Newsletter

Older People and Occupational Therapy
Newsletter
May 2010
Volume 5 Number 2
Featured topics:
Forthcoming COT
conference with
COTSS-OP
conference running in
parallel
Articles on:
Exploring the
experience of living in
residential care
through photography
My Parkinson’s story
Acute and Emergency
© Henry Grant/Mary Evans care
Picture Library
Taking the lead

Delivering best practice
Contents
CHAIR’S CHAT ......................................................................................... 3

EDITORIAL .............................................................................................. 4
COLLEGE OF OCCUPATIONAL THERAPISTS 34TH ANNUAL CONFERENCE AND EXHIBITION..... 7
CARE INFORMATION FOR OLDER SCOTS .............................................................. 8
ARTICLES ................................................................................................ 9
EVERY-PICTURE TELLS A STORY: EXPLORING THE LIVED EXPERIENCE OF LIVING IN
RESIDENTIAL CARE THROUGH PARTICIPATORY PHOTOGRAPHIC RESEARCH METHODS .......... 9
DIGNITY CAMPAIGN 2010 ........................................................................... 10
THE EXPERIENCE OF HOSTING THE “ME2” CONFERENCE ........................................ 11
ROTHERHAM CARE HOME LIAISON SERVICE ...................................................... 13
LUNCH CLUB ........................................................................................... 14
MY PARKINSON’S STORY ............................................................................. 16
WORKING WITH PEOPLE WITH LEARNING DISABILITIES – EVERYONE’S JOB ................. 19
OTS WORKING IN ACUTE ASSESSMENT UNITS ................................................... 23
DEPARTMENT OF HEALTH TRANSFORMING COMMUNITY SERVICES: AMBITION, ACTION,
ACHIEVEMENT: TRANSFORMING SERVICES FOR ACUTE CARE CLOSER TO HOME ............ 24
A&E EVIDENCE REVIEW UPDATE!................................................................... 26
SLIPS AND TRIPS E-LEARNING PACKAGE ........................................................... 27
BOOK REVIEWS ..................................................................................... 28
CD REVIEW: MY DREAMS OF BEING ................................................................ 28
RESEARCH AND DEVELOPMENT ............................................................. 30
RESEARCH AWARD..................................................................................... 30
REFERENCES WHICH MIGHT BE OF INTEREST TO MEMBERS ...................................... 30
COT PUBLICATIONS................................................................................... 31
COTSS – OLDER PEOPLE ANNUAL CONFERENCE, BRIGHTON 22ND TO 25TH JUNE ............ 31
CLINICAL FORUM UPDATES ................................................................... 32
FALLS CLINICAL FORUM .............................................................................. 32
MENTAL HEALTH CLINICAL FORUM.................................................................. 32
INTERMEDIATE CARE CLINICAL FORUM ............................................................ 33
DEMENTIA CLINICAL FORUM ......................................................................... 34
ACUTE / EMERGENCY CARE CLINICAL FORUM ..................................................... 35
CARE HOMES CLINICAL FORUM ..................................................................... 36
THE INFORMATION LOOP ...................................................................... 37
ELECTRONIC RESOURCES ............................................................................. 37
HIGHLIGHT – OCCUPATIONAL THERAPY NEWS .................................................... 38
NATIONAL EXECUTIVE COMMITTEE INFORMATION............................... 40
Views expressed in articles and reviews do not necessarily represent those of the
College of Occupational Therapists Specialist Section – Older People. The editor
cannot accept responsibility for the accuracy of the articles or advertisements in
the newsletter.
2 SS Older People Newsletter May 2010 Volume 5 Number 2

Chair’s Chat
Hello all,
I am writing this during my long train journey back from Edinburgh to
Southampton, having contributed an invited paper about the ‘occupational
therapy perspective’ to the opening session ‘what’s new in rehabilitation?’ at the
start of the British Geriatrics Society Spring meeting.
Although the public sector is undoubtedly suffering within the current economic
climate, I found many positive developments to talk about: innovative service
development in acute and emergency care, and the plans of our Clinical Forum,
about to be re-launched with new Forum Leads at conference; the great
examples of OT practice with people with dementia in the latest edition of OT
News; the substantial contributions that OTs can make to public health initiatives
for older people (reference NICE public health guidance 16), and the latest work
about environmental and behavioural adaptations to reduce risk for and with
older people, also represented within the conference programme in Brighton. It
was also very gratifying to report on the rapidly expanding evidence base which
informs our practice with older people.
Volcano permitting (!), I shall be leaving the UK on Sunday for both a holiday,
and to attend the World Federation of Occupational Therapists conference in
Chile, where I shall selflessly devote myself to the task of noting innovations in
OT practice and research with older people to share on my return! Watch this
space for further information in the next edition ….
Although we are all working hard, it is wonderful sometimes to take a moment to
reflect on how fabulous it is to be an OT, and on what a long way the profession
has come!
Wishing you all a great summer, and hoping you manage to enjoy some rest and
relaxation at some point!
Dr Claire Ballinger
Chair
SS Older People Newsletter May 2010 Volume 5 Number 2 3

Editorial
This month we have a enthralling newsletter for you, packed full of interesting
articles sharing best practice, so thank you to all of those who contributed! It
makes the job of editing so much easier to have material to work with. It is
heartening to note that we have three articles relating to acute and emergency
care, which probably reflects an upsurge in activity in the forum since our two
forum co-leads took over, Judi and Ebby. We don’t have any book reviews this
month, but the abundance of articles certainly compensates for that. There are
some book reviews currently being undertaken which will feature in the
September newsletter.
As you may know, I come to the end of my term of office as Communications
Officer in November this year, so if there are any nominees willing to take the
mantle, please contact our Secretary Jennifer Beaumont for a nomination form
and job description (Jenniferb223@gmail.com). It is a very rewarding position to
hold. I have found that my term of office has created so many opportunities for
me, via contacts made through networking and by being so involved in COT work
– I would genuinely urge anybody interested to do it.
The next newsletter will predominantly focus on conference feedback, but as
always I am still seeking articles, so please do let us hear about your service
developments, any study days that you have attended, research that you are
involved in or any other innovative practice that would be of interest to our
membership. You can send articles to me at alison.pighills@bradford.nhs.uk. I
would love to hear from you!
Dr Alison Pighills
Communications Officer

Editorial
Adaptation by design Ticking all the boxes...
Hampshire based Wessex Lifts have been making homes accessible for over 35
years. Part of the Ratcliff Group, Wessex Lifts is among the country’s leading
designers and manufacturers of hydraulic lifting platforms for the disabled.
Designed for use in home adaptations the Wessex Homelift meets all of the
standards and directives.... It ticks all of the boxes. Building work and
installation normally takes no longer than 2 days for this space saving
adaptation.
To complement the HomeLift, Wessex has designed a wide range of Steplifts,
catering for travel heights up to 2 metres. The workhorse of the Wessex Steplift
range is the LR, and as with the HomeLift, the LR complies with all the standards
and ticks all the boxes.
The standard LR package has a lifting capacity of 300kg and travels to a
maximum of 1m finished floor to finished floor. The LR range comes as through
access and in three platform widths – 800mm, 900mm and 1100mm. The range
is finished as standard in a high quality architectural powder coat and is the only
lift of its type that comes with a five year anti-corrosion warranty as standard.
Adaptation by design Ticking all the boxes...

