Transcript EDEN UNIT - NHS Grampian

THE EDEN UNIT
GUIDE FOR PATIENTS
& THEIR FAMILIES & FRIENDS
The Eden Unit, Block C Clerkseat Building,
Royal Cornhill Hospital, Cornhill Road,
Aberdeen AB25 2ZH
Using this Folder
We want you to feel welcome here and we
know it takes a while to get used to the way
things are done. Eden Unit Patients asked for
this information pack, and have been lead
authors and editors in its production. We are
indebted to Amanda Brooks who produced
the first draft in consultation with her peers in
May 2010. Many other patients, carers and
staff members have contributed to each draft,
and the aim is to continue to update the folder
with each new development.
We don’t want you to feel overwhelmed - please don’t feel you have to read all
of this folder on the first day or indeed ever.
Some people keep the information for reference and others like to consult it to
get an idea of expectations, guidelines and attitudes to treatment. Let us know
if you notice any inaccuracies or omissions. We are always open to
improvements and welcome creative suggestions.
CONTENTS
Eden Unit – history and geography
 What happens when you are first admitted?
 Your rights and responsibilities as a patient here
 The dining room and afterwards
 Confidentiality
 Who’s who?
 Our Weekly Timetable
 Treatment for patients with weight-losing disorders
 Arrangements for discharge
 Day Programme
 Further work of the Eden Unit – research, publicity, education
 The
The Eden Unit
– history and geography
For many years Scottish patients suffering from severe eating disorders had to
go to England, at great expense and with the added hardship of being treated far
from home and often the transition back home led to relapse because of lack of
continuity.. Even when private facilities opened in the South of Scotland there
were similar problems
In 2005 Grampian, Highland &Tayside set up the North of Scotland Managed
Clinical Network for Eating Disorders. The work of this group and its Lead
Clinician, Dr Harry Millar, resulted in the decision, in 2006, to open our 10
bedded inpatient unit and its associated Day Programme.
On 25th May 2009,we had our official opening by Sheila Robison,
Minister for Health and Sport.
The Eden Unit
– history and geography
The Unit is hosted by NHS Grampian and situated
in the Royal Cornhill Hospital in Aberdeen. We take
referrals not only locally from Aberdeen and wider
Grampian but also from Tayside, Highland, Orkney,
Shetland and the Western Isles.
We have close links with specialist outpatient eating
disorder services and general adult mental health
services in all of our partner areas. In addition we
enjoy a close relationship with Dr Alastair McKinlay
and colleagues in the specialist Gastrointestinal
services at Aberdeen Royal Infirmary.
What happens when you are first admitted?
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When you first arrive you will have a physical and psychological examination
from the admitting doctor and nurses – if they have serious concerns about
your medical state you may be temporarily treated in Dr McKinlay’s ward at
the Infirmary to make sure it is safe for you to start the Eden programme of
treatment
You will be allocated a key nurse who will take a special interest in your care
and will ask about your medical and personal history as well as asking you to
complete some assessment questionnaires. The whole nursing team will be
looking after you, but the key nurse leads the development of your care plan
When you first join us
You will have your own bedspace – and if possible your own
room, at least in the early part of your admission. There also
is a dorm of four beds, each with curtains . It is not possible to
guarantee that you will occupy the same bed for the whole of
your stay – this is a hospital rather than a hotel! – and staff
may not always be able to give as much warning as they
would like before asking people to move. Please do try to be
understanding about this.
Voluntary patients are of course free to come and go as they
wish – the door is locked to keep patients safe from theft or
inappropriate visiting. It is also helpful for staff to have to
open the door for people so that they are aware of who is out
and who is in the Unit.
When you first join us
Some of your biggest anxieties will be about the dining room and about ‘the
rules’. So the next page is an attempt to explain what the hospital expects and
what the Eden Unit prescribes as the best treatment for its patients.
We try to be as flexible as possible in making treatment an individual matter
for each patient – this means that you may be asked to do, or not do, things
that do not apply to other patients. It may seem ‘unfair’ – it may even BE
unfair. But we believe it would be wrong to make everyone follow the same
treatment plan if they have different needs or find themselves at a different
stage of treatment.
All the same there are certain matters which have been laid down as essential
by the Hospital Management or other authorities to protect all of us - staff
and patients - who live and work here.
