June 13, 2018

Presenters: Catherine McNulty & Chris Wood, Social Change community group Lincolnshire and Sheffield Hallam University.

One of the last presentations on the last day at the Occupation station at #RCOT18

If I had to choose only one word it would be FANTASTIC!! All occupational Therapists need to know about this concept that fits beautifully with our core principles and focuses on capturing the human story without it feeling like you are being assessed, treated or put under the spot light. It is an excellent approach to facilitate understanding. Enabling people to learn from each other and promote empowerment.

Human Library’s originated in Copenhagen, Denmark following a tragic violent incident where a young man was attacked with a knife at a music festival. The root cause was tracked back to prejudice and discrimination.

Menneskebiblioket means ‘Human Library’. It has been a very successful movement and its trademarked concept spread globally earning recognition as an international inequalities movement. It is successfully addressing barriers and enabling people to not only get their views heard but learn from each other, developing understanding, compassion and finding common ground.

The Hearing Voices group in Sleaford learned of the Human Library movement and identified a need within their Hearing Voices Social Change group to facilitate conversations that did not feel pressured, negative, and anxiety provoking or focused on vulnerabilities. The group decided on a gentler perspective where the focus was not purely on discrimination or prejudice but facilitated conversations.

Catherine and Chris were engaging and fun. They explained how a Human Library works and brought it alive in the space. Within a few minutes the participants in the room were encouraged to take part and grab a badge that said one of the following:

Book. Choose story about you, your life, your experiences, wishes, fears anything you wish, write the title on a piece of paper and brief synopsis. Once a reader chooses your book you answer the questions of the reader.

Librarians.The librarians put the papers on a metaphoric book shelf and once the reader has chosen a story they sign it out and introduce you to the ‘human book’, they time keep as the maximum book loan is 15 mins.

Readers. Read the synopsis and choose a book to read, once introduced to a human book they ask questions or share what interested them about the book.

Group rules

Books must be treated with respect. They do not have to answer questions and can end a conversation if they wish.

15 mins is kept and there is no opportunity to extend or renew.

The Librarians facilitate time and guidelines and rights of the readers and books.

Similar to standard library there are a selection of books on offer.

Once we all had decided which role we wanted to try and briefly prepared, Chris read a poem written especially for Human Library movements by the poet by John Welsh 2016,

IT IS GOOD TO TALK

Silence read the poster

Quiet was the command

Hush the words whispered

Study, read, understand

But now a new library has opened

Where words are said out loud

Talking, Living, human books

And vocal readers allowed

Come to Human books

And vocal readers allowed

Come to Human Library

Have stories all explained

Know from your close engagement

That understanding will be gained

The session was lively and engaging I had a go at being a book and a reader. It is incredible the flow and ease of the conversation and I was surprised by some of the things I said while talking about my book ‘The leaf’ and reading a colleagues book of returning to her home town in Ireland. Discussions were filled with laughter, support, sharing, encouragement and empathy.

The feedback was extremely positive, see the photographs of some of these.

In keeping with the fun and engaging theme of the session it was finished with a song

I’ll Tell Me Ma – The Belle of Belfast City

The concept is so transferable while I sat there I got excited about the potential of this approach with an intergenerational approach to address negative stigma on ageing or cultures.

Thank you Catherine, Chris and facilitators for an inspiring and fun afternoon.

For further information look at the website or the UK twitter site.

www.humanlibrary.orgor twitter #HumanLibraryUK (is in its early formation)

Written by Marie Barstow. @mrsbaistow

#BlogSquad2018, OTalk

RCOT2018 Blog 10b. Keynote. TEC Futures – from Technology Enabled Care to Technology Enabled Living.