College of Occupational Therapists 34th Annual
Conference and Exhibition
PLUS TWO Specialist Sections’ Annual Conferences:

• Older People
• HIV/AIDS, Oncology, Palliative Care
22-25 June 2010
Brighton Centre, Brighton, Sussex
Book your Conference place at a special discounted rate.
The Older People conference highlights include:
• Heléna Herklots, Service Director, Age UK, presenting on older people care
as life expectancy and demands for quality of life increases
• Professor Jane Gilliard, Department of Health having a conversation with
Kate Moore and Julie Pejonivic of the Alzheimer’s’ Society, about how the
National Dementia Strategy has given raise to practical initiatives that have
improved the lives of people who are affected by dementia.
• Geoffrey and Dorothy Atkinson winners of the Patient Safety Awards at the
NHS Health and Social Care Awards 2009, explaining how they have helped
other older people to identify overlooked fall hazards in their own home.
• Dr Finbarr Martin, President Elect of the British Geriatric Society, outlining
his three wishes for older people care.
The Older People Conference programme will also include sessions on:
Housing design for an older population
Find out how house design can enable older people with reduced agility to be
able to remain safe and independent in their own homes.
Active ageing
As older people are remaining active, they are becoming more demanding of the
services and resources available to them. Hear how occupational therapists have
supported active ageing, and enriched the lives of older people.
Remember all members of the Specialist Section – Older People are entitled to a
specially discounted conference rate.
Older People Specialist Current conference rate
Sections’
Special Discounted rate
Fee Type Full Day Full Day
BAOT member £330 £211 £462 £271
Non-member £462 £384 £515 £449
Associate member £255 £195 £326 £255
Student* / retired** £128 £ 89 £128 £ 89
Presenter £255 £195 £326 £255
For more information visit, www.cot.org.uk/annualconferences

To book your place visit www.eventznet.com/abs/acs/cot34/
September 2010 Newsletter

Deadline for Copy: 31st August 2010
If you have good practice examples, or information that you feel would benefit
other members, then do please submit an article for a future edition of the
Newsletter. Information for publication should be submitted via email as follows:
• Word format, Verdana font, 11 font size and

• Maximum of 2 sides of A4 for the Newsletter
If submitting research articles, please include reference to attainment of ethical

approval.
Please send to: Alison Pighills, Communications Officer at
Alison.pighills@bradford.nhs.uk
Care information for older Scots
Older people who need care should find the process easier in future, thanks to a
new information service launched today.
Care Information Scotland (CIS) offers a single point of information - through
one phone number and web address - on the care available for older people
throughout the country. It offers detailed information for older people and their
families on the range of community care services available from local authorities,
the private and voluntary sector.
Link http://www.scotland.gov.uk/News/Releases/2010/03/02094001
Elizabeth MacDonald
Policy Officer - Scotland
College of Occupational Therapists
E-mail:elizabeth.macdonald@cot.co.uk

Articles
Every-picture tells a story: exploring the lived experience

of living in residential care through participatory
photographic research methods
In 2007 it was estimated that within the UK approximately 486,000 older people
were living in care home settings (Help the Aged 2007). Whilst this represents a
significant number we know less about the experiences of these individuals and
their occupational needs than those of community living older people. This is in
part because the population is generally much frailer and in part as a result of
some of the methodological challenges of capturing their voices.
There has been a growing recognition that many established qualitative
techniques which rely completely on the ability of the individual to verbally
articulate their experiences and views are not appropriate to elicit the views of
vulnerable and marginalised groups. Consequently there has been a shift to
explore innovative research methods including those utilising arts based media
and photography (Prosser 2006)
Over the last two years, as part of a PhD with the Art and Design Research
Centre at Sheffield Hallam University I have been involved in exploring what
such arts based media offer occupational therapists and the individuals they work
alongside. The focus of my study is to look at how older people living in care
environments might use photography to create a record of their experiences. I
hope to explore specifically whether this media can offer individuals a vehicle
through which they can identify and express their occupational needs. Since
October I have been working as a photographer in residence in a care home in
Sheffield and the funding from COTSS – older people has allowed me to buy a
range of cameras and digital equipment for use by residents. Without this
equipment the study would simply not have been possible.
Much has already been learned
around ethical practice when using
image making within research and
the power of photo-elicitation as a
method of data-collection.
Photography seems to be
completely cognisant with the
philosophy of occupational therapy,
where knowledge is co-created and
generated in partnership and where
process of image-making has itself
led to the development of new
hobbies amongst residents.
On a personal level this study has
offered me the opportunity to
combine two great passions: photography and working with older people. Taking
a broader perspective I very much hope that the research will offer new insights

in relation to the lived experience of life in care and the practices and principles
of image making as a technique for the beneficial engagement of older people. I
would like to extend my thanks once again to COTSS – older people for giving
me this opportunity through their funding and I very much look forward to
sharing the findings of this work with you in future newsletters and publications.
Claire Craig
References
Help the Aged (2007) My Home Life: Quality of Life in Care Homes: a review of
the literature. Help the Aged. London.
Prosser, J. with Schratz. D. (2006). "Photographs within the Sociological

Research Process" in: D. Hamilton (Ed.) Visual Research Methods. Sage, London.
Dignity Campaign 2010
In the summer of 2009, College of Occupational Therapy’s Specialist Section for

Older People (COTSS-OP) was approached by the British Geriatric Society (BGS);
asking for a representative to take part in the Dignity Project that they were
planning. As this is an area I am interested in, I volunteered and, with the
agreement of our Chair and other members of the NEC, I attended the first
meeting at the end of July.
At the first meeting, Dr Jackie Morris explained the remit behind this project.
Following on from an earlier successful campaign lead by BGS, entitled ‘Behind
Closed Doors’, (looking at privacy and dignity when assisting someone to use the
toilet), it was decided that it would be a good idea to look more widely, at all
aspects of care, when looking after individuals within either a hospital or care
home setting.
We all agreed that we expect our loved ones, and ourselves, to be treated with
dignity and respect in all aspects of care. Sadly, somewhere in the midst of the
challenges of a lack of time, resources etc, patients/residents are almost being
viewed as “objects who must be processed” as quickly as possible. Often it is
perceived as quicker to do the care to someone, rather than engage with them
as individuals, offering choice and treating them with respect and dignity.
Hence started the major challenge, we needed to think about how to challenge
habits and bad practice whilst acknowledging fewer staff and increased
caseloads. After much discussion, we agreed that once admitted to hospital or a
care home, it only takes a few days for an individual to become institutionalised
and more dependent on staff. We therefore argued that if the individual can be
encouraged to remain as independent as possible, they will ultimately require
less staff time to care for them and, in the case of hospital patients, may be
discharged home more quickly. Our plan was to convince staff that an initial
investment of time, getting to know the client as an individual, and encouraging
them to take a more active role in their own care would ultimately lead to more
independence and therefore less dependence on staff to assist with care tasks.
We then proceeded to “brain storm” various aspects of care, thinking about how
the client’s experience of the whole care process could be improved. Our initial
thoughts were organised into the following categories: Dignity & Respect, Eating
& Drinking, Use of the toilet, Communication and Mobility. We decided at this
stage to create 2 different posters – one to be displayed in care homes (where
care would be ongoing and a major part of one’s lifestyle) and the other one to
be displayed in hospital settings (where care should be temporary and usually
with a rehabilitation bias). These draft ideas were then further discussed in our
workplaces or team meetings before returning to a follow up meeting in
September.
In September, our massive lists had to be reduced – if everything was added to
the posters we were planning, we certainly wouldn’t be able to see the wood for
the trees! There followed many heated debates as each participant felt
passionate about what had to be included or how things should be phrased e.g.
the initial heading of feeding elicited feelings of feeding animals at the zoo,
hence it was changed to eating and drinking etc.
When we met together in November for the final time, a representative from the
Department of Health, who had commissioned the project, joined us. Suddenly
the goal posts were changed – instead of creating 2 posters we now had to
create an A3 poster aimed at those working in care homes and a credit card size
prompt for staff working in hospital settings. Yet again our lists had to be
whittled down, and as this was the last time we would meet as a group, there
had to be a consensus about the words and phrases used. There followed a lot of
debate!
The final drafts were then circulated amongst colleagues and peers to gain some
objective feedback. At COTSS-OP NEC, the general feeling was that a credit card
size document would be hard to read and therefore would probably be ignored –
we suggested that an A5 size document would be easier to read and could be
kept inside our work diaries as a prompt. I fed back this idea to Dr Morris and
was very pleased when she said that she would agree to take this suggestion on
board. A few other changes were made at BGS and pictures were added to the
documents.
In February 2010, the A3 poster and A5 flyer were published. They will be
formally launched at the BGS Spring Conference in April and will start appearing
in professional publications from March.
As space was such a premium, a link has been provided at the bottom of each
document. By going to the website, interested parties can find further articles
and recommended reading.
The whole exercise has proven to be a very interesting experience – never did I
expect such passion when arguing for what could remain and what should be
removed from a poster! It is sad that we ever had to return to basics in order to
create such documents but hopefully they will be received as a gentle reminder
of treating the individuals we care for with dignity and respect, encouraging them
to remain independent and have an active role in their care.
Cynthia Murphy
Intermediate Care Forum Co-Lead
The experience of hosting The “Me2” Conference
Should we do something exciting like host a Conference?