YOUR RESPONSIBILITIES IN THE EDEN UNIT
You are expected to make reasonable efforts to take part in the unit programme and
work with staff on treatment. Ambivalence is part of the disorder, but we ask you to
open your mind to the experiment of recovery whilst you are a patient here.
Violent, abusive or destructive behaviour is unacceptable and is treated seriously.
Being a resident of the Inpatient Unit does not protect against the involvement of
Police when necessary (in cases of violence or stealing, for instance). We do of
course attempt to assess to what extent people were behaving badly under the
influence of illness.
The use or possession of non-prescribed drugs, solvents and alcohol is not allowed.
Patients must not return to the Unit under the influence of any intoxicating
substance. In an eating disorders service, items of food and drink are regarded as
‘medicines’ which are prescribed for patients. Individuals should not keep supplies .
Smoking is discouraged and is not allowed inside the hospital building. We accept
that this is too stressful a time to ask someone to give up smoking. So patients may
smoke in designated places (outdoors from the Unit) at times permitted by staff. We
are delighted to provide help and support if you do chose to give up smoking.
There is no sexual contact between people in the Unit.
We expect staff and patients to respect each other. Racist, sexist, or ‘size-ist’ bullying
and intimidation are unacceptable and will be taken very seriously.
Confidentiality must be maintained - we particularly ask patients and their families
not to make public any information which was entrusted to you by fellow patients
or their families. You must not take any photographs of staff or patients.
FINDING YOUR WAY AROUND
On the ward there are two lounges - the larger lounge is used for supervision and many of the
groups whilst the smaller one is a cosy sitting room for more informal use. There are freeview
televisions with dvd players in all bedrooms and in each lounge and also a Playstation and in the
big lounge.
The tables adjacent to the main lounge can be used with the sewing machine and arts and craft
supplies. There is also an array of DVDs and board games. There are two computers in the
smaller lounge but you will need your own ‘dongle’ to use internet.
The hospital asks you not to bring in blankets or duvets from home but to use what they supply –
this is because of fire safety regulations.
There are laundry facilities in Eden’s ‘Sluice Room’: washing machine, tumble dryer, clothes’
airers, iron and ironing board. You are requested to provide your own washing powder – but just
ask if you don’t have any.
Beyond the Unit, up by the Clerkseat Entrance to the Hospital, there is a visitors’ canteen and
voluntary-run newsagents shop which also sells a few toiletries. Opening hours are 10-4 on
weekdays and 2-4 at weekends for shop. At weekends visitors may use the Staff Canteen (just
down the same corridor) since the Visitors’ canteen is shut. Visitors can also use staff canteen
2.30-5pm on weekdays.
There is a visitor’s overnight stay room that can be booked through nursing staff for £5 if available.
The Hospital has a side entrance at Berryden Road which is most convenient for the Unit, especially
when shopping, but this and the door from the Corridor close at 9pm sharp every night and people
must then use the main entrance from Cornhill Road and main door at the Clerkseat Building.
Around the Cornhill/Berryden area There is a Sainsbury’s, Next, Mothercare, Toys’r’us, JJB Sport, Argos, PC World, post office and
other shops right by side entrance to Royal Cornhill Hospital and walking distance to
Rosemount Place and Rosemout Viaduct where smaller shops, hairdressers and cafes are.
It is a 15-20 minute walk to Union Street and shopping centres.
 Travelling by bus
Regular buses run from by hospital and a short bus ride will take you to newest shopping centre,
Union Square, where the main Guild Street bus station and railway station are found.
Buses that serve Aberdeen city centre to Royal Cornhill Hospital are numbers 5, 10, 12 and 59.
 Travelling by car
Free parking is available in the grounds of the hospital but spaces are limited and you may have
to park a short distance from the Unit. There are Pay and display regulations in force on
neighbouring streets.
There are also a number of taxis available at taxi stances in the city centre or companies to
telephone. There is a free-phone taxi telephone available at the main reception of hospital.
More information on nearby facilities can be given by staff.