June 13, 2018June 24, 2018 lgpersonaldev

……. continued from blog 10a

3. Role of technology : in transforming how care is delivered

While the title suggests this was the ‘main stage’ focus, it was not. No criticism intended just a fact! But for our profession this was a silver lining, an opportunity to unpick our core skills and see how they fit in the wider strategic directions and challenges. I did not feel compartmentalized to the “tech people” it didn’t box me in, rather opened up scope of opportunity and clarity on viable direction for the profession. It clearly highlighted technology is moving at a pace that is similar to sound …fast!!! It quite rightly challenged the question “are we technology ready”? The analogue is soon to be switched off which means the 1.7 million people in the U.K that currently rely upon a response to technological services that are connected to analogue need to have confidence it is fit for purpose.

Paul confidently demanded that as a society we need to absolutely know that internet protocol services are affective and responsive to not only offer a reliable response but also to maximize technology to enable people to live empowered and independent lives.

In keeping with Paul’s theme an indication of where Occupational therapists can not only make a difference but add value and impact is in within maximizing the potential and purpose of technology within the home and surrounding community. Paul quoted statistics that state in the very near future on average a household will rely and interact with 29 different internet based devices, the current figure is 8. While recognized to be a game changer and a place to develop innovative roles Paul urged Occupational Therapist to recognise core skills to be part of the development trend within this network.

He explained that the role of technology is to not only deliver, safe effective, responsive, enabling support but to deploy the bend the health care cost curve. Paul made a clear reference at this stage to the Royal College Of Occupational Therapy publication Strategic Intentions 2018- 2023 that outlines the professions commitment to developing practice that embraces technology advancements and preserves the foundation of the profession.

Paul cited Occupational Therapists as a profession that will utilise technology to promote purpose and function to support healthier lifestyles and wellbeing. I did of course afford him the lapse in language term as it is easy for a non-Occupational Therapist to use these terms and indicate we are promoting purpose. We know as an Occupation Therapist it is indeed Occupation, the doing that makes a real difference to the narrative that integral and vital for health, wellbeing and self-reported good quality of life.

4. Re-design Care

I would say a large proportion of the presentation incorporated the concept of a need for service re-design. Paul cited several factors such as the challenges and opportunities of extended longevity, funding, projected deficit in workforce supply, technology advancements and the heroic healthcare culture to “fix it” that are creating a re-think.

Paul proposed the question “Is it business as usual?” or” is it time for change”? He clearly presented arguments for the latter to be his personal and professional viewpoint. He called for a person centric not system centric approach, stating “we need to get it right now”. He believes our profession has the core philosophies, theories and values to lead on change and design pathways that seek to understand via a ‘wellbeing lens’ that supports preventative, enabling and purposeful approaches. Strong principles of ‘ what matters to you’ ? as the beacon of direction. He was not critical of the traditional biomedical model of ‘what is wrong with you?’ but proposed an overwhelming need to look at other more whole person models of care.

He stated an asset based approach in the care system is needed. He referred to Occupational Therapists as asset workforce, the expert professionals who skillfully bring a person’s occupational story alive. We find purpose, meaning and identity. He recognised our unique selling point is to understand participation, purpose and occupation and its value in engaging people with goal orientated interventions.

Paul advocated for change but called for caution to not take a” bolt it on” approach to redesign. Paul called for a rise in disruptors as opposed to disruptive, he saw our profession as key people who can prevent something especially a system or process from continuing as usual, he believes we should be relevant, strategic and implement our core skills upon change in the care system. He encouraged ambition!

In summary Paul delivered an obviously well-rehearsed, experienced, effective, diverse, informative, thought provoking, inspiring and jam-packed presentation that championed Occupation Therapy as the potential game changers to the challenges and opportunities with health and social care needs of the population.

For me it reinforced the value and impact of my profession. I believe passionately it works, my beliefs are so deep rooted they could be found at my cellular level! It highlighted we are change makers and must seize the moment to strategically plan services to embrace the need for understanding what matters to human beings, that we engage in interventions to understand and facilitate meaningful occupations, strife to put occupation in the heart of our communities.