This wild suggestion came at the end of an Older Peoples Mental Health Team,
Occupational Therapy Community forum.
Initially this idea was met with surprise followed by enthusiasm, it was agreed
that we would think the idea through in detail and discuss it further in a month’s
time.
During that month most forum members expressed their concerns and doubts,
we had no experience of staging such a large event, nor did we know where to
start or if we had the confidence, we are a relatively small team, did we have the
expertise? Funding? Or self belief to forge ahead……… we almost talked
ourselves out of this grand notion.
Almost immediately we all felt disappointed, why were we so quickly defeated?
We decided to do a little research and put together an action plan so that at the
very least we could make an informed decision.
We listed appropriate venues; we discussed the target audience, number of
places, agreed the theme of the conference, and then we made a list of possible
speakers. We put our information together and explored the funding options, as
this would be the main determining factor.
We contacted the Trust’s promotion officer who willingly agreed to meet with us
and offer his support and advice.
Our wild suggestion had become a possibility, one person visited and priced
venues, themes were highlighted, one contacted possible speakers, one
developed ideas for workshops, one designed a logo, one formulated a
programme and flyer and so it went on.
We had our meeting with James the promotions officer and he was very
encouraging and enthusiastic, he was also able to offer some practical help with
promoting the event, design, printing and booking options.
Funding was agreed.
Our wild suggestion had become a reality. The “Me2” Conference was now
scheduled for, March 2010.
Our conference logo some members of our team

The Title and logo was chosen to represent and symbolise what we wanted the
conference to be about.
ME = Remembering the person behind the dementia, their roles, relationships,
likes and dislikes.
ME 2= to symbolise that there are often more than one person living with
dementia. It can symbolise, the person and their carer or the person and other
support systems, formal and informal, it can also represent others diagnosed
with dementia.
Full House Networking

The Conference was a wonderful learning experience for us all and the
opportunity for us to work together as a whole team, both community and ward
based Occupational Therapists.
We were able to promote our work, and to promote person centred dementia
care. The conference was a great success, the feedback, both written and verbal
was very positive.
Some comments from the conference evaluation:
“A really informative and enjoyable day”
“The conference definitely achieved the aims identified by its organisers and
surpassed my personal expectations, an excellent variety of speakers all with an
excellent knowledge base, providing an inspiring, educational and thought
provoking day”
The ripple effects of the conference continues to influence our working practice
positively; our team has increased in confidence and we have improved our
network opportunities and are able to share good practice nationally and locally.
The team have been invited to speak at another conference scheduled for
November 2010 and to provide further training locally.
I am writing this to share my experience and to encourage others to “have a go”
most things are achievable if we believe they can happen.
“If people believe in themselves, it's amazing what they can accomplish” (Sam
Walton)
Elizabeth Cashmore OT (OPMHT)
North Staffordshire Combined Healthcare NHS Trust.
Rotherham Care Home Liaison Service
Anyone who has had contact with care homes will know that they can be heavy
users of services due to the complex needs of the residents and the way that
care homes are organised. In Rotherham, as in most areas, services were
provided to care homes but in a fragmented and reactive way. Following work

done around emergency callouts, A&E attendances and raising awareness of the
issues, NHS Rotherham commissioned our service for an initial pilot period of 3
years.
It fell to myself, as lead Occupational Therapist, and the lead Nurse for care
homes to set up the service and we each share the operational management
whilst still having a clinical role in the team.
Our main aim is to reduce ambulance callouts and A&E visits but within that we
hope to support care homes in improving quality. We work in up to 3 care homes
at a time (depending on size) for 6 months and take referrals for 1-1
intervention, provide training and 1-1 advice regarding the management of
problems. At the end of the 6 months we hope to leave the care home with the
knowledge and confidence to deal more effectively with the health needs of their
residents, so that problems don’t become a crisis.
The structure of the team was decided according to the needs of our client group
and so we have an OT, a Physio., a CPN, a Dietician, a Speech and Language
Therapist, Contract Reviewing Officer, a generic Support Worker and admin
support. This enables us to address the multiple health needs that are usually
present in older people and in this group in particular. We take a team approach
to our work and so it is usual for all members of the team to have input with
residents.
So far, we have reduced emergency callouts in all the homes that we have
worked with and this has translated to significant savings for the PCT. We
recently had a visit from Karen Middleton (Chief Health Professions Officer) who
said that this was a good example of a service delivering on the QUIPP principles.
We also recently won our Chairman’s Award for an outstanding contribution.
Comments from the care homes have been very positive, staff and managers say
that they feel more empowered and feel that they benefit greatly from the
training and from the access to a dedicated team.
The team enjoy their work immensely and particularly like working in a team
with no professional boundaries. We all learn from each other and the benefits
for the client group are obvious.
Paula Allen
Joint lead/lead therapist for care homes
Lunch Club
Following on from the Christmas newsletter, two OT students from Brighton

University, Kate Grey and Mary McDonagh completed their running of a Lunch
Club and sought feedback from the three participants, who took part.
Group members arrived at the day centre late morning and proceeded to prepare
and cook a meal together in the rehabilitation kitchen with assistance from the
students. Patients and students then sat down together to enjoy the meal.
Meal plans were discussed and agreed upon one week in advance and the
students obtained the ingredients. The cost was split between each group
member, working out at around £2 per meal on average. Examples of meals
included smoked haddock pie followed by trifle and roast lamb followed by mince
pies.
These sessions provided the opportunity for participants to engage in gentle
exercise, to practise cookery skills, enjoy social interaction and increase
confidence in becoming involved in activities.
The lunch club was a major success and was thoroughly enjoyed by patients and
students alike, as the enclosed reactions testify:
What did you enjoy most about the group? (What other aspects did you
enjoy?)
K – We are able to do things we can’t do at home, such as cooking a roast
dinner. There are aspects of cooking that you can’t do at home because you
need support or supervision.
J- The group offers friendship and company.
What did you enjoy least about the group? What improvements would
you recommend?
J- That it’s not long enough and I can’t come back again (B and K agreed)
K- I’ve got no grumbles…sharper knives would be good.
J- ‘The group is perfection to me’
Do you feel this group has had any impact upon your daily activities at
home?
K – To come here and be active has improved my ability. K reported that she
recently made a casserole at home.
J- I do cooking [at home]. I get meals delivered but do not order them so I can
cook for myself. I cook things such as sausages and baked potatoes and cooked
breakfasts.
B – No. – B reported that she does not do any cooking from scratch. She cooks
ready meals in the oven. She has cereals for breakfast.
Has attending this group encouraged you to access other groups in the
community?
B –Yes, craft groups
K – Yes. Although J reported transport is a problem with some community
groups.
J- No. J reports being quite happy at home in the bad weather although reports
would like to do craft groups.
Would you recommend that this group be continued for other members
of the community? Why?
K- Yes, it gets you out to meet people and do things.
J- Yes because we enjoy it and it’s done us the power of good - Good therapy
B- Yes, it’s a great help when you’re disabled and there’s no one to take you out.
Meeting people, doing things.
B- ‘It’s been great, really wonderful to get here’.

Nina Booth
Community Rehabilitation Team
My Parkinson’s Story
My name is Phil. I was diagnosed when I was 44 with early

onset Parkinson’s. Some of you may recognise me from the
time I worked for Trafford Direct (now Access Trafford) based
in Old Trafford Library.
I said to myself, “Do I wave the white flag or fight?”

It felt like a curved ball had smacked me in the
mouth after Parkinson’s had left its calling card. Why
me?
My life felt out of control of my body, I questioned
my faith and what would be my family’s future as my disability
progressed. They didn’t deserve to suffer. These times were the start of a whole
range of emotions, such as; depression, frustration, feeling less intelligent, and
stressed.
Physically, I soon began losing some of the control of some of my muscles; legs,
arms, face. These examples affected my walking gait, strength and speech. The
first two can cause a good deal of pain and discomfort. The latter is affected by
my breath control, which is frustrating as my voice can come across quieter or I
sometimes stutter.
I worked for two years after being diagnosed during
which I spent long periods off work through fatigue. My
employers were very supportive and explored every
avenue to enable me to continue my employment, with adaptations
and working hours for example. I retired at the age of 46, down but
not out.
This was when I reached my lowest point having a feeling of low
self-esteem and full of anxiety despite the medication. The ‘old me’
was dying, but a ‘new me’ was being born. “Doctor Who”, eat your
two hearts out.
THE BIG FIGHT BACK – round by round
1. Speech Therapy
2. Writing poetry which created a world my words controlled. I am now a
published author
3. Performing on stage – confidence and breath control
4. I have been in two shows including one written, directed and performed
with 7 other top draw Old Trafford stars.
5. I am now working alongside the communities of Old Trafford.
“It’s a win, with a fifth round K.O.”
My Parkinson’s has been enabling rather than

disabling, which surprised me. With the help and
support of my family and friends, together with
those at the Trafford Branch of the P.D.S., my
condition has somehow made me a ‘richer’
person despite the changes that will inevitably
come.
“IT’S NOT THE END!!!!!!”
Parkinson's Disease Society of the United Kingdom. Charity registered in England and Wales
No. 258197 and in Scotland No. SCO37554. A company limited by guarantee. Registered No.
948776 (London).
Registered Office: 215 Vauxhall Bridge Road, London SW1V IEJ
Tel: 020 7931 8080 Fax: 020 7233 9908
Email: enquiries@parkinsons.org.uk
Website: www.parkinsons.org.uk