(please insert maps – plan of RCH and google map of local area)
Looking after your property
Cornhill Hospital’s policy is that personal property is brought in at the owner’s risk, so it would be
unwise to bring items of high or sentimental value into the Unit. If you do bring things that are
valuable, fragile or not permitted in your room, you may prefer to hand these to staff for
safekeeping. Handbags, diaries and so on should not be left lying around even though obviously
we hope most people will be trustworthy and respectful of all property, both private and that of the
Hospital.
You will not need too many changes of clothing – dress is fairly informal and there is a laundry
room for patients’ use.
We ask that neither patients nor their visitors bring in any of the following:
-Drugs, alcohol, food, and drink, sweets, laxatives, chewing gum
Any items that people may use to hurt themselves should be handed in to staff who can them let
you have them back for appropriate use. These would include:
-Razor blades, knives, scissors, tweezers, mirrors and other glass objects, matches and lighters.
If you bring in personal electrical items, e.g. Hairdryers and mobile phone chargers, these may need
to be checked by hospital electrician prior to use.
Don’t forget to collect your belongings when you leave the ward again!
THE DAILY ROUTINE ON EDEN
The day starts with breakfast – unless you are weighed that day. Most people will be weighed 3
times a week or even more often at first. Sometimes staff will ask you to be weighed
unexpectedly, because anorexia can make people ‘fake’ their weight. We ask you not to have
anything to eat or drink on the morning you expect to be weighed, but to go to the treatment
room in pyjamas. You are asked you to empty your bladder and you may be asked to provide a
urine sample too. This can be checked for signs of infection or other problems, and can also
be used to assess whether you are under- or over-hydrated. First thing in the morning we
would expect most people to have concentrated urine, and if this is not the case then it’s likely
that your weight is an over-estimate of the true value.
Of course, you may also have medication dispensed first thing too.
Breakfast is at 8am . It is courteous to wear day clothes – dress is casual but you are expected to
wear clothes that express consideration of other people’s feelings and that are appropriate to
the time of year and temperature. Patients are expected to be punctual for all meals and
snacks..
Most of the rest of the day’s events are described in the account of ‘eating for recovery’ or in the
weekly timetable. Do ask staff to explain anything we have not made clear.
Our Weekly Timetable
Each week the day starts with a 15 minute community
meeting except on Tuesdays when the Staff meet for
the morning Ward Round at which patients’ care is
reviewed and developed. Patients themselves
prepare a report for the staff to consider, and
feedback is provided the next day (Wednesday)
The rest of the week is structured by a series of
meetings and groups between meal and snack times,
and by the increasing number of individual
appointments that will be provided for you as you
become able to engage in therapy. We enclose a copy
of the current timetable – this changes from month
to month in accordance with the needs of the patient
group and the availability of different opportunities.
Weekends are quieter times on the ward, but still
involve the hard work of tolerating renutrition and
rest and their physical and psychological sideeffects. They are also opportunities to practise reengaging in interpersonal contacts and relationships
without using eating disordered ways of coping with
the stresses involved.
Eating for Recovery
Everyone eats three meals and three small snacks each day in the Dining Room.
WHAT DO WE EAT? Tina, the dietician, prescribes what you are to eat. Nursing staff
decide on the portion size and serve it to you. Your job is to eat all of what you are given.
HOW DO WE EAT IT? Most patients need guidance to learn the etiquette expected in the
dining room. This is unlikely to be what you have been used to at home. It is not the only
way for healthy people to eat, but we use this approach because it is a way you can learn how
to eat healthily again.
Some members of staff ask you to do things differently from others, and you may also notice
that not all patients are expected to follow the same guidance. Patients will be at different
stages of recovery and not all will have the same difficulties. It’s not helpful to compare
yourself with others but to accept staff guidance. On the other hand, if you are asked to do
something that mystifies you (for instance not to wear loose sleeves or scarves) it may be that
staff are taking precautions against behaviours that have undermined other people’s recovery –
please cooperate rather than quibble!
WHAT HELPS? Of course many people are terribly anxious and sometimes this takes the
form of anger and stubbornness. Part of recovery involves trying to make the atmosphere as
pleasant and ‘normal’ as possible, however hard this may feel. You are asked to save
complaints or questions about the food or portions until you are alone with a member of staff,
not to raise these at the table. We make conversation about intersting things - not about food,
diets , weight or appearance.
