or www.rcotss-ip. org.uk/profile/catherine-manley-

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Autism Professionals Conference

Hear, learn and be inspired This annual two-day conference is a unique opportunity to share knowledge and experience. Join us to hear the latest information from world-renowned experts and gain insight from case studies.

Prof Emily Simonoff, Dr Felicity Sedgewick, Dr Jacqui Shepherd and other leading experts will discuss key topics at the conference: • • • • • •

mental health and wellbeing diagnosis identity happiness and quality of life communication multi-disciplinary working.

Find out more:

Live streaming on demand Not available for the two days?

Not a problem. For the first time we will be live streaming the Autism Professionals Conference, so you can enjoy the content from the comfort of your own desk or watch it on demand for seven days after the conference.

www.autism.org.uk/conferences

© The National Autistic Society 2019. The National Autistic Society is a charity registered in England and Wales (269425) and in Scotland (SC039427) and a company limited by guarantee registered in England (No.1205298), registered office 393 City Road, London EC1V 1NG Job No: 3621_051119

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OT AT SCHOOL During your career you will have gained a wealth of transferable skills, even some that can be beneficial in an educational setting. From how to manage workload to helping to take part in sports clubs, there are multiple ways you can improve the classroom for disabled children

O

ccupational therapists can be utilised in schools in multiple different ways, whether you are based in a school, working with a young person’s family or providing assessments and interventions. If a child has had an accident or has a disability, they may need adaptations or assistance to continue with everyday school life.

As an OT working in an educational setting you will work with children from pre-school age through to college or university in both mainstream and special education settings.

STUDY

Participation in school activities is essential to helping pupils maintain independence and enables them to work alongside their peers. Pupils with a disability may need assistance and adapted resources to carry out functional tasks like handwriting, using scissors and reading.

Advancements in assistive technology have made the classroom a more inclusive and functional place, allowing children and young people with additional needs to access learning materials alongside their peers.

Electronic worksheets, spelling software and talking calculators are all simple tools to assist learning.

DEVELOPMENT

Alongside functional tasks in the classroom, OTs can help pupils to stay on task, work with others, socialise at break times and manage their time.

These skills will be of benefit both in and out of the classroom, improving overall wellbeing.

Tasks that might seem simple, like moving between classes or subjects, can be more complex if a pupil has additional needs. Finding a solution that works for each individual child is essential to enjoyment at school. Once in place, these same tools will go on to benefit them during the transition between primary and secondary school through to higher education.

PLAY

Taking part in physical activity, sports clubs and extra curriculars allows pupils to add more advantages into their school experience. While most pupils find socialising with others, playing and participating in activities easy, this can present challenges for some children.

Understanding how these activities can benefit a pupil’s physical, mental and emotional wellbeing will help you to advise school staff on how best to ensure a child is included and can access these activities.

UNIVERSAL APPROACH

Your skills as an OT stretch further than individual pupils – taking a whole school approach can support policy development and training in schools.

Collaborating with teachers and staff will allow you to advise on reasonable adjustments, suggest adaptations and provide consultation for the school as a whole.

Although each school is unique in its workings, all schools experience similar challenges during events like the start of a new school year, with the support of your skills and experience, students with a disability and additional needs are sure to flourish.

FOR MORE INFORMATION

OT for Kids (www.otforkids.co.uk) provides assessments and information about occupational therapy in schools and how to utilise your skills.

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BEHIND THE LENS The world around us is continually changing, and so is how we facilitate care. In a more technologically advanced world, we ask, where does virtual reality come into play?

V

irtual reality (VR) has become an immersive experience for people in various sectors, none more so than in the health care industry.

Technology most commonly used with VR therapy includes the use of a VR headset or multi-projected environments, sometimes with props.

ADVANCED

In theory, VR can be described as a computer-generated simulation of threedimension images or environments, allowing people to interact with the simulations. It might sound futuristic, but, in fact, VR has been playing a helping hand in care for decades.

“Although research for VR within healthcare and education dates back to the seventies, the average person still associates VR only with zombies and entertainment,” explains Rebecca Gill founder of VR Therapies. Going onto discuss the use of VR further, she adds: “This immersive environment can be similar to the real world or it can be fantasy, creating an experience that is not possible in ordinary physical reality.

The environment could be anything from the middle of the ocean to different galaxies or worlds – it is only limited by our imagination.”

Through the advances in technology, VR is becoming an important tool for health professionals.