I am a Carer
I have had several job titles in my career but never thought that when I retired
would become a full time carer.
In 2000 my partner and I went on a well earned holiday to the
Caribbean to celebrate my big 60.
Being with someone 24/7, I began to realise that things were not
quite as they should be. Before going away I had noticed the odd
episode, but brushed it aside as something to do with the ageing
process. While on this holiday it was changes in movement, softer
speech, tiredness and slowing down of mobility that made us on our
return go to the doctor and then visits to two consultants for further
opinions, who all arrived to the same conclusion ...... Parkinson’s
Disease.
At the time it was a case of don’t worry we will sail through this situation...... it
will work out.
As time went by we soon realised it was not to be.
It was so unfair to see someone so fit and active a person to begin
to stoop, difficulty with mobility, some days virtually no voice, not
able to write as before, to shave, to wash, to dress, I could go on.
But on the up side we have a wonderful group of friends who offer
support so freely when needed..... just that short break...... a little me time.......
sounds so selfish, but oh so important, as I now realise, and at last now
understood by my partner...... because without my good health the situation at
home would be very different.
But it is not just friends, it’s the back up and support we have received from
within the community...... Doctors...... District Nurses...... Occupational
Therapists......Physiotherapists….. Speech Therapists...... Dieticians...... Trafford
Carers...... Crossroads...... etc. Also by joining the Trafford branch of the
Parkinson’s’ Disease Society, and now a committee member, has also been a
bonus..... .to be able to talk to fellow carers and share our problems.
As I well know from my working days, there is no such thing as a
problem......problems are to be solved. On joining this group it became obvious
in discussion that all people with Parkinson’s are very different.....by listening to
various speakers at our meetings again opened doors to
available help and treatments.
As a carer, Parkinson’s is a challenge...... each day never
being the same, but knowing at the end of each day we have
together achieved and won over yet another obstacle.
Parkinson’s UK is the operating name of the Parkinson’s
Disease Society of the United Kingdom. A charity registered in England
and Wales (258197) and in Scotland (SC037554).

Working with people with Learning Disabilities –
Everyone’s Job
For many years the needs of people with learning disabilities have been met by
specialist learning disability services. However, over recent years this trend has
been shifting with more and more people accessing mainstream health services.
This is no coincidence; this drive for greater inclusion of people with learning
disabilities has been supported by a range of government documentation. In
2001 the landmark paper ‘Valuing People’ was published. Amongst other things
this paper stated that:
“We will ensure that people with learning disabilities, including

those from minority ethnic communities, have the same right
of access to mainstream health services as the rest of the
population.”
(DoH 2001)
Unfortunately this has been slow to progress and it was not until 2007 when
Mencap published their hard hitting document ‘Death by indifference’ that much
stronger drives for change were demanded. Death by indifference told the story
of 6 people with learning disabilities who experienced poor quality care from all
professionals involved with them and who later died completely avoidable deaths
as a result. Mencap launched an inquiry into this and concluded that:
• People with learning disabilities are not a
priority in the health service
• Many health care professionals do not
understand much about learning disabilities
(leading to diagnostic overshadowing - this
is when a professional assumes a particular
problem is related to the persons learning
disability rather than checking other things)
• Professionals don’t listen to families and
carers
• Understanding about the law surrounding
capacity and consent is limited.
• Health professionals rely inappropriately on
estimates of a person’s quality of life.
• The complaints system in the NHS is slow and inaccessible.
This problem is compounded by the fact that people with learning disabilities
have a higher than average prevalence of a number of additional health
problems such as mental illness, epilepsy, thyroid dysfunction, dementia, gastro-
oesophageal reflux, osteoporosis, dysphagia, musculo-skeletal problems,
problems with muscle tone, nutritional and swallowing problems, weight
problems and sensory impairment (Gustavson et al 2005).

In many places it is reported that institutional discrimination still exists for
people with learning disabilities. Institutional discrimination happens when the
people working in a place or organisation do not:
• Value all people equally. There is much
evidence that people make judgements
about the quality of life of someone with a
learning disability which impacts on the
way they treat/ or do not treat the
person.
• Understand that different people have
different needs – the Disability
Discrimination Act (1995) requires us to
make reasonable adjustments for people. This might mean making
information more accessible or changing routines to suit a persons needs.
It does not only mean making buildings accessible.
• Change the way they deliver a service so that it meets different needs,
again this might mean changing routines or standard systems, changing
the times you visit or the way you assess.
If this kind of discrimination happens for a long time, staff get used to it and
don’t notice that it is wrong.
No longer is acceptable to use the argument that people with learning disabilities
have specialist needs that cannot be accommodated within mainstream services.
It is now the responsibility of mainstream services to develop the skills to work
with this client group. Increasingly specialist learning disability services are
taking on a consultancy role and will be more than willing to offer training and
individual support to help facilitate this process.
College of Occupational Therapy

Specialist Section- People with Learning
Disabilities set out in their Practice
Principles (2003):
“People with learning disabilities have the

right to access generic health and social
care”
If a person has an identified need for occupational therapy, unrelated to their

learning disability, then he or she should access the relevant generic
Occupational Therapy service e.g. Social services, mental health, and acute
generic hospital.
The College of Occupational Therapist has been involved in a joint project with
Mencap called ‘getting it right for people with learning disabilities’. A leaflet has
been produced which can be found both on the mencap and COT websites. The
leaflet gives simple advice about how to support people with learning disabilities.
To help you think more about how you work with people with learning disabilities
we have developed the following case study for you to reflect on.

HIV/AIDs, Oncology, Palliative Care
A person with a learning disability and cancer is admitted into a hospice. They
have Down’s Syndrome, are 36 years old, live with their parents and have no
concept of dying. How would you adjust your OT input to take the person‘s
learning disability into account?
Housing
You have received a referral for a person with a learning disability moving from
shared living to their own home where they will have paid carers for PADL. They
need a bathroom adaption as they cannot get in or out the bath. They have
profound and multiple learning disabilities and are 26 years old. How would you
adjust your OT input to take the person‘s learning disability into account?
Neurological Practice
A person with a learning disability is admitted to a neurological rehabilitation unit
because during an epileptic seizure they sustained a head injury. They are 21
years old, live with their parents and are assisted by paid carers. How would you
Older People
An older person with a learning disability and dementia is admitted onto a ward
with stomach pain for investigation. They usually manage at home with a full
care package. As you are involved in the discharge planning, how would you
Rheumatology
A person with a learning disability and hand injury is referred to you for splinting.
She is 46 years old and lives alone with a small amount of incoming care. She is
not keen to wear a splint. How would you adjust your OT input to take the
person‘s learning disability into account?
Trauma and Orthopaedics

A person with a learning disability is admitted onto an orthopaedic ward for a
planned total hip replacement. He is 50 years old and lives with elderly parents.
You are involved in the pre and post surgery role. How would you adjust your OT
input to take the person‘s learning disability into account?
Work
You have received a referral for a person with a learning disability and autism
who wants to work. Their skills are tidying and sorting. They are 21 years and
live in a shared home. How would you adjust your OT input to take the person‘s
learning disability into account?

