'User Voice'

 

It is quite rare that you find a genuine passion and enthusiasm comes across on an interview on television, such as on BBC. Often you might find people tend to try and be more 'professional' and reserved. Which is precisely why I was hooked listening to Mark Johnson (Founder of 'User Voice' charity) speaking about the issues regarding the rehabilitation of prisoners, and his thoughts in relation to the announcements that seven prisons are to close and two more will be partially shut in England. The BBC reported that the government have plans to build a new 'super prison' which can hold 2,000 places.


Johnson was on the BBC last week, speaking about how he disagrees with the proposals to create one 'super prison' and instead believes that placing prisoners in smaller prisons would be far more beneficial to the success of their rehabilitation. He explains that this is because smaller prisons, which feel more like a living environment, rather that a 'warehouse of people', gives individuals more opportunity to be open and honest to communicate with the rehabilitation programmes, to get to the route of why it is they commit crimes, and what the solution is to prevent them from re-offending.

Johnson also raised a very interesting note about the rehabilitation programmes which are currently in place. He shares with the viewers that the programmes are all focused and driven towards regaining employment. However, as he identifies - the majority of people who are engaging in these programmes hold offences relating to drink driving, substance misuse, or other issues which employers will inevitably find undesirable. He explains that during his time in prison, he was taught the skills of a baker, yet he returned to a life of crime when he left prison. The statistics show that over 50% of individuals in prison re-offend within the first year alone, which suggests that the current system of rehabilitation is not working.

So what does Johnson propose? He has the philosophy that prisoners should be given a voice about the decisions which are made about the services they receive, and the flagship program for giving prison users voice is Prison Council. The rates of prisoner participation in the councils now surpass 50 percent. Johnson explains that these examples of improved engagement with the community and with social processes, indicate a personal level of responsibility-taking—the first step to real social rehabilitation.
 So from an O.T perspective, the professionals role within the prison service may be addressing the issue of occupational deprivation, and have a focus on rehabilitation to promote reintegration into the community. Promoting service user choice and voices is something which occupational therapists have always had in the heart of their practise, and recognise that an appropriate environment is essential to enable successful outcomes.  Anyway, just to point you in the direction of this very interesting man, and to see all the inspirational work he does. A role emerging placement perhaps?!  http://www.uservoice.org/ 

Going it alone

I have gotten out of the habit of posting blogs (which I might blame at getting to grips with third year! I won't mention the dreaded 'D' word...)

But I've tried to share some things I  have found interesting in last few months (except I haven't been writing about it - whoops!)

One thing that I have been thinking about recently is the opportunities for OT's to go it alone. With the changes happening to the national health service within the U.K, it's not suprising to see independant practice being a genuine consideration for OT's. This months OTnews is focused on independant practice, and has ' invaluable advice for anyone considering independant practice'.

And they're right - there certianly is some very good advice in there! It was really intersting reading the story of OT Maggie Winchcombe who in 2007 co-founded the 'Years Ahead' partnership alongside Marie Hendry and David Silver. The website explains that the business aims to :

• ' bring easier living products and services out of the specialist sector (which has been the province of healthcare professionals) and into the mainstream market place. ' 

 and

• ' advise  organisations on how to develop their proposition in a way that enables consumers to enjoy living longer and living well. '

Maggie talks about that despite not 'treating anyone' in the sense of a therapist, it was her focus on occupation in its purest sense which enabled her to realise that her customers were wanting professional help to deal with changing circumstances. 

From reading Maggie's story, and checking out the website (which is well worth a loo) http://www.yearsahead.co.uk/ got me curious about other independant OT services. So a little search on google led me to a few websites that you might want to look at just to see what is going out there:

http://occupationaltherapyessex.co.uk/

http://www.westcountrytherapy.co.uk/

http://iotherapy.co.uk/

http://www.krysalisconsultancy.co.uk/index.htm

http://www.iots.org.uk/index.html

http://www.accessindependent.co.uk/about.asp

http://www.qualityindependence.co.uk/

http://www.dorsetoccupationaltherapist.co.uk/index.html

http://www.thrivingminds.co.uk/

http://www.able-2.co.uk/


and there are many more! I'm quite suprised at how many independant OTs are out there, and it is nice to have more career opportunities available, either as an independant OT or to work for an independant occupational therapy service.

