Transcript Community Based Project Bournemouth University and Dorset

Rehabilitation of People with
Acquired Brain Injury
Bournemouth University, Headway,
Dorset & Dorset Healthcare NHS
Foundation Trust .
ENOTHE CORK
October 2007
Greetings from
Bournemouth!
Melissa Forsyth
Theresa Weston
Where is
Bournemouth?
Presentation Outline
•
Introductions
•
Target group
•
Acquired brain injury
•
Current service providers
•
Introduction to initial project
•
Summary of project outcomes July 07
•
What is an expert patient?
•
Content of generic expert patient programmes
•
Revised planned project outcome
•
Relevance to OT
•
Three key tasks
•
References
Target Group
•Improved post-accident care, has resulted in an increased number of
survivors with Acquired Brain Injury (Headway ca2006)
•“The majority of health, social and employment services have not yet
adapted to meet the rehabilitation needs of people with ‘hidden’
cognitive disabilities” (Headway ca2006)
•Potentially individuals within this client group are at risk from
occupational deprivation as their complex needs are not being met
•A need was identified in collaboration with our partner agency – Dorset
Healthcare NHS Foundation Trust
Acquired
Brain Injury
What is an acquired brain injury?
• An injury to the brain which has occurred since birth (Turner et al, 2002).
• traumatic or non-traumatic ( tumours, infectious disease, toxins.)
What does it mean to have ABI?
•Visual difficulties and fatigue are persistent often five years after the
accident
•Cognitive, behavioural and emotional difficulties persist
•32% of those working at 2 years were not working at 5 years post
accident.
(Olver 1998).
Current Service Providers
Headway Dorset: Voluntary charitable organisation
Established 1993 by carers of people with acquired brain injury
(Headway 2006)
Dorset Healthcare Trust Community Brain Injury Service:
Multi-disciplinary Team, Occupational Therapists, Physiotherapists,
Psychologists, Consultant
Dorset Healthcare Trust Vocational Rehabilitation Service: Aims to
assist people to recover existing skills, learn new skills, enable people
to live satisfying and purposeful lives in the community. May involve
paid employment or voluntary work. 30% of clients have a brain injury
Introduction to Initial
Project
•The project was established in 2006 and the proposal presented at the
Ankara ENOTHE conference.
•To deepen knowledge of community facilities that the individuals wished
to access along with other complementary healthcare.
• It consisted of three threads:
•It aimed to establish if the expert patient programme was suitable
for this particular client group.
•To research whether a book prescription service would be a viable
venture.
•Investigate potential for access to leisure activity.
•Progress was recorded, presented at the end of the year and a report
sent to ENOTHE.
Project Outcomes
July 2007
•Information on the book prescription service and a database format for
accessing community facilities was completed within the academic year
and handed over to our partner agency – Dorset Healthcare NHS Trust.
• In the case of the Expert Patient Scheme possible scope for further
development had already been recognized and continued support was
requested by Headway Dorset. This will be achieved through
continuation of the project in regard to the Expert Patient Scheme
into 2007-8
BUDGET:
This project is based on time and involvement resources as opposed to
financial
What is an Expert Patient?
• Expert patients are people living with a longterm health condition, who are able to take more
control over their health by understanding and
managing their conditions, leading to an
improved quality of life.
• Expert patient programmes at present are
generic and take place over 2 1/2 hours per
week for six weeks and are led by people who,
themselves, live with a long-term health
condition.
Content of the Generic Expert
Patient Programme
People learn a variety of relevant skills, which include:
• Setting goals.
• Writing an action plan.
• Problem solving skills.
• Fitness and exercise.
• Better breathing (participants are taught diaphragmatic
breathing).
• Fatigue management.
• Healthy eating.
• Relaxation skills.
• Communication with family.
• Working better with health care professionals, including
communicating better with them.
• Making better use of medications.
Revised Planned Project Outcomes
•Identify if there are any expert patient schemes operating for people
with traumatic brain injury and if this could be replicated in Dorset
•Locate other expert schemes in our geographical area
•Gather information on how to set up an expert patient scheme
•Make an action plan for setting up a scheme
•Present to the stake holders
Relevance to Occupational
Therapy
We are aiming to work towards a just society and
reduce the risk of occupational deprivation this will
be achieved through :
1. Empowering the individual
2. Providing choice and opportunity for involvement
and social inclusion
3. To enable occupational rights and equality.
As OTs, we are well placed to offer support, help and
education on the 3 key tasks identified in the expert
patient leader manual.
THE 3 KEY TASKS
• Managing the illness
• Taking medications
• Changing diet and exercise
• Managing symptoms of pain, fatigue, insomnia,
shortness of breath, etc.
• Making best use of health care available
• Managing daily activities and roles
• Maintaining roles as spouse, parent, employment, etc.
• Managing the emotional changes
• Managing anger, fear, depression, anxiety, etc.
The Expert Patients Program Leaders Manual
“Occupation is seen as a
human right and occupational
deprivation as a violation of
human rights”
(COT 2006)
THANK YOU FOR LISTENING
ARE THERE ANY QUESTIONS?
References and Further
Reading (1)
COLLEGE OF OCCUPATIONAL THERAPISTS, 2006. Statement on the
relationship between occupation, mental health and well being [online].
COT, London. Available from:
http://www.cot.org.uk/newpublic/practice/pdf/vision-statement.pdf
[Accessed 4 October 2006].
OLVER, J. H., 1996. Outcome following traumatic brain injury: a
comparison between 2 and 5 years after injury. Brain Injury [online].
Volume 10 (11). Available from:
http://ejournals.ebsco.com/direct.asp?ArticleID=XR7UQRJFX9FUHY3N
99GG [Accessed 4 October 2006].
References and
resources(2)
• BRAKE, ca2006. Injuries from crashes [online]. Brake,
Huddersfield. Available from:
http://www.brake.org.uk/index.php?p=597 [Accessed 4 October
2006].
• DEPARTMENT OF WORK AND PENSIONS, 2006. Pathways to
work: qualitative research on the Condition Management
Programme [online]. London, DWP. Available from:
www.dwp.gov.uk [Accessed 04/10/06]
• DORSET HEALTHCARE NHS TRUST, 2006. Community Brain
Injury Team [online]. Dorset, Dorset Healthcare NHS Trust.
Available from:
http://www.dorsethealthcare.nhs.uk/Default.aspx?tabid=154
[Accessed 4 October 2006].
References and Further
Reading (3)
HEADWAY ESSEX, ca2006. Brain injury statistics [online]. Essex,
Headway. Available from:
http://www.headwayessex.org.uk/facts/statistics.html [Accessed 4
October 2006].
HEADWAY
NATIONAL HEALTH SERVICE, 2003. Expert Patient Programme [online].
http://www.expertpatients.nhs.uk/what.shtml [Accessed 04/10/06].
Expert Patients Programme. Available from:
http://www.expertpatients.co.uk/public/default.aspx [Accessed 3 October
2007]
References and Further
Reading (4)
WHITEFORD, G., 2004. When people cannot participate: Occupational
Deprivation. In: C. CHRISTIANSEN & E. TOWNSEND (eds).
Introduction to Occupation: the art and science of living. New Jersey,
Prentice Hall, 221-242.
TURNER A., FOSTER M., JOHNSON, SE., 2002. Occupational Therapy
and physical dysfunction. Edinburgh. Churchill Livingston.