Mental Health
A person with a learning disability and psychosis is referred to the acute inpatient
unit. He is a young, British black man with a history of homelessness and
substance misuse. He is currently in temporary housing. How would you adjust
your OT input to take the person‘s learning disability into account?
Here are some points that might help you:

• Research suggests that longer appointment times, the use of symbols or
pictures on information and regular health checks help to overcome these
issues (Martin et al 1997, Melville et al 2006).
• You may need to offer the person extra time and support to make
decisions, communicate and do everyday tasks, e.g. consider how food is
ordered in hospitals.
• For every day activities such as washing and dressing, find out how they
do it at home, try to replicate this, do assessments at the time that person
would normally be doing that activity.
• What does the person normally like doing, can you take time to do this
with the person first to help build a relationship and for you to see their
skills in an activity that motivates them?
• Are there staff or family who can show you how to best communicate and
engage with the person? Can you consider flexible visiting hours to allow
the person to have support?
• Use familiar cues, routines and objects.
• Give the person as much control as you can and explain what you are
doing. It may be helpful to demonstrate on someone else first.
• Consider how self explanatory the environment is! e.g. does a commode
look like a toilet or a chair?
• Consider how you explain the ‘unspoken rules’ e.g. what it means when
curtains are closed around someone's bed.
• Share information and get other people involved!
And finally...
One of the most significant ways that you can
help someone with learning disabilities is to
make the information you give them more
accessible. Accessible information is the term
used to describe ways of making information
easier to understand for people with learning
disabilities. Frequently, the term is used to
refer to resources that are produced in
accessible format however this fails to account for the dynamic processes
involved in interpreting the resource.
Accessible information includes concepts such as the use of clear and simple
language, the use of a variety of symbols, the use of objects and might also
include demonstration, using familiar people to help communicate the message.
In order to make information truly accessible you must have an understanding of
the individual’s communication needs.
Jo Tinkler
COTSS - People with Learning Disabilities

Useful resources/ contacts
Am I making myself clear
Boardmaker software
Your local Community Learning Disability Team
www.plainenglish.co.uk/atoz.pdf
www.mencap.org.uk
www.easyhealth.org.uk
www.bild.org.uk
http://www.valuingpeople.gov.uk
References
Department of Health (2001) Valuing People: A new strategy for learning
disability for the 21st Century, London, The Stationery Office.
Department of Health (2008) Valuing People Now, London, The Stationery Office.
Disability Discrimination Act (1995) London, Her Majesty’s Stationary Office.
Human Rights Act (1998) London, Her Majesty’s Stationary Office
Mental Capacity Act (2005)
Disability Rights Commission (2005) Equal Treatment: Closing the Gap Interim
Report
Mencap (2007) Death by indifference
Gustavson, Umb-Carlsson, Sonnander (2005) A follow up study of mortality,
health conditions and associated disabilities of people with intellectual disabilities
in a Swedish County Journal of intellectual disability research 49 905-914
Melville C, Cooper S-A, Morrison J, Finlayson J, Allan L, Robinson N, Burns E,
Martin G (2006) The outcome of an intervention study to reduce the barriers
experienced by people with intellectual disabilities accessing primary health care
service Journal of intellectual disability research 50 (1) 11-17
Van Schrojenstein Lantman De-Valk, Metsemakers, Haveman, Crebolder (2000)
Health problems in people with intellectual disability in general practice: a
comparative study Family practice 17 405-407
Martin, Roy, Wells (1997) Health gain through health checks: improving access
to primary care for people with intellectual disability Journal of intellectual
disability research 41 401-408
Foundation for People with Learning Disabilities (2004) Estimating Future
Need/Demand for Supports for Adults with Learning Disabilities in England,
Institute for Health Research, Lancaster University.
OTs working in Acute Assessment Units
We are a Team of OTs working within an acute hospital who currently cover an
Acute Assessment Unit with the aim of discharging patients within 24-48 hours.
There are two types of patients that we currently assess: complex patients who
will need to be admitted to one of the complex wards for further multidisciplinary
or medical assessments and patients who are suitable for rapid assessment and
can be discharged home from the unit within 48 hours. If a complex patient is
transferred to a complex ward, we currently hand them over to the OTs that
cover the complex wards in line with the hospitals complex care pathway.
We are currently looking for the evidence base behind the importance of
beginning the assessment process on admission for the complex patients and the
impact this has on reducing length of stay. We would like to hear from any OTs
working in similar settings who would be willing to share their day to day working
practices or any examples of evidenced based practice.
Please contact: The ‘front of house’ occupational therapy team on: 01473
704164 or email: kathryn.rice@ipswichhospital.nhs.uk or hannah.lord-
vince@ipswichhospital.nhs.uk
Department of Health Transforming Community Services:

Ambition, Action, Achievement: Transforming Services
for Acute Care Closer to Home
In June 2009 the Department of Health published The Transforming Community

Services Programme (www.dh.gov.uk/tcs) with the ambition to provide high
quality care for everyone.
The programme includes six transforming community services reference guides:
• Transforming Health, Wellbeing and Reducing Inequalities
• Transforming Services for Children, Young People and their Families
• Transforming Services for Acute Care Closer to Home
• Transforming Rehabilitation Services
• Transforming Services for People with Long Term Conditions
• Transforming End of Life Care
The Acute and Emergency Care Clinical Forum of the College of Occupational
Therapists Specialist Section Older People are particularly interested in is the
Transforming Services for Acute Care Closer to Home guide. The ambitions of
this guide are:
1. Getting the basics right - every time
a) Knowing about local health needs and plan services accordingly
b) Create effective health and care partnerships
c) Implement services/approaches
d) Access and availability
e) Care planning and case management
f) Information and technology
g) Education and training
2. Making everywhere as good as the best
a) Knowing about local health needs and plan services accordingly
b) Create effective health and care partnerships
c) Implement services/approaches
d) Access and availability
e) Care planning and case management
f) Information and technology
g) Education and training
3. Delivering evidence based practice
a) What does the evidence say?
b) Acute care closer to home as good as hospital care
c) Intravenous treatment at home is becoming more common
d) Community follow-ups can replace out-patient visits
e) Community out-reach clinics improve patient satisfaction
f) Telemedicine reduces re-admission to hospital
g) Hospital at home
h) Offering acute care requires skills
i) Achieving effective wound care healing rates
4. Developing and supporting people to design, deliver and lead high quality
community services
a) Actions to develop a ‘social movement approach’ to change, owned and
led by local services and practitioners
b) Demonstrating the six attributes in services for acute care closer to
home, practitioners and teams are:
I. Health promoting practitioners
II. Clinical innovators
III. Professional partners
IV. Entrepreneurial practitioners
V. Leaders of service transformation
VI. Champions of clinical quality
The Acute and Emergency Care Clinical Forum welcome the ambitions of the
report and its aims to provide the public with the type of acute care support they
want i.e. care delivered closer to home. The big question is will the government’s
ambitions be able to provide all the types of services the public need, including:
• provision of appropriate care for patients in the community
• specialist advice and intervention according to their problems e.g. older
persons advice from an older persons specialist
• timely intervention
• easy access to services
• awareness of services
• abolishing the post code lottery for services
• resolving the difficulties of having a GP in one PCT when the patient lives in
another i.e. city PCT and county PCT differences
• provision of night services
A number of issues and questions are raised, such as:
• Reducing unnecessary hospital admissions should reduce costs on one
hand, but particularly in the short term as services are being established,
there may be increased costs involved in providing the intense, short-term
support that will be needed. How will this be addressed in the current
financial climate?
• To deliver the ambitions of this document could require significant change
in the ways that health and social services departments communicate and
share aspects of their services. There are likely to be funding implications
involved and changes to established ways of working that could have a
significant impact on Occupational Therapy services in both areas.
• It is not fully clear how the role of rehabilitation is envisaged to contribute
to ensuring that patients reach their full potential once the immediate crisis
is over.
• Although this document pertains to England, the aspirations, challenges
and potential resolutions are equally applicable to Northern Ireland,
Scotland and Wales.