The thinking behind the way we eat
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Tina, our dietician, will explain more about this
– but in essence the aims of the eating programme are:
To make eating as manageable as possible rather than frightening.
To gradually set you free from the physical and psychological effects of starvation
To help you cope with the physical and psychological effects of refeeding
To help you to establish a regular eating pattern and eat a healthy variety of foods so
that you get the best health benefits from a slim body.
To accustom you to healthy new eating habits that you follow regardless of the way you
feel or what is going on around you
To support you to take back the responsibility for caring for yourself, including feeding
yourself , digesting what you have eaten, and resting your body.
Vitamin and mineral supplements are prescribed to restore deficiencies and prevent imbalances .
Your meal plans need to be gradually increased as your body functions better, speeds up the rate
of metabolism and repairs the damage done by starvation. At first your weight may oscillate a
lot, then it is likely that you will gain an average of 0.5 to 1.0kg per week, usually a little faster at
start, then slowing down as you body begins to work normally.
Much of what the public hears about a ‘healthy’ diet is what is aimed at an increasingly
overweight population. We are not taught about the importance of fats, for instance, because
most people eat too much of such food, but they are essential to good health.
Whilst your brain and heart, in particular, recover from starvation, it’s as important as when you
were a growing child to take in food rich in phosphate, such a milk.
WHAT HAPPENS IF WE ARE TOO ILL TO EAT ENOUGH?
All of us have to eat – human beings, like other animals, don’t have any
choice in the matter if they are to live. The only choices we do have are about
how and what we eat, and how much is enough. People with severe eating
disorders become too anxious to make these choices wisely and need to be
guided by experts to master the fear and learn new eating skills. The staff on
the Eden Unit have experience & skills to help you eat as normally and
healthily as possible.
Very occasionally people don’t manage to eat enough of the food on their plan
so will be prescribed a nutritional drink instead (usually ‘Fortisip’ or
equivalent). More rarely still, patients cannot manage to take in what is
prescribed at all and then, after careful discussions between staff and with the
Scottish Mental Welfare Commission, people may need to be fed by means of
a soft plastic tube. Sometimes this is also used to start the refeeding process
where a person is so fragile that a normal diet could be physically dangerous.
Coping after mealtimes
It is rather misleading to talk about ‘eating’ disorders, since most patients
struggle not only to eat but also to allow the nutrients to stay in their
body. For many people there is terrible discomfort leading to urges to
be sick or to ‘burn off calories’ which leads people to purge or engage
in obsessive physical activity, usually in secret.
We therefore ask people to stay together in the sitting room for a period of
about half an hour after each meal, for a period of ‘supervision’. This
is of course a time of tension and anxiety for many people, and it is
helpful if you can discuss with the group and with the supervising
nurses how best to create a supportive atmosphere. Some people
manage best by playing board games or cards, whilst others like to
read, watch TV, knit or sew, or converse quietly. Please do be open
minded about other people’s ways of coping and experiment with
different ways to distract yourself.
For patients who struggle particularly with compulsions to purge or
overexercise, or who are so starved that they are in danger of losing
control of their appetite, there may be extra supervision arrangements
involving accompanying patients even in bathrooms or at periods other
than after mealtimes. These will be carried out with maximum dignity
and compassion.
VISITORS
Visiting times are 7-8.55pm during the week and 2 – 3.15, 3.30 – 4.55 and 7 – 8.55pm
at weekends.. At other times visiting may be arranged with special agreement of the
staff team, particularly if visitors have long distances to travel or work shifts. During
normal ‘working’ hours patients have to concentrate on groups, activities and therapy
so we ask visitors to respect the ward timetable. Obviously you need not receive a
visitor unless you want to be visited!
Sometimes it’s not helpful for patients if there are too many visitors on the Unit - they
may feel terribly exposed when they don’t feel well. Occasionally patients become
distressed or confused and when they are well again feel embarrassed to think they
had been visited by any people except the very closest. Patients may entertain visitors
in their own rooms or in the shared spaces, but should always respect other people’s
peace and privacy.