PROS

Rebecca continues: “The response has been amazing. I get to take those too poorly to walk, swimming with dolphins, children undergoing chemotherapy to explore space. The benefits are immediately apparent as people forget their pain, breathe easier and smile more.”

Sessions utilising VR has an incredibly positive impact on a person’s rehabilitation and recovery time.

Currently, VR is used in over 150 hospitals and healthcare institutions and it seems to be a technological step in the right direction for care.

“VR in particular is changing

I am passionate about only healthcare professionals becoming VR therapists everything from pain management by offering an alternative to addictive pain-killers, to helping communicational and behavioural difficulties for autistic people,” adds Rebecca.

However, with all new medical remedies and medicines: there has to be in-depth research, analysis and review of the long-term impacts. Could utilising stimulated landscapes and locations be detrimental to patients?

alternative to many situations (such as those for phobias or social anxiety) but will never replace the real world. It is the same as other treatments – you have to consult your doctor first.”

Research currently undergoing is looking at the benefits and limitations to VR therapy in a wide landscape of scenarios. From the us of VR for veterans living with PTSD, used within a hospice or as a physiotherapy tools: it appears continued research will show that VR in a controlled medical setting could soon become a viable form of care.

Rebecca concludes: “More and more specific clinical therapies are being developed incorporating biofeedback, which has amazing potential. Children are growing up around technology, so it will be exciting to see the next generation of innovation.”

CONS

“There is always risk involved with any therapy, which is why I am passionate about only healthcare professionals becoming VR therapists,” emphasises Rebecca. “VR provides a low-risk

FOR MORE INFORMATION

Learn more about the pros and cons of virtual reality from VR Therapies (www.vrtherapies.co.uk) and Portland College (www.portland.ac.uk).

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Technically AHEAD

Access to mainstream and adapted technology can open new lines of communication for people who are often reliant on others. Technology can assist people with a disability, an expert OT in the field reveals how

T

echnology can be used to enhance the lives of almost anyone, but it is particularly helpful for people who have a disability that limits their mobility, movement or speech. Assistive technology can therefore help people carry out everyday tasks they would otherwise be unable to do.

Augmentative and Alternative Communication (AAC) services are located throughout the UK providing assistive and rehabilitation technology to people with a disability. Josephine Curley is the senior OT at the AAC Compass hub, located at the Royal Hospital for Neuro-disability in London.

Josephine’s role looks at how accessing a high-tech device to communicate can improve quality of life.

TRANSFERABLE SKILLS

As an OT you already have the necessary skills to recommend lifeimproving technology to your clients, Josephine explains: “You just need the right mindset and transferable skills.

Also, a keen interest in technology and knowledge around mounting products and wheelchairs would be beneficial; and experience with neurological conditions.”

As only one OT is on a team at any one time, five years experience would be beneficial to have core skills imbedded.

Josephine didn’t undertake any special training to reach her level of expertise, but stresses that there could be more than you know to assistive technology. “I’m sure a lot of

people come across someone using a device in their role and know about assistive technology like pressure pads, sensory technology and telecare, but this is actually different to that,” says Josephine.

The depth of and advancements in technology are something Josephine only came to understand once she started her role at Compass, she explains: “There is an incredible amount of learning, I’ve only dipped my toe in.”

PROBLEM SOLVING

Finding the right progressive technology to fit clients’ individual needs takes problem solving and collaboration with other professionals.

“It is quite different to what other OTs do in a way, you have to make sure you know about other disciplines because you are working with technicians, engineers, and other therapists,” reveals Josephine.

“The people we work with are amazing in terms of their technical skills,” continues Josephine. “They can make machines do incredible things, but sometimes they don’t have an awareness of how that connects to the person, to the role that they’re in.”

This gap is where an OT is an invaluable asset to the team, armed with the necessary knowledge to see how technology can help a person in the context of their situation.

Josephine and other OTs in AAC teams work to find a person’s point of access, this could be as small as movement in one knee or elbow,

Josephine adds: “If they have got movement then they are able to use a switch to control a device.

“We might save someone who is potentially trying to communicate or get a message across but due to their circumstance all they can do is move their eyes or flick their finger.”

Problem solving is essential in these situations. If they believe a patient is trying to communicate different methods can be used to determine how this could be possible.

While technology used by teams like Compass is progressive, mainstream technology can also be utilised to support clients. Devices like smartphones and tablets are constantly opening new doors to communication.

MEANINGFUL

Although a team of technicians and engineers could create and put in place assistive technology, an OT is essential to identify how this can be purposeful for a client.