We would like to pose some questions to begin a discussion among members of
the Acute and Emergency Care Clinical Forum:
• How can Occupational Therapists provide ‘added value’ to the services and
ambitions proposed in this document? The possibility of Occupational
Therapists in Emergency Departments is mentioned. Is this the most
appropriate use of Occupational Therapists’ skills or are there other areas
we should be proposing that we become involved in?
• What about rehabilitation? Is there a danger of Occupational Therapists
being reduced to ‘discharge co-ordinators’, or is being an Occupational
Therapist who co-ordinates discharges in such an acute setting a valid
specialist role in itself?
• Occupational Therapists are often at the forefront of joint working between
social and health services. How can we build on these well established
relationships to ensure we contribute to the ambitions of this document?
What do we need others to provide or do in terms of systems, structures
etc to enable us to offer the best possible service?
• What are the experiences of Occupational Therapists already working in
Emergency Departments, Rapid Response Teams and other similar
services? Perhaps you have further information and experiences to share.
We hope to post some of these questions on the COT website discussion forum
for Older People, so please join in, share your experiences and raise your own
issues.
Dr Judi Edmans
Acute and Emergency Care Lead
judi.edmans@nottingham.ac.uk
Ebby Sigmund
Acute and Emergency Care Lead (alternate)
e.sigmund@nhs.net
A&E Evidence Review update!
The A&E Evidence Review was commissioned by COTSS - Older People to review
the current literature for A&E OTs. This was to then move towards producing
practice guidelines for OTs in A&E. The document is now nearing completion. A
draft document is in place and is being reviewed by the Practice Publications
group at COT. Key themes have emerged: Follow up in the community is
needed; links need to be built with the community services/A&E; communication
is the key to discharge planning; OTs should target core groups to aid transfer
back to the community.
OTs are the ideal health professional to be based in an A&E setting. Some
evidence suggests some benefits to OTs within A&E but we need more research
into this area. A randomised control trial is needed to show the benefit of OTs
within A&E setting as opposed to other allied health professionals. We need to
show how we decrease admissions and assist people to live at home. It has been
a long journey to complete the review first started by AESSOT 2005. Now all we
need are keen volunteers to put forward a research proposal and start a research
project!
Racheal Eckford

Slips and trips E-learning package
I was “required” by my Trust to complete the “Slips and Trips E-learning

Package” and obediently, albeit reluctantly, did so - I already perceived myself as
well read on the topic having completed a PhD. in the environment and falls!
Thank goodness I did – I was bowled over!! What an AMAZING resource – I
learnt so much about falls and the environment and was aghast at my preceding
lack of knowledge …. So don’t prevaricate like I did, get on and do it – then we
can all be well versed in our specialist subject!
http://www.hse.gov.uk/slips/step/launch_sector.htm

Book reviews
CD review: My dreams of being
Author: Dr. D.J. Nightingale

Available through: VITALYZ (Seated Therapeutic Activities). www.vitalyz.com
price: £20.00
‘My Dreams of Being’ is a 33 minute audio CD, with a transcript booklet. It was
originally written and designed to provoke thought and encourage discussion
with carers who help those with dementia. It is presented as the thoughts of an
elderly care home resident who has dementia, dysphasia and mobility problems
following a stroke.
The conversational manner of the CD brings out the resident’s feelings about his
care, both good and bad. This approach allows the resident to give his reasons
for his behaviour towards the staff when they do not respect his personal
preferences in activities like bathing, the types of drinks he prefers, shouting
when he is not deaf, to mention a few. This is contrasted with his behaviour
towards the staff who know his preferences and treat him with respect. Among
other things, it also highlights an inconsistent attitude to health and safety with
an unsafe van tail lift compared with no pens for bingo.
This is a resource for both new and experienced people working with those who
have dementia. It is a very good training asset, both thoughtful and innovative.
Extra guidance for trainers would be helpful. As it stands, any trainer would
have to know the contents of the CD well, before guiding the discussion that
needs to be held after listening to it. Good ‘enlightened’ people would
understand the concepts Dr. Nightingale is trying to bring to the fore. Those who
do not understand the resident’s perspective will need extra help to gain
enlightenment.
This is a good training resource for any facility that deals with people with
dementia.
Beth Wilson
Occupational Therapist
Torphins Health and Resource Centre

Occupational Activity
Training
Vitalyz are passionate
about bringing activity
into the lives of seniors
and less able adults.
Specialising in Seated
Exercise, Vitalyz training
is designed to be
motivational and practical
to encourage and enable
carers to introduce
occupational activities
into daily living.
***
An excellent balance of light
hearted presentation with constant
reference to the implications of
fitness provision.
Vitalyz Gold
A Level One - One Day
Course
Introduction to Basic
Seated Exercises in a
Social Care Setting
Why not join our

Team?
Empathy, knowledge and
experience are essential,
so we believe that OTs
make great freelance
trainers.
Applicants are allocated a
region which they are
happy to cover and as a
Vitalyz Champion they are
best placed to promote

Research and development
We have had several requests to circulate details of research projects which need
input from our members. I do hope you feel able to support these requests.
It is important that we continue to grow and develop our evidence base.
May I just remind members that we are always happy to help with research and
to circulate details to other members of COT-SS Older people- provided;
1. The request is from a member of COT-SS Older People (!) (i.e. has a
membership number)
2. The research has appropriate ethical permission (e.g. copy of approval letter)
We also ask for a copy of the protocol.
Finally please come and meet the committee at Brighton. I’m really keen to have
any feedback - positive or negative - specifically about R&D issues.
Dr Avril Drummond
R&D lead
Research award
A reminder that we are offering a £1000 research award to support members’

post graduate research. Closing date is 31st October.
Details on our website.
We are offering one sum annually now as it was thought this would be more
attractive to members.
References which might be of interest to members
Forster A, Lambley R & Young JB.

Is physical rehabilitation for older people in long-term care effective? Findings
from a systematic review
Age & Ageing 2010; 39 (2): 169-175
Callisaya ML, Blizzard L, Schmidt MD, McGinley JL & Srikanth VK.
Ageing and gait variability – a population-based study of older people
Age & Ageing 2010; 39 (2): 191-197
Delbaere K, Close JCT, Mikolaizac AS, Sachdev PS, Brodaty H & Lord SR.
The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal
validation study
Age & Ageing 2010; 39 (2): 210-216
Klenk J, Becker C & Rapp K.
Heat-related mortality in residents of nursing homes

Age & Ageing 2010; 39 (2): 245-252
COT Publications
Please find attached details of three titles recently published by COT:
Changing lives, changing practice: occupational therapy in social work, enabling

independent living in Scotland
(downloadable from:
http://www.cot.org.uk/homepage/publications/?l=l&ListItemID=1794&ListGroupI
D=248)
Occupational therapy for people with Parkinson’s: best practice guidelines
(downloadable from:
D=248)
Working for health: occupational therapy and how it can benefit your
organisation
(downloadable from:
D=248)
All are available in hard copy via print on demand (see the attached sheets for
details of codes and prices).
COTSS – older people annual conference, Brighton 22nd

to 25th June
Work continues in preparation for our annual conference, which will be running
alongside the COT annual conference in Brighton. We hope to see as many of our
members as possible at the conference. Come and see us on the main COT stand
or join us for a glass of wine at the fringe meeting on the Wednesday the
23rd at 17.00.
Dr. Avril Drummond
R&D Lead

Clinical forum updates
Falls Clinical Forum
Membership
There are now over 462 members of the falls forum of which 373 are members
of the Specialist Section. However, the site has remained very quiet compared to
a couple of years ago when our inboxes were overflowing! This is a wonderful
opportunity to share good practice, ask questions and have debates on line with
colleagues, so do please use the site!
National Falls and Bone Health Audit
Catherina Nolan and Zoe Long represent the COTSS-OP at the meetings at the
Royal College of Physicians regarding the next National Falls and Bone Health
audit, due to happen later this year. The pilot audit has already gone out to
participating Trusts and the final decisions on the questions to be included in the
audit are being confirmed.
COT/CSP Falls Audit work
In January this year, Kate Robertson and Catherina Nolan attended a meeting at
CSP with 3 Agile representatives to explore whether, and how, to update the
CSP/COT Falls Audit Tool first published in 2000. It was agreed we would all take
a section of the Tool to update and this work is now ongoing - it is hoped to
produce a document that can be circulated to members electronically.
Falls Awareness Week 21st to 25th June 2010
Just a reminder that instead of Falls Awareness Day this year, 2010 will see the
first Falls Awareness Week. We have no doubt there are lots of members out
there who will be involved in activities in their areas - do let us know what you
have planned or how it went after the event. If you have not yet planned an
event then more information is available at the age UK website
http://www.ageuk.org.uk/get-involved/events-and-challenges/national-falls-
awareness-week/
The week coincides with COT Annual Conference in Brighton - if you are at the
conference come along and say hello!
Kate Robertson & Zoe Long
Falls Clinical Forum Leads
Mental Health Clinical Forum
I would like to apologise for my forum report last edition, somehow the wrong
document was sent on to the editor, hence, a rather abbreviated and incomplete
report was published.