Friends, family and other carers deserve some rest and respite from caring. Children –
particularly young ones – may be upset to see their relative so ill, and may be
frightened by the hospital or resentful of the time taken up by the illness. We can
arrange a
meeting to explain things to them if you feel this would be helpful
Confidentiality
Please check out your expectations of confidentiality and privacy with staff
members. The members of the team treating you do not make private
information about you available to the public without your express
permission. Indeed your medical records are only released if there is a ‘sub
poena’ by a court of law. The staff team do share information with each other
– and to some extent with your GP and outpatient staff – in order to maintain
helpful communication. The balance between good and important
communication on one side and privacy and confidentiality on the other is
extremely difficult and sensitive.
On the other hand , family, friends and other carers do not have an automatic
right to have information about you without your permission. People who
care for you do have a right to general information about the disorder from
which you have been diagnosed to suffer. They may also be provided with
information needed to care for you when on pass. They do not have
automatic rights to staff confidentiality. Staff don’t pass on sensitive personal
material unless they believe this is crucial, but in general they assume that
communication from relatives can be made known to the patient involved.
Going on pass
Once people are well enough to safely go for walks in the hospital grounds or beyond, we
negotiate this together. We do need to know at all times where the patient is, and who is with
them. We may insist that patients go out only with nurses, or with family, and we often ask
them to stay indoors when it is dark or cold . We have to bear in mind that we are part of a
Psychiatric Hospital, where other people may at times inadvertently pose a risk of infection
to underweight patients . We often offer drives or outings in wheelchairs to provide fresh air
and a change of scene.
Weekend or indeed any other ‘home pass’ is not supposed to be simply a ‘break’ from
treatment! In fact it is likely to be very hard work for everyone involved. The aim is to see
whether the treatment set up in the Unit can continue at home. For instance, prescribed
medication should be taken, food and exercise plans followed, and planned behaviours
practised. Patients are expected to refrain from using alcohol, cannabis and other substances
during pass, just as on the Unit. Much as you want to be back in the normal world, it is
important to remember that unprepared passes can set back the treatment badly. Please help
us all to plan and practice the work with you.
Who’s who in Eden?
Consultant Psychiatrist
Dr Jane Morris
Trained in both Adult Medical
Psychotherapy and Child &
Adolescent Psychiatry, she is
Chair of the Scottish Eating
Disorders Eating Disorders
Interest Group, and leads a
Research Group adopted by the
Scottish Mental Health Research
Network. She has published
papers and books in the fields of
Eating Disorders and
Psychotherapies
Medical Doctor
Dr Lesley Pillans
(insert photo and short bio)
Consultant Physician
Dr Alastair McKinlay
Ward Manager
Pauline Milne
(insert photo and short bio)
Deputy Ward Manager
Lindsey Money
(insert photo and short bio)
Who’s who in Eden?
Dietitian
Tina McGilton
Art Therapist
Leslie Spillman
Occupational Therapist
Shona McCulloch
Cognitive Behavioural Therapist
Jan Templeton
Physiotherapist
Sandra Philip-Rafferty
Pharmacist
Who’s who in Eden?
Secretarial/Admin Staff
Wendy Pawlik and
Rona Walker
worked in the field of
Eating Disorders even
before the Eden Unit
opened and have worked
here from its inception.
Rona is also administrator
for the EEATS organisation
Chaplains
The Rev Muriel Knox and the
Rev Jim Simpson lead the
non-denominational
Chaplaincy neighbouring the
Eden Unit in the prefabricated
building
Ward Cleaner
Sangit leads the cleaning of
our Unit
At present we have vacancies for
a Social Worker and for a
Psychotherapist
The Nursing Team
The Eden Unit is staffed by both formally trained nurses and by nursing assistants who, though
they may not have a Nursing Degree, will have undertaken specialist Eating Disorders Training and
in some cases other paramedical skills, such as phlebotomy (taking blood samples). The team is
led by our two most senior nurses, Ward Manager Pauline Milne and her Deputy Lynsey Money.
Our most experienced Staff Nurses are frequently entrusted with the role of Mentor to the Student
Nurses who undertake work placements on our Unit. The teaching and learning roles allow our
whole Team to engage in the continuing learning process that maintains the quality of the service
we offer and often provides creative advances in the treatment of anorexia and related disorders.
At times of intensive demand on the nursing team our regular staff may be joined by members of
Cornhill Hospital’s Nurse Bank. These nurses may not have training specific to the care of people
with eating disorders and are guided by our permanent staff.
