“Occupational Therapists work with people who have physical, mental and or social problems, either from birth or as a result of accident, illness or ageing. Their aim is to enable people to achieve as much as they can for themselves, so they get the most out of life. When people cannot do things which are important to them- such as getting dressed, having a shower, going to work, socialising or undertaking a favourite hobby- an Occupational Therapist can help them in many ways, based on each individual person’s needs and lifestyle”.
British Association of Occupational Therapists
We provide assessment and individualised rehabilitation programmes to enable you to take steps towards engaging in and achieving your personal goals. Our programmes focus on the development of lost physical, cognitive and psychological functions such as movement, coordination, memory, attention, esteem and confidence to enable these skills to be used to participate in activities that are important in your day to day life.
We carry out our treatment sessions in settings to suit the activity. This could be at home, your local community, workplace, college or school.
We believe that team working is vital to help you make successful progress and so we work closely with all involved in your day to day support and rehabilitation. We can provide training to those who support you to ensure programmes are continued outside of therapy sessions.
We are able to provide advice on equipment and adaptations to your home, environment or other places that are important to you.
Andrew is a sixty year old man who sustained a very severe traumatic brain injury resulting in significant physical, communication and cognitive deficits thirteen years ago. He had received little rehabilitation as he had not been compliant with services offered in the acute stage and was discharged to a nursing home where he lived for eleven years. Initially on arriving at the nursing home it was reported that he displayed frequent behavioural outbursts and was dependent for all aspects of his personal care and mobility. He engaged in few social or leisure activities other than in the nursing home environment.
A referral was made to Occupational Therapy by Andrew’s Case Manager in 2008 and an assessment of his level of function was commenced. A referral was also made for Speech and Language Therapy. Physiotherapy was already being provided.
Andrew was able to express at a basic level that he wished to participate in more social outings, go on holiday and live in his own home. At this initial stage recommendations were made for additional support hours to be used to explore activities to expand the Client’s day, provision of a powered wheelchair and a vehicle for personal use to expand opportunities for increasing mobility indoors and into the community. Guidelines and training were provided to his support worker to encourage Andrew’s participation in aspects of daily living. At this stage Andrew displayed very fixed behaviour and had struggled to cope with changes to his established daily routine however he responded positively to the gradual changes introduced to his programme.
Over the following year Andrew engaged increasingly in his self care, preparation of his breakfast, trips out to shops, concerts and the cinema and a weekend break away. During this time he maintained a clear desire and goal to live in his own home with support and given his ability to adapt to changes in his daily and weekly routine and an expanding team of therapists it was agreed to set up a trial of supported living within the local community.
The trial involved rental of a ground floor flat, purchase of adaptive equipment and training to ensure support staff had a clear understanding of the Client as a person, his functional difficulties and abilities, the process of providing rehabilitative support and specific guidelines for providing routines and using strategies in relation to Andrew’s needs . The process provided an exciting opportunity to assess Andrew’s ability to engage in choices about his new environment, establish new routines and participate in new experiences. This involved extensive collaborative working between all members of the multidisciplinary team, the nursing home staff and a local care agency to provide an increased package of support with a rehabilitative approach.
In the following eighteen months Andrew successfully extended his stays at the flat to five nights a week. Through gradually upgrading his goals and routines clear progress was evident in his communication, confidence, mood, physical abilities and cognition.
In March 2012 Andrew received the key for his new bungalow. He has now been happily living in the community with a twenty four hour support package for the last two years.
Our Client sustained a brain injury following complications during the birthing process in 2000. He was later diagnosed with severe quadriplegic cerebral palsy. He presents with severe developmental delay, severe learning difficulties, visual impairment and epilepsy. He is unable to sit or stand independently and his head control is variable. He relies on full support from carers 24 hours a day 7 days a week. Our service was engaged by the Client’s family in 2009 and we have worked in partnership to support his ongoing developmental needs and ensure his environment contributed to the rehabilitation programme.
The Occupational Therapy assessment identified the need to significantly adapt his current living accommodation to meet his complex needs and recommendations made by the team for adaptations and equipment were accepted resulting in a fully adapted and accessible property which included a sensory / therapy room. The sensory equipment is tailored to the Client’s needs providing stimulation and motivation to improve communication. Activities in this area were developed which also supported the carers to communicate with the Client in a more effective way. Regular reviews of his rehabilitation / development goals ensure that our service provision remains relevant to the Client’s changing needs.
The Paediatric Occupational Therapist also led and encouraged a joined up approach with professionals from the statutory sector in relation to the Client’s 24 hour postural needs and sourced necessary equipment to support his complex needs, which due to budget restraints, were unavailable through local services. Through accessing specialist equipment the Client has been able to fully engage within their home environment, school environment and wider community. By supporting the Client’s posture in a variety of equipment maximum function and interaction were possible. To ensure appropriate use of the equipment in place, N-Able staff worked with the carers and provided them with full training and visual guidelines. Without this equipment and support his ability to function would be severely impaired and his quality of life reduced.
Therapy work continues with the next phase focusing on developing upper limb control to support the Client to use new technology, increase his independence and communication skills. Joint working with carers, statutory and private services continues to take place at home and school. This will ensure continuity of care across all settings and contribute to good working practice and planning.