Nice Guideline
We have been asked by COT to comment on the skills required by band 5 and 6
OT’s in order to implement the NICE guidance. The draft COT plan to implement
the NICE guideline mentions the COTSS-older people with reference to carrying
out a focus group with band 5’s and 6’s.
Tai Chi programme
I have written an article for the BGS newsletter about a Tai Chi programme that I
have been involved in and await confirmation of its acceptance.
Research project on the use of Nordic Walking with older people
I am in contact with the University of Northampton, department of sport and
exercise, regarding a possible joint research project on the use of Nordic Walking
with older people. I hope to arrange to do some research with older people to get
some data/evidence to support it’s efficacy in the UK. I have access to some
researchers in Japan and Finland on the subject.
Primary Care Conference
I attended the primary care conference in Brimingham on the 6th May as an
invited speaker. There were 350 delelgates in the AHP conference section which
was nice to see!
Sue Rey
Mental Health forum Lead
Intermediate Care Clinical Forum
In January, Val and I emailed all IC Forum members, inviting them to share with
us how they would like to use our Forum, and asking them to express an interest
in joining the e-journal club should we decide to re-launch it.
We are delighted to report that a small number of interested parties have
expressed a keen interest in critiquing journal articles and therefore the e-journal
club was re-launched in April. Hopefully this will continue to gather momentum
and lead to more discussion and debate about how Intermediate Care is being
implemented throughout the country.
Cynthia’s involvement in the Dignity Project, lead by British Geriatric Society, has
now finished. An A4 poster and A5 flyer have been produced – further
information is available in a separate article in this month’s newsletter.
Val continues to attend the Specialist Section Clinical Forum meetings and
disseminates relevant information to NEC members. Unfortunately regular
attendance at all future meetings may not be possible due to cost savings within
her OT Service.
Val has been liaising with Amy Edwards at COT, and with Catherina Nolan, about
collating the responses received in relation to Transforming Community Services.
An email has been circulated to all the Intermediate Care Forum membership to
advise about some free intermediate care workshops, which are being run
throughout the country, by the Department of Health, in relation to the updated
Intermediate Care guidance and the new hospital discharge document. The
“Ready to go? Planning discharge and the transfer of patients from hospital and

intermediate care” document can be directly downloaded from the Department of
Health website.
Our IC Forum web page has been updated and will be reviewed regularly. Please
let us know what you would like to see posted there.
Like all our NEC colleagues, we are both looking forward to this year’s COT
Conference in Brighton and hope to meet as many forum members as possible,
both at the fringe meeting and at our COTSS-OP stand.
Val Killala & Cynthia Murphy
Intermediate Care Clinical Forum Co-Leads
Dementia Clinical Forum
I am in the very fortunate position of having Pasna Sallis helping with the
dementia forum; she will formally stand for election at the next AGM.
Pasna Sallis
I am delighted to be given the opportunity to be actively involved in the
dementia forum for COT-SS-older adults. This is my eleventh year as a qualified
Occupational Therapist. My career to date has spanned across NHS services in
Scotland from general and mental health ward settings to community based
adult mental health, paediatrics and now a mental health team for older adults.
The broad range of experience has provided me a good grounding in
Occupational Therapy across conditions and lifespan.
Currently I am a member of the AHP expert panel for Dementia care in the run
up to the release of the National Dementia Strategy (Scotland). During the
recent first Scottish AHP Mental Health Conference, the Scottish Government
recognised a community based leisure project that I have been involved in
setting up and delivering as an example of good AHP practice for the Delivering
for Mental Health document. The Scottish Government has also shown an
interest in this project with connection to the National Dementia Strategy for
Scotland. I have spoken about my ongoing projects at Glasgow Caledonian
University to Occupational Therapy students and at the Gerontology Interest
group at University of the West of Scotland (Hamilton) to a multi-agency
professional audience. This year I am presenting at the COT-SS-older adults
conference in Brighton. Previously, I was invited to 10 Downing Street to meet
the Prime Minister as one of the AHPs in recognition of services to the NHS. I
have attended a WFOT conference in Montreal and had a second year university
placement in New Delhi.
My interests are older adults and active ageing; networking across agencies;
innovative practice; promoting the profession and what it can offer to dementia
care; health promotion; leisure occupations.
I am looking forward to liaising with occupational therapists via the specialist
section and to contribute to working towards our shared vision.
The other big news is that the Scottish dementia strategy will be launched on the
1st June, so look out for that. It would be great if you could keep us informed of
how our members in Scotland plan to implement the strategy, clearly from the
last OT News our members in England and Wales have found creative ways to
integrate the dementia strategy into their practice.
The Dementia Guidance for OT’s in non specialist settings is continuing and we
are now at the point of reviewing the literature.
Heather Edwards & Pasna Sallis
Dementia Clinical Forum Co-leads
Acute / Emergency Care Clinical Forum
Forum name change

Our first priority for the forum was to clarify who we represent (i.e. ‘Accident and
Emergency’ or ‘Accident and Emergency and Acute Care’). Consequently, we
emailed members of the A&E forum with the suggestion and rationale for a name
change for the forum as a start to its re-launch.
A&E to most people means 'Accident and Emergency' rather than Acute and
Emergency care and we considered the shorting to A&E leads to confusion for
members. Apart from that, the term 'Accident and Emergency' is no longer used
and has been replaced by 'Emergency Department'.
We considered this and thought of 'Acute Care and Emergency (ACE clinical
forum' - we thought that represented the group better than A&E and ACE is the
type of service we all strive to provide for our patients.
We asked members to let Judi know their views and whether they were happy
with the new title.
We had replies from 10 NEC members and 17 ordinary members, mainly
supporting the name change. If you haven’t sent your comments to me yet,
please do so as soon as possible. The final decision will be made at the SSOP
AGM at the COT Annual Conference
A&E edition of OTN
The May edition of OTN was focused on A&E (or Emergency Departments) with
articles on the role of Occupational Therapists in A&E departments, and
evaluating their impact. These articles included background information, name of
service, geographical location service structure, how long the service had been
running and an evaluation of the service.
Ebby and I submitted two articles for this edition of OTN, one introducing
ourselves as the acting forum leads and one on the Department of Health
‘Transforming Community Services: Ambition, Action, Achievement:
Transforming Services for Acute Care Closer to Home’ Transformational Guide,
offering our views and raising issues and questions.
A&E review
Rachael Eckford has worked very hard to complete the A&E guidance review
under extremely difficult circumstances. There are a few minor amendments to
be made to complete the review prior to publication by COT. To ensure the
review is up to date, Judi Edmans is undertaking a top-up search for articles
published during the last couple of years, with assistance from Andy Hughes at
the COT library. Hopefully the review will be published later in 2010.

Hot topics in A&E
In the last newsletter, Ebby and I requested that members let us know about the
current ‘hot’ topics for those working in this area of practice. We asked about the
initiatives you are taking forward and the issues that are causing you concern.
To date, we have only had one reply, which was about the evidence for OT
assessment within 24 hours of admission to the 'Emergency Assessment
Unit'. There, managers questioned the need for an OT on such a unit and
whether the OT assessment should take place once the patient is transferred to
one of the wards within the hospital. Our aim is to put this type of question on
the discussion forum page on the website, to facilitate discussions between
members on current ‘hot’ topics.
Future plans
Our next aims are to tackle updating the forum webpage on the SSOP website,
emailing members and reviewing the A&E R&D strategy.
We also need to decide the best way for us to take the forum forward and
whether we require virtual or real meetings to do so.
Ebby and I will both be at the SSOP/COT Annual Conference, so please come and
make yourselves known to us. I will be assisting the COT Scientific Programme
Committee throughout the conference but will try to attend as many SSOP
sessions as possible.
Dr Judi Edmans
Acute and Emergency Care Lead
judi.edmans@nottingham.ac.uk
Ebby Sigmund
Acute and Emergency Care Lead (alternate)
e.sigmund@nhs.net
Care Homes Clinical Forum
We are still seeking a lead for this Clinical Forum. If you would be willing to stand
for election to lead this forum, please contact Jennifer Beaumont, Secretary by
email Jenniferb223@gmail.com

The information loop
Electronic resources
College of Occupational Therapists’ Library Alert Service 13th May 2010
Title: NICE launches guidance webpage for patients and the public
(01/05/2010)
Link: http://www.nice.org.uk/newsroom/news/GuidanceWebpageForPatientsAn
dPublic.jsp (accessed 13/05/2010)
Homepage: http://www.nice.org.uk
Title: Next steps for complementary therapy (01/05/2010)

Link: http://www.nihr.ac.uk/news/Lists/News/DispForm.aspx?ID=1025
(accessed 13/05/2010)
Homepage: http://www.nihr.ac.uk
Title: Sainsbury Centre guide shows how to put recovery at the centre of
mental health services (27/04/2010)
Link: http://www.scmh.org.uk/news/2010_putting_recovery_at_centre.aspx
(accessed 13/05/2010)
Homepage: http://www.scmh.org.uk
Title: Telephone therapy for depression? Study says yes (10/05/2010)