Written by Marie Barstow

Any questions feel free to contact me on twitter: @mrsbaistow

#BlogSquad2018, OTalk

RCOT2018 Blog 10a. Keynote. TEC Futures – from Technology Enabled Care to Technology Enabled Living.

June 13, 2018June 24, 2018 lgpersonaldev

Presented by: Professor Paul Burstow

Paul most definitely had his three shredded wheat yesterday morning. The title did not do the content justice. Paul’s underlining direction of the multi-faceted presentation was ‘How will care be fit for the 21st century’? He emphasised that the design and delivery needs to both meet the challenges and the priorities of wellbeing, where quality of life is central.

Paul is extremely well placed and experienced to voice views on the direction and needs of social care service design. He was an MP for 18 years for two of those years (2010-2012) held the position of Minister of State for the Department for Health. He is current Chair of the Social Care Institute for Excellence and the CEO at Travistock and Portman NHS Foundation Trust. He is also president of Telecare Services Association an industry body for technology enabled care. (https://www.tsa-voice.org.uk/paul-burstow-tsa-president)

Paul clearly presented his values and vision throughout the presentation which are valued based and co-production focused. He views Occupational Therapists as having instrumental key roles within the future he envisages.

I found it a real challenge with my dyslexic brain to write a summative blog on such a jam-packed session. I decided to group the four key areas Paul linked to his objective of the event.

Within the 40 minutes there were over 30 slides, I lost count! A 4min 30 second awesome video and nonstop well-paced and engaging narrative. It included endless stats and research findings, political trends, population profiles, food for thought, challenges on status quo and a vision of whole a person-centered approach.

The title never met expectation …it blew it out of the water. The core message was a ‘need for change, now ‘ and Occupational Therapists are the profession to take an instrumental lead and impact upon this if strategic, relevant and proactive.

Paul clearly understands the value, core principles and theories of Occupational Therapy. It never felt tokenistic, it was genuine and recognized the potential impact and growth for our profession. He actively encouraged ambition to lead on designing and co-delivering services that support intrinsic human need to be occupied in a meaningful and purposeful way.

There was effective use of pictorial slides which maximized the impact of each individual key take away messages. There where so many and most presenters would not be able to successfully execute so much content and take away messages, that delivers humor, engagement and buy in, but he di! My head is still buzzing a little from this but all good and inspiring.

He offered four key areas as the overarching themes that highlighted the challenges and opportunities for Occupational Therapists. These were :

Healthy ageing
Safe Social Care
Role of technology
Re-design of care

1.Healthy Ageing

A positive message he shared was to see an ageing population as an opportunity for the profession. Yes there is a profound change in age demographics that have serious impact upon health and social care provision, at the NHS’s100th birthday year (2048) there will be a 100,000 people aged a 100 and over in the U.K.

Paul proposed it would be forward thinking not to focus upon the challenges related to increased longevity and the related health and social care economic arguments rather recognize and acknowledge these challenges but focus upon the opportunities it delivers, especially to the profession of Occupational Therapy.

Paul presented a slide that depicted the 100 year cycle for a person of such age in today. The diagrams upon the slide illustrated a multi staged life filled with potential for multi journey options and experiences.

He referred to a recent trip to America where he met at a campus residing student of 80 years old. It was an alternative approach and vision of residential care. The student was healthy, happy and self-reported great quality of life. Paul noted our society values and extent of bias may be creating barriers to our own plans that facilitates an 80 year old student to life on campus as opposed to traditional residential care home.

Self-bias and society’s perspective on ageing needs challenging and exploring. There is evidenced to indicate that if you label a product towards an older person, the older person stops buying it. This suggests that societal views or bias about ageing is a barrier to wellbeing in later years or at least fosters self-bias to ageing. Research directly attributes this to a negative impact upon engagement and outcomes of services designed for Older People. I suppose simply put post 65 the client group deemed Older People can become their own internal demise towards intervention and valued occupations.