This months OTnews is full of features on independant practice so if it is something you might consider, or might think about in the future make sure you don't throw out the November 2012 issue!

'Tourette's: Let Me Entertain You"

On the 10th of September, BBC 3 broadcast a show entitled 'Tourette's: Let Me Entertain You". Episode one is only available at the moment, but more will be available soon so keep your eyes peeled!

Before watching, I knew nothing of Tourette syndrome (TS) or how it can affect individuals. On the show, Reggie Yates (Radio 1 DJ) goes on a quest to find individuals who are affected by Tourette's but who also have musical talent. The programme introduces the viewer to Ruth, Steve and Greg who all experience both verbal and physical 'tics'. According to Tourette's Action, tics are involuntary and uncontrollable sounds and movements. Interestingly, Ruth highlights that 90 percent of people with TS do not swear uncontrollably (the technical term is 'coprolalia') which is interesting because I imagine this is what most people would normally associate with Tourette's. I'll admit that I did before watching the programme!

The programme introduces a further three individuals, all of whom are teenagers and also experience Tourette's. Jake, Emily and Tom all experience TS differently. For example, Emily will involuntary collapse and is unable to suppress her ticks. Jake, on the other hand, has the ability to suppress his tics whilst in school, but upon returning home has a very intense period of tics because of the suppression during the school day.

All of the people on the show provide a very honest depiction of how Tourette's has affected their lives and the coping strategies they implement in order to try to control their tics. A recurring theme (I'm pleased to say!) is engaging in meaningful occupations. And as jargon-y and professional that may sound, it's a very strong theme throughout the show. For example Greg, 18, roller skates and explains that when he is wearing his skates, his tics are almost non-existent. As soon as they are removed they act as almost a psychological trigger and his tics come back. He explains how he drums and how this has a similar affect. I found it fascinating to watch on the programme, because to hear him speak and to see him when he is wearing his skates is so very different to when he isn’t wearing them.

Ruth was explaining how TS makes social life difficult. When she is on a bus somewhere and her tics become very noticeable, she finds that strangers on the bus almost group together and in her words, “unite in hostility”. This highlights the ignorance towards this condition and how difficult it can make day-to-day activities. Ruth sings, and when asked by Reggie what she feels from getting a round of applause following a performance, she explains how she feels a sense of affirmation, worth and that she belongs within society. I thought this was a really great way to highlight how important it is to do things in life that are meaningful because they really can benefit your wellbeing.

Anyway, I think it is a really good watch, and there are more episodes coming, so if you have some spare time it is worth a watch!

From an OT perspective, I found a little slideshow which gives a brief explanation of how OTs can work with individuals who experience Tourette's but the link doesn't seem to be working, so I'll try and post it at a later date.

You can watch the programme using this link: http://www.bbc.co.uk/iplayer/episode/b01mqvr7/Tourettes_Let_Me_Entertain_You_Episode_1/


Enjoy!

Sex, Lies and Parkinson's

As I was having a little browse through Channel Four's '4oD', I came across this short documentary about Vicki's experience of Parkinson's disease, and how she feels that the side effects of her medication have impacted on her behaviour and lifestyle choices. Vicki was diagnosed with Parkinson's before her 40th birthday, which makes her one of just 500 people diagnosed with young onset Parkinson's each year according to Parkinson's UK.

Vicki feels that the side effects of medication have had a big impact on her life, but the documentary mentions no other ways to help her manage Parkinson's. I suppose that as an OT to be, I was thinking something along the lines of developing coping strategies so that the individual is empowered to self-manage their condition as effectively as possible. Although I can only imagine the challenge of accepting that you have a long term condition at such a young age must make you want to pretend that this isn't happening and to forget about dealing with things.

Anyway, take a look and see what you think!

Sex, Lies and Parkinson's

I got a little too excited when I saw this....

Me being the OT geek that I am, can't seem to escape OT, even when I'm on my holidays! Whilst away with some friends in Newquay, outside the restaturant/shop part of the complex, I spotted this beach wheelchair. I'd never seen a wheelchair specifically designed for use on a beach before (you might think, being an OT student that I would have figured out such a wheelchair exists, but I'd never thought about it really!). There was a slight gradient to get down on to the beach, and I thought it was awesome that they had left this out so that passers by could see that the beach is fully accessible.

