With occupational therapy you CAN… by Wendy Chambers

If I had a penny for each time during my career someone asked me “what is occupational therapy?” I wouldn’t need to be playing the lottery this weekend!

Next week is national occupational therapy week, November 7 – 13^th2016, #OTweek16 for those Tweeters out there.

So prior to its launch on Monday I’m offering you the opportunity to have an insight into this lesser understood, enigmatic profession. So pour yourself a contemplative cuppa and have a read.

Occupational therapy is a science degree-based health and social care profession, regulated by the Health Care Professions Council. It is one of the ten allied health professions. You can train to either degree or masters level, at any of three universities across Scotland.

Occupational therapy takes a whole-person approach to both mental and physical health and wellbeing, enabling individuals to achieve their full potential.

We work with children and adults across a variety of settings including health organizations, social care services, housing, education, re-employment schemes, occupational health, prisons, and voluntary organizations or as independent practitioners.

So what does that mean, what do occupational therapists actually do?

Well, as occupational therapists we think about “occupation” as any activity any of us does day to day, which is important, necessary or which we enjoy.

The range of “occupation” is endless. If I use myself as an example some of my daily “occupations” would be putting on my clothes in the morning, reading my emails at work, making a meal for my family, riding my bicycle.

The occupational therapists job is to consider how, if I was the service user, the changes in my mental or physical health are making it difficult for me to be able to do these “occupations”- the things I want or need to do day to day.

They need to understand what’s important to me in my life? What would allow me to stay in control and live my life my way?

Occupational therapists are adaptors; maybe that chameleon like ability is why people are often unsure what it is we do?

So for example in order to help me to keep riding my bike after an episode of depression the occupational therapist will problem solve and adapt either:

–the activity itself: maybe I should try going out for 10minutes, twice a week, with a close friend who also bikes, somewhere that’s easy to access and doesn’t take long to get there, with a nice coffee shop on the way back

–the surrounding environment and tools I use: maybe a tarmac cycle route would be easier, at a quiet time of day, and my bike could do with a service first so it’s working properly (they help me think through planning and organizing that)

–me: set SMART goals which I can achieve, to keep me motivated, help me think about what I value about biking and help me understand and make the link between doing an activity I enjoy and feeling better about and improving my mental health

So back to that question again “what do occupational therapists do?”

I guess the bottom line is it ends up looking different each time, as we are all different as people and what’s  an important “occupation” to me may not be important to you.

And we work in so many different settings, with different age groups of people, that that also makes what we “do” look different.

Ultimately it isn’t what the occupational therapist “does” that matters, rather what the person ends up being able to do that’s important.

So for occupational therapy week this year I’ll leave you with this thought,

“With occupational therapy you CAN….”

Wendy Chambers is Team Lead Occupational Therapist for Mental Health and Learning Disability Service at NHS Dumfries and Galloway

 

All Men (& Women) are created equal? by @lynseyfitzy

Since taking up the post of Equality Lead at the end of October 2012, I’ve heard various comments such as “What does THAT involve?” and “Surely that’s a made up job?”.  If only.  If only it wasn’t the case in Scotland that only 0.3% of apprenticeships go to people with a disability or that women are paid 14% less than men in full time work.  But possibly the worst comment I have heard so far is “people need to have a sense of humour about some things”.  I’m sure those people that have suffered discrimination would be delighted to hear that all this could be resolved if they simply lightened up and learned to laugh about it….

With the ongoing work around person-centred care and  patient experience, equality and diversity couldn’t be more relevant, after all, each and every one of us has at least one ‘protected characteristic’ and we are all at risk of being discriminated against at one point in our lives.  Most of us will at some point have to engage with health services and I’m sure that none of us would like to be treated less favourably because of one of our protected characteristics.

After attending the Patient Experience event in September 2013, where I couldn’t help but think that equality and diversity is at the heart of so much of this work, I came across the following articles by columnist Ian Birrell who has a disabled daughter and writes passionately about discrimination. He cites an example of a patient with Downs Syndrome being made “not for resuscitation” without any discussion with loved ones as it was just assumed by medical staff that his life held no quality. He also quotes some frightening statistics about disabled patients being left to die as it was considered “the kind thing to do” by medical staff. Two of his articles can be read here and here.

It would be easy to think that we work in a place where discrimination like this doesn’t exist, and I often hear the words “I treat everyone the same” as if this excuses someone from needing any further training or development on equality issues.  One thing which is clear though is that treating everyone the same or basing decisions on our personal assumptions is not equality and, as these articles highlight, can be dangerous.  People (staff and services users) should be treated as individuals, with a range of different needs.  Some of the complaints which I have been involved in since October 2012 could easily have been avoided if those involved had taken the time to consider the needs of the individual rather than a ‘one size fits all’ response.

At the recent Big Burns Supper event held in Dumfries, I had the wonderful opportunity to see a one man show called “If These Spasms Could Speak” which was about the way in which disabled people experience the world and how they feel about their bodies.  The show is by Robert Gale, a disabled actor, and had rave reviews when it was shown at the Edinburgh festival (There are clips on You Tube for anyone that might be interested in finding out more, one of which can be viewed here).  Despite the spasms which are probably the first thing people notice, and are so very aware of, the first thing that Robert sees when he looks in the mirror is a “cute face” despite the attitudes of others to his own physicality.  However, one of the funniest, yet probably most worrying parts of the show is when he describes visiting his brother in hospital and a young doctor proceeds to ask him personal inappropriate questions, assuming that he “must be somebody’s patient”.  This highlighted the way in which non-disabled people often view those with disabilities, in this case Robert’s own cerebral palsy and speech impediment.

Not only is it good practice to consider equality from a moral viewpoint, but by law we have had to become more pro-active about eliminating discrimination, advancing equality of opportunity and fostering good relations.  One of the ways in which NHS Dumfries and Galloway have done this is to come up with a set of equality outcomes, which you can read more about here.  We are also in the process of reviewing our equality impact assessment policy and toolkit, again something which is required to be completed by law but something which is often seen as something which is a bit of a nuisance.   If the fear of being personally fined if there was ever a claim against us isn’t enough, then think of it this way.  You have gone to all the bother of writing a policy/coming up with a strategy/started the process of service change (delete as appropriate).  Surely it makes sense to ensure that you have considered and consulted as many different people and groups of people as possible.  This can only improve your service or your policy and make it better than it already is, and may save you having to go back and make changes at a later date.

This is not to say that there isn’t already lot of good work being done out there.  For example, we have several areas within our Board currently undertaking the LGBT Charter Mark.  As an employer we are signed up to the disability two ticks symbol and each of our directorates have developed their own action plans on how equality and diversity can be mainstreamed into day to day business.  There is a lot of good work being done out there and a lot of our staff willing to consider people as individuals with a range of needs and requirements which they are more than willing to try and accommodate.

But, for the time being anyway, it looks like I do have a ‘real’ job as equality and diversity is no laughing matter….

Lynsey Fitzpatrick is Equality and Diversity Lead for NHS Dumfries and Galloway