TRAINED NURSES:
NURSING ASSISTANTS:
Angie Milne – Day Programme Nurse
(insert photo)
Rose Amos (insert photo)
Donna Campbell (insert photo)
Bernadette Laidlaw (insert photo)
Jacqui Holmes (insert photo)
Debbie MacDonald (insert photo)
Christine Leonard (insert photo)
Claire McFarlane (insert photo)
Emma Riley (insert photo)
Elaine Ross (insert photo)
Kerry Robson (insert photo)
Emma Stephens (insert photo)
Jenny Swankie (insert photo)
Dawn Watt (insert photo)
Irene Thomson
Kerri-Lee Watt
The Key Worker Role
Your individual care will be entrusted to a Key Worker identified from among the
trained nurses. Your key worker takes a leading role in discussing, planning,
implementing and monitoring your individual care plan. This may involve looking at
past experiences to learn from which solutions and skills have worked well, which
have not so far helped you and which may not have yet been tried.
The Key worker may also act as your particular advocate with the team, for instance at
Ward Rounds and other meetings, and will encourage you to complete questionnaires
and assessments. However, you are encouraged to work with several different
members of staff – it is not the case that you must put your entire trust in this one
member of staff! When your own Key Worker is not on shift it is important to identify
someone else who can take time to catch up with your progress and feelings
Treatments for weight-losing disorders
Members of the Eden and Aberdeen Eating Disorders teams were part of the group which
met in 2006 to review the 2004 NICE Guideline on Eating Disorders, to update the
evidence base and make recommendations specific to the Scottish context. These
were published by QIS (Quality Improvement Scotland) and form the basis for
treatment here.
We are guided by evidence from other Eating Disorders and Medical Units to keep people
alive and healthy in terms of warmth, rest, body chemistry, protection from infection
and other aspects of health planning, and use dietetic expertise to inform nutrition.
Unfortunately, there is very little research evidence for management of severe low weight
anorexia nervosa and of complicated disorders. The best available evidence suggests
positive results for the use of the drug Olanzapine. Younger patients and those living
at home also benefit from Family treatments. The Eden Unit therefore offers these
whenever possible but also returns to first principles in using individual
‘formulations’ to map out personalised care plans for each patient.
‘Formulation’ is a way of integrating the physical, emotional and psychosocial
interactions of people’s strengths and vulnerabilities into a design for working
towards recovery. Our multi-disciplinary team uses the 24/7 inpatient experience to
build up a picture of each patient. We also incorporate the information provided by
each patient, by families, and the results of questionnaires.
Finally, we are proud to be part of several research initiatives exploring and developing
best practice, and hope you will be interested in participating if invited.
Working with families and other carers
Family work is the most strongly evidenced treatment for Anorexia nervosa. We therefore
include relatives and carers wherever possible.
For many patients this will mean parents or partners are asked to take over the same sort of
responsibilities at home as taken by the staff team here in the hospital. This is of course
MUCH harder to do if you are emotionally involved with the patient and if you have already
built up expectations of the way the relationship works. For patients, accepting a change in
the relationship to help with earlier discharge home is an important part of progress.
It’s also important to acknowledge that several studies have shown that the burden of stress
involved in living with someone with anorexia nervosa is even greater than living with
someone suffering from the most severe mental illnesses such as schizophrenia. It is helpful
for carers to learn skills to deal with the extreme tension and often aggression that the illness
can cause unless it ‘gets its own way’.
The NEEDS groups are self-help monthly meetings for both patients and carers which we would
encourage carers of our patients to attend. Staff can let you know of the dates, and the
meetings are held just around the corner, in the Fulton Clinic.
What are the treatments offered?
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Patients are given an individual dietary plan prescribed by the dietitian, and will be
offered nutritional supplements such as vitamins and minerals to repair deficiencies.
The physiotherapist offers programmes for the appropriate levels of physical activity
for each patient’s physical and psychological needs
Medical management may include medication for pre-existing medical or psychiatric
disorders as well as symptomatic treatment and medications known to be helpful in the
management of anorexia or other eating disorders
Eden offers a variety of individual and group treatments including Body Image
therapy, Self Esteem enhancement, Nutritional Education, Cognitive Behavioural
Therapy, Art Psychotherapy, Occupational Therapy and Physiotherapy. The programme
varies from time to time to reflect the needs of the current group of patients
With your permission, family and other carers will be invited to participate in
supporting your recovery
Individual key worker sessions will occur whenever your key worker is available.