When I googled 'beach wheelchairs' lots of different types and models came up, and it's quite interesting to see the range of wheelchairs available. The OT in me was loving seeing this, as not only is it enabling individuals to remain engaging in those activities they enjoy most, but it is also sending out a clear message that disability is not a barrier!

Loved seeing this!

Ps Thanks to Will  for getting the snap, would have hated to have missed it!

'No Won't, No Can't, Only How'

Spencer West, 31, Toronto.  I'd not heard of his name or known anything of him until today when I read that he has climbed Mount Kilimanjaro (which in itself is an incredible achievement). But Spencer West had reached the summit with a special difference. A rare spinal disorder meant that Spencer had had his legs amputated when he was a child. Doctors told him that he "would never do much with his life". This led to Spencer beginning his journey to defy this by becoming a motivational speaker and starting his 'Redefine Impossible' campaign to raise money for Free the Children's sustainable water initiative in Kenya. Spencer West climbed the summit by using his hands alone for an astonishing 80% of the journey. The climb was completed over 7 days and West has raised an incredible $500,000 for the initiative.

When I read the name of the campaign, I couldn't help but keep saying it. It really struck me as a very powerful and emotive title which challenges the attitudes which were expressed regarding West's recovery. The clinical judgements or subjective opinions from health care professionals (based on a generalisation of previous experience relating to prognosis or future outcomes) can be very damaging and distressing for the individual and family. I feel it is really important to challenge these attitudes in the workplace, and as a newly qualified OT I will want to work in a person-centred way, and approach interventions as  possibilities, instead of settling for the easiest, and often risk adverse option. In my experience, interventions can sometimes be held back because a team attitude may deem an intervention 'impossible' without any concrete and transparent justification or evidence. Of course, I recognise there are limitations in practice, and each individual has personal limitations, however I do feel that sometimes in practice, incredible opportunities can be missed because they are not given a proper chance.

On West's blog, he talks about each stage of the journey, and this part I thought I'd leave you with. You can read his blog here : http://www.freethechildren.com/redefinepossible/2012/06/possible-redefined.php

" Things do happen, good and bad, to all of us. But what defines us is not what we look like, the colour of our skin, or how many limbs we have. Not even close. It's who we are inside, and what we choose to do with the time we are fortunate enough to have on earth.


Today I reached the top of the tallest free-standing mountain in Africa by, for the most part, walking on my hands.

What is possible for me has now been redefined. That is my hope for all of us.

You don't have to climb a mountain to redefine your possible. But thank you for climbing this one with me.

How will you redefine your possible?"

Postcode Lottery

Hello readers! (if I have any....) I have been on holiday for 10 days and so have not had a new post up here for some time; I'll get back on it now that I am home again!

Here's one to get you started: I watched an inspiring story on BBC's 'Week In Week Out' programme. It tells the story of Helen and her battle for her mother to receive NHS Continuing Healthcare Funding. Helen's mother, who had severe dementia, was not considered ill enough to receive this until her final hours of life. Helen is campaigning for carers rights in Wales and is working hard at promoting her cause. Helen's story is available to watch on BBC iPlayer here: http://www.bbc.co.uk/iplayer/episode/b01jzq1t/Week_In_Week_Out_Helens_Story/ which is definitely worth a watch. Alternatively you can check out the BBC article here: http://www.bbc.co.uk/news/uk-wales-18496004

It really made me reflect on the difficulties that health care professionals face when completing assessments which may sometimes affect the eligibility for service-users' care. The director of the Royal College of Nursing (RCN) in Wales, Tina Donnelly, explains that the union was concerned about the tick-box style tools nurses had to use to assess eligibility for free care. This concern can be applied across different areas when completing assessments, and Helen's story highlights how entitlement to care can change (depending on who completes the assessment and the location in which the service-user may reside). It's something to consider in practice.

If you would like to show your support for Helen, you can follow her campaign on twitter @dementia_tch

More posts to follow shortly :-)