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If you’ve got a voice, you’ve got choice and you’re involved

“It’s not just about access,” emphasises Josephine. “It’s also about making sure that their communication is meaningful to them, that’s where occupational therapy comes into it more. It has to be in the context of an activity, so [a client has] a reason to communicate.”

Introducing technology in a setting that is familiar and interesting to a client increases the likelihood that they will utilise it, in turn improving their level of communication and independence.

“If you give them the motivation it almost means there’s a reason to use [the technology] and it gives them a bit of life,” adds Josephine.

When Josephine first started working with the team this is an aspect they often struggled with, she says: “Sometimes they haven’t thought about why someone isn’t using a device, then I come and say maybe it’s because they’re not motivated or because normally they enjoy being outside but they have only been given the

opportunity inside.

“It’s just that different way of thinking, OTs have a big impact because other professionals don’t get trained in the same way.”

Motivation can come in many different forms and getting to know your client’s history is essential to finding out what makes them tick, Josephine explains: “If you’ve got a voice, you’ve got choice and you’re involved – when you don’t have a voice you are reliant on those around you to advocate for you, but you might not agree or want to say something different.”

Using your transferable skills as an OT to find meaningful uses for both mainstream and assistive technology can help give clients a new mode of communication and independence.

FOR MORE INFORMATION

More information on AAC and teams like Compass can be found at www.rhn.org.uk

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Product Roundup Here are our top picks of products on the market to aid in your level of care

KIDS

HOME

POTTY CHAIR

SENSORY

Smirthwaite, From £269 smirthwaite.co.uk, 01626 835 552

UV TIME FUN KIT

Explore Your Sense, £55.14 inc VAT www.exploreyoursenses.co.uk, 01535 662812

Introduce tactile and visual play for children and young people with learning disabilities and autism.

Including four spiky wrist bands and two rattle sticks: the kit is entertaining, the UV light can promote stimulating visual effects and improving understanding of light and colour.

MOBILITY

A freestanding and highly supportive potty chair, it has been specifically designed for young clients who require assistance when sitting, balancing, and toileting. Sides provide privacy for a child with handrails for balance.

The chair is also available in a range of colours and sizes to fit in a variety of environments.

E-PACER

Rifton, POA www.jiraffe.org.uk, 0114 285 3376

Adding to the Pacer family, the E-Pacer combines the electric lift column and secure body support of Rifton’s TRAM alongside classic features of the Pacer. Accommodating clients up to 160kg, this is a life changing product for those who have grown too large or dependent to be safely transferred into manual gait trainers.

ADULTS

MOBILITY

QUICKMOVE

OT Stores, £2,100 inc VAT www.otstores.co.uk, 0845 260 7061

MOBILITY

PILL POPPER AID

This transferring aid will increase ease when moving and handling a client.

QuickMove actively supports the clients during rising to standing and transfers, the product is suitable for clients with balance issues and limited leg strength. Easy to attach, a back support belt can also be purchased separately for additional security.

HEALTH

PASSIVE EXERCISER

HappyLegs, POA www.fortunamobility.com, 020 8805 2020

For clients who spend long periods of time sitting or standing without moving, the HappyLegs passive exerciser automatically exercises the legs whilst still seated. Three hours of passive exercise is the equivalent of walking for one hour, sure to boost physical and mental health whilst naturally stimulating circulation.

Pivotell, £23.99 pivotell.co.uk, 01799 550979

The Pivotell Pill Popper gun is an aid to push tablets easily and quickly from a tablet blister pack. Get access to medication easily, hygienically, and efficiently – ideal for people living with dexterity problems. Similarly, the gun is dishwasher safe, features a removable tube for larger tablets, and is eligible for VAT exemption.

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KEYS TO

Independence T

here are around two million licensed drivers with a disability in the UK, many of whom require adaptations to drive safely and comfortably. Within your role, it is important to know about the support and adaptations available to your clients.

Clare Jones is an OT and assessment team manager at the Regional Driving Assessment Centre (RDAC) in Birmingham. The centre assesses client’s medical fitness to drive and advises on adaptations for people with medical conditions and disabilities.

Driving is often tied up in people’s identity and is essential to maintaining independence, Clare says: “It is being able to access the normal day to day activities that are important from a wellbeing point of view.

“It’s of huge benefit to people and particularly people with disabilities because cars can often offer a lot more flexibility than public transport options can currently give. We will also offer advice on getting around without a car if that is no longer an option.”