Other nurses will offer input too, particularly if your key nurse is not about. Our
trained nursing staff have experience of counselling techniques and use the underlying
principles of the therapeutic approach to inform their support of your needs as well as
to contribute to an assessment of your readiness for...
More formal individual psychotherapy, carefully matched to your stage of recovery.
Please note that psychotherapy can be a stressful experience so that if this occurs whilst
your automatic response to stress is to lose more weight, it can hinder rather than help
your recovery.
Arrangements for discharge
Most patients stay for a few months rather than weeks, although very short admissions can
sometimes be planned. There are no no hard and fast criteria for discharge – it happens when
you are able to continue recovery without the support of the inpatient unit, so it depends on your
own levels of motivation, the skills you have learned and the support available to you outside the
unit both in your home and at the local Eating Disorders service. Social workers and Out Patient
team may be involved in your discharge planning meeting, which takes the same form as the 6
weekly review meetings you have been used to holding throughout your stay.
Sometimes patients are discharged sooner than they expected, or decide to leave before the
original date planned for discharge. The Team will usually host or attend a Discharge Planning
meeting even after you have left, because of the importance of communicating what has been
learned from your admission and the need to assess the follow up care you need.
It is often the case that in-patients move over to join the Day Patient programme as a stepping
stone to full discharge to out patient care. The Day Programme expects people to commit to a
minimum of a 12-week session, with 6 weekly reviews. Some patients will need substantially
longer to consolidate recovery. The Day Programme is unique in Scotland in offering intensive
support to translate the new skills learnt in the inpatient unit to your home setting.
Day Programme
The Day Programme attached to the Eden Inpatient Unit provides suitable patients with an
opportunity to generalise progress made in IPU or to avoid requiring admission altogether in
some cases. Some patients may be treated for more than 12 weeks. All patients are asked to
prioritise attendance on a Tuesday, as this is currently the day on which the Day Programme
weekly Community Support Group is held. In addition to this, Day Patients will meet for
individual sessions, therapy on an individual, couple or family basis, and groups which may be
shared with Inpatients or may be pitched to a more advanced level of motivation. Some patients
may attend on 5 weekdays plus weekends, whereas others may need only one or two days. This
will vary, usually decreasing during the admission.
Not all inpatients benefit from Day Programme attendance. In some cases it is preferable to
resume links with a well known outpatient therapist as soon as possible. Other patients may have
to travel too far for attendance to be feasible. In these cases we hope to have offered
opportunities for extensive home passes to allow patients to test out their capacity to live
independently and still continue to progress.
All patients are reviewed after 6 weeks. The Outpatient worker or their representative attends
reviews as well as the discharge planning meeting
COMMUNICATING WITH US
AND MAKING YOUR VIEWS KNOWN
The Eden Unit telephone numbers are as follows:
Nurses’ Office:
01224 557586
Nurses’ Station:
01224 557521/557699
Ward Secretaries
01224 557769/557758
There is a cordless phone available for your incoming calls and if you are available a member of staff will bring
this to you. The number for this phone is 01224 557440 – calls to be limited in length.
If you or your carers wish to communicate by email, the Unit’s email address is [email protected].
Emails are receievd and accessed by our secretaries who then forward them to the individual member of
staff to whom they are addressed. They may also be printed and stored in patients’ medical records where,
theoretically they may be accessed by other medical staff.
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We welcome any comments you have regarding your stay in hospital. If you would like to comment on the
care you have received or on any aspect of your stay in hospital please let us know by completing one of the
Grampian NHS Feedback Cards. These are available from any member of nursing staff.
If you are unhappy with any aspect of the service you receive, please speak to the Unit Manager, Pauline
Milne (or in her absence to the Nurse in charge).
If you have any suggestions or complaints and for any reason you would prefer not to speak to a member of
staff, you may wish to complete a Feedback Card.
The Hospital Advocacy Service is also available to help represent your expressed views. Their office is next
to the canteen, opposite the WRVS hospital shop.