Social care
Social care
Feature with carers and team leaders on the floor , helping residents with mobility , transfers , personal care , eating and leisure activities , the occupational therapist is able to build trust and rapport , increase knowledge of the residents ’ needs and explain directly to staff the reasoning behind certain interventions .
Getting to know people as individuals
Part of building relationships with staff was getting to know carers as individuals and also how they functioned as a team , what the culture was like in general , and also how this could change depending on who was on shift .
Some staff were immediately receptive to my input and welcomed this , as I welcomed their input and expertise . Others took longer to build rapport with , and I found it challenging , but rewarding , to work alongside them and build this trust .
As I have got to know the personalities of different carers , I have learnt how to adjust my communication style accordingly , just as I would with patients . After building these relationships I found that carers were more willing to update me with relevant information and more receptive to trying new techniques or equipment .
The timing of communicating with staff is important , as care homes are busy environments with huge demands on the staff , and it is difficult trying to convey information when someone is rushing around and isn ’ t mentally present .
Being a regular presence allowed me to choose my moments as to when I felt that staff had the time and ability to take in information , and to reinforce this regularly .
Providing the right equipment
The patients I worked with were in short-term health-funded beds , so the care homes weren ’ t expected to buy extra equipment for them , and I ordered in anything they needed on loan from the community equipment service .
However , when rummaging through store cupboards to find equipment to borrow in the meantime , the absence of certain key pieces of equipment was often evident , for example not having full length slide sheets , wheeled commodes with missing footplates , and wheelchairs with fixed footplates , creating a hazard when mobile residents transfer into them .
Having an occupational therapist based in care homes would help to regularly review and advise on core equipment , potentially avoiding injury or skin damage .
Promoting and supporting independence
An interesting challenge was working alongside carers to encourage residents ’ independence . There was often a well-meaning but ingrained culture of ‘ doing to ’ the resident , for example during personal care or dressing , as opposed to supporting residents to complete tasks themselves .
Instilling this new attitude of rehabilitation and promoting independence took time , and staff were often surprised at what someone could do for themselves .
Completing moving and handling regularly with carers identified areas for improvement around training and correct equipment . This included incorrect use of slide sheets , and pulling residents up by their arms . Being a regular presence allowed me to set an example through practise of safe and effective techniques .
Positioning in bed was an area that came up frequently , while seating within care homes is also an area that could be improved through regular occupational therapy intervention .
Sometimes I saw residents that weren ’ t on my caseload that I felt did need a referral for specialist seating , however often it was just basic improvements that were needed , such as chair raisers or using a cushion to reduce the seat depth .
These are small interventions , but can reduce pain or discomfort and increase independence . I also found myself giving frequent reminders to use pressure cushions – often there would be a pile of these in the room , but these hadn ’ t been used with the people sitting there .
The care homes that I worked in mostly had an active timetable of activities for residents to engage with and staff dedicated to this . They were also proactive with encouraging residents to eat together in a dining room and to utilise communal living rooms .
However not all care homes have this culture , and an occupational therapist would be well placed to encourage this , and to identify individual activity plans .
To summarise , being in the care homes regularly allowed me to build relationships with staff and I hope made them more receptive to working with me . So many core occupational therapy specialisms – moving and handling , seating , falls prevention , equipment , meaningful activity and encouraging independence – are core components of how a care home runs , and I feel having this regular input has many benefits for residents and staff alike .
Words LORNA SANKEY , Occupational Therapist , was working in a locum role at the time of writing this article
April 2024 OTnews 33