It’s Occupational Therapy week

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It’s Occupational Therapy week! For the next five days we’ll be celebrating our fantastic OTs who work with children and adults and explaining how their invaluable skills support people.

Today, in our final piece for Occupational Therapy Week Faye Burke, OT team leader, tells us about the OT team’s personalised care pilot project that started in April, reviewing the care packages where service users were being visited by two carers at a time…

“New technology, equipment and manual handling techniques mean that many people can now be safely cared for by just one carer in a visit rather than two. It’s better for the service user as there’s more dignity and independence and it’s better for the council as we spend less and create more capacity in the care system as well as reducing delayed discharges from hospital.

“For example, Mrs B had seven hours of care each week with two carers visiting each time. She had been provided with a level-access shower on the ground floor and a specialist shower/commode chair on wheels by the OT service this February but she had never used either and was still washing with the carers’ help.

“The OT reviewed Mrs B’s manual handling needs and completed a risk assessment. The existing equipment didn’t need to be changed, however the OT provided advice and techniques on how to use it with support from one carer.

 “Mrs B was previously distressed and frustrated by her care as it lacked personalisation. She is now delighted with her new package of care and feels that her wishes are being respected. The changes in how her care is provided have not only had such a positive impact upon Mrs B, but will result in a cost saving to the council of £4,335 each year, and has also released a care worker to provide support to someone else in need.”

An occupational therapy assessment can be requested by any professional as well as members of the public.

Referrals for children and adults can both be requested online.

Occupational therapists don’t just work with adults, Liverpool City Council also has a team of OTs who support children.

On Thursday, Lisa, a mum of twin girls, explained how children’s OT Anita Walsh has made a huge different to her daughters’ lives…

“My twin girls, six, both have autism, global development delay, hypermobility and sensory difficulties. Anita has been working with us for a while and I can’t explain how much of a positive impact it has made having her in our lives. The work she has done at school and home is outstanding making sure the girls’ needs are met and supported. Anita has been into school many times working with both the twins and staff with recommendations for seating and sensory solutions during lesson times along with safety recommendations and much more. Anita continues to support and I sure that the school would agree that Anita’s professional support is making a big difference.

“At home, I found it a struggle getting in and out of the house and Anita quickly recognised the issues. We have had level-access steps put in at the front and rear with grab rails for support and it has been great.

“Also, we had a big struggle during bath time lifting the twins in and out of the bath and holding on to them so that they wouldn’t slip which put a lot of pressure on my back. Anita ordered an electric bath chair which now and we are having a level-access shower fitted. The girls are also learning how to use the toilet but could not support themselves securely so Anita ordered toilet frames and bath steps.

“During meal times, the twins were finding it hard to sit comfortably at the dining table so Anita applied for two chairs which can support the girls to sit right. Now both girls are enjoying sitting eating their meals in a comfortable and safe way which again has made life so much easier for them. 

“I can honestly say that with Anita’s support our lives have become a million times easier. I can’t imagine how much we would be struggling if we had not had Anita working with us. She is a wonderful person and is great at her job. I think it is amazing what occupational therapists do for families with children with extra needs and can’t imagine what we would all do without them. We really appreciate everything that has been done; it means my daughters can carry on being happy little girls.”

Small Change, Big Impact – that’s the theme for Occupational Therapy Week. On Wednesday, occupational therapist Hollie Bradley tells us how just one chair made a family safer and happier…

“We received a request to assess a service user who had a diagnosis of dementia and complex behavioural issues and who was living with her brother. There were concerns about how she could be kept safe in the arm chair in which she usually sat. She was often falling from the chair and her brother was struggling to cope with her demanding and challenging behaviour.

“Following my assessment and a joint visit with a seating provider, we were able to provide a specialist chair that was then set up in the right position. The benefits were noticed instantly. As well as the chair being the right dimensions the lady’s behaviour changed dramatically. She was no longer distressed.

“Previously, the lady would have felt unsupported and most likely fearful. The new chair not only supported and comforted her physically but also emotionally and cognitively.

“This was a great outcome not only for the service user, but also for her brother who could carry on caring for his sister and it also reduced stress for the service user’s son.