Link: http://www.mentalhealth.org.uk/information/news/?entryid17=78752
(accessed 13/05/2010)
Homepage: http://www.mentalhealth.org.uk
Title: Genes found for schizophrenia are involved in brain signalling

(10/05/2010)
(accessed 13/05/2010)
Title: UK elderly care costs could soar by £300bn in 20 years (05/05/2010)

Link: http://www.publicfinance.co.uk/news/2010/05/uk-elderly-care-costs-
could-soar/ (accessed 13/05/2010)
Homepage: http://www.publicfinance.co.uk
Title: Why is late-life depression harder to treat? (04/05/2010)
(accessed 13/05/2010)
Title: Occupational physiotherapist: CSP/COT joint position statement

(07/05/2010)
Link: http://www.csp.org.uk/director/members/newsandanalysis/news.cfm?ite
m_id=7320F2F4C7008F50F367939B521A6DF4 (accessed 13/05/2010)
Homepage: http://www.csp.org.uk
Highlight – Occupational therapy news
COLLEGE OF OCCUPATIONAL THERAPISTS 34TH ANNUAL CONFERENCES AND

EXHIBITION
Plus two Specialist Sections’ Annual Conferences: HIV/AIDS, Oncology, Palliative

Care and Older People
22-25 June 2010 Brighton Centre, Brighton, Sussex
Preparing to live longer - Hear how older people care will change as life
expectancy and demands for quality of life increases from Heléna Herklots,
Service Director, and Age Concern and Help the Aged. Supporting family and
carers in palliative care - Explore how the family dynamics changes in a palliative
care context from Professor Sheila Payne, Help the Hospices Chair in Hospice
Studies, Director of the International Observatory on End of Life Care, Lancaster
University. My three wishes for older people care - Dr Finbarr Martin, President
Elect of the British Geriatric Society will outline his vision for older people care
and how OTs can help make his wishes come true. Latest innovation in pressure
management - Find out how pressure-related problems can be addressed with
specialist seating that incorporate pressure relieving materials. Hear also how
pressure mapping system is applied in a clinical setting from Kirton Healthcare
Group. “The conference provided a valuable opportunity to network with
colleagues working in a similar clinical field, to share good practice and ideas for
future developments in my own service." Becky Darnton, Team Lead
Occupational Therapist, Coventry Community Health Services Receive TWO
College publications when you book by 16 April 2010 The Occupational Therapist
and the Court; Upper Limb Prosthetic Rehabilitation; Falls Management; Fatigue
Management for People with Multiple Sclerosis; Occupational Therapy: Law and
Good Practice; Building in Evidence: Reviewing Housing and Occupational
Therapy; The Dr Elizabeth Casson Memorial Lectures 1973-2004.
Link: www.cot.org.uk/annualconferences (date accessed 23/2/10)
Homepage: http://www.baot.org.uk/homepage/
LIFE AFTER STROKE AWARDS (01/10)

Each year, The Stroke Association organises the Life After Stroke Awards to
recognise and celebrate the achievements of stroke survivors and others who
support them. The Excellence in Stroke Care Award recognises exceptional
service in the provision of stroke care and this year will be awarded to an
occupational therapist.
Link: http://bit.ly/cbAVK0
Homepage: http://www.stroke.org.uk/

National executive committee information
COTSS-OP National Executive Committee
Committee Post holder Contact details
Position
Chair Dr Claire Ballinger C.Ballinger@soton.ac.uk
Vice Chair (Acting) Catherina Nolan catherina.nolan@imperial.nhs.uk
Secretary Jennifer Beaumont Jenniferb223@gmail.com
Communications Dr Alison Pighills alison.pighills@bradford.nhs.uk
Officer
Treasurer Jenny Langran langran@ntlworld.com
R&D Officer Dr Avril Avril.Drummond@nottingham.ac.uk
Drummond
Dementia Forum Heather Edwards heatheredwards@nhs.net

Lead Pasna Sallis pasna.sallis@lanarkshire.scot.nhs.uk
Falls Forum Leads Kate Robertson Katerober74@aol.com
Zoe Long zoe.long@nhs.net
Mental Health Sue Rey sue.rey@nht.northants.nhs.uk
Forum Lead Post Vacant
Intermediate Care Val Killala Valerie.Killala@erhtsp.nhs.uk
Forum Lead Cynthia Murphy cynthia.murphy@btinternet.com
Acute / Emergency Dr Judi Edmans judi.edmans@nottingham.ac.uk
Care Forum Lead Ebby Sigmund e.sigmund@nhs.net
Care Homes Post vacant
Network Lead
For Membership and Administration Enquiries please contact: Selvin Ennis
By email: selvin.ennis@cot.co.uk
By telephone: 020 7450 5477
By letter: Specialist Section Membership Administrator
College of Occupational Therapists, 106-114 Borough High Street, London SE1 1LB

www.cot.org.uk/olderpeople
R Registered Office: 106-114 Borough High Street, Southwark, London

E SE 1 1LB
Telephone: 020 7357 6480 Fax: 020 7450 2299 www.cot.org.uk
College of Occupational Therapists Ltd. Reg. in England No. 1347374

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Older People and Occupational Therapy

Taking the lead

CHAIR’S CHAT ......................................................................................... 3

2 SS Older People Newsletter May 2010 Volume 5 Number 2

SS Older People Newsletter May 2010 Volume 5 Number 2 3

4 SS Older People Newsletter May 2010 Volume 5 Number 2

Adaptation by design Ticking all the boxes...

Adaptation by design Ticking all the boxes...

SS Older People Newsletter May 2010 Volume 5 Number 2 5

PLUS TWO Specialist Sections’ Annual Conferences:

SS Older People Newsletter May 2010 Volume 5 Number 2 7

September 2010 Newsletter

• Word format, Verdana font, 11 font size and

If submitting research articles, please include reference to attainment of ethical

Care information for older Scots

8 SS Older People Newsletter May 2010 Volume 5 Number 2

Every-picture tells a story: exploring the lived experience

SS Older People Newsletter May 2010 Volume 5 Number 2 9

Prosser, J. with Schratz. D. (2006). "Photographs within the Sociological

Dignity Campaign 2010

In the summer of 2009, College of Occupational Therapy’s Specialist Section for

The experience of hosting The “Me2” Conference

Should we do something exciting like host a Conference?

SS Older People Newsletter May 2010 Volume 5 Number 2 11

Our conference logo some members of our team

Full House Networking

Rotherham Care Home Liaison Service

SS Older People Newsletter May 2010 Volume 5 Number 2 13

Following on from the Christmas newsletter, two OT students from Brighton

SS Older People Newsletter May 2010 Volume 5 Number 2 15

My name is Phil. I was diagnosed when I was 44 with early

I said to myself, “Do I wave the white flag or fight?”

“It’s a win, with a fifth round K.O.”

My Parkinson’s has been enabling rather than

“IT’S NOT THE END!!!!!!”

SS Older People Newsletter May 2010 Volume 5 Number 2 17

18 SS Older People Newsletter May 2010 Volume 5 Number 2

“We will ensure that people with learning disabilities, including

SS Older People Newsletter May 2010 Volume 5 Number 2 19

College of Occupational Therapy

“People with learning disabilities have the

If a person has an identified need for occupational therapy, unrelated to their

20 SS Older People Newsletter May 2010 Volume 5 Number 2

Trauma and Orthopaedics

SS Older People Newsletter May 2010 Volume 5 Number 2 21

Here are some points that might help you:

22 SS Older People Newsletter May 2010 Volume 5 Number 2

OTs working in Acute Assessment Units

Department of Health Transforming Community Services:

In June 2009 the Department of Health published The Transforming Community

SS Older People Newsletter May 2010 Volume 5 Number 2 25

A&E Evidence Review update!

26 SS Older People Newsletter May 2010 Volume 5 Number 2

I was “required” by my Trust to complete the “Slips and Trips E-learning

SS Older People Newsletter May 2010 Volume 5 Number 2 27

CD review: My dreams of being

Author: Dr. D.J. Nightingale

28 SS Older People Newsletter May 2010 Volume 5 Number 2

Why not join our

SS Older People Newsletter May 2010 Volume 5 Number 2 29

A reminder that we are offering a £1000 research award to support members’

References which might be of interest to members

Forster A, Lambley R & Young JB.