ASSESSMENT

At the centre, OTs work alongside experienced specialist driving instructors to assess clients, including

experienced drivers wanting to return to driving or learner drivers just starting out. Clients can self-refer or be referred by healthcare professionals and organisations like the DVLA and Motability.

“There’s two sides to what we do,” explains Clare. “One is looking at the individual’s ability to drive and relevant vehicle adaptations, the other is cognition and whether they are safe to drive with the medical condition they have.”

Each assessment is guided by an individual’s needs, using a holistic approach to determine what adaptations or specialised vehicle a client will need to get them from door to door, not just to drive.

Along with drivers, passengers with a disability may also require adaptations to help them travel safely and comfortably.

RDAC offers advice for children and adults and runs a regular child car seat clinic along with other paediatric services.

Adaptations can vary from small to more elaborate and expensive, Clare says: “Anything from small pieces of equipment, to seats that swivel out of the vehicle for people to do a slide transfer and swivel in; or a wheelchair accessible vehicle where people can remain in their wheelchair – there are lots of available forms.”

Driving is often essential for independence, but finding the right adaptations requires collaboration and additional knowledge

COLLABORATION

Alongside collaborating with colleagues, OTs like Clare who specialise in motoring also liaise with OTs and other healthcare professionals in the community.

“We can share our knowledge with them and discuss the opportunities and hurdles to getting back to driving after an illness and DVLA licensing laws,” Clare explains.

Clare also works with OTs in the community if a client needs to work towards driving again after, for example, experiencing a stroke, she explains: “Whether it’s specific movements or practising techniques relevant to driving, maybe trying to get a person to multitask and get back into lots of cognitively taxing activities if they have spent time in hospital recovering.”

From sharing knowledge on medical conditions and disabilities, to answering questions: it’s imperative to take a collaborative approach to motoring when clients need advice and adaptations.

FOR MORE INFORMATION

Further references are available from RDAC, and Driving Mobility to provide information on motoring to OTs and clients, find your closest mobility centre using the postcode search at, www.drivingmobility.org.uk

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Becoming a

Specialist A

round one in every four people experience a mental health problem each year: OTs can make a big difference for people struggling with their mental health.

OT Áine Loi specialises in mental health at Nightingale Hospital, a private mental health hospital in Central London. The hospital helps people who have mental health conditions and addictions along with people who have eating disorders – the area where Áine aids a large portion of her clients.

“It’s quite niche and people who haven’t worked in it before won’t have any idea about it, it’s still occupational therapy but very specialist,” Áine reveals.

SPECIALIST

Áine supports groups of clients through social lunches, meal planning, food shopping and preparing meals, all of which can be extremely difficult for people with an eating disorder.

“It’s about supporting people, some will be anxious in the supermarket or

Specialising as an occupational therapist can open doors in your career and allow you to form a deeper connection with clients.

One specialist OT discusses her work in the mental health sector and how she got there

they will be obsessively looking at labels and so [it’s all about] teaching them to pick up items in a timely way without obsessing,” explains Áine.

Each exercise is followed by a discussion with patients on how they felt about the experience, where they would like to improve and how they would like to challenge themselves in the future.

INSPIRATION

Áine’s desire to specialise in the mental health sector stemmed from her time on placement while at university. After she started a job at Nightingale Hospital as a mental health OT she started to learn more about the treatment of eating disorders.

“I was working on the eating disorder unit and really enjoyed it and so I just really fell into the specialism,” recalls Áine.

Inspired by her work, Áine decided to pursue a part-time masters in eating disorders and clinical nutrition while she works.

Áine Loi

VARIETY

Before she entered the specialism, Áine had a wealth of experience as an occupational therapist from working in areas including cardiology to intensive care.

“It has set me up to be able to work with a wide range of people and people in different situations,” explains Áine.

“Here at the eating disorder unit we have a range of ages and backgrounds.” Áine also works to bring laughter back into her clients’ lives, she reveals: “Part of the role is enabling people to have leisure activities and enjoyment.

“That’s the key: What do they enjoy or what did they enjoy before they became unwell?”

Now, Áine would recommend other OTs interested in the area to draw on the knowledge of other healthcare professionals through shadowing days and networking.

Alongside mental health, work, trauma, housing and more are specialist sections of occupational therapy. What specialism will pique your interest?

FOR MORE INFORMATION

Join a Specialist Sections branch of the Royal College of Occupational Therapists (www.rcot.co.uk) to learn more about training in a specialty.

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