Paul was very clear longevity costs cannot be put off. Poorly managed co-morbidities and complex needs of older people vastly increase costs of care.

2. Safe Social Care

A ‘mind the gap’ slide clearly brought to the room the stark realization that by 2025 to just stay still, i.e. provide the current social care provision as now, there will be a 2.6 billion pounds short fall. Paul indicated research of fiscal studies shown there needs to be a 50% increase in gross domestic product from 1% to 1.5% to meet financial burden in social care.

Paul stated he felt this was wholly achievable but demands within the current political climate may not share his views. Paul strongly advocated for financial equity between health and social care, he clearly recognized the Nhs has its own funding demands ,he wished for a suitable70 th birthday gift in the means of funding for the astounding and cherished Nhs but equally noted while the Nhs” may get the cake, social care will inevitably get the candles”.

The whole presentation repeatedly made multiple reference to disproportionate social care funding, Paul stated that social care has lived within the shadow of health for far too long, him eloquently and arguably proposed funding for both needs of health and social needs are equally a priority going forward.

Paul offered the notion ‘ providing care HOW?’ While he did not deliver the answer he clearly delivered the message that there is potential for change to impact upon a person’s wellbeing, a life worth living not merely existing. He advocated for a proactive not reactive approach has to under pin and direct the future of care.

The demand for care workers is outpacing domestic supply- retention, recruitment and experience are ongoing challenges within the care sector. By 2025 there will be a shortfall of 1.83 million care staff in adult social care. Paul once again identified Occupational Therapist as the profession with the skills and knowledge to have a positive impact upon on these statistics. He is confident that the core Occupational Therapy skills can design successful recruitment, retention and educational programs at local and national level to not only deliver a skilled care workforce but promote the resilience and staying power a worker needs to exist and flourish within in such personally challenging work environments.

continued in Blog 10b……

Written by Marie Barstow

Any questions feel free to contact me on twitter: @mrsbaistow

#BlogSquad2018, OTalk

RCOT 2018 Blog 9 Sess. 29 Evidence Based Practice and National Guideline Development. Do the National Institute of Care and Excellence (NICE) guidelines provide Therapists with meaningful evidence for practice?

June 13, 2018June 24, 2018 lgpersonaldev

This thought provoking seminar was hosted by Dee Christie who is a retired occupational therapist and a current NICE Fellow. It explored the presenter’s experiences of chairing the NICE guideline committee on Intermediate Care and the challenges of incorporating guidelines into practice. I was motivated to attend in order to develop my understanding of how NICE guidelines are produced, and have the opportunity to discuss strategies for incorporating evidence – based paradigms into practice.

As an introduction the steps involved in producing NICE Guidelines were discussed, this process usually takes about two years and includes involvement from working groups who are made up of health and social care professionals, patients, carers, members of the public and experts in the field.

As well as discussions about the development of the guidelines this seminar identified the ten commandments of EBP (as defined by Bannigan and Burleson, 2007) and also covered the challenges of embedding guidelines into practice.

Examples of NHS Trusts that have well established governance structures that ensure guidelines are incorporated into frontline clinical care were discussed and practical strategies of how to embed evidence into practice personally were included.

These included:

Find yourself guidelines that support your practice and discuss it with your team
Take responsibility for your personal learning, be active in seeking out actively appropriate evidence to support your practice
Make a commitment to yourself to do something simple for CPD every month, one example from the presenter was to commit to reading one article from the BJOT a month, small actions like this can then become habitual over time.

There was a lively discussion relating to the benefits and disadvantages of implementing the guidelines into clinical practice, the sheer number of guidelines available was discussed and the lack of time available to implement recommendations. Some therapists have suggested that guidelines can lack a client centred focus. However in contrast the increasing opportunities for AHP’s to get involved in the development of the guidelines was emphasised, and the robustness of some of the recommendations was identified as supportive for occupational therapists working in MDT’s.