“The service user was calm, happy and content and her brother was very happy with the intervention. He told me that it was the first time he had seen his sister smiling for a very long time.”

On Tuesday, Louise McCann, an occupational therapist for over 30 years, told us about a “typical” day on the job. She says the role is “varied, interesting and extremely rewarding but it can also be stressful and emotionally demanding”…

Today I have four home visits beginning in the early morning so I can meet visiting carers from the agency who are caring for Mr B, 58, who has had a severe stroke.

I’ve arranged modifications to his ground-floor bathroom and a special toilet/shower chair has been delivered by the NHS Equipment Service and I’m visiting today to make sure the toilet/shower chair is suitable, comfortable and safe. Mr B can’t walk or stand so his carers are using a hoist to move him from his bed to the toilet/shower chair. The carers are able to manage this successfully and Mr B is wheeled into his new shower room without any difficulty. I show the carers how the chair goes over the automatic toilet and how the automatic wash/dry toilet works. Mr B has had to use a commode since leaving hospital so he is really happy to be able to use an actual toilet (something I think we all take for granted!). He has been washed whilst sitting on a hospital bed so was “really looking forward to his first shower in months.” I leave so he can carry on and enjoy his shower.

My second visit is to Mrs P who has Motor Neurone Disease. I have seen her many times since she was first diagnosed. She was able to walk and talk at first but now she is fully wheelchair dependent and unable to speak. Today I’m visiting with an assessor from a specialist seating provider as she has become unable to sit in her own armchair. The assessor is a physiotherapist and we work together to build a supportive and comfortable chair that enables Mrs P to eat and drink and even breathe more easily. The chair will also protect her from possible pressure sores. Unfortunately we can’t leave the new chair as I have to complete funding application.

My next visit is to a building site! The build is to the rear of family E’s home and will become a downstairs bedroom and toilet/shower room for Mr E. This is real-life DIY SOS! Mr E has spent the last 18 months in hospital after an accident which left him with total paralysis of all four limbs and torso and he needs to use a powered wheelchair. Today I have the details about his powered wheelchair from the hospital and will be confirming lots of measurements with the building surveyor and contractor on site. Mr E’s four young children are really excited to see the preparations for their dad to come home. The build is progressing and I will start to arrange installing assistive technology that will enable Mr E to open doors and windows independently, answer his phone and the front door and other daily living tasks.

Finally, I have a new referral for Mrs K who has a terminal illness. She wants to stay at home for as long as possible but is struggling to climb stairs and so is staying upstairs to be near the toilet/shower room. She wants to be able to join in family time downstairs but be able to go upstairs to rest when she feels tired and unwell. I assess Mrs K as being able to manage a stairlift and look at the staircase to work out it we can install one.

Back at the office, I complete an online report for today’s visits and complete the reports for the specialist chair, the assistive technology and the stairlift but not before I get a very big cup of tea, a very late lunch and some of the chocolate from our OT stash!  This helps with the mountain of forms to complete, phone calls to make and emails to send. It also helps to be in a team that is caring, supportive and who look after each other if ever “a day in the life” does not go so well.

On Monday, OT team lead Aimee Attrill explained what occupational therapy is…

“Occupational therapists (OTs) work in a variety of roles across health and social care, housing, third-sector organisations and in private practice. They work with people who face barriers that are limiting their day-to-day living. Those barriers may not just be physical they can also be emotional, social or environmental.

“When we work with someone on an OT assessment, we’ll look at how those barriers are affecting someone’s well-being and we’ll do everything we can to remove them.

 “Our OTs specialise in housing, providing equipment or small or major home adaptations which mean that people can continue living safely and independently in their own home. Changes can range from fitting just a grab rail in a bathroom, to extending a property so that someone’s bedroom and bathroom are all on one level.

“About 26 per cent of referrals through Careline are for OT, and demand is increasing due to our ageing population. But this increase is a good sign.

“Getting the right adaptations into someone’s home at the right time means that we can prevent further health needs. Delivering help through home adaptations often means we can reduce the cost of care packages, making the best use of scarce resources.

“Sometimes it can be the smallest change that makes the biggest difference to a person’s quality of life.”