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Small changes, big impact

Paula works in the Community Access Team

When a person is referred to OT by themselves or a professional, family member or friend this is the start of a journey that can sometimes provide support in unexpected areas of the person’s life.

Paula says, “Our role is to think about preventing that person from becoming dependant on care so that they can continue to live a full and independent life as soon as possible, but also thinking about measures we can take to prevent that person’s health deteriorating.

“We always look at the person first and foremost and what they want in order to have a full life. Occupational therapy is about what ‘occupies your time’ so whilst in a traditional sense that can mean getting to the toilet, in and out of bed and the bath, we also want to know what affects that person’s well-being ; their social as well as their physical environment. Are they a parent, a carer, do they take part in sports, hobbies or social activities? Then we can work together with colleagues and partners from other services to see how else we could support them to live independently.

“Even though people clearly need some support we like to be able to frame things positively, focusing on what they can do instead of what they can’t. For instance, instead of saying, ‘I understand you’re having problems getting to the toilet?’ we might instead ask, ‘Tell me about how you get to the bathroom.’ The professional skills required to have a conversation with someone using this ‘strengths-based approach’ recognises that people are their own expert and that we will work with them to find out exactly what they need to live a full life. It’s our job to find out what the person actually wants and needs and therefore reduce their need for more formal care.

“This can all often be done within the space of a telephone conversation. As the person is the expert on their own situation, it’s not always necessary to carry out a home visit or assessment, the end result of which will be to confirm what the person knew themselves at the outset! And it’s often more appropriate for a person to discuss personal care over the phone than in person where they might feel less comfortable.

“In OT we often talk about how a small change can have a big impact. Unless we think that the person is at risk without a home visit we can often find a solution the first time they call; we can order small equipment such as grab rails, hand rails, swivel stools and arrange for them to be installed quite quickly. Sometimes people can send us photographs which can help us decide on the most appropriate equipment or adaptation even more swiftly. This has been useful during the pandemic. I’ve provided advice on voice control for smart TV’s and phones for people who can’t use remote controls or keypads.

“We provided an over-bath shower for a young woman which totally changed the course of her life. Having this equipment gave her the confidence to move forward into higher education – I’ll never forget the day she rang me from the university coffee shop.

“A big part of our role is to provide advice and information. The new online directory Live Well Cheshire West produced by the Council and our health partners, has been a crucial tool in providing people with access to accurate, up to date, local information that’s relevant to them. Importantly, they can use this to look up information when it suits them rather than having to call our team, even though we love speaking to people! I’m passionate about finding out how a person communicates, and how we can support them to communicate even better. If a person can’t use their voice for example, something as simple as an alphabet chart or phone/tablet app can make a huge difference as well as signposting the person to more specialist equipment.

“Thinking about prevention should also extend to carers. Especially since the pandemic carers are under increasing pressure as day services close and there is little or no respite from caring responsibilities. Even though practical needs such as shopping and prescription collection can be taken care of by the community response to local restrictions, people still often need support with their social and emotional connections – activities that are meaningful to the carer or the person they care for.

“We often hear people say, ‘I used to be able to ….’ and in OT we aim to support them to turn that into ‘Now I’m able to….’”

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