University of Sydney OT Students Stepping in to Support Communities

Although COVID-19 created numerous challenges for students—especially limited opportunities to complete placements—it also created new avenues to promote occupational therapy services. An ongoing partnership between the University of Sydney School of Health Sciences and the Red Cross resulted in a role-emerging placement focused on community dwelling and residential-based older adults, and how to promote collective, meaningful engagement for these clients1. Between 17 August 2020 and 11 December 2020, eight in-country and four offshore occupational therapy students engaged in 13 placement opportunities to introduce occupational therapy input to Telecross and the Community Visitors Scheme (CVS) programs.

Sanetta du Toit, Senior Lecturer, University of Sydney

Creating Community Connections

Many older people living in the community are lonely, and reach out to service providers like Red Cross helplines. This intensified during the COVID-19 pandemic, with a lack of social and community support increasing risks of social isolation, boredom, and physical deterioration in older adults. Occupational therapy students followed up clients referred from the Telecross program, and used an on-line application, GENIE2,3,4 (Generating Engagement in Networks Involvement), to re-establish and expand networks for older, lonely, and isolated adults in the community.

For one inner city client, 87, who had been social all his life, contact with the occupational therapy students made him realise how much he had become isolated. He had no family, had outlived most of his social group, and had mobility issues. The client told Red Cross community project officer Helen Barns that having visitors “brought out the person I used to be. I used to love socialising, but because I can’t really leave my flat, I don’t get out. Having the students come around has made a big difference. I look forward to seeing them each week and will miss them very much”. He is now having regular weekly visits from a volunteer, and with the encouragement of the students has gone to several meetings at Counterpoint, an outreach centre close to home. Besides building client networks, students also ensured that clients who needed extra services were referred on. Another inner city client, 80, also reported to Helen how much he appreciated the occupational therapy input. “They made a real difference to my life. Just by raising the toilet seat two inches it has made it easier for me to use the bathroom. It’s amazing how much it has changed my life. It’s amazing that they were able to see little things that I didn’t think about. I am getting a new bed as well, which will make a difference to me. I will be able to get in and out of bed without problems, and I will have a proper mattress. I’m having surgery soon and it will make a big difference. I can’t tell you how much they have changed my life,” he said.

For older adults living in the Shoalhaven area, receiving telecare input from a health professional—in this case, based in Canada!—had a positive impact. Another Red Cross Staff member reported at a joint services meeting that, “I spoke with a client today to organise follow-ups. The client wanted to pass on how thankful

Induction day at Cumberland Sydney School of Health Sciences Campus on 17 August 2020 Jordan Goldberg in front of her computer working on a GENIE map

she is for Blessing’s education, assistance, and help with her diabetes. She has changed a lot since her interaction with Blessing and cannot thank her enough.”

Student Investment

Four students were offshore in Canada and Singapore and honoured AEDT working hours. The Canadian students specifically implemented various strategies to manage academic and professional expectations, while restructuring personal routines to cope with the time change. Their work week began on Sunday and ended on Thursday, with placement hours between 5pm and 2am.

Jordi, who completed two placements within this period, implemented various adjustments: “I activated world clocks and calendars on my scheduling systems to ensure that appointments and meetings would be transferred from Sydney time to Toronto time accurately. I set up a home office with appropriate lighting, privacy, and general environment for therapeutic service provision. I took courses and seminars on how to enhance therapeutic experiences while using telehealth services.”

Outcomes for Students

Some of the predominant advantages of role-emerging placements are the impact on student understanding of the uniqueness of our profession, and developing their professional identity through their own efforts5 .

Student Bronte felt the nature of the placement prompted students to learn how to reach people who needed occupational therapy, and help them with the resources available:“I believe this placement was crucial in shaping my perception of what the occupational therapy role is, and how we as therapists can change the lives of others in the simplest of ways…It made me question the scope in which occupational therapists work, and allowed me to delve into a world of social occupations and their importance on mental health and activity engagement.”

Shermaine, based in Singapore, also indicated that challenges associated with telehealth practice was a good way to develop her professional identity “in a multidisciplinary context while working with Red Cross professionals and clients who may have limited occupational therapy knowledge.”

Blessing, who engaged remotely from Canada with older adults in rural NSW, contemplated how the skills she gained could bring much-needed health care services and care to rural Edo State, Nigeria: “I always wanted to help more back home (without)…moving back… and now, because I have successfully completed my final two placements from a different country via telehealth, I have the skills, confidence, and hope to make a difference back home in Nigeria, too.”

Impact

This is an Australia-first for the implementation of GENIE6—developed by the University of Southampton, UK—which gave the Red Cross a visual map of client networks and how networks expanded due to service input. On a personal level, occupational therapy students valued the rapport they built with Red Cross clients, while staff reported observed “improvement in mental wellbeing as result of student visits from last and current placements.”

Helen summarised her appreciation of the new scope of occupational therapy: “Having students placed with our existing Telecross program was a wonderful experience for our clients. Not only were they able to assist our client with advice regarding local services, they also were able to help make physical changes to contribute to our clients having a better quality of life. They were also instrumental in encouraging clients to venture out and join outreach programs, and to seek assistance from our Red Cross CVS program, and have a volunteer come and do a weekly visit.”

The success of this pilot phase has resulted in additional funding for fieldwork supervision to expand the role-emerging placement into the first semester of 2021. During the next phase, students will be focusing on expanding and developing the visitors scheme in Scalabrini Villages and Calvary Ryde for implementation of Java Memory Care (group activities) and Tangible Memories (life-story individual activities), and expanding the GENIE data base for community care providers. About the Author Sanetta du Toit is an international occupational therapy researcher and practitioner with an established reputation for innovation in aged care. She is currently employed as a senior lecturer at the University of Sydney. She also holds a research fellowship at the University of Free State (RSA) and previously had clinical positions in the UK, USA, and RSA. As a founding director of the Eden Alternative South Africa, Sanetta endeavours to be an advocate for older people’s right to a meaningful life in institutional care settings. Acknowledgements The success of this project would not have been possible without the support of Tanja Djordjevic (Social Support Manager, Red Cross), Dr Ivaylo Vassilev (University of Southampton), Judy Harper (Regional Manager Central Southern Region, Red Cross), Maggie Bianco (Village Manager, Scalabrini Bexley), Tracey Gill (Wellbeing Coordinator, Scalabrini Bexley), Elmien de Klerk (Occupational Therapy Placement Supervisor, Red Cross) and the WIL team (The University of Sydney School of Health Sciences), and the enthusiastic involvement of Jodi, Blessing, Bronte, Claudia, Meriam, Germaine, William, Jia Jun, Chloe, Brook, and Shermaine.

References 1. Du Toit, S.H.J., Brown, M.M., Adams, F., & Casteleijn,

D. (2019). Occupational Justice within Residential

Aged Care Settings – Where are We at Working with

Collectives? British Journal of Occupational Therapy, 82(9), 578-581. https://doi. org/10.1177/0308022619840180 2. https://GENIE-net.org 3. https://GENIE.soton.ac.uk/eng/ 4. http://www.health.org.uk/sites/health/files/

ImprovementScience.pdf 5. Clarke, C., Martin, M., Sadlo, G., & de-Visser, R. (2014).

The Development of an Authentic Professional

Identity on Role-Emerging Placements. British

Journal of Occupational Therapy, 77(5), 222-229 6. Vassilev, I., Rogers, A., Kennedy, A., Oatley, C. &

James, E. (2019). Identifying the Processes of Change and Engagement from Using a Social Network

Intervention for People with Long-Term Conditions, A qualitative study. Health Expectations, 22(2), 173-182