In response to a comment from the floor that suggested there are some topics that currently aren’t properly covered by NICE guidelines the discussion moved onto how occupational therapists need to focus on creating more evidence from our practice to build the evidence base, with the presenter concluding that if our profession isn’t defined by evidence then we wont move forward.

Since attending the seminar I have had time to reflect on the funding opportunities that are currently available for occupational therapy clinicians who are interested in developing a research career (through organisations such as the NIHR and the Elizabeth Casson Trust ) and I would encourage anyone interested in doing this to visit their websites for more info as to how to get started.

I left the seminar with a better understanding of how NICE Guidelines are created, and developed, and with strategies to take back to my clinical team to enable us to embed them deeper into our practice.

Written by Elspeth Clark @Els_OT

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RCOT2018 Blog 8 Sess. 45 Mindfulness & Zentangle: Science, Health & Happiness…even when you do not think there is time

June 13, 2018June 24, 2018 lgpersonaldev

As this was my first time at conference I was keen to try the occupation stations on offer, and I jumped at the chance to attend this Tuesday afternoon session. This hands on mindfulness session was facilitated by Christine Urish, Occupational Therapist and Professor at St Ambrose University in the United States (find her on Twitter @curish).

Mindfulness as a therapeutic approach is becoming increasingly popular in the occupational therapy paradigm. This was clearly reflected in the the large numbers of delegates keen to attend this session! Although I arrived early I had to sit on the floor as the session was jam-packed! I have used mindfulness both personally and professionally in my own practice with service users on a mental health placement, and was keen to hear from Christine how this approach might be applied to different client populations.

Christine explained how she has worked within psychiatric services and with university students, identifying the need for effective interventions to combat stress and anxiety. She undertook specialist training and has now used mindfulness approaches with clients for the last two years, explaining how mindfulness involves being present in the moment, free from judgement.

Christine briefly introduced us to the Koru Mindfulness Program. This is an evidence-based course designed to teach mindfulness, meditation and stress management to college students and young adults. Christine guided us through one of the strategies within this training – diaphragmatic breathing. This technique is useful in calming the mind and body by activating the parasympathetic nervous system. She uses strategies such as this to encourage clients to become more mindful and centred, in preparation for engaging in Zentangle.

Zentangle is a creative and artistic occupation in which the participant draws a beautiful image from repetitive patterns. Christine explained how clients with stress and anxiety respond particularly well to this occupation, as it enhances self-esteem and self-efficacy. Patterns are called ‘tangles’ made up of dots, lines and curves. These patterns are drawn onto small pieces of card or paper called ’tiles’ which can then be assembled into mosaics.

This occupation can be used with almost every population group, including children and older adults. We were provided with our own Zentangle materials, including a selection of tiles and pens. We had a go at creating our own tiles and Christine encouraged us not to compare ourselves and reminded us within Zentangle, there are no mistakes! Although I am not particularly artistic I found myself becoming absorbed in the activity and lost track of time, suggesting this occupation has the power to facilitate flow for service users. The client is encouraged to take the activity at their own pace and the philosophy of Zentangle is anything is possible…one stroke at a time! This was reflected in the relaxed and informal ethos of the session.

So how does it relate to occupational therapy? Zentangle has important implications for many areas of practice. Within paediatrics it can be used to improve fine motor skills, concentration, attention, sequencing skills and sensory and emotional regulation. For older adults it can be used to facilitate reminiscence, provide opportunities for social interaction if ran as a group session, and provides participants with the chance to engage in a creative and meaningful occupation. With palliative care it can foster a sense of positivity, by encouraging the client to be creative and share their creation with loved ones.

Christine explained how after being introduced to Zentangle many clients pass on the activity to friends and family, which encourages them to undertake meaningful roles. Zentangle also provides occupational therapists with a useful tool for their own self-care by enabling reflection and relaxation, and reducing the risk of professional burnout.

Written by Cathy Roberts @